Cosmetic Surgery and Procedures

Common Procedures and Surgeries

Common cosmetic skin procedures

There is a wide range of cosmetic procedures that don't involve surgery.

Laser resurfacing.

This uses a laser light to heat, damage, or destroy the upper layers of the skin. This can tighten the skin or cause new skin to grow. It is typically used to remove or improve the appearance of wrinkles, brown spots, shallow scars (from acne, surgery, or trauma), and sometimes the appearance of small veins.

Chemical peel.

This uses a chemical solution to remove the top layers of skin, allowing new skin to grow. It is most often used to remove wrinkles, superficial skin growths, shallow scars, pigment changes in the skin, and other skin problems.

Dermabrasion.

This uses a fine wire brush or a diamond wheel with rough edges to remove the upper layers of the skin, allowing new skin to grow. It may be used to treat acne scars and wrinkles around the mouth or to treat an enlarged nose (rhinophyma) caused by rosacea (facial inflammation and redness).

Microdermabrasion.

This uses a mildly abrasive technique to treat just the top layers of the skin. It is used to reduce fine lines and wrinkles, treat light scarring, and improve uneven skin coloring.

Filler injections.

These are used to smooth wrinkles or pitted scars in the skin. They are also used to make the lips fuller. Fillers can restore volume and structure that is lost due to age or weight loss. There are several types of fillers available, including fat taken from your own body. When injected under the skin, a filler raises or puffs up that area. This goes away with time.

Botulinum toxin injections.

These use a form of botulinum toxin that can be injected to reduce or eliminate fine lines and wrinkles on the face. The effect is temporary, lasting about 3 to 4 months.

Spider vein removal.

This procedure removes spider veins by injecting a solution into the vein that causes it to close and fade (sclerotherapy). Or laser treatments may be used to remove them.

Laser hair removal.

This procedure permanently removes unwanted hair such as facial hair. In laser hair removal, light treatments are used to heat and destroy hair follicles. This reduces the number of body hairs. A series of treatments may be needed.

Tattoo removal.

Laser treatments can remove tattoo ink from your skin. Depending on the size and design of your tattoo, a number of sessions may be needed to remove the ink.

Nonsurgical fat reduction.

There are several nonsurgical procedures for reducing fat cells under the chin, around the belly, and in other areas of the body. These involve injecting chemicals into fat cells, freezing fat cells, and heating fat cells with laser or radiofrequency energy.

Common cosmetic surgeries

Cosmetic surgery can be done on many different areas of the body. These are some of the more commonly done surgeries.

Facelift (rhytidectomy).

This removes excess skin and fat and tightens the muscles to smooth the face. Improvement is especially seen along the jawline and in the neck.

Eyelid surgery (blepharoplasty).

This removes excess skin, fat, and muscles from the eyelids to correct drooping eyelids and remove bags and puffiness. Surgery may be done on the upper and lower lids.

Nose reshaping (rhinoplasty).

This reshapes the nose by removing or rearranging its cartilage and bones. Rhinoplasty is done to change the appearance of your nose, improve breathing and nasal function, or achieve a combination of both.

Breast enlargement (augmentation).

This places an implant under the breast tissue or the chest muscle to make the breast larger. Or fat from your own body can be removed with liposuction and injected into your breasts. This is called a fat-transfer breast augmentation.

A breast lift (mastopexy) may be done at the same time as the enlargement. A breast lift raises breasts up by removing extra skin and tightening the nearby tissue.

Breast reduction.

This removes excess breast tissue and skin to reshape and lift the breast. You may have breast reduction to change your appearance or reduce back pain. Some people have this surgery so they can do activities that are limited by having large breasts. It can also be done to make the chest look more firm and flat.

Liposuction.

This involves removing fat from the body. Areas often treated include the face, neck, breasts, belly, upper arms, hips, thighs, knees, and ankles. During liposuction, other techniques such as laser, ultrasound, or pressurized water spray may be used to tighten the skin and reshape the body.

Liposuction may be used in other surgeries, such as a facelift, breