HelloMD.com COSMETIC / PLASTIC
SURGERY
BREAST IMPLANTATION (RECONSTRUCTION OF
BREASTS)
The Risks
Complications of breast augmentation include infection which is rare,
and Haematoma (accumulations of clotted blood) which need to be
removed surgically. Much more common is a bad result, where implants
are lopsided, with one breast higher than the other. The surgeon does
the operation with you lying on your back but will often sit you up to
try and ensure that your new breasts hang evenly.
Most women are completely comfortable with their new breasts and soon
cease to be aware of the implants.
Ideal age: late teens to late forties
Length of stay in hospital : one night
Anesthetic: general
Other drugs: painkillers and antibiotics
Discomfort levels : low to moderate
Time before the signs of surgery disappear : four weeks
Length of time results last : permanent
LIPOSUCTION
Liposuction is removal of fat by suction. It is the most common
operation carried out in the United States, more common even than
hernia repairs, and 6,00,000 liposuctions were carried out in the US
in 2002.
Today, liposuction is most successful
when used on young, healthy women. But it may be used satisfactorily
on middle-aged women who are within a stone of their ideal body weight
and who have good skin tone. Skin should be elastic enough to contract
after the fat has been removed. Although the best results are obtained
with the elastic skin of younger women, teenagers are likely to be
disappointed because their expectations may be very high. Neither is
it a good idea to use liposuction on adolescents because young women's
weight often takes several years to settle down. If a woman has
liposuction and then gains weight, she may well develop a lumpy shape
because new fat cell may grow unevenly. However, liposuction can be
extremely successful at dealing with diet-resistant areas of fat -
such as saddlebag thighs and love handles.
Where it works
As the technique of liposuction is refined and improved, the age limit
to having it done has been extended to 50 or 55 in cases where it is
combined with a tummy tuck or face-lift.
- Beneath the chin, as part of a face lift in
someone older.
- On the upper arms, which does not work well.
- On the breasts, as part of a breast
reduction.
- On the abdomen, as part of tummy tuck.
- On the lower back, where the skin is too
thick for it to work well
- On the lower part of the abdomen, where it
works well if skin is thick
- On the upper part of the abdomen, where it
does not work so well.
- On the hips (love handles), where it gives
excellent results.
- On the buttocks, where it gives good results.
- On the outer thigh, where it gives good
results.
- On the inner thigh, where results are poor
because skin is thin.
- On the inner part of the knee, which works
well Just above the knee, which doesn't works well.
- Just above the knee, which doesn't works
well.
- On the lower leg, where it is less
successful.
What is involved
The surgeon should check your general health and advise you to lose
excess weight if you need to. You should also be told about the pros
and cons of having liposuction.
The operation is normally carried out under general anesthesia if you
are having a large area treated, although a lot of fat - up to 1.5
liters - can safely be removed as a day case. If you have more than
that taken out you will need to stay overnight, due to the loss of
fluid from you circulation which will have to be replaced. Very
occasionally when a large amount of fat is being removed, a blood
transfusion is necessary.
Before the operation, you will have the areas to be treated marked out
by the surgeon and then you will be put to sleep. Fat is removed
either by a dry technique or a wet (tumescent) technique, where the
area to be treated will be injected with a mixture of saline, local
anesthetic (which lasts eight hours), adrenaline (to stop bleeding)
and a drug called hyalase to allow this fluid to penetrate the body
fat. Roughly, the same amount of fluid is injected as the amount of
fat to be sucked out.
The surgeon takes a fine cannula (just 3 mm in diameter), which comes
with different heads and is coupled to a high vacuum chamber, to suck
out the fat. Through a small stab wound, the cannula is moved in
different directions to suck out enough fat from that particular area,
then moved to another. The surgeon will keep feeling the skin to check
that fat is being removed evenly and that a smooth contour will be
left. The surgeon will try to remove as much fat as possible. But some
people's fat is more difficult to suck out than others.
When one side of the body is finished, the fat will be measured and
the same amount removed from the other side. As much fat as possible
will be removed, but there must be some left beneath the skin so it
does not stick to muscle. The amount of time taken to do a liposuction
depends on the area treated. For hips and thighs, it will take about
an hour.
Afterwards a stitch is placed in each incision, wide elastoplasts is
stuck over treated areas and you will be dressed in an elastic
compression garment. This is worn to prevent the accumulation of fluid
under the skin and to help skin spring back into shape.
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