The American Society of Plastic Surgeons (ASPS) is the largest plastic surgery specialty organization in the world. Founded in 1931, the society is composed of board-certified plastic surgeons who perform cosmetic and reconstructive surgery.

Plastic surgery is a medical specialty concerned with the correction or restoration of form and function. While famous for aesthetic surgery, plastic surgery also includes a variety of fields such as craniofacial surgery, hand surgery, burn surgery, microsurgery, and reconstructive surgery.

Cosmetic Surgery defined as a subspecialty of surgery that uniquely restricts itself to the enhancement of appearance through surgical and medical techniques. It is specifically concerned with maintaining normal appearance, restoring it, or enhancing it beyond the average level toward some aesthetic ideal.
Plastic Surgery in the true sense of the word is that surgery performed by plastic surgeons. Plastic surgery can further be divided into cosmetic surgery and reconstructive surgery. The difficulty in the question is that alot of non-plastic surgeons advertise that they are “cosmetic surgeons”. Only plastic surgeons are certified by the American Board of Plastic Surgeons.

Scarring is an inevitable result of the wound healing process. However a very fine lined scar placed in the correct orientation may be virtually invisible. A plastic surgeon has spent years mastering techniques to place scars in the most desirable location. Nevertheless there are certain areas of the body such as the back and chest which produce more severe scarring regardless of the technique used for reconstruction and closure.

Although the primary interest of a dermatologist is the skin, the plastic surgeon as an equally important role of the treatment of benign and malignant tumors of the skin. The skills of a plastic surgeon are especially needed when large areas of the skin must be removed and replaced especially where disfigurement may result or when these areas are in conspicuous areas such as the face.

Aesthetic surgery, also known as cosmetic surgery, seeks to improve an individuals appearance. These type of operations most often involve the nose, ears, face, forehead, eyelids, breasts, abdomen, hips and thighs.

• Aesthetic (also called cosmetic) problems with the face, neck and trunk, including forehead, eyes, nose, ears, lips, chin, neck, breasts, abdomen, hips, buttocks, thighs, calves, arms, and skin.
• Any type of skin cover and replacement problems.
• All types of reconstruction following removal of cancer resulting in disfigurement of any part of the body including the face, breasts, trunk.

Training to become a plastic surgeon is one of the most rigorous pathways known to medicine. To become board certified by the American Board of Plastic Surgery a physician must complete a specialized post-graduate training course of five to seven years. Prior to official certification by the American Board of Plastic Surgery the physician must pass a rigorous set of both written and oral examinations. Although numerous physicians use the term “plastic” surgeons only those certified by the American Board of Plastic Surgery are true plastic surgeons.

Plastic surgery is a surgical sub-specialty that deals with the healing and restoration of patients with injury, disfigurement or scarring resulting from trauma, disease or congenital defects. It includes aesthetic (also called cosmetic) surgery to correct or rejuvenate facial and bodily features not pleasing to the patient. Derived from Greek, the word plastic means molding or giving form and does not refer to the use of plastic materials.

The Plastic Surgery Channel is a company devoted exclusively to educational and entertaining programming about cosmetic and reconstructive surgery. Our goal is to provide credible, up-to-date information to people considering plastic surgery or a cosmetic procedure, as well as coverage of the latest news and hot topics from the field of plastic surgery.

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If you have more skin excess than fat excess in your arms, i.e., the skin envelope is not overstuffed with its content (fat) then you are a better candidate for an arm lift.  If the reverse is true, you are relatively speaking young and have good quality skin, a liposuction procedure may be sufficient to correct your concerns.

The anesthesia by preference should be general, but local with twilight could alternatively be used.

Costs vary greatly depending on the experience of the surgeon, the exact procedure to be performed and the geographic area. You could best inquire by having a consultation with one or more surgeons of your choice. In my particular practice, the lowest fees are for liposuction only; approximately $2,000.00 per arm to full scale arm lift (brachioplasty) at $5,000.00 per arm. Note: I do not believe it is a good idea to publish fees on our site.

