Plastic Surgery Stats for 2008

In 2008 alone, there was over 10 million plastic surgery procedures recorded by the American Society for Aesthetic Plastic Surgery (ASAPS).  Of those procedures the top 5 surgeries performed were:

1. Breast augmentation
2. Liposuction
3. Eyelid surgery
4. Nose job
5. Tummy tuck

Most likely due to the economic recession, the total number of procedures performed decreased from 2007 nearly 12%.  With the economy on the upswing, the number of cosmetic procedures should begin to increase over the next year.

Below are the surgery numbers for the top 5 procedures performed last year:

Breast augmentation – 355,671
Liposuction – 341,144
Eyelid surgery – 195,104
Nose job – 152,464
Tummy tuck – 147,392

A Brief History of Rhinoplasty

A rhinoplasty, more commonly known as a nose job, is one of the better known plastic surgery procedures and has been performed since 1794.  Rhinoplasty was first developed by Sushruta, who many refer to as the father of plastic surgery.  He and his later students used rhinoplasty to reconstruct noses that were amputated as a punishment for crimes. The techniques of forehead flap rhinoplasty he developed are practiced almost unchanged to this day and are used to reconstruct noses after skin cancer surgery or after major trauma. . This knowledge of plastic surgery existed in India up to the late 18th century as can be seen from the reports published in Gentleman’s Magazine (October, 1794). As the techniques of reconstruction evolved the concept of improving the appearance of the nose for cosmetic reasons developed.

Today, the term rhinoplasty generally refers to cosmetic improvement of the nose. While originally a reduction operation, i.e. making the nose smaller, the art of rhinoplasty has evolved where some parts of the nose may be reduced while other parts may be enhanced using the patient’s own cartilage or bone as a graft to add support and change the shape of the nose. Synthetic implants should generally be avoided as the complications can be very difficult to correct.

A skilled rhinoplasty surgeon must have a keen aesthetic eye, an in-depth understanding of nasal anatomy and function, and the technical skills to create a pleasing natural appearing nose that functions properly.

Although rhinoplasty is usually considered to be safe and successful, several complications can arise. Post operative bleeding is uncommon and often resolves without needing treatment. Infection is rare and can occasionally progress to an abscess that requires surgical drainage under general anesthetic. Adhesions, which are scars that form to bridge across the nasal cavity from the septum to the turbinates, are also rare but cause nasal obstruction to breathing and usually need to be cut away. A hole can be inadvertently made at the time of surgery in the septum, called a septal perforation. This can cause chronic nose bleeding, crusting, difficult breathing and whistling with breathing.

Should You Get a Breast Lift?

Breast lift surgery is a popular procedure that helps a woman rejuvenate her figure and fight off:

• Gravity
• Pregnancy
• Breast Feeding
• Natural Sagging from Age

The breast lift is most popular among women with naturally larger breasts since sagging is more pronounced in them as they get older, however women with smaller bust sizes can also benefit from the surgery.

The degree of droop, (medical term is ptosis), determines the type of lift necessary to restore a youthful breast shape and nipple areola position. Minimal drooping requires minimal incisions with minimal scarring. Historically, a full breast lift involved incisions within the crease underneath the breast, an incision around the areola, and a vertical incision extending from the areola to the incision underneath the breast. This incision is sometimes called an anchor incision or an inverted “T”. This traditional technique has been widely used because it consistently produced the desired shape and position of the breast on the chest wall and nipple areola position. In this technique excess skin is removed, the breast is elevated and frequently the size of the areola is reduced. This approach allows maximal change to the breast.

In the past decade many plastic surgeons are changing to a technique generically referred to as a vertical scar technique. In this technique the incision in the fold beneath the breast is eliminated. Besides eliminating a significant amount of the scarring, the technique  may result in a more pleasing breast shape compared to the more traditional method. Which approach is used depends on a patient’s anatomy and surgeon experience, expertise and comfort.

The scar is in three distinct locations that each have a characteristic pattern of healing. In the peri-areolar area, scarring is partially concealed by the change in color at the transition from breast skin to the pigmented skin of the areola. The vertical incision from the areola to the crease may be hidden in shadow. The inframammary portion of the scar, along the fold created by the breast is often the thickest of the scars, but it may be hidden in the inframammary fold. The scars fade over time but remain visible in most cases.

It is important to realize that this procedure is not permanent and in some cases requires an additional surgery to maintain the breast shape and positioning.  Breast lift surgery is not an ideal procedure for women planning on having additional children since pregnancy and breast feeding could cause additional sagging.

A Guide to Anesthesia

One of the most common fears that patients have prior to any surgical procedure is anesthesia, therefore I wanted to practically inform you on the different forms of anesthesia practices. Every surgery has different sedation prerequisites, so it is important to discuss all the available options with your physician.

Three Primary Anesthesia Methods:

General Anesthesia

This is a state of total unconsciousness resulting from general anesthetic drugs. A variety of drugs are given to the patient that have different effects with the overall aim of ensuring unconsciousness, amnesia and analgesia. The anesthesiologist will select the optimal technique for your procedure.

Regional Anesthesia

Regional anesthesia is anesthesia affecting only a large part of the body, such as a limb. Regional anesthetic techniques can be divided into central and peripheral techniques. Regional anesthesia generally involves the introduction of local anesthetics to block the nerve supply to a specific part of the body, such as a limb, so patients cannot feel pain.

Local Anesthesia

Local anesthesia is any technique to render part of the body insensitive to pain without affecting consciousness. It allows patients to undergo surgical procedures with reduced pain and distress.

