Plastic Surgery Advice

Copyright (c) 2008 Dr. Robert Kenevan

At the highest level of care, every surgery has risks as well as benefits. Every surgery contains some kind of risk even though complications are seldom and usually correctable.

Cosmetic surgery risks frequently have to do with the patient’s health and emotional well being. If a person is not physically healthy, or has a history of illness that might boost plastic surgery risks, they should be advised against having plastic surgery

The 10 most common complications that may occur during and after surgery are:

1. Bleeding: Blood loss is normal with any procedure. However, if there is excessive bleeding, it can create major complications. If bleeding occurs after surgery, it can accumulate under the skin and require an additional surgery. Discuss with your physician what you can expect as far as bleeding and bruising.

2. Swelling: almost everyone experiences some swelling, which peaks at 48 hours and often significantly decreases after that point.

3. Infection: Antibiotics reduce infection risk dramatically. However, if infection does occur, it is very serious. People who smoke, take steroids or have certain vascular conditions are at greater risk. The longer your surgery lasts and the more blood you lose, the more likely you are to have an infection.

4. Seroma: a pocket of fluid that can collect under the skin and can occur after breast augmentation, liposuction or a tummy tuck.

5. Blood Clots (DVT): A blood clot in the veins can be fatal. They can occur as a result of a medical condition or from immobilization (which allows the blood to pool) such as pregnancy, international airplane flights, and recovery from surgery. They are difficult to predict. To help prevent them, during recovery do not stay in one position for too long and to make sure that you are up, and walking around as soon as possible after surgery. Compression garments worn reduce the risk of DVT.

6. Drop in Blood Pressure: Some decrease in blood pressure is normal during surgery. However, a sudden drop due to blood loss could lead to irregular heart beat and other serious complications.

7. Aspiration: Aspiration occurs if you vomit during surgery and the vomit is forced into the lungs. Aspiration can cause mild discomfort, and can also lead to infections, chronic cough, an obstruction in the lungs or pneumonia. This is why it is extremely important to not eat prior to your surgery.

8. Skin Death or Necrosis: usually follows an infection, or hematoma, and is much more likely among smokers. The skin is excised (surgically removed) and this may affect the cosmetic outcome.

9. Slow or Delayed Healing: due to age, skin type, failure to follow doctor’s advice or factors beyond anyone’s control.

10. Numbness/Tingling: often temporary, sometimes permanent loss of sensation. This results from injury to sensory or motor nerves.

Although the risks and complications are rare, they can happen. That is why it is important to be honest with your cosmetic surgeon and disclose all and any information about your health, medications and any supplements you might be taking.

In Chicago, plastic surgery may not be as popular as it is in cities like Los Angeles or New York, but it is quickly becoming the fastest growing medical sector in the region. Popular plastic surgery procedures in Chicago include Botox, tummy tucks, liposuctions, laser skin rejuvenation and breast augmentation.

If you’re considering Chicago plastic surgery, read on for a full overview of each of these five popular treatments, including a hot tip on where you can find the best cosmetic doctors in Chicago.

Botox Injections

The most requested Chicago plastic surgery treatments are Botox injections. Because Botox isn’t technically a surgical procedure, it requires little financial commitment and doesn’t permanently affect a patient’s appearance, so is consequently in high demand.

Botox works by stopping the facial muscle’s ability to create the chemical acetylcholine. That chemical is what allows the muscle to contract and create wrinkle-causing facial expressions. By essentially paralyzing the muscle, Botox stops it from creating or worsening wrinkles, like frown or worry lines.

Abdominoplasty Surgery

The tummy tuck is clinically referred to as an abdominoplasty and for postpartum mothers, it’s an incredibly popular Chicago plastic surgery procedure.

A tummy tuck surgery wasn’t developed to remove excess fat and so isn’t intended for obese patients. Instead, ideal abdominoplasty patients should be an average weight and simply in need of a basic abdominal restructuring and tightening of existing skin.

Liposuction Surgery

Liposuction is a somewhat invasive surgical procedure that actually involves scraping fat cells from under the skin and suctioning them out using a vacuum device. While multiple areas of the body can be treated simultaneously, the goal of liposuction isn’t to eliminate fat all over the body. Instead, it’s designed to target specific areas of fat deposits.

Laser Skin Resurfacing

Laser skin therapies are becoming increasingly common in Chicago. Plastic surgery has expanded beyond the scalpel and into laser light therapy, which penetrates deeper and longer than chemical peels or microdermabrasion procedures to reveal younger, brighter looking skin.