As with any surgery, body sculpting carries significant risks including blood clots, infection, excessive scarring, etc. These risks should openly be discussed during your consultation and in general, are much less common in the hands of well trained surgeons and in properly selected patients.

Most likely you would benefit from another procedure.

Yes.

Yes.

There are a number of “non invasive liposuction” procedures subject of current research. Beware of hype promoting some of these procedures! Even the ones who show preliminary promise are not likely to replace traditional liposuction in the near future. They may work for a few, highly selected patients.

Liposuction, by itself, is highly effective for treatment of most patients with saddle bags. After major weight loss, if residual saddle bags exist, a body lift combined with liposuction may be the appropriate approach.

The classic breast lift or mastopexy involves the removal of excess skin and suturing to provide a tightening of the patient’s “skin brassiere”. The scars in this traditional procedure are typically around the edge of the pigmented skin around the nipple (areola) and involve an incision vertically from the bottom of the areola to the breast fold. Depending on the technique there may or may not be a scar in the breast fold as well. This procedure is usually performed under general anesthesia. There is generally is not too much discomfort associated with a breast lift since it is predominantly a skin procedure. A few days of recovery is typical and arm motions are usually is restricted for a few days to weeks.

A careful consultation should be performed by your surgeon to determine if a breast augmentation will be sufficient to correct your loss of volume and provide an optimal fill to your skin envelope.  If you have considerable ptosis (droop), you may benefit from a breast lift (mastopexy) either at the same time as your breast augmentation or as a staged procedure. It is important to consider the fact that a breast implant will increase the volume of your breast, and therefore increase your cup size.  If you do not want larger breasts, than do not get a breast augmentation.

Breast implants are not lifelong devices and will need to be replaced during a woman’ lifetime.  Saline implants will eventually deflate, and silicone implants will eventually rupture.  Manufacturers have information about rupture and deflation rates for specific implants available on their web sites.* Patients must also consider that in addition to their implants aging, their breast tissue and skin will age as well.  Events such as weight gains and losses, pregnancies, breast feeding, and eventually menopause, will all have an effect of the appearance of their breasts and how long the look of their breast augmentation will last.

Yes—in addition to the standard breast lift described above there are more minimal procedures including a circumareolar or “donut” mastopexy where a circular rim of skin is removed from around the outside of the pigmented skin of the areola and a pursestring suture is placed to tighten the breast skin around the areola. The areolar diameter can be reduced with this procedure. If the pursestring suture breaks the size of the areola can expand to an even greater size than it was before surgery.  There is also a crescent mastopexy which can be used to achieve a small elevation of the nipple and areola, usually only about one half to one inch at most. This involves removal of  a small crescent shaped piece of skin from above the areola. Your Board Certified plastic surgeon can discuss the relative merits of these options with you in relation to your anatomy and desired outcome.

Women who have experienced childbirth or weight loss, or even changes from aging may see a deflation effect resulting in sagging of the tissues. If you are bothered by these changes you should discuss the possible options with an experienced plastic surgeon who is board certified by the American Board of Plastic Surgery(hotlink?).  Some cases may require surgical removal of excess skin but mild laxity can often be corrected by placement of a breast implant. Your surgeon should be able to easily offer you these options and discuss the benefits and trade-offs involved with each one.

Unless a patient has more pregnancies or has significant weight gain and loss, the results of a breast lift should be maintained going forward. Some patients have poor skin elasticity and they may experience some stretching and loss of perkiness. This could particularly be seen if the patient chooses to have a breast implant placed in addition to the breast lift, due to the additional weight of the implant. In almost every case of a breast lift patients will experience loss of fullness of the top of the breast over time due to gravity.

