Going Under the Knife

Let's face it -- everyone has a few flaws that we would love to improve. It may be the bump on your nose, the fatty bags under your eyes, ears that stick out, or a weak chin. Cosmetic surgery of the face involves far more than just the basic garden variety facelift today.

The good news is that with modern methods, most surgeries can be done as a day case under a twilight anesthetic. I see clients from all over the United States and United Kingdom, with manifold questions on topics ranging from Blephs to Botox. Some procedures are more drastic and invasive, while others simply involve consistent maintenance. Before you venture into the realm of cosmetic enhancements, it's important to get good impartial advice and recommendations for highly qualified physicians and surgeons.

Eye Candy
Heavy-hooded upper eyelids may obliterate the once-sharp crease that served as a platform for your eye shadow, and blobs of fat that cushion the eyeball create a permanent puffiness no matter how much sleep you've had.

"Blepharoplasty," or eyelid surgery, can reduce droopy upper eyelids, eliminate bulging fat bags under the eyes, and restore the contours so that your baby blues get noticed again. Upper eyelid surgery involves an incision that follows the natural skin fold of the eyelid crease extending into the crow's feet where lines already exist so the scar will be less noticeable. The fat bags can also be removed from the inside -- which leaves no visible scars -- and combined with laser resurfacing to smooth any loose skin and wrinkles.

Back to work or play: seven to 10 days

High Brows
Although the idea of lifting one's brows may conjure up images of the doe in the headlights look, you don't have to look perpetually surprised. As frown lines across the forehead appear, the increasing heaviness tends to pull the brows down to the point where they seem like they are resting on your lids.

A brow lift will tighten loose skin and drooping brows can be yanked up. Part of the muscle that causes vertical lines between the brows can also be removed, which can stifle the need for Botox injections for a while.

There are two basic techniques: the traditional coronal brow lift and an endoscopic forehead lift. For a coronal brow lift, the incision is made slightly behind the natural hairline, running from ear to ear across the top of the scalp where a headset would sit. For an endoscopic browlift, three to five little incisions of approximately one inch are made, and a small wand with a camera on the end connected to a monitor is inserted to allow the surgeon a clear view of the muscles and tissues to be tightened beneath the skin.

Back to work or play: seven to 10 days

The Lift
Once your neck is going south and your jowls start squaring off, it's time to think about the "F" word. A proper facelift is the only real option when the lower face and neck have begun their inevitable descent.

A common misconception is that once you have a lift, you have to keep having them. The results of a lift can last forever, and you'll always look better no matter when you do it. Some of us will only have one facelift in our lifetime, others may have a second surgery seven to 10 years later when the tissues have relaxed again, and there are those will go in for a little fine tuning every few years. On a young neck with springy skin, fat can be liposuctioned. If you have a "turkey gobbler" neck, you won't be able to get away with it.

The traditional facelift requires a continual incision that starts above the ear in the temple, then down in front of the ear, around and into the crease behind the ear with an extension into the hair, which adds up to about 8 inches.

Short scar techniques, also known in some circles as an "S-Lift," may cut the scar to half that, and are a good option for early lift-ees. These are less invasive, which translates to reduced swelling, scarring, bruising and risk, but usually not cost. The end result leaves you refreshed without changing your look significantly.

Back to work or play: 10 to 14 days

Nose Refinement
Today it is entirely possible to have a natural-looking nose that has been surgically altered, instead of the very obvious "nose job" look of yesteryear. At least half of all nasal surgeries performed are actually revisions to improve previous surgery. Secondary nose jobs are common requests. The major limitations of the procedure have to do with your skin type, skin thickness and position of your nasal bones.

The shape and position of your nose ultimately changes as you mature. It may appear longer and the tip eventually droops, so if you don't like your nose at 25, you will probably like it less at 45.

There are two basic ways to do a "rhinoplasty": open and closed. Open involves a scar hidden in the underside of the nose; the more common closed technique doesn't require any external scars as the resculpting work is all done from the inside.

Back to work or play: seven to 10 days

Body Work
Whether your ultimate goal is to look better in your clothes, fit into a smaller size, or to look good naked, there are many excellent options.

• Breast Lifts and Reductions
  Alas, gravity is not a girl's best friend, especially after breastfeeding twins. The natural order of things is that past the childbearing years, most women are content if their breasts are just self-supporting.

  A breast lift or reduction reshapes breasts that have sagged as a result of the forces of nature. For confirmation, just glance around a communal dressing room at the gym. Breast lifts and reductions consist of removing excess skin, reshaping the areola and elevating the nipples so they no longer point to the equator.

  The most common technique is the anchor scar pattern with incisions made around the nipple, vertically on the breast, and horizontally under the breast. Modified scar-saving methods popularized in breast-baring countries like Brazil can abolish the long scar under the breast fold. The doughnut lift involves only one incision around the areola, but is usually reserved for very small breasts. Generally, the more tissue that gets removed, the better the shape possible. If your breasts are big and plump, liposuction may be used to reduce their size using a few small incisions instead of long scars. When perkier breasts are the goal, a lift can be combined with an implant to pump up the volume.

  Back to work or play: 10 to 14 days

   

• Liposuction
  Liposuction reduces the overall number of fat cells, and magically whisks away unsightly bulges from any area from your chin to your ankles. The most popular areas for women are the tummy, inner and outer thighs, hips and knees. In men, it's the chest wall, belly and love handles. Before consulting with a surgeon, bravely evaluate your nude body in distinct units, like the upper abdomen, lower abdomen, outer thighs, etc., to prioritize the exact spots that would benefit most from recontouring. The scars are tiny and hidden in the most inconspicuous places, like inside the knees or under the crease of your tush.

  There are several methods of liposuction used today. Thin instruments are inserted under the skin and moved back and forth as clumps of fat are sucked out through holes at the tip. Ultrasonic sound waves, like shock waves, transmitted from the tip of the cannulae probe, can liquefy fat cells, which are then removed by low-pressure vacuum through a suction tube. One of the latest advances is power liposuction, in which motor-driven cannulae vibrate to make fat removal easier and faster.

  The more elastic your skin, the better liposuction works. If you have flabby skin, liposuction can leave you ripply.

  Back to work or play: three to eight days

   

• Tummy Tuck
  If your tummy bulge is stopping you from showing a little skin in low-rider jeans, an abdominoplasty, commonly known as a "tummy tuck," can be the answer to your fashion dilemmas. A tummy tuck will remove excess skin and fat and tighten the muscles that get stretched in childbirth.

  A tummy tuck usually involves a wide incision that runs from pelvic bone to pelvic bone. The scar can sometimes be angled to hide under a high-cut thong. If there is a lot of skin to be redraped, a new tummy button may be made. With a mini or modified tummy tuck, the incision is shorter and the tummy button may not need to be moved, but this only works when there is very little to be tucked.

  Back to work or play: two to three weeks

   

• Body Lift
  Body lifts are essentially considered "facelifts for the body." If you have the guts to look in a full-length mirror naked, and pull up the saggy skin of your hips to stretch out your upper thighs and tummy area, you get an idea of what a lower-body lift can do. The added benefits are an overall smoothing of dimpling and lumpy, bumpy bits, as well as a general elevation of your private parts to a more youthful status. The trade-off is that the recovery is longer than any other cosmetic surgery and the scarring is like a belt around your torso. Body lifts are usually performed under general anesthesia because it is considered major surgery.

Wendy Lewis is renowned internationally as an independent cosmetic surgery consultant and has been seen on CNN, NBC, ABC, and in Vogue, Allure and many others.

Source: HealthNewsDigest.com

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