The goal of cosmetic surgery is to improve a person's appearance and, thus, self-esteem by changing the way she or he looks. Cosmetic surgery can be performed on any part of the face and body.

Types

The Face

The Body

Before making an appointment to see a cosmetic surgeon, people should consider their motives for wanting to change how they look. Because cosmetic surgery can bring lasting and dramatic changes to the outside appearance, it is important to understand how these changes may affect people on the inside.

Many physical characteristics can be successfully changed through cosmetic surgery; others cannot. Good candidates for cosmetic surgery:

  • Have realistic expectations about what can be accomplished.
  • Understand the medical risks, physical effects during healing, how the surgery will affect them personally and professionally, what lifestyle changes may accompany the recovery period, and the expenses involved.
  • Have discussed their goals for surgery with their surgeon and resolved any questions.
  • Have diabetes or other chronic medical conditions under control.
  • Have no history of smoking or commit to abstain from smoking (including secondhand smoke) and nicotine products, including chewing tobacco and nicotine patches, gums or lozenges for six weeks before and after surgery.
  • Have had a stable weight for six months to one year.

Reasons to stop smoking if considering cosmetic surgery

  • Nicotine, carbon monoxide and other toxins decrease blood flow to the skin.
  • Smoking affects wound healing and worsens scarring.
  • Smoking increases the risk of post-anesthesia complications (pneumonia, blood clots, hypertension).

All surgeries, including cosmetic procedures, carry risk. Those with a history of cardiovascular disease, lung disease, diabetes or obesity have a higher risk of developing complications such as pneumonia, stroke, heart attack or blood clots in the legs or lungs. Smoking also increases risks and interferes with healing.

A meeting with the surgeon will include a discussion of these risks and others related to the patient's health history.

Possible complications for any surgical procedure include:

  • Complications related to anesthesia, including pneumonia, blood clots and, rarely, death
  • Infection at the incision site, which may worsen scarring and require additional surgery
  • Fluid build up under the skin
  • Mild bleeding, which may require another surgical procedure, or bleeding significant enough to require a transfusion
  • Obvious scarring or skin breakdown, which occurs when healing skin separates from healthy skin and must be removed surgically
  • Numbness and tingling from nerve damage, which may be permanent

Questions for the patient to consider before pursuing cosmetic surgery:

  • What are my motives for wanting to change how I look?
  • What are the specific attributes of my appearance that I want to change?
  • Do I have realistic expectations about the results of the surgery?
  • What aspects of my life will be affected such as family, work, travel and social obligations?
  • What time in my life will work best so that I have the greatest chance for a successful recovery?
  • Have I talked about my concerns and questions openly with my health care provider?

Questions to ask the cosmetic surgeon:

It is a good idea to bring a notepad to write down answers.

  • What are your qualifications?
  • How long have you been board-certified?
  • How many procedures have you done similar to the one I'm considering?
  • What other health care professionals are involved in my care?
  • What side effects can I expect?
  • What results can I expect?
  • What are the possible complications of the cosmetic surgery I am considering?
  • What kind of help will I need at home following surgery?
  • How long before I see the final results of my surgery?
  • How long before I can go back to work and/or resume exercise?
  • Are there complications unique to my health history?
  • Will I have any scars and if yes, what will they look like?
  • If my procedure requires stitches, when will they be removed?
  • How much does the procedure cost?

Questions to ask about a procedure:

  • What does the procedure do? What does it not do?
  • What are the risks and complications associated with this procedure?
  • How long is the recovery period?
  • Can I expect much discomfort?
  • Will I have scars?
  • Are there other procedures I should consider at the same time?
  • Will I need a physical examination prior to surgery?
  • How long will the results last?
  • How much does it cost?
  • Care is targeted to the individual needs of each patient.
  • Realistic expectations are key — the goal is improvement, not perfection.
  • Everyone is asymmetrical.
  • Each patient has a different result.
  • Patients will have at least two visits with the surgeon and/or another member of the health care team before surgery.
  • It is essential that a patient be in good physical and mental health.
  • Abstaining from all nicotine products and avoiding secondhand smoke for at least six weeks before and after surgery is crucial.
  • Surgical scars are permanent.
  • Bruising and swelling are temporary.
  • Some surgeries require drains.
  • Recovery times vary by person and procedure, but a minimum of 6 to 12 weeks is typical for many cosmetic surgeries.
  • Insurance does not usually cover cosmetic procedures.
  • Patients may need follow-up surgeries to achieve their goals.
  • The wait between surgeries is generally at least four months.

The most important factor in deciding whether to have cosmetic surgery is to have a clear understanding of what will happen before, during and after the procedure, and what results to expect. Many physical characteristics can be successfully changed, while others cannot. The more realistic a person's expectations, the more likely she or he will be satisfied with the results.

Meeting the surgeon

During the first meeting, your surgeon will explain how cosmetic surgery can change the body and what you can expect as a result. This is an opportunity for patients to explain what they hope to achieve with surgery. Understanding the options and possible outcomes will help make the best decision.

Patients will be informed about specific procedures, what to expect, the benefits, risks and possible complications, as well as other alternatives. The physician may recommend additional procedures to enhance the overall result.

The concept of asymmetry will be explained. The human body is asymmetric, meaning one side of the body looks naturally different from the other. Consider the image reflected in the mirror — a photographic image is a true image, the opposite of the mirror image. The surgeon helps patients understand this so they can fully appreciate their true appearance and how this may change with cosmetic surgery.

The surgeon also will explain the concept of balance — how changing one part of the body may affect overall appearance and how additional surgical procedures may bring greater balance.

Nurse review

Following the surgeon's consultation patients meet with a registered nurse, who reviews general questions about health, current medications — including aspirin, vitamin E, over-the-counter medications and supplements — and lifestyle issues, such as smoking history. The nurse will also review what patients can expect following surgery, including pain, medications, diet, activity and work restrictions, and details such as the need to arrange for a ride home following the procedure.

By listening and following instructions from the surgeon and health care team, patients can help minimize the risks and complications of surgery.

Consent form

Patients will be asked to sign a consent form so that photographs may be taken before and after surgery. Photographs serve as a reference for the surgeon during the procedure and become a part of the cosmetic surgery patient record.

Estimate of costs

Patients will be asked to visit the Business Office to get a Cosmetic Surgery Package Quotation, a written estimate of surgical fees. Insurance typically does not cover cosmetic surgery procedures. Prepayment is required prior to surgery.

Preoperative examination

Patients may be scheduled for a pre-operative examination to assess general health prior to surgery.

The operation

Cosmetic surgery procedures requiring general anesthesia or IV (intravenous) sedation are performed in the hospital under the care of an anesthesiologist/nurse anesthetist team. Others procedures, such as injections of facial fillers, may be performed in an outpatient setting or physician's office under local anesthesia. Prior to surgery, patients see the surgeon (or a member of your health care team) one more time to answer any remaining questions.

Recovery

Prior to outpatient surgery or before discharge from the hospital, patients will receive:

  • Instructions for post-surgical care specific to your procedure
  • Limited amounts of supplies, as well as information on where to purchase them
  • Medication instructions/prescriptions (i.e., pain medications, antibiotics)
  • Phone numbers to call for questions

Patience and time are important to recovery. Even with instruction and preparation, patients may be alarmed by the bruising and swelling that follow cosmetic surgery and how long they last. Bruising may take a minimum of three weeks to diminish; swelling may take even longer. Camouflage cosmetics may be helpful during this time.

It is not uncommon to experience a brief period of "the blues" or low spirits during recovery. Prematurely judging the results of the surgery or waiting to return to normal activities may contribute to feelings of disappointment and frustration.

The health care team members are committed to compassionate understanding of patient's concerns and to be available to answer questions.