The most common complications associated with mastopexy or breast lift are:

• infection
• bleeding
• loss of skin or nipple sensation
• problems healing including open wounds
• excessive scarring
• unsatisfactory cosmetic result
• asymmetry (breasts don’t match)
• malposition of the nipples
• possible need for additional surgery and expense
• problems related to implants if used

Rare complications would include:

• problems related to anesthesia
• blood clots
• other rare or unknown complications

The answer to this question depends on both your anatomy and your goals. If you desire to have fullness in the top of the breast in addition to being lifted then an implant will most likely be necessary. It is important to remember that the addition of an implant will definitely increase the size of your breasts. If being larger is something you wish to avoid then you should probably not have an implant. Some surgeons may be willing to do both a breast lift and placement of an implant  at the same surgery, however many will insist on doing these as separate procedures. You will want to discuss this with your surgeon.

Breast augmentation is performed for physical reasons as well as for psychological and self-esteem issues.

• The most common physical reasons include:
  • Chest wall deformities-asymmetries
  • Significant weight loss
  • congenital deformities such as Poland syndrome and thoracic hypoplasia
• The most common psychological- self-esteem issues include:
  • Women who have always had small breasts and wish to be larger
  • Women who have lost breast volume and shape after pregnancy and nursing
  • Women who want larger breasts for their own personal reasons

Any woman who has reached full breast development, may be a candidate for breast augmentation, however:

• You must be over 18 years of age to undergo a breast augmentation with saline implants or enter into a clinical trial with the Form stable Highly Cohesive gels. Exceptions may be given to patients when the augmentation is considered reconstructive
• You must be over 22 years of age to be a candidate for breast augmentation with round silicone gel breast implants
• Many practices may require a screening mammogram for patients over the age of 35
• You should be able to undergo a surgical procedure and recovery

There are currently three types of implants available in the United States:

• Saline filled breast implants: are available in both a round and shaped device.
• Round silicone gel breast implants: FDA approved in 2006
• “Gummy Bear” or Form Stable Highly Cohesive Gel breast implants: are always textured and shaped devices, and require enrollment into a clinical trial until they are FDA approved.

Complications can be divided into early vs. late complications.  In addition complications may be related to the surgical procedure or the selected implant.

Early complications after breast augmentation may include:

• Hematoma
• Infection
• Swelling
• Pain
• Seroma
• Infection
• Scarring
• Allergic reactions
• Nipple or skin sensation loss
• Thrombosed veins
• Pain
• Malposition deformities
• Suture problems
• Delayed wound healing
• Skin discoloration
• Cardiac complications
• Pulmonary complications
• Shock

Late complications of breast augmentation related to the implant can include:

• Implant Failure-rupture of silicone or deflation of saline
• Capsular Contracture
• Malposition deformities
• Tissue Stretch, visibility and palpability
• Chest wall irregularity
• Asymmetry
• Gel bleed or silent rupture
• Surface contamination- late seroma
• Infection or capsular contracture
• Interference with mammography
• Personal financial expenses
• Unknown risks

Although each patient will experience a slightly different recovery, most patients should expect a return to normal everyday activities within 24-48 hours after surgery, without the use of narcotics or pain pumps.  Most surgeons will advise their patients to avoid any cardio- type exercises for about 2 weeks to reduce the risk of bleeding after surgery. Individual surgeons will advise their patients on returning to weight lifting, and other types of training, but most patients should be back to their normal routines in 4- 6 weeks.

Rhinoplasty reshapes the nose usually to improve appearance however it may also be required to relieve breathing problems.

Post-operative pain from rhinoplasty is surprisingly mild. A splint is usually worn over the nose and sometimes inside the nose for five to seven days. There may be some bruising around the eyes however this clears in one to two weeks.

Nasal reconstruction is most often encountered when removal of part of the nose is necessary for cancer removal. Plastic surgeons are specially trained to utilize available tissues to reconstruct the nose and match the pre-operative anatomy as close as possible.

Revisions after rhinoplasty or nasal reconstruction are sometimes necessary. In general, it is prudent to wait approximately one year prior to any additional surgery.

Otoplasty is an operation done by plastic surgeons to normalize overly protruding ears. This operation is performed via incisions placed on the back of the ear that are very well hidden post-operatively. Results are excellent from this type of surgery.