Questions to Ask Your Physician

Sometimes the most difficult component of choosing the right plastic surgeon is deciding the proper questions to ask during the consultation. Below are some basic questions that can help guide you through the selection process:

1. Can I see before and after photos of other patients who have gone through the procedure?

A good physician will have an excellent selection of images that illustrate his or her past client’s success.

2. Will the surgery be performed at the office or hospital?

If you are nervous about the surgery, being able to know where the procedure will take place can help put your mind at ease. If the doctor suggest his office, make sure that the facilities are fully accredited for the procedure you will go through.

3. Can I speak with other patients who have gone through the same procedure I’m going through?

A good physician should have a strong list of references that you can speak with.

4. What type of anesthesia will I have to go through for the procedure?

The doctor is not an anesthesiologist, however he should have a good idea of what type of anesthesia your surgery requires.

5. How in-depth are the surgery recovery instructions?

An experienced physician should have a solid rehab plan for you after the procedure.

How Does Botox Work?

Botulinum Toxin-Based Injectable, more commonly known as Botox, has entered mainstream use over the past decade. Despite what many people may believe, Botox is not a filler, it is actually an injectable that helps improve wrinkles around the face. The procedure typically lasts six months, at which point you and your physician can decide on the proper next steps for wrinkle treatments.

A History of Botox:
Researchers discovered in the 1950s that injecting overactive muscles with minute quantities of botulinum toxin type-A would result in decreased muscle activity by blocking the release of acetylcholine at the neuromuscular junction, thereby rendering the muscle unable to contract for up to a period of 3 to 4 months.

Alan Scott, a San Francisco ophthalmologist, first applied tiny doses of the toxin in a medicinal sense to treat ‘crossed eyes’ and ‘uncontrollable blinking’, but needed a partner to gain regulatory approval to market his discovery as a drug. Allergan renamed the drug Botox.

As of 2007, Botox injection is the most common cosmetic operation, with 4.6 million procedures in the United States, according to the American Society of Plastic Surgeons.

Is it Time for a Brow Lift?

In the past decade, the brow lift procedure has dramatically increased in popularity.  In fact, the American Society of Plastic Surgeons reported hat over 50,000 brow lift procedures were performed in 2005 alone.  Why is it so popular?  The position of the brow affects how others perceive us.  A brow that has fallen can make someone look angry or sad as well as tired looking and old. A brow elevated to the appropriate position “opens-up” the eyes making the patient look youthful and energized with a positive outlook.  A well-positioned brow enhances the beauty of the upper eyelids.  Often times when patients think that they need upper eyelid surgery, what  they really need is a brow lift. Finally, a brow lift can diminish the prominence of forehead line and creases.

In many cases the brow lift is performed in combination with other procedures such as:

• Eyelid surgery
• Fat transfers
• Facelifts
• Facial laser rejuvenation procedures

The most popular age range for this surgery is 40-70, however younger individuals have also taken advantage of the procedure if he or she is experiencing early aging signs.

How it Works
Most brow lifts are performed though several  small  incisions, about an inch long, hidden in the scalp.  This can be done with or without an endoscope. While there are still some patients who require an “open technique” with a long incision in the scalp ,this is not necessary for most patients.  When the degree of elevation required is minimal, the procedure can be performed through a well -concealed incision made in the upper eyelid crease under local anesthesia.

A Beginner’s Guide to Liposuction

If you are looking to target specific areas of your body for fat loss, liposuction might be for you. Certain areas of the body can develop fat deposits that traditional dieting and exercise cannot remove, and this surgical procedure has been a proven process that can achieve optimal body results. The areas of the body that can be targeted are below:

• Abs and stomach
• Back
• Thighs
• Hips
• Buttocks
• Knees
• Arms
• Face
• Neck

If you are contemplating this surgery, you are not alone. In 2007, liposuction was the most performed cosmetic procedure performed in the US (source: American Society for Aesthetic Plastic Surgery).

There is a wide range of options available to liposuction patients, so make sure to consult with an experienced, well-trained, board certified  plastic surgeon to decide what specific  procedure is appropriate for you. Two key aspects of the surgery  
you will want to discuss with your doctor are the type of liposuction being used –traditional, laser (Smart Lipo), ultrasound (Vaser), power liposuction,  aqua liposuction, or infrasonic liposuctio—and the type of anesthesia.

Anesthesia – General anesthesia is the traditional practice for  
liposuction, however there are newer technologies, such as Smart Lipo that can be performed under local anesthesia which makes for a quicker recovery, increased safety, and decreased cost. If your doctor is using one of the newer technologies make sure he/she didn’t just take it “out-of-the box”. Ask to talk to some patients who have already had the procedure.

Most  surgeons are happy to facilitate patient connections.

The Mini Facelift

If you feel like you are not ready for a full facelift you may be a candidate for a mini facelift.  Mini facelifts have grown in popularity over the past several years due to individuals searching for a subdued procedure that would take approximately five years off their face.

The mini facelift procedure utilizes small well-hidden incisions. Due to the fact that the procedure is less invasive and therefore there is less bruising and swelling recovery is typically much faster than traditional facelifts.  A mini facelift can be combined with other procedures such as  fat transfer to restore the volume and  youthful  facial contours  as well as laser treatment to eradicate sun damage and smooth away lines and wrinkles.

As this combination therapy, mini face lift, volume enhancement, and laser skin rejuvenation is relatively new consult with your physician to see if this surgery  
is aligned with your goals.