| A-Z SURGICAL PROCEDURE GUIDE |  |
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The three components for reconstruction are: 1) Skin envelope. 2) Breast mound. 3) Nipple. Breasts need to be reconstructed
after: Reconstruction of a breast may require multiple, staged procedures. 1) Skin Envelope:
Medical Insurance would usually cover the costs of breast reconstructive surgery.
Breast implants are inserted to: i) Enlarge small breasts.(augmentation) ii) Lift sagging breasts.(ptosis correction/mastopexy) iii) Refill breast skin envelopes. - Weight loss/ breast feeding/ pregnancy and aging often results in loss of breast tissue. iv) Reconstruct absent breasts.(breast reconstruction) v) Correct unequal sized breasts.(symmetry correction) Breast
implants are one of the most commonly performed Plastic Surgery operations.
Breast implants have a low complication rate and very high patient
satisfaction rate. Woman with large breasts often complain of backache and related problems. They often get rashes under their breasts in summer, difficulty in buying "off the peg" clothes, will not participate in sport and can be socially withdrawn. Breast reduction is an operation, which removes skin and breast tissue or occasionally breast tissue only. Young women with good skin tone and moderately enlarged breasts can be reduced by liposuction. Very large, glandular (non- fatty) breasts or breasts that have excess skin are reduced by an excisional surgical procedure. The choice of the surgical procedure will depend on the patient's particular problem. Breast reduction surgery usually results in significant scars. Woman that have undergone breast reduction surgery are usually very accepting of these scars, as they are happy to have been relieved of their "load".
All men have some breast tissue. Breast development occurs in most teenage boys, but usually regresses. Breast tissue in men is embarrassing and is corrected by liposuction or excisional surgery with pleasing results. Medical Insurance would usually cover the cost of male breast surgery.
Ptosis correction or mastopexy is the correction of drooping breasts and nipples. The causes of breast ptosis are: age, reduced female hormones, gravity, weight loss, pregnancy and breast-feeding. Their combined effect is stretching of the skin and loss of breast tissue. The method of treatment of ptosis is determined by the underlying problem and the patient's expectations. Treatment may involve: A face-lift is a major surgical procedure that takes two-three hours. A face-lift tightens the skin of the face and neck and mainly removes deep, heavy lines. The excess facial and neck skin is excised and discarded. Modern face-lifts often involve adjustment of the deeper foundation layers of the facial structures. Tightening the deeper layers of the facial structure allows a better face-lift with less tension on the skin. (SMAS face-lift) Patients seeking facial rejuvenation surgery that are over 55 years of age derive the maximum improvement from a face-lift procedure. Patients less than 50 years of age benefit more from other Facial Rejuvenation procedures, the facelift being a complimentary procedure. The heavy lines that a face-lift improves have resulted from many years of gravity and the action of the muscles of facial expression. Aging also causes a reduction in the layer of fat beneath the skin. This sagging and thinning takes years to develop and is not fully established under the age of 50.
Skin resurfacing is a procedure that causes shrinkage and tightening of the skin envelope of the face. The imporvement is most noticable on the fine (crepe) lines of the eyelids and the lipstick bleed-lines of the lips. After a skin resurfacing procedure the skin is tighter, has a more uniform colour (pigmentary blothchyness is improved) and the skin texture is softened. Methods
of skin resurfacing are: Exposure to sunlight, wind, smoking and aging all contribute to fine wrinkling of the facial skin. Acne scarring is also treated by skin resurfacing
procedures. Medical insurance may pay for treatment of acne scarring. A persistent surly look can result from the deep furrows between the eyebrows in people with active muscles of facial expression. There are many methods of treating frown lines. Temporary paralysis of the muscles of facial expression results from Botox injections. Botox needs to be repeated every 4 months. A method of obtaining a permanent improvement of frown lines is achieved by serial (2-4) fat injections. Fat is removed from an area of excess (eg.tummy) and injected into the hollow of the frown. The fat injections often have to be repeated until the grooves are filled up. 
Caused by: 1) Obesity. 2) People of normal weight who carry excess fat in their necks. 3) Under development of the jawbone. 4) Age and gravity - gravity causes a continual sagging and descent of facial fat. People of normal weight can develop jowels and fat deposits under their chin as a result of the slow settling of facial fat into the areas of dependency under the chin - gravity and time. Treatment depends on the underlying problem: Restoring the angle between the chin and neck with
liposuction and occasionally also a chin implant, is a very satisfactory
method of restoring a strong chin, good bone structure and facial
profile. People develop upper eyelid bags due to age, gravity and especially the overactivity of the facial muscles caused by the glare of bright light. The excess upper eyelid skin can overhang the eyelashes and reduce the person's ability to see. Treatment is by surgical removal of excess skin and
underlying tissues. The remaining skin with its fine crepe-like wrinkles
can be tightened via laser resurfacing as a secondary procedure.
Acne scarring results from nodular cystic acne. Different types of scars can result. Treatment of acne scarring depends on the type of scarring. Treatment of acne scarring might entail: Medical insurance may pay for treatment of acne scarring. The tear-trough is the hollow shadow below the "bag" of the lower eyelid. The above are caused by:
The forehead skin and eyebrows descend with time due to the action of gravity and the muscles of facial expression, resulting in a sombre "hang-dog" look. A brow lift is a surgical procedure that elevates the level of the eyebrow. The surgical technique employed to elevate the eyebrow is determined by the underlying problem. This describes the deformity of the neck resulting from excess skin. A turkey-gobbler neck deformity usually occurs in thin people or after weight loss. Treatment is by surgical excision. Different techniques are employed to correct the problem.