The physicians who do cosmetic surgery at Mayo Clinic are all board-certified in their specialities and experienced in cosmetic and reconstructive surgery. Many have earned national reputations for their expertise.

Minnesota

Dermatology

Facial Plastic and Reconstructive Surgery, Otorhinolaryngology

Ophthalmology

Plastic Surgery

Arizona

Plastic Surgery

Otorhinolaryngology (ENT)

Florida

Plastic Surgery

The physicians who perform cosmetic surgery at Mayo Clinic are board-certified specialists experienced in cosmetic and reconstructive surgery. Many have earned national reputations for their expertise.

Mayo's cosmetic surgery team will take time to ensure that all questions and concerns and every aspect of care is addressed, from complications to costs.

Cosmetic surgery patients have access to the same world-class medical professionals, facilities and technology and the same level of service available to every Mayo patient.

Also, Mayo can address other medical needs at the same time. Virtually all medical services a patient might need — doctor visits, testing, surgery, hospital care — are available "under one roof" at Mayo Clinic. The scheduling of these services is done in a coordinated and efficient way, so that care can usually be completed in a few days.

At Mayo Clinic, you can be treated in private, and return home recovered and renewed.

Schedule an appointment for a consultation and surgery as soon as possible to secure time in the surgeon's schedule and to allow time to make needed preparations. Patients may be asked to change their medications or supplements up to three weeks prior to the procedure, or to address an issue, such as high blood pressure, which takes more time to change.

Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people. In most cases, Mayo Clinic doesn't require a physician referral. Some insurers require referrals or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.

Mayo Clinic offers a variety of services to help people enhance their appearance through elective cosmetic surgery. Most cosmetic services are provided by board-certified cosmetic surgeons from plastic surgery, dermatology and ENT (Otorhinolaryngology), with support from other specialists in preoperative evaluation and postoperative care.

Cosmetic surgery doctors

Cosmetic surgeons offer a complete range of facial rejuvenation and body contouring procedures using the techniques proven to be most successful.

For appointments or more information, call the Central Appointment Office at 800-446-2279 (toll-free) 8 a.m. to 5 p.m. Mountain Standard Time, Monday through Friday or complete an online appointment request form.

Cosmetic Surgery at Mayo Clinic in Florida offers a comprehensive choice of cosmetic surgery procedures, provided by a team of board-certified surgeons specializing in cosmetic procedures. The team includes specialists from the departments of Ophthalmology, Otolaryngology and Plastic Surgery.

Most cosmetic surgery procedures are done at the state-licensed first floor surgical facility located in the Mayo Building on the Mayo Clinic campus in Jacksonville. The surgery center affords excellent safety, privacy, and convenience. The center has six operating rooms; a fully monitored post-anesthesia care unit; a 23-hour observation unit; and the support services of Mayo Clinic. Depending upon the procedure, patients may return home after the surgery, stay in an on-campus hotel or recuperate overnight at the surgery center under the care of our nursing staff.

For appointments or more information, call the Central Appointment Office at 904-953-0853 8 a.m. to 5 p.m. Eastern time, Monday through Friday or complete an online appointment request form.

Mayo Clinic uses a team approach to cosmetic surgery. Members of this team will include your surgeon, anesthesiologist, registered nurses and other health care providers. The team approach helps ensure all questions and concerns, and every aspect of care, is addressed, from complications to costs. Each member of this team is important to developing an individualized approach to care.

Physicians and surgeons involved in cosmetic surgery at Mayo Clinic are board-certified in their specialty and experienced in cosmetic surgery procedures.

Cosmetic surgery is performed by physicians in the following specialties:

For appointments or more information, call the Central Appointment Office at 507-538-3270 7 a.m. to 6 p.m. Central time, Monday through Friday or complete an online appointment request form.

See information on patient services at the three Mayo Clinic locations, including transportation options and lodging.

See a list of publications by Mayo doctors on cosmetic surgery on PubMed, a service of the National Library of Medicine.