While the actual length of a full laser skin resurfacing is only about 10 to 20 minutes, the recovery time can be as lengthy as 10 days depending on the depth of the treatment. While patients typically are able to return to regular activities the next day, scarring and redness may last for the full 10 days.

Breast Implants

By inserting an implant, saline or silicone, either above or behind the breast muscle, a breast augmentation seeks to improve the size and shape of a woman’s breast. It’s a full surgical procedure and recovery can take several weeks, so additional time away from work and other normal activities should be planned in advance.

Finding a Doctor or Practice in Chicago

Given the surgical nature of several of these procedures, it is imperative that you select a doctor with utmost care. Obtaining recommendations from trusted family members or friends should be a high priority before moving forward.

Additionally, to find certified, high-quality Chicago plastic surgery doctors, search the database available at the American Society of Plastic Surgeon’s website.

As serendipity would have it, the San Francisco Bay Area consists of five extremely cosmopolitan counties, which themselves could be called five reasons to seek aesthetic surgery in the area. San Francisco may have more doctors per capita than any major city in the country. The truth is that the city itself has less than 750,000 residents.

In San Francisco you will find dozens of physicians who practice in the downtown area, in buildings on Sutter Street and Post Street near Union Square. Just west of the upper Haight Asbury District lies the University of California Medical Center, one of the two great medical schools in the Bay Area. As with most medical schools there are surrounding clinics and specialty medical services that provide services and also serve as teaching centers.

South of San Francisco lays the suburban County of San Mateo, which also has a large number of practicing physicians. Mills-Peninsula Hospital is a large, full service medical center with multiple locations. Also in the county is Seton Hospital which has a large surgical center. Between the two you will find a substantial number of board-certified plastic surgeons that not only provide out patient services in their offices but also are on the staff roster for one hospital or the other.

Continuing southward you will find Santa Clara County, home of Silicon Valley. At the northern tip of the county are Palo Alto and the Stanford Hospital. Stanford’s medical school is recognized as top notch; many of its graduates remain in the area. It’s an affluent area, which means that your choice of plastic surgeons and cosmetic treatment centers is going to be considerable. In San Jose, the largest city in the bay area, there are four or five major medical centers and established clinics that include outpatient cosmetic surgery services.

From San Jose, the next leg of your travels will take you from the bottom of the bay northward into Alameda County. This is a large county anchored in the north by Berkeley and Oakland and in the south by a number of middle class and affluent suburbs. In the north, Alta Bates Hospital has built a conglomerate of services that includes all manner of clinics and outpatient services.

The fifth option for finding quality cosmetic surgery services is Marin County, across the Golden Gate from San Francisco. Here you’ll find some of the nicer neighborhoods in the Bay Area and because it is separated by a crowded bridge from San Francisco, you’ll also find the quality medical services that include plastic surgeons with experience and with successful practices.

 Find information about all types of cosmetic plastic surgery procedures including breast implants, breast augmentation, face lifts, and liposuction. A Board Certified Plastic Surgeon Resource.com is the place to locate a Plastic Surgeon in San Francisco

Breast augmentation is a procedure to enhance the size of your bust by using saline breast implants or silicone breast implants. By inserting breast implants a plastic surgeon in Beverly Hills can increase a woman’s bust line. Advances in implant technology and surgical technique are making this plastic surgery procedure a popular option among women. The breast implant can be placed either partially under the pectoralis major muscle (submuscular) or on top of the muscle and under the breast glands (subglandular) depending on the thickness of your breast tissue and its ability to adequately cover the breast implant. You should discuss with your surgeon the pros and cons of the breast implant placement selected for you. There are three common incision sites: under the arm (axillary), around the nipple (periareolar), or within the breast fold (inframammary). If the incision is made under the arm, the plastic surgeon may use a probe fitted with a miniature camera, along with minimally invasive (very small) instruments, to create a “pocket” for the breast implant.

In 1992, the FDA called for a voluntary moratorium (delay) on the use of silicone gel-filled breast implants until new safety information could be thoroughly reviewed by the FDA’s advisory panel. That same year, the FDA lifted this moratorium and announced its decision to allow access to silicone gel-filled breast implants for reconstruction patients under controlled clinical studies, called Adjunct Studies. In 1999, the FDA allowed the use of silicone gel-filled breast implants in Allergan’s Core Clinical Study to assess the safety and effectiveness of these devices.

