Cosmetic Surgery Options

There are many cosmetic surgery options to improve or change your face and body. When you talk to your surgeon, be open about what you want, but be willing to listen to their recommendations. Your surgeon may recommend a different procedure to achieve a similar result.

Are You a Good Candidate for Cosmetic Surgery?

You may be a good candidate for cosmetic surgery if you're healthy, have reasonable expectations, and know the risks of the procedure you're considering.

You may not be a good candidate for cosmetic surgery if you have serious health problems such as diabetes, high blood pressure, a bleeding disorder, heart disease, or depression.

If you're obese or if you smoke or drink too much alcohol, you may not be a good candidate for cosmetic surgery.

Your surgeon may ask you to make some changes before surgery. For instance, some surgeons ask smokers to quit for 2 to 4 weeks before surgery and not smoke for at least 2 to 4 weeks after surgery. This allows the body to heal properly from the surgery. If you don't smoke, you should avoid secondhand smoke before and after surgery.

Before your surgery, you and your surgeon should talk in depth about your health, your lifestyle (including exercise, drinking, and smoking), any conditions you have, and any medications or supplements you take. That discussion will help you know if surgery is a good option for you.

Be sure you tell your doctor about everything you take, even vitamins and herbal products that don't require a prescription. Some may affect bleeding risk or interfere with other medications used during surgery.

Making the Decision to Have Cosmetic Surgery

Your skin type and other unique characteristics should factor into your decision to have a cosmetic procedure. For example, skin resurfacing techniques work best on people with fair skin and light-colored hair. People with thin and delicate nasal skin get the best results from nose surgery (rhinoplasty).

This list will help you determine if you are a good candidate for a specific facial cosmetic procedure:

• Lip augmentation. You’re a good candidate if you are young and want bigger lips or if you are older and your lips have thinned. You are not a good candidate if you have recently taken the acne drug Accutane or if you have one of these conditions: herpes, diabetes, an autoimmune disease like lupus or rheumatoid arthritis, serious allergic reactions of any type. Also, you must accept the risk of allergic reaction to the implanted material.
• Cheek implants. You are a good candidate if you have flat cheekbones or early sagging of the cheeks. You are not a good candidate if you have excess sagging of the skin, which is better treated with a facelift. Also, you must accept the risk that the implant could become infected, be rejected by your body, or shift to an abnormal position requiring more surgery.
• Chin implant. You are a good candidate if you have a weak chin or if your chin is not balanced with your nose. You are not a good candidate if you have an abnormal dental bite that requires jaw realignment. Also, you must be able to accept the risk that the implant could become infected, be rejected by your body, or shift to an abnormal position requiring more surgery.
• Forehead/brow lift. You are a good candidate if you have heavy eyebrows, deep forehead wrinkles, or frown lines. You are not a good candidate if you are balding or scar easily. Also, you must be able to accept the risk of losing your hair around the surgical area and the possibility of having some numbness in your forehead and scalp.
• Eyelid surgery (blepharoplasty). You are a good candidate if you have droopy eyelids, bags, or puffiness around your eyes. You must be able to accept the risk of blindness (extremely rare), dry eyes, visible scars, and eyelid "pulling" (which can cause eye irritation).
• Nasal surgery (rhinoplasty). You are a good candidate if you have a large or crooked nose that is droopy or has a bump. You are not a good candidate if you have thick skin, are a child (not fully physically developed), or play contact sports. Also, you must be able to accept the possibility that in 15% to 20% of cases, additional surgery is needed for best results.
• Face/neck lift (rhytidectomy). You are a good candidate if the skin and soft tissues on your face and neck sag with deep wrinkles, jowls, and a double chin. You are not a good candidate if your skin is not elastic and flexible or if you are significantly overweight. You must also accept that aging continues and be willing to accept the risk of skin loss, scarring, numbness, partial facial paralysis, or a change in hairline.

Remember, these procedures won't stop the natural aging process. Think about whether you're at the right age for cosmetic surgery. For example, you can have a facelift in your 30s, but it may last only 5 or 10 years. Some people delay having a facelift until they are in their 40s or 50s, hoping to have only one or two procedures.

Cosmetic Surgery Options

Often a less invasive or more isolated procedure will do almost as well as a more involved surgery. And in some cases, your doctor may recommend one of a number of skin care products or nonsurgical cosmetic procedures to treat your problem. Below is a summary of some of the newer options available.

Isolated cosmetic surgeries

For people with less facial aging, a neck lift, forehead lift, mid-face lift, eyelid surgery, or chin surgery can minimize the effects of aging and offer a fresher, more youthful look.

Cosmetic procedures to improve the body's appearance include liposuction, breast enlargement or reduction, and abdominoplasty (also known as a tummy tuck).