Brow lift

(Synonyms: forehead lift, coronal brow lift, eyebrow rejuvenation)

Aging usually causes lines across the forehead and between the eyes to deepen. The distance between the eyebrows and eyelashes shortens as skin and soft tissues lose elasticity. The combination of low eyebrows and deep creases can make a person look aged, tired or disgruntled. This condition can be accentuated by folds (lateral hooding) of skin which can form between the eyebrow and eyelid near the outside corner of the eye.

By raising the forehead skin, altering muscles and removing excess tissue, a brow lift can soften facial lines, raise the eyebrows and restore a softer, more pleasing appearance. A forehead lift can be done alone or with other facial procedures.

What to expect

Three surgical approaches can be used to accomplish a brow lift. Each enables the surgeon to hide the incision:

Coronal brow lift
An incision is made in the hairline across the top of the head from ear to ear. The surgeon lifts the forehead to its new position, with the scalp in front of the incision overlapping the scalp behind it. The overlapping scalp is removed and the remaining scalp sewn together. Some muscles of the forehead are deliberately weakened to alleviate horizontal forehead lines. Sensory nerves at the top of the head are involved, and as a result, temporary itching or numbness is common following the procedure.

Hairline brow lift
A hairline brow lift is often used if someone has a high receding hairline. An incision is made between the top of the forehead and the beginning of the hairline. The hairline is not pulled back when the skin is removed. The technique can yield dramatic improvements in horizontal creases. However, depending upon healing, a scar may be visible along the hairline. The technique works best for those who wear bangs.

Endoscopic brow lift
Using an endoscope with a tiny camera mounted at its end, the surgeon makes four to six small incisions behind the hairline and then shifts the skin backward on the head. Some surgeons place small screws into the skull bone to temporarily support the skin until it heals. Stitches are placed around the screws to anchor the skin at its new location.

Each technique has advantages and disadvantages. Your cosmetic surgeon will work with you to decide which technique is best.

A brow lift will not diminish crow's-feet or affect the puffiness or bulging that can occur in the upper or lower eyelids. Some horizontal lines will likely return in people who have expressive faces. Eyelid surgery (blepharoplasty) can be combined with a brow lift or with a face-lift to decrease the visible signs of aging.

Risks

The risks associated with brow lift may include, but are not limited to:

  • Problems related to anesthesia
  • Bleeding
  • Infection
  • Swelling and bruising for several weeks

Coronal brow lifts often cause temporary or permanent numbness on top of the scalp. This numbness is usually not a problem with endoscopic lifts. Paralysis of the forehead as a result of nerve damage occurs in fewer than 1 percent of patients.

If the new position of brows appears higher on one side following the surgery, it may be consistent with the asymmetry present before the surgery. Since everyone is asymmetrical, asymmetry may remain after surgery.

Brow lifts are performed by specialists in Facial Plastic and Reconstructive Surgery (Otorhinolaryngology) and Plastic and Reconstructive Surgery.

Cheek lift

(Synonyms: mid-facelift)

As we age, gravity pulls down on the cheek, flattening it. At the same time, the lower eyelid may droop, creating a sad or tired appearance.

A cheek lift or mid-facelift restores fullness to the cheek, softens deep lines extending from the corner of the nose to the corner of the mouth (nasolabial folds) and raises the outer portion of the eyebrow, creating a more rested and youthful appearance. The cheek lift may be done as a single procedure or with other facial surgeries.

What to expect

Under general anesthesia, the surgeon makes an incision above each ear beyond the hairline and in the gum line above each upper canine tooth. A stitch is placed inside each oral incision to catch the cheek pad. The stitch is then secured under the scalp.

A mid-facelift can dramatically change your appearance. Initially, the cheek pad is overcorrected, creating an unnatural smile. With time, the cheek settles into a more natural position. Dimpling may appear in each cheek and diminish over time. Most patients have temporary difficulty puckering their upper lips, making it difficult to drink from a cup or through a straw. Swelling and bruising around the eyes may occur, but can be decreased by elevating the head and using cold compresses on the eyes for three days. Most patients experience some aching in their cheeks, which can last for several months.