While these studies are collecting information specific to Allergan Medical’s Silicone-Filled Breast Implants, the National Institute of Health’s Institute of Medicine (IOM) released a landmark 400-page report entitled “Safety of Silicone Breast Implants.” This 1999 report on the safety of silicone concluded “There is insufficient evidence to support an association of silicone breast implants with defined connective tissue disease.” The IOM also stated “There is no convincing evidence for atypical connective tissue disease or rheumatic disease or a novel constellation of signs and symptoms in women with silicone breast implants.” For more information, please read the IOM report which contains the history of breast implants and studies concerning their safety.

The unique qualities of today’s silicone gel-filled breast implants help make it the filler of choice for patients in countries where both saline-filled and silicone gel-filled breast implants are widely available.

Your final result from plastic surgery will be determined far more by your choice of plastic surgeon in Beverly Hills than by which breast augmentation technique is used or which breast implant you choose. Not only is this your most important choice, it is also the hardest one to make. One thing on your side is that this is elective surgery, and totally non-urgent. If you make a pact with yourself to wait until you are 100% comfortable, you will have the breathing space to choose the right plastic surgeon for yourself. Get informed and learn more about plastic surgery and what it has to offer.

Please consult a board certified plastic surgeon if there is anything you don’t understand about these plastic surgery procedures.

Science has helped make a marvelous difference to all aspects of our life. The developments that modern science and technology offers have made it possible to live life on our own terms. You no longer need to be worried about any of the imperfections that have made a negative impact on your looks. With state of the art plastic surgery facilities it is now possible to make the required changes in your overall looks. Whether it is a breast implant or laser hair removal that you have been contemplating, it is now possible with the modern infrastructure and facilities.

Toronto is known to have one of the best plastic surgery facilities in the world. From state-of-the-art equipment, infrastructure to the very best team of doctors, Toronto has it all. Plastic surgery can be used to make the desired changes. Whether it is a problem that you have been facing for some time now or imperfections caused due to an accident, plastic surgery has the perfect solution for you. The solutions are offered by the most experienced plastic surgeons who are experts in their chosen field.

There are many conditions that may make you feel embarrassed by your own looks. All you need is a minor surgery by an expert and it can be corrected to make you feel truly on top of the world. Whether it is treatment for conditions like acne, rosacea, varicose veins or spider veins, the best solution is right here. If unwanted fat has been driving you crazy every time you look into the mirror then liposuction is what you need to consider. With the latest technology and equipment, liposuction has been made very simple and will not be restrictive in leading a normal life. The range of procedures and services offered aim at catering to all your needs.

Plastic surgery when on one hand can offer you the best of results, on the other hand, it can actually lead to a host of additional problems. This is the sole reason why the plastic surgery must be done at the hands of an expert. Ascertaining the credentials of the plastic surgeon and verifying the results of the surgery undertaken by him in the past is very important. You must also ensure that he has a valid license and is reputed. Plastic surgery is a major decision as regards finances and also the after effects of the surgery. It must be thus, done by a qualified and experienced plastic surgeon.

Toronto plastic surgeons are known for their professionalism and knowledge in the field. With a Toronto plastic surgeon you will not go wrong. A few years back, undergoing a plastic surgery would mean putting a full-stop to your life for a few months. However, the state of the art technology used for the plastic surgery procedures will ensure that you are back on your feet in no time at all. Discover the real “YOU” and do away with the imperfections with the services of plastic surgery offered by our team of trained and experienced surgeons.

An Unspoken Concern

While most plastic surgeons will outline the risks of having an elective surgical procedure performed, very few tend to speak directly to the issues regarding safety and post operative complications. Often, a surgeon will make a general statement regarding the risks of surgery, such as, “All surgery carries risks which includes, bleeding, infection, difficulty breathing, swelling, clotting, and other illnesses in a small percentage of patients,” and then move directly into talking about the benefits of the procedure. Patients need to inform themselves of the actual risks associated with cosmetic surgical procedures, especially the risk of a stroke or cerebral vascular accident (CVA). As a physician, I understand that there is no value in frightening our patients without cause. Yet I still firmly believe that patients should never be too quick to decide on an elective surgical procedure without fully realizing the potential for devastating complications.

Patients and physicians alike need to recognize that most patients who are receiving some sort of cosmetic care are generally considered to be healthy individuals. Thus, neither patient nor physician is necessarily ready for the onset of a complication. This fact alone can make a complication much more serious than if the very same complication arose during a medically necessary procedure. For instance, even during a routine knee surgery, physicians do not see their patients as completely healthy, and are more guarded against the onset of blood clots or other risk factors for stroke.

