At times people are dissatisfied from their looks or body shape that may be changed by means of cosmetic surgery. These problems may be congenital or acquired with aging e.g. depressed or parrot beak shaped nose, facial wrinkles, sagging breasts, disproportionate fat deposits etc. one of the main aims of cosmetic surgery is to restore the mental health of the person thus permitting return to social participation.
Rhinoplasty (change in shape of nose): for broad, depressed, deviated nose, parrot beak shaped nose, acquired defects or other unsightly problem. Incision / scar is almost always inside the nose and doesn’t show up. Hospitalization is usually needed for a day.
Genioplasty (change in shape, size of chin):for disproportionately protruding or recessed chin. Incision / scar is almost always inside the mouth and doesn’t show up. Hospitalization is usually needed for a day.
Otoplasty (change in shape, size of ear): for large, prominent or cup shaped folded ears. Scar is usually behind the ear.hospitalisation is needed for a day only.
Face lift, browlift and necklift: For aging face — to correct wrinkles & sagging skin of face, neck and sagging eyebrows. All these three procedures may or may not be needed in a person. These procedures can be done separately or together in a person as per the requirement. With aging gradually eyebrows sag downward and look like hanging on upper eyelids. These may or not be associated with drooping upper eyelids. Correction of sagging eyebrows is done with incision in scalp behind hair line and so the scar is not visible. Facelift is needed for wrinkles on face. For its surgery incision is just in front of ear at junction of ear and cheek that extends upward in hair line. If brow lift is also to be done then both the incisions are combined. The same incision extends in neck and behind the ear to variable length for necklift. Necklift is done for wrinkles on neck. With time these scars fade to great extent.
For facial wrinkles and drooping eyebrows thread lift is also an option where no surgery is required.
Blepharoplasty: for correction of sagging eyelids or wrinkles on eyelids.
Mammoplasty (change in size shape of breast):
1 Breast augmentation -For underdeveloped and small breasts that may be a cause of lack of self – confidence and depression. It’s done by silicon prosthesis and it doesn’t interfere withbreast – feeding at all.
2 Brest reduction –for hyper plastic, large, poetic breasts, which not only look awkward, but are also a cause of shoulder, neck and back – ache.
3 Breast reconstruction- it’s neededinpatients of breast cancer whose disease has been cured or in some girls with congenital absence or hypo plastic breast. Reconstruction is done by flap from abdomen or back with silicon prosthesis.
Gummy smile (exposure of gums while smiling): in few persons upper teeth and gums are excessively visible while smiling. This can be corrected by a day care surgery.
Congenital black spots (nevus), moles: excision of small nevi or the area. Tissue expander is an useful device for better results in these situations.
Change in size of lips:
1 Reduction –for overly thick, unsightly lips. It’s an outdoor procedure and scar is always inside the lips.
2 Augmentation- usually done by lip filling and is a day – care surgery.
Scar revision:revision of most of the facial scars is an outdoor procedure and hospitalization is usually not needed. However in case of large scars which can’t be removed under local anesthesia, hospitalization for a day may be needed. We should remember that “once scar, always scar; it’s quality can definitely be improved “. At times it may be possible to vanish a scar but it’s not the usual story.
Post acne scars: these scars need correction by dermabraision. Sun exposure has to be avoided for 3-4 months after surgery.
Post burn scars:Deep burns if left to heal by secondary intention, always leave scars. Modalities of treatment vary according to size, sight and nature of scar. Excision of scar is followed by skin replacement that may be done by split thickness skin graft, full thickness skin graft, local skin flap. Large scars on face are best managed by tissue expansion.
Baldness:Most common cause for baldness is male sex hormone and is commonly known as male pattern baldness. Other causes may be some skin disorder, scars following burn or other injury. Surgical options for correction of baldness are hair transplantation, scalp flaps or tissue expansion. For transplantation hairs are taken from back portion of head as these hairs are not affected by male sex hormones. There are two methods of hair harvesting. Common method is by taking a thin strip of skin from back portion of head and under magnification this strip is dissected to separate hair follicles. These hair follicles are then transplanted in desired areas of scalp under magnification
Vitiligo / leucoderma: surgical option is adopted only in cases where lesion has been stationary in size for at least last two years. Small facial sport may be excised and defect repaired by suitable plastic surgery procedure. Larger lesions elsewhere on body are managed by excision and skin grafting. Tattooing is good alternative and gives satisfactory results in experienced hands.
Liposuction: some people develop fat deposits that don’t respond to exercise or dietary restrictions e.g. over abdomen, waist, thighs, gluteal regions, neck, below chin (double chin) or subscapular region which looks awkward under the blouse in females (blouse bulge). It’s a safe procedure and may be combined with other surgeries also. Once treated these fat deposits don’t recur. Now days it’s done with special syringes (tumescent liposculpture technique) that offers better results with negligible complication rate. This is a very good technique for correction of gynecomastia. This is usually a day care surgery or at maximum, hospitalisation for a day may be needed.
Lipofilling: This is used for cheek or lip augmentation or correction of facial asymmetries by fat injections. Fat is retrieved by liposuction and is injected in desired areas under strict aseptic and anaerobic conditions. Fat retrieved by machine liposuction is not suited for injection.
Abdominoplasty: It’s indicated where fat deposition is associated with loose sagging skin e.g. after multiple pregnancies. Besides removal of excess fat and loose sagging skin, abdominal muscles are tightened also so as to restore their tone.
Gynecomastia (Breast enlargement in males) : Liposuction is the best way to manage this problem. Glandular tissue can be removed by surgical excision only.
Peri-ocular melanosis (dark circles around eyes), Melasma / Chloasma: These can be effectively treated by chemical peeling, without any surgery. Sun exposure has to be avoided during treatment.
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