Risks

The risks associated with a cheek lift may include, but are not limited to:

  • Problems related to anesthesia
  • Blood clot in leg (deep vein thrombosis) or lung (pulmonary embolism)
  • Hematoma (blood under the skin) or seroma (fluid under the skin), which can cause scarring, skin discoloration or an irregular surface
  • Infection
  • Hair loss along the incision
  • Healing problems
  • Facial numbness
  • Partial loss of facial expression
  • Facial weakness or paralysis; usually temporary; rarely permanent

The healing process requires patience. Although patients may feel able to return to regular activity within several weeks, healing can take as long as four months.

This procedure is performed by specialists in Facial Plastic and Reconstructive Surgery (Otorhinolarnygology).

Key Facts

Anesthesia: General anesthesia

Inpatient/outpatient: Same day or overnight in hospital

Length of procedure: 1 1/2 to 2 hours

Anticipate: Dimpling in each cheek and bruising around eyes (for at least three weeks); flattened upper lip

Discomfort: Moderate with prescription pain medications

Final result: 2 to 4 months

Duration of results: Typically 5 to 7 years

Circumferential body lift

An abdomen reduction and buttock reduction done together is called a circumferential body lift. This combined procedure is major surgery that takes longer to perform and is associated with more pain. Patient priorities and medical conditions are considerations in determining if someone is a candidate for a circumferential body lift.

What to expect

The incisions are made around the entire circumference of the body. The position of the incisions varies from person to person, but is usually hip to hip, front and back. The excess skin between the incisions is removed. The incisions are then pulled together and closed.

Risks

Risks associated with circumferential body lift include, but are not limited to:

  • Problems related to anesthesia
  • Infection
  • Bleeding
  • Blood clots
  • Poor wound healing
  • Wound separation
  • Widened or raised scars
  • Seroma (fluid collection under the skin)
  • Numbness in the abdomen (usually temporary)

This procedure is performed by specialists in Plastic and Reconstructive Surgery.

Key Facts

Anesthesia: General anesthesia

Length of procedure: 1 1/2 to 2 hours

Length of stay: Usually home the same day

Discomfort: Moderate with prescription pain medications

Anticipate: Swelling for up to 6 weeks

Final result: Up to 1 year

Duration of results: Lasting, unless substantial weight gain

Cosmetic dentistry

Cosmetic dentistry involves procedures to reposition, restore or replace teeth. Primarily it is done to improve a patient's smile or facial profile. Uneven teeth can be gradually guided to their proper location using orthodontics. Malformed teeth may be covered with artificial materials such as porcelain. In some cases, teeth may have to be removed, and replaced by artificial ones.

Orthodontia

Orthodontic treatment moves teeth by installing wire or plastic braces to slowly push or pull them into proper alignment with adjacent teeth. Treatment may take as long as two years, with periodic return visits to inspect, tighten and readjust the braces. Occasionally, it is performed along with jaw repositioning (orthognathic surgery). Tooth restoration or replacement may follow orthodontic procedures, after teeth have been moved into their proper locations.

Orthodontia Risks

Risks associated with orthodontic work include:
  • Problems with dental hygiene that lead to permanent marks on the teeth and tooth decay
  • Gums or cheeks can be injured when the braces rub against the soft tissue
  • After the braces are removed, the corrected teeth may move out of place
  • Teeth roots may shrink

Orthodontia Key Facts

Anesthesia: Typically no anesthesia is needed
Length of procedure: Braces may need to stay on teeth for up to 2 years
Length of stay: No overnight stays
Discomfort: Mild to moderate
Anticipate: Mild to moderate discomfort after each adjustment
Final result: After braces are removed
Duration of results: Long lasting

Restoration

Teeth can be built up and resurfaced through various treatments. Natural or synthetic bone material may be grafted to the jawbone to build up the facial and jawbone contours. Surfaces of individual teeth can be covered with an artificial material such as porcelain. The tooth can be built up using another material onto which the new surface is applied. Teeth may need to be strengthened to serve as anchors for replacement teeth.

Restoration Risks

The risks associated with tooth restoration may include:
  • An allergic reaction to local anesthesia
  • Need for further treatment such as root canal therapy, gum recontouring, or tissue grafting

Restoration Key Facts

Anesthesia: General anesthesia or local anesthesia with IV sedation for some procedures
Length of procedure:
Length of stay: Typically return home the same day
Discomfort: Mild to moderate
Anticipate: Mild to moderate soreness in the jaw and mouth
Final result: Within months for restorations, slightly longer for restorations on dental implants
Duration of results: May need replacement at 10-year intervals on average

Tooth Replacement

Sometimes teeth are missing or must be removed because they are too weak to support artificial teeth. Replacement teeth may be installed either as a removable bridge, which is held by surrounding permanent teeth, or permanently implanted onto a metal post (dental implants). The metal post (an osseointegrated titanium implant) is implanted into the jawbone and allowed to heal for several months before installing the tooth or teeth onto it.

Tooth Replacement Risks

The risks associated with dental implant tooth replacement include:
  • Intolerance of anesthesia
  • Infection at the implant site. If infection occurs after a post implant, the implant may have to be removed.
  • Loss of bone or soft tissue adjacent to implant requiring further corrective surgery
  • Swelling and discoloration for 7 to 10 days

Tooth Replacement Key Facts

Anesthesia: General anesthesia or local anesthesia with IV sedation
Length of procedure: One to two hours
Length of stay: Usually return home the same day
Discomfort: Mild to moderate
Anticipate: Bruising and soft tissue swelling
Final result: 4 to 18 months after tooth has been attached to bridge or post
Duration of results: Long lasting, in comparison to conventional tooth replacement

Treatment is performed by specialists from Dental Specialties and Oral and Maxilliofacial Surgery.

Facial contour

(Synonyms: chin augmentation, chin reduction, genioplasty, chin implant, cheek implants, malar implants, malar augmentation)

Facial implants

Facial implants for the cheeks and/or chin can bring facial features into greater harmony and enhance their definition and youthfulness. Both types of implants can strengthen the features and profile of the face. Each involves placing synthetic materials deep under the subcutaneous tissue and onto the underlying bone. There are several types of facial implants made of different materials. The surgeon will choose an implant based on prior experience and what is best for the patient.

Cheek and chin implants are distinctive from other cosmetic surgeries in several ways: multiple options; minimal surgical access can often be used to place the implants; and results are often dramatic. Most people are pleased with their decision to have facial contour procedures. Adjusting to a new appearance is a consideration in making a decision.

What to expect

Usually, chin and cheekbone implant surgery is performed through incisions made inside the mouth. In some cases, surgery will be performed through a small incision under the chin. The surgeon will explain which procedure is best. The implants are placed into a pocket or space created under the skin. They may be secured there with small surgical screws or permanent sutures.

In a few cases reducing cheekbones or the jawbone may be the best option. This is done by contouring the underlying bone or removing excess skin and subcutaneous tissue.

Chin alterations
Cosmetic surgery of the chin enhances a person's profile by creating a proportional balance with other facial features such as the neck, lips, nose and forehead. A receding chin, for example, can make an average nose seem large.

A large chin can be reduced with surgery. The surgeon makes an incision inside the mouth and beneath the lower lip and reduces the bone using bone-contouring instruments. Once the incision is closed, special tape may be placed over the chin during the initial healing period. This surgery can be performed alone or in combination with other facial cosmetic surgery, such as rhinoplasty or a facelift.

A small chin can be augmented with a variety of implants, which are inserted through an incision beneath the chin or inside the mouth behind the lower lip. A pocket is created at the tip of the chin and an implant is positioned inside it. The oral approach avoids a visible scar. Once the incision is closed, the chin may be supported by tape for several days to decrease swelling and prevent fluid accumulation.

