The Art and Science of Plastic Surgery (Adobe Stock)

The number of plastic surgeries performed each year has steadily increased over the years. There were approximately 15.9 million cosmetic procedures performed in 2015 according to the annual report of the American Society of Plastic Surgeons. The top five most commonly performed plastic surgeries included:

  • Breast augmentation
  • Liposuction
  • Rhinoplasty
  • Eyelid surgery
  • Tummy tuck

Read more about how plastic surgeons perform these procedures and what techniques they employ after the procedure to achieve maximum results.

 

Most popular plastic surgery procedures

1. Breast augmentation

Breast augmentation is the most popular cosmetic surgery performed in the United States. Many women undergo this procedure in order to balance size, restore volume, or for aesthetic reasons. During this procedure, an implant is inserted under the pectoral muscle or behind the breast tissue. Surgeons can make incisions in the crease underneath the breast, around the outer edge of the areola, within the armpit, or above the belly button in order to insert the implant.

There are different implants that can be used in this procedure. Implants are silicone shells that are filled with saline or silicone gel and come in round or anatomic or “tear drop” style depending on the preference and desired outcome of the patient. The size of an implant ranges from approximately 150cc to 800cc. Fat from the body can also be used in a fat transfer as an alternative to silicone implants.

After the procedure, a patient may be sore for the first week. The surgeon may suggest that you wear a supportive surgical bra for a specified amount of time after the procedure to allow for optimal healing.

2. Liposuction

Liposuction reshapes the contours of the body and improves body proportion by slimming and reshaping target areas of the body. The procedure involves making small incisions in order for a thin, hollow tube to be inserted into the skin. The surgeon uses the tube to dislodge fat that can be suctioned out of the body using a surgical vacuum.

Liposuction is commonly performed on the following areas:

  • Thighs
  • Abdomen
  • Back
  • Hips and buttocks
  • Upper arms
  • Inner knee
  • Chest area
  • Chin, neck, and cheeks
  • Calves and ankles

The recovery period may take several weeks. A patient is usually required to wear a compression garment or bandages to help keep pressure on the new body contours and to control swelling.

3. Rhinoplasty

Rhinoplasty is a cosmetic surgery that adjusts the proportions of the nose. While it can be a cosmetic procedure to enhance aesthetics, a rhinoplasty can also help correct deviated septums and other structural defects.

A rhinoplasty can be performed as a “closed rhinoplasty” or an “open rhinoplasty.” During a “closed rhinoplasty,” surgeons make incisions inside the nose, hiding them completely. In an “open rhinoplasty,” a surgeon makes an incision across the skin separating the nostrils, called the columella. Once an incision is made, either inside or outside the nose, surgeons adjust and reshape bone and cartilage to create a desired shape and look.

After a patient undergoes a rhinoplasty, they typically wear a nasal splint for the first week of recovery. Swelling and bruising may last until a few weeks after the surgery.

4. Eyelid surgery (blepharoplasty)

Eyelid surgery involves removing or repositioning excess skin and fat from the eyelids in order to improve obstructed vision or to enhance aesthetics. This surgery can be performed on the upper and the lower eyelid. A surgeon typically makes incisions in the natural creases of the eyelid to reduce the appearance of scarring after the surgery.

A double eyelid surgery can also be performed in order to create a more defined eyelid line. This procedure is the most common plastic surgery procedure in South Korea.

Patients may experience symptoms including dryness of the eye, swelling, and bruising for a short while after the procedure. Patients may also be given a cold compress to help treat these symptoms.

5. Tummy tuck (abdominoplasty)

A tummy tuck tightens the abdominal area to create a slimmer overall appearance. Surgeons remove excess skin to create a flattened and toned midsection. There are several options for tummy tucks ranging from mini-tummy tucks to full tummy tucks.

Mini-tummy tucks involve a single, horizontal incision through which surgeons tighten muscles and remove excess fat in the lower belly. However, during a full tummy tuck, a surgeon makes a longer incision that runs from hip to hip and improves the upper and lower abdomen.

After this procedure, patients wear an abdominal support garment. Doctors may insert surgical drains to drain liquid from the site of the procedure. Your surgeon may also encourage you to walk around during the first few weeks in order to help ease swelling.

 

How surgeons reduce scarring after plastic surgery

These plastic surgeries would not have the same impact if postoperative scarring was prominent and visible. Certified plastic surgeons employ many methods during procedures to reduce the appearance of scarring. However, the effectiveness of these methods depends on the age of the patient, the size of the incision, the patient’s genetics, and the tone of the skin. Read about some of the techniques that surgeons use to reduce scarring.

Scar location

Plastic surgeons receive training on how to hide scars. They are aware of which areas of the body are likely to scar poorly and which areas will heal better to hide scars. Eyelids and facial areas heal well and often hide scars. Other areas, however, like the back, shoulders, joints, and breastbones may result in dark, thick scar lines. Although no scar from plastic surgeries can be completely invisible, most scars heal nicely over time.

Sutures

Plastic and cosmetic surgeons have much experience in careful handling of body tissue, especially when it comes to placing sutures. They typically use smaller sutures that are placed under the skin or sutures that will absorb into the body in order to reduce potential scarring. Using sutures that absorb into the body avoids the need for suture removal and external marks.

Post-op care

For many of the procedures mentioned, plastic surgeons may prescribe medication, instruct patients to avoid sun exposure and to rest for an allotted period of time. Doctors may also use draining tubes, surgical bras, and fresh bandages to help speed up the recovery process. In many cases, patients will also be asked to avoid strenuous activities and vigorous exercise to allow the body to heal properly.

In many aspects, this extreme care and attention to detail required in plastic surgery make this profession an art and not just a science.

Shahram Salemy, MD
Dr. Shahram Salemy is a board-certified plastic surgeon in Seattle, Washington. He graduated from Yale University’s School of Medicine and is currently a member of the American Society of Plastic Surgeons and a Fellow of the American College of Surgeons.

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