While the approximated one to two percent of cosmetic surgery patients who will experience a stroke seems like a very limited number of patients, the effects of these strokes can be devastating

Who is at Risk?

Few patients really consider themselves at risk for a possible stroke because they associate the condition as an event that occurs to people over the age of 55. While in some cases age does bear a factor, it is far from the determining factor of a stroke. In fact, a healthy 65-year-old woman can be less likely to have a stroke than a 35-year-old woman who is undergoing invasive cosmetic surgery. Patients should understand the causes of a stroke in a post operative environment in order to assess more realistically their level of risk. However, as a physician I can testify to the fact that sometimes there simply is no way to ascertain why a stroke occurred for one individual and not for another with the same health history, the same risk factors, and the same surgical procedure.

Most post operative strokes occur when a blood clot dislodges, which typically occurs in the lower section of the body. This blood clot then travels through the body and may lodge itself in the brain or more commonly the lungs. This action of a blood clot traveling through the body post surgically is commonly referred to as an embolism and usually arises from a larger blood clot that usually forms in the lower body known as a deep venous thrombosis or “DVT”. DVT is a prime concern for surgeons, and can be considered a precursor to a stroke.

Understanding the Potential Danger

Blood clots generally become trapped in either the lung or the brain when they break free from other parts of the body. When the blood clot becomes caught in a blood vessel in the brain, it results in a CVA or stroke. When it becomes trapped in a blood vessel in the lung it is known as a pulmonary embolism or PE. Either condition is life threatening and can carry serious consequences.

While blood clots and strokes are a significant risk for all patients having any type of invasive surgery, plastic surgeons run into a unique scenario that generally makes it a little more difficult for our patients to get treatment and help in a short amount of time. Incidents of blood clots and stroke can happen anywhere between several hours post operatively up to about ten days after surgery. Thus, these incidents rarely occur within a medical environment and usually happen at home. Patients who remain in the hospital or a medical center after a medically necessary procedure are more likely to have these incidents in the hospital.

Patients, who are going to experience a cosmetic procedure, or any type of surgery for that matter, should familiarize themselves with the general symptoms of post surgical pulmonary embolism or stroke. Symptoms that include shortness of breath, chest pain, disorientation, and sometimes even a sense of altered mental status are likely either to be related to a pulmonary embolism or a stroke. Patients and physicians alike should also understand the basic risk factors for these complications and prior to a surgical procedure. While there are still studies being conducted, which will help determine a patient’s risk level in the future, there are some pretty basic factors, which point to a likely candidate.

Risk Factors For Patients

Women are more likely to experience these types of complications than men, as are smokers. There are numerous medications, which place patients at a higher risk for postoperative blood clots, including but not limited to hormone replacements and birth control pills. Weight plays a significant factor as does the level of activity the patient generally participates in. Patients who generally lead a sedentary lifestyle are at a higher risk. Obese patients are at an even higher risk. Increased age and a previous history of deep venous thrombosis are more obvious risk factors. Patients who have a current diagnosis of cancer are at a particularly high risk.

Reducing the Risk Factors for Safer Surgery

Whenever a patient is booked for surgery in my practice, I always insist that they have a medical clearance by an internist to help determine their general risk level for elective surgery and the possibility of medical complications, which includes the risk of abnormal blood clotting. I also take into consideration the type of surgery that I am performing on the patient. In general, surgical procedures that have a longer operative time and involve body contouring carry a higher risk than those that are minimally invasive and are performed on the head and neck. The internist will review a list of current and recent medications, as I do myself, and will verify that the patient is physically fit to tolerate the procedure that is desired. There are still no guarantees, but knowing a patient’s medical history, their obvious risk factors, and having a second pair of eyes look over the same information that I am presented with, ensures that I am taking all possible precautions.

I also use something known as pneumatic compression boots for every patient undergoing any surgical procedure and I urge other physicians to do so as well. These boots are able to keep the muscles of the lower extremities moving in a fashion similar to walking, which can help prevent blood clots. I insist that my patients carry on an active lifestyle, to help prevent DVT formation and to directly assist with both preoperative and postoperative care. Proper positioning in the operating room allows for additional prevention of blood clot formation as well.

Physicians and patients need to understand that the potential for serious complications related to cosmetic surgery can be devastating. Knowledge is power and education can help reduce the number of blood clots and such rare but devastating complications as strokes that occur after surgery. With current research and education practices, we should be able to reduce the number of post operative strokes and blood clots over the coming years.