Another option is to move a portion of the bone at the tip of the chin forward (a sliding advancement genioplasty). This makes the chin more prominent and can also address any needed vertical changes as well. The surgery is performed through an incision inside the mouth in the area of the lower lip. The bone is cut above the lower border of the chin and below the lower front teeth. The chin is carefully detached, moved forward and stabilized with wires, or plates and screws.

Cheek alterations
A number of procedures are available to enhance the cheekbone (malar). These procedures are typically performed through small incisions inside the mouth in the upper jaw area. A pocket is created and the implant positioned and secured.

Special situations
In some cases patients may benefit from a custom implant. Special imaging is used to create a model that is used to fabricate a custom implant for the specific need.

Risks

The risks associated with facial contour alterations may include, but are not limited to:

  • Problems related to anesthesia
  • Infection. Your physician may prescribe antibiotics after surgery to prevent infection of an implant. If an infection develops with the implant, removal may necessary.
  • Extrusion, a condition in which the implant can be seen through the skin, is a rare risk. If this occurs, the implant must be surgically removed. In some cases, the implant may shift or collect fluid, also requiring a second surgery.
  • Swelling and discoloration of the overlying skin may last for several weeks to months.
  • Some temporary numbness or tingling may occur but will usually diminish over time. Permanent numbness is rare.

There have been no reports of medical diseases or disorders caused by using synthetic materials for facial contouring. Some studies have shown slight bone erosion under some implants placed on the chin. Rarely, chin erosion can be significant and even affect the roots of teeth.

This procedure is performed by specialists from Oral and Maxillofacial Surgery and Facial Plastic and Reconstructive Surgery (Otorhinolaryngology).

Key Facts

Anesthesia: General anesthesia or local anesthesia with IV sedation

Length of procedure: 1 to 2 hours

Length of stay: Usually home the same day; overnight stay if performed with other procedures such as facelift or rhinoplasty

Discomfort: Mild to moderate

Anticipate: Bruising up to 3 weeks; swelling may take several weeks to months to diminish with implants; some temporary numbness of the lower lip for up to several months.

Final result: Approximately 4 to 6 months

Duration of results: Lasting

Inner thigh lift

Weight loss and aging can create loose skin in the inner thigh. Exercise, while good for health, will not eliminate excess skin. A medial thigh lift removes excess skin and lifts the remaining skin to create smooth inner leg contours and a more attractive upper leg. Liposuction may also be helpful to reduce the volume of fat in the inner thigh. Potential candidates should discuss with the surgeon the benefits of each of procedure and the risks associated with doing them both at the same time.

What to Expect

An incision is made in the groin crease extending back toward the crease in the buttocks. The incision can also be made vertically from the perineum to the knees if there has been dramatic weight loss. A wedge of excess skin is removed and the incision and scar is hidden in the groin. Drains may be placed during surgery. Because of friction with walking and other activities and moisture in this area, healing in the inner thigh can take extra time. It is not uncommon for stitches to separate and have to be redone.

Risks

Risks associated with inner thigh lift include, but are not limited to:

  • Tingling in the inner thigh (usually temporary)
  • Complications with healing
  • Stitches separate
  • Prolonged healing
  • Infection
  • Blood clots, though uncommon, are more likely to occur in individuals who have diabetes or who smoke.
  • Skin may sag if weight is lost afterwards.

This procedure is performed by specialists in Plastic and Reconstructive Surgery.

Key Facts

Anesthesia: General anesthesia

Length of procedure: Up to 2 hours

Length of stay: Usually home the same or next day

Discomfort: Moderate to severe; controlled with prescription pain medication

Anticipate: Swelling up to 6 weeks, bruising up to 3 weeks, unless liposuction is also performed

Final result: About 6 months

Duration of results: Lasting

Skin problems

(Synonyms: skin blemishes, spider vein removal, scar revision, tattoo removal)

Aging, heredity, hormones, sun exposure, smoking, skin care regimens and other life choices take a toll on the skin. Fortunately, there options are available to improve the skin's appearance.