Thin lips can be "plumped out" by injections. There are various injectable preparations available. Permanent augmentation of the lips is obtained with fat injections. Usually about three fat injections sessions are required to obtain lip fullness. Fat is removed from an area of excess
(eg.tummy) and injected in thin columns, thereby increasing the volume
of the lip in a serial fashion. The cause of spider veins on the face is not
known. There is an association between: Treatment: The projection and contour of the chin can be improved by placement of a chin implant. A "strong chin" is associated with masculinity and good looks in men. Men often hide their weak chin behind a beard. Facial beauty - the chin in women enhances a good bone structure. Patients often believe that their facial proportions
would be improved by surgery to reduce the size of the nose. Their
problem is often one of underdevelopment of the chin. Placement of
a chin implant restores normal facial proportions. Ears need operative correction when: Correction of ear abnormalities can be done at any age, but is usually done before a child begins school. Medical insurance will often pay for ear corrective
surgery in children. A Rhinoplasty is a procedure performed to change the shape of the nose. A Rhinoplasty is often necessary following trauma, to straighten the nose or to correct breathing problems. A nose can be corrected by: A Rhinoplasty is a major surgical procedure that can take up to three hours. Patients are required to wear a plaster cast on the nose for approximately ten days. Following nose corrective surgery the final result will not be apparent for up to one year. Medical insurance may pay for nose reconstruction following trauma
or if there are concomitant nasal airway problems. Hair growth can be restored to areas of the scalp following loss due to balding and injuries. Small groups of hairs with their roots are transplanted from an area of the scalp, where there is good hair growth and where balding will not occur to the areas of hair loss. The newly transplanted hair takes a few months before it starts growing.
Hair transplantation is done in multiple stages. The size of the bald
area and the thickness of the hair will determine the number of stages. Dupuytrens Contracture is a condition affecting the hands of mainly people of European origin. The process affects the palms of the hands and results in contraction of the skin of the hand that results in permanent "curling up" of the fingers. The little and ring fingers are the most commonly affected fingers. Correction of the deformity involves excising the affected tissue in the palm of the hands. Medical insurance would usually pay for correction of Dupuytrens
Contracture. Abdominoplasty removes excess skin and tissue of the lower abdomen. Abdominoplasty is performed for: Abdominoplasty is a major surgical procedure that takes two hours. One or two nights hospitalization is required. Abdominoplasty is a very effective method of correcting the lower
abdominal excess that dieting, weight loss and exercise will not correct. Liposuction or Liposculpture is the removal of fat through a small (3-5mm) incision. Liposuction is most effective in removing diet-resistant fatty deposits in people with good skin tone. Liposuction is not a treatment for excess fat / obesity. The following areas are successfully re-contoured with liposuction: Absent or under-developed calf muscles are enlarged by placement
of calf implants. Under-developed or unequal cheekbones are enhanced with placement of cheek implants. The skin is often over-stretched as a result of gross obesity. Massive weight loss reults in redundant skin. Various surgical procedures remove redundant skin: One side of the chest may be underdeveloped due to the absence or underdevelopment of the pectoralis muscle from birth. Symmetry can be obtained by placement of a pectoral implant. Bilateral underdevelopment of the pectoral muscles can occur - this is corrected by placement of bilateral pectoral implants. Skin tags are harmless growths of the skin. Skin tags are easily
removed with minimal scarring. Indications for removal: Birthmarks can often be successfully treated with modern laser. Successful treatment depends on: 1) Size. 2) Location. 3) Colour of birthmark. 5) Colour of skin.
Moles are a normal part of the skin. Moles can occasionally change and become cancerous. Reasons for removal of moles: Warts are unsightly growths on the skin caused by a virus. There are many treatments to remove warts. The treatment of warts is associated with a high rate of recurrence. The treatment of warts with a vascular laser reduces the rate of recurrence. Warts on the soles of feet are called plantar warts. Plantar warts are associated with an especially high rate of recurrence. The recurrence rate of plantar warts is significantly reduced if the defect on the sole of the foot, following removal, is surgically reconstructed and not merely left to heal. Sunspots are rough patches on the skin often red or white in colour. Sunspots are caused by accumulated ultraviolet light exposure. There are various treatments for sunspots. Scars are more noticeable if they are: 1) Stretched. 2) Differ in colour from the surrounding skin. 3) Unyielding and raised. 4) Not in the same direction as natural skin creases. Large ugly scars can result following burns and deep abrasive injuries. Scar correction usually involves multiple surgical procedures. The skin can be left with ugly impregnation tattoos following abrasive injuries. Most tattoos are acquired voluntarily! The removal of tattoos depends on: There are various techniques for removing tattoos,
including surgery and laser. Rodent ulcers are cancerous growths of the skin associated with exposure to ultraviolet light. Rodent ulcers need to be surgically removed. Medical insurance would usually pay for treatment of rodent ulcers.
The loss of a uniform skin colour is due to aging and sunlight. Fine wrinkles, texture and colour variations are improved by a resurfacing procedure.
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