Minimally invasive cosmetic surgery

For many surgical procedures, including cosmetic surgery, the method of choice has shifted from traditional open surgery to the use of less invasive techniques. Minimally invasive surgery is surgery done with the aid of a viewing scope and specially designed surgical instruments. The scope allows the surgeon to perform major surgery through several tiny openings without the need for a large incision.

These minimally invasive alternatives usually result in less pain, less scarring, and a quicker recovery for the patient, as well as reduced health care costs. Most surgeries -- from heart operations to vasectomies -- are now being done with minimally invasive methods. In fact, operations and therapeutic procedures performed through smaller incisions are becoming standard in surgical medicine.

In cosmetic surgery, minimally invasive procedures use newer technologies, such as a laser, to perform procedures that once required extensive surgery and recovery time. Today's plastic and cosmetic surgeons have available a variety of tools and techniques that make procedures such as facelifts and eye lifts more accessible and affordable.

In fact, most cosmetic procedures are performed on an outpatient basis in fully equipped operating rooms under either local or general anesthesia.

Recovery times vary depending upon the procedure, but generally the healing period is between 1 and 2 weeks for facial cosmetic surgery. In fact, most patients resume their normal activities within 2 weeks following surgery.

Skin care products and nonsurgical procedures

Troubled by fine lines and wrinkles, sun damage, or unwanted facial or body hair? If so, a number of skin care products and nonsurgical cosmetic procedures -- many of which can be performed during a lunch hour -- may help.

• Correct the sun-damage of aging. There are a variety of physician recommended skin care products available. These products are effective for correcting aging skin, sun-damaged skin, uneven pigmentation and acne, while offering superior skin rejuvenation capabilities. Products such as Retin-A can help reverse some of the effects of sun damage, and ingredients such as vitamin C minimize the adverse effects of oxygen radicals on the skin. Such skin care products have been scientifically shown to have a beneficial effect on aging skin.
• Rejuvenate tired skin. Chemical peels, microneedling, micropens, and microdermabrasion offer state-of-the-art renewal of skin that is tired, dull- looking, or damaged. Patients emerge with smoother, softer and healthier-looking skin. Laser rejuvenation, intense pulsed light, radiofrequency, electrical, heat and low-level light devices are other techniques that can be used to refresh skin and correct some of the signs of aging.
• Lift sagging skin. Thread lifts are in-office procedures that are done to lift sagging skin.
• Remove unwanted hair. Laser treatments remove hair more quickly, less painfully, and more reliably than even electrolysis.
• Remove unwanted fat. Heating, cooling, lasers, radiofrequency and ultrasound devices are used to noninvasively remove fat.

How to Find a Cosmetic Surgeon

First, you should interview two or three surgeons whose specialties match your needs. The surgeons should be board-certified and members of one of these professional organizations:

• The American Academy of Facial Plastic and Reconstructive Surgery
• The American Society of Plastic Surgeons
• The American Academy of Dermatology
• The American Society for Dermatologic Surgery

There may be qualified surgeons in other professional organizations, but these are the primary groups that certify that doctors are qualified to perform cosmetic surgery.

Personal recommendations are important. Ask friends for referrals if they’ve gotten a similar procedure. Get opinions from your family doctor or other medical professionals.

Remember, cosmetic surgery is a very competitive field. Don't be confused by groups claiming to be "the only" or "the best," because this excludes many surgeons who may be better choices for your particular issues. Ask about their fellowship training -- specialized training in specific procedures. Check with your state's medical board to verify the surgeon's board certification, education, and license. And check whether disciplinary action has been taken against the surgeon.

Questions to Ask Your Cosmetic Surgeon

When you’ve narrowed your choices to one or two cosmetic surgeons, look at things like:

• What is the surgeon's area of expertise?
• Has the surgeon practiced for many years or performed many of these procedures?
• Is the surgeon friendly yet confident and professional?
• If the procedure will not be performed in the doctor's office, does the surgeon use a certified surgical facility with board- certified anesthesiologists and up-to-date emergency equipment and anesthesia monitoring devices?
• What is the total price of the surgery? (This includes the surgeon's fee, operating room, anesthesia, and other charges.)
• Are you allowed to see before and after pictures of other patients? Are computer images available for you and the surgeon to view together?
• Does the surgeon encourage you to ask questions?
• Are the surgeon's answers to your questions realistic?
• If a second surgery is needed, what is your financial responsibility?

After you've settled on a doctor and a procedure, you may want to get a second opinion. This will help you feel confident about your final decision.

The Initial Cosmetic Surgery Consultation

At the initial consultation for cosmetic surgery, your doctor will perform a detailed history, a physical exam, and a detailed analysis of the patient's area of concern. Photography and computer imaging may be performed and the results are shared with the patient to give them a clear picture of the planned changes.

Make sure you have a full discussion with your surgeon about the risks and complications before you undergo any cosmetic surgery or procedure.

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