Questions

What is plastic surgery

Plastic surgery is a medical specialty that deals with the reconstruction of congenital defects, lesions caused by trauma or burn, defects caused following tumour removal and cosmetic surgery.

They say plastic surgery does miracles. Is this an exaggeration or is there really great potential in plastic surgery?

In some cases plastic surgery does miracles and in other cases options are limited. It is important for a patient to understand what there is to expect from an operation so that he may be satisfied afterwards. There are types of cosmetic procedures that do miracles (rhinoplasty, blepharoplasty, otoplasty, breast augmentation and liposuction). There are others that although they correct the problem they either leave scars or the degree of improvement is positive yet underestimated by the patient who sees the glass half empty rather than half full (buttock and thigh lift, abdominoplasty, breast reduction). The same goes for reconstructive surgery. Treating a defect does not necessary mean that the result will be aesthetically perfect, as if the defect had never existed. (This is not a case of “no harm done”).

Why do they say that plastic surgery leaves no scars particularly with the use of laser?

Indeed, there are certain procedures that leave no scars, such as rhinoplasty (within the nostrils) or otoplasty (behind the ears), either because incisions are very small and become invisible as in the case of liposuction and breast augmentation or, finally, because in some parts of the body scars are not easily visible, such as in blepharoplasty or face lift (plastic surgeon). Laser is not a cure-all technique and its use requires certain indications. In some cases the result may be worse if a surgeon uses the laser to make an incision on the skin.

Where are plastic surgery procedures performed?

All procedures must be performed in organised hospitals and clinics. Small-scale procedures with local anaesthetic, such as mole removal can also be performed in a well-equipped surgery.

What kind of anaesthesia do plastic surgery procedures require?

Depending on the gravity and type of procedure as well as the targeted area of the body, a surgeon may use general anaesthesia, epidural analgesia, neuroleptoanalgesia (sedation) or local anaesthesia

How dangerous is general anaesthesia?

A pre-operative check-up is performed before every surgery. If all measures are taken, there is zero risk related to anaesthesia. However, all types of anaesthesia, whether local or regional, have risks. Sometimes, the stress of local anaesthesia is greater and can even cause cardiac arrhythmia. The presence of an anaesthesiologist is always necessary.

What should I be careful about before surgery, in order to reduce risks and get the best possible result?

It is important to be fully informed by your doctor as to the type of procedure you will undergo. Each procedure has different needs and requires different treatment. In general, however, the doctor must know about all and any medication that you might be taking. You may have to stop taking some of your medication for a while. For example, aspirin leads to haemorrhage problems during surgery. You should tell your doctor of any allergies you might have. In case of mitral valve prolapse you must take an antibiotic before surgery. Health conditions such as diabetes or microangiopathy are associated with haematosis problems and the doctor must proceed with a less invasive approach. Smoking also reduces skin haematosis. A long-term smoker may have developed a chronic obstructive pulmonary disease and must be submitted to appropriate pre-operative treatment. Good spirit as well as optimism also has a positive role. On the morning of your surgery you must take a good shower with antiseptic and arrive at the hospital on an empty stomach (and no water intake for at least 6 hours).

What should I be careful about after surgery, in order to reduce risks and get the best possible results?

Each surgery requires special care and attention. However, in general, refraining from smoking for at least one week is necessary. Aspirin intake must also be avoided for 4-5 days after surgery. Anticoagulation treatment is sometimes considered necessary and subcutaneous injections are prescribed for 10 days approximately. You should follow all doctor’s advice as to the antibiotics you must take for preventing infection, the use of elastic bandaging (elastic compression garments, socks, sleeves, bras etc), wound dressing changing, keeping the area clean and adjusting your posture as well as sleeping and resting position during the first days after surgery. In the coming months, depending on the surgical procedure, you may need some special massage sessions, creams or elastic bandages to maintain or improve the result.

Which season is considered most appropriate for a plastic surgery procedure?

Apart from laser procedures and dermabrasion on the face there are no restrictions as to the season during which plastic surgery can be performed. The patient shall decide on the right time according to his own schedule. Christmas, Easter and summer vacations are often preferred since the patient has more time to recover. Procedures such as liposuction impose the use of a compression garment for 20 days after surgery. This is quite uncomfortable during hot months. In general, patients prefer to undergo such procedures when the weather is cooler.

Where is the incision for implant insertion made?

There are many techniques which you may discuss with your Doctor. Each one of them has its advantages and disadvantages. An incision made in the inframammary fold gives very good access to the area underneath the breast and is used in many cases. An incision made at the top of the armpit allows very good access to the area underneath the muscle. An incision on the areola mammae delivers a very good aesthetic result but may jeopardise the breast’s sensitivity and future lactation

Where will the scars be seen after surgery?

There are many techniques which you may discuss with your Doctor. Each one of them has its advantages and disadvantages. Scars may have the shape of a reversed T or a vertical scar may be seen underneath the lower part of the areola mammae in the inframammary fold, or, finally, there may be only one scar around the areola mammae. In any case, incisions will take their final shape within approximately 1 year.

Will I be able to breast feed after surgery?

Some women are unable to breastfeed even without surgery. There are techniques that do not affect the breast’s milk ducts. This way future lactation is possible. However, it is very difficult to guarantee such result.

How can I find out what is the cost of plastic surgery procedures?

It is very important to know and discuss the cost of a procedure with the Plastic Surgeon. Total cost includes Doctor’s payment, hospitalisation cost, Anaesthesiologist’s and Pathologist’s fees as well as the cost of the silicon implant.

My breasts have dropped. Can this be changed?

Breast ptosis is usually corrected in surgery with mastopexy or breast augmentation or a combination of the two. It is very important to choose the right technique and to have a relevant thorough conversation with your Doctor

What are the suspension sutures?

Suspension sutures are anchor stitches used for lifting the forehead and face in general. They can be placed with local anaesthesia.

I’ve heard about hyaluronic acid injections. Are they safe?

There are many products already available in the market. So far, hyaluronic acid injections are the safest and do not cause any allergic reactions.

Is liposuction safe?

Unfortunately in the past there have been serious complications from liposuction around the world. However, in all cases the procedure was performed either by doctors with insufficient training or involved the removal of very large volume of fat. The ideal candidate is a patient with stubborn fat who is, however, close to his ideal weight.

When is the right time for breast reconstruction after a mastectomy?

Selecting the right time for breast reconstruction is very important and the decision shall be made by the patient along with the Surgeon, the Oncologist, the Radiotherapist and the Plastic Surgeon. Immediate reconstruction may be a good choice. However, depending on the case, delaying reconstruction may also be advisable.

What type of reconstruction is best?

The decision for the best possible method of reconstruction is made by the patient along with the Surgeon, the Oncologist, the Radiotherapist and the Plastic Surgeon. In general, there are two basic methods of reconstruction that involve either silicon implants or autologous tissue flaps or a combination of the two. It is very important to know about the alternatives so that you may take the right decision.

When is the right time for breast reconstruction after a mastectomy?

Selecting the right time for breast reconstruction is very important and the decision shall be made by the patient along with the Surgeon, the Oncologist, the Radiotherapist and the Plastic Surgeon. Immediate reconstruction may be a good choice. However, depending on the case, delaying reconstruction may also be advisable.