There are various degrees and stages of facial aging. Plastic surgeons have undergone very specialized training to address all areas of facial rejuvenation. A face lift tightens and lifts the redundant skin in the face and neck. Additional procedures are available to improve the aesthetics of the forehead, eyes, mouth, chin and neck. Minimally invasive endoscopic techniques are also available. Fine wrinkles of the face may be best treated by laser resurfacing, chemical peels or other skin care treatments.

During a face lift incisions are made in the hair line, temple region extending down in front of the ear and then around the back of the ear into the hairline. These incisions vary depending on the technique used by your plastic surgeon. Many plastic surgeons are well trained in more than one face lift technique. The skin of the face and neck is dissected into the cheeks and neck allowing it to be mobilized upward producing a tightening and smoothing result. Many plastic surgeons now also tighten the muscular layers underneath the skin as well during a face lift procedure. Years of specialized training are necessary to safely perform this procedure. However, spectacular results are possible.

Yes, however, as with other scars plastic surgeons have been trained to place them in areas that are very inconspicuous. Your plastic surgeon will be able to show you exactly where your scars will be following your surgery.

Brow lift – A brow lift elevates the brows/forehead to their aesthetic position, as well as the obliteration of the transverse forehead wrinkles and vertical frown lines.

Depending on each patient, the approach may be done with an open incision or a minimal incision endoscopic technique.

Blepharoplasty is the procedure done to correct this condition. Excessive skin and fat may be removed from both upper and lower eyelid. Tightening of the lower lid may also be done in concurrence with this procedure. One to two weeks of bruising and swelling is expected from this procedure. Blepharoplasty may be done in combination with or separate from face lifts or other types of aesthetic surgeries of the face such as brow lifts.

Brown spots also known as age spots are the result of prolonged, unprotected exposure to the sun. There are many different ways to treat these spots. An at-home approach would involve specialized skin lightening creams that contain hydroquinone and/or kojic acid. Other times a chemical peel may be preferable. For the quickest and most intensive approach lasers may be used. Whatever method you choose be sure to complement it with a powerful broad-spectrum sunscreen to ensure that your spots don’t return

There are a variety of signs of aging that we begin to see as the years march along. These can include (just to name a few) sun damage, dry, scaly skin, dark age spots, fine lines, wrinkles, mottled skin tone, enlarged pores, sagging facial skin, ruddy skin texture, loss of skin elasticity and a decrease in the skin’s healing abilities. You can effectively address aging skin with skin care products, microdermabrasion, lasers, dermal fillers and neuromuscular blockers.

If you have had laser skin resurfacing, your skin is more sun sensitive.  Even with a high SPF sunscreen, sun tanning or tanning beds significantly increase your risk of hyperpigmentation (blotchy brown spots), which can be quite difficult to treat, especially in the first few months after treatment. It is recommend that you stay out of the tanning beds permanently.  You’ll avoid premature aging from photo-damage and reduce your risk of skin cancers.  Get a spray tan instead.

A chemical peel may be helpful for some types of acne scarring, but may not eliminate acne problems. If your concern is with continued acne breakouts and persistent skin problems, then you may be best served by a consultation with a dermatologist. If you want to decrease the scarring or effects of prior acne problems, then an evaluation by a plastic surgeon and his/her aesthetician team may yield some skin care options up to and including chemical peels.

The best treatment for your skin will depend on the nature of the skin changes (such as depth and number of scars) and your skin characteristics (such as oiliness and pigmentation), so that one particular treatment -like chemical peel- will not fit everyone’s needs.

Chemical peeling and microdermabrasion are both resurfacing procedures that exfoliate the skin. Used together, they can cause serious damage to the skin because of the double peeling effect.

While microdermabrasion works well on superficial skin imperfections (some acne scars, fine lines, wrinkles, enlarged pores and sun spots), a chemical peel is more effective on serious skin problems like deeper scars and wrinkles. But the after care and downtime are also longer.