Skin blemishes

Many treatments are used for skin problems, such as surface irregularities, scars, blemishes, discolorations such as freckles and birthmarks, acne, wrinkles and spider veins. Laser therapy can vaporize blemishes, seal blood vessels or penetrate deeper into skin tissue. Chemical peels and dermabrasion smooth the skins surface. Sclerotherapy (see below) closes off unsightly blood vessels.

Spider veins

Small superficial veins (telangiectasias or spider veins) are a common concern in women, especially after pregnancy. They also frequently occur in people who have varicose veins. Those who have spider veins and varicose veins can reduce the risk of rapid recurrence of spider veins by having the varicose veins treated first.

Medium and large spider veins are best treated by sclerotherapy — a chemical solution is injected into the vein to cause it to inflame and ultimately disappear. Laser therapy is most effective on small and medium-sized veins.

What to expect

Sclerotherapy can be performed in the physician's office and does not require hospitalization. Depending upon the area being treated, the procedure may take as long as 30 minutes. No sedation or anesthesia is necessary. Injection sites are covered with gauze and tape, and the legs are usually wrapped with an elastic wrap. The vessels gradually disappear over the next month. Several schlerotherapy sessions are usually needed to achieve the desired improvement. Sessions are typically scheduled six weeks apart.

Patients may experience a temporary burning sensation as the solution enters the vessel. This discomfort usually diminishes within minutes. Veins may appear darker and more visible after treatment. Over the next month, the darkness fades.

The skin should be protected from sun exposure for one year following either treatment.

Risks

Risks associated with sclerotherapy include, but are not limited to:

  • Swelling, if the injections are around your ankle
  • A small scab may develop at the injection site due to solution escaping from the vessels
  • In rare cases, mattelike telangiectases (small sunburst-like vessels) develop at the injection site. The remedy is reinjection or laser treatment.
  • Development of brownish colored skin in the treated areas; usually disappears within two to six months

Scar revisions

Scar formation is the body's way of healing following surgery or injury. Because everyone heals differently, there is no way to predict how a scar will look after healing. With time, many scars that are firm may soften and fade. Wide, raised scars are known as hypertrophic scars. Keloid scars grow out of the incision line. Treatment options range from allowing more time for a scar to heal, applying pressure to the scar, massage, injection or excision.

To minimize the visibility of any scar, protect it and the skin from the sun by using a sunscreen with an SPF of at least 15.

Tattoo removal

Tattoos are created by ink drops placed under the skin by a needle. Q-switched Yag laser is most often used to remove tattoos and other pigmented or discolored skin. The laser light passes through the skin and is absorbed by the ink, causing it to break into smaller pieces. The body's natural filtering system absorbs the small pieces of ink. Bright green, yellow and red inks are most difficult to remove.

What to expect

There may be a stinging sensation during the laser treatment. This is sometimes described as "hot specks of bacon grease hitting the skin." Most patients do not require anesthesia, although local anesthesia may be used. After a session, the skin over the treated area may appear to have a light abrasion. Ointment and a light dressing are applied to the affected area after treatment.

Each session lasts five to 15 minutes, depending on the size and color of the tattoo. Multiple treatments are usually needed over a period of months.

Usually, fading of the tattoo is the best result that can be accomplished. Sometimes the tattoo will disappear.

Maintaining healthy skin

  • Use sunscreen of SPF 15 every day; avoid sun tanning
  • Drink eight glasses of water a day
  • Get enough sleep
  • Eat a nutritious diet
  • Limit your caffeine consumption
  • Maintain a skin care regimen
  • Wear sunglasses with UVA/ABB protection
  • Do not go to tanning salons

Skin problems are treated by specialists in Dermatology and Facial Plastic and Reconstructive Surgery.

Sep. 12, 2014