Cosmetic procedures

Cosmetic procedures are performed to reshape structures of the body and to alter a person’s appearance. Like any form of surgery, they should be carried out by a medical practitioner trained in the procedure, and they require appropriate recovery time, healing and proper care.

Risks include problems related to anesthesia and surgery, excessive bleeding, infection, scarring and failure to heal.

Where procedures should be performed#

For safety, surgery such as liposuction and any procedure involving anesthesia (including intravenous sedation, or anything more than a low dose of local anesthetic) should be carried out in a properly registered private hospital or day procedure centre. Many places have laws requiring this.

If you are unsure whether a facility is registered, ask to see its certificate of registration. This is usually displayed somewhere consumers can see it easily. You can also contact your local health regulator to ask questions or to report suspected illegal activity relating to liposuction, cosmetic surgery or anesthesia.

Choosing a qualified practitioner#

Always choose a registered, fully qualified and reputable medical practitioner. Ask about their specific training and experience in performing the procedure you are considering. You may also want to ask your doctor for a referral.

Check that your practitioner is registered with the relevant medical regulator in your area. In some places, practitioners can complete additional accredited training and gain a formal endorsement in cosmetic surgery; where this applies, it will appear on their registration.

Before you decide#

Before having a cosmetic procedure, think carefully about your expectations and get a full explanation of the anticipated results. Ask about possible side effects or complications and what to expect afterwards.

A technique or procedure will change your appearance and may improve your self-confidence, but it won’t necessarily deliver your ‘ideal’ body image or change your life. Don’t be swayed by advertisements that promise amazing results: if they sound too good to be true, they probably are.

Think about the impact on your finances, as cosmetic procedures are often not covered by health insurance. It is a good idea to have a ‘cooling off’ period after your first consultation, to give yourself time to think things through.

It’s natural to feel some anxiety, whether it’s excitement about a new look or stress about the operation. Don’t be shy about discussing these feelings with your practitioner. If you don’t feel comfortable, seek a second opinion.

Types of cosmetic procedures#

A variety of techniques are used, including facelift, eyelid surgery, body contouring, dermabrasion, laser skin resurfacing, implants and liposuction. Injections of botulinum toxin Type A (available under brand names such as Botox® or Dysport®) or soft tissue (dermal) fillers, such as collagen or fat, may also be used.

Facelift (meloplasty)#

The skin is cut in the scalp and around the ear, separated from the underlying tissue, pulled tighter and stitched, and leftover skin is cut away. The procedure can be done under local or general anesthetic and may take two to four hours. The face will be bruised and swollen for some weeks. Numbness or an uncomfortably tight sensation are common and may continue for months after surgery.

Eyelid surgery (blepharoplasty)#

The eyelids are cut along their full length to the ‘crow’s feet’ wrinkles at the outer corners, and excess skin and fat are removed. Laser resurfacing may also be done to treat remaining wrinkles. The procedure may take one to two hours, under local or general anesthetic. The eyes will be bruised and swollen for a few weeks. Side effects include blurred vision, overproduction of tears and a changed shape of the eyes, usually only temporary.

Chemical peel#

A chemical peel removes the surface layers of skin. A solution is wiped over the face, which may then be left uncovered or masked with lotion or tape. The chemicals burn the skin, and the healing process promotes new growth. Deep burns remove the most wrinkles, but also increase the risk of complications such as scarring and infection.

Dermabrasion#

A device similar to an electric sander is applied to the face under local or general anesthetic. The rough surface of the rapidly rotating pad rubs off the skin surface, and the healing process promotes new growth. Deep dermabrasion removes the most wrinkles, but also increases the risk of scarring and infection.

Wrinkle reduction#

Wrinkles can be reduced using friction or ‘plumped out’ with a variety of methods. Laser skin resurfacing uses a laser beam to burn the skin. Botulinum toxin can be used in small doses to relax the underlying muscles responsible for forming skin wrinkles, which can be a safe and effective temporary treatment for fine facial lines. Injections of fat or collagen can be piped along wrinkles to smooth them out. Botulinum toxin Type A (available under brand names such as Botox® or Dysport®) is sometimes used to treat frown lines between the eyebrows.

External ear surgery (otoplasty)#

Ears that stick out can be repositioned any time after the age of five or six years. The fold of skin behind the ear is cut and the excess cartilage is reduced or remodelled. The procedure takes around one hour, and bandages need to be worn for a few weeks to manage bruising and swelling.

Nose surgery (rhinoplasty)#

In most cases, nose surgery is performed through incisions in the nostrils, leaving no visible scars. Bone and cartilage are trimmed and the nose reshaped. Nostril packs and splints may be required. The procedure takes around two hours, and bruising and swelling may take three or four months to fully subside. Complications such as bleeding or infection are comparatively rare.

Facial implants#

Sometimes a chin implant is inserted to balance the profile. The implant is placed through a small incision in a concealed place, for example inside the mouth.

Lip enhancement#

Thin lips can be fattened with a variety of procedures offering short or long-term results. Injections of collagen or fat are both eventually reabsorbed by the body. A permanent implant, similar to a small foam rod, can be threaded through the lip.

Liposuction#

Liposuction removes fat from areas such as the abdomen, thighs, buttocks, arms and throat. A narrow tube (cannula) is inserted through a skin incision and the fat is sucked out with a powerful suction pump. The procedure can be done under local or general anesthetic. A pressure garment needs to be worn for some months to help the skin contract and contour. The area will be bruised and swollen for weeks or months. Complications can include failure of the skin to contract, causing a corrugated look.

Tummy tuck (abdominoplasty)#

A lipectomy removes extra skin as well as fat. Excess skin and fat from the abdomen are removed and the underlying abdominal muscles are tightened. Often the navel will need to be relocated. Incisions are generally made along the ‘bikini line’ to minimize visible scarring. This procedure is done under general anesthetic. Numbness and uncomfortable tightness are common and may continue for some months. Complications include infection and the formation of fluid pockets.

Breast augmentation#

Augmenting or enlarging the breasts (augmentation mammoplasty) requires the insertion of saline or silicone implants. An incision is made under the breast or in the armpit and the implant is pushed through, positioned either behind or in front of the chest (pectoral) muscle. There will be bruising and swelling for a few weeks. Complications include hard scar tissue forming around the implant, deflation of the implant, and implants moving out of position.

Breast reduction (reduction mammoplasty)#

Incisions are made beneath each breast and around the areolae of the nipples, and excess skin and fat are removed. The remaining breast tissue is remodelled, and the nipples are repositioned and stitched in place. Scars can take up to one year to fade but will remain visible for life. Complications include reduced nipple sensation.

Key points#

• Like any form of surgery, cosmetic procedures carry risks, including problems related to anesthesia, excessive bleeding, infection, scarring and failure to heal.
• Always choose a registered, fully qualified and trained medical practitioner, and check the facility is properly registered.
• A procedure may improve self-confidence, but won’t necessarily deliver an ‘ideal’ body image.
• Cosmetic procedures are often not covered by health insurance.
• Numbness and an uncomfortably tight sensation are common after many procedures and may continue for months.

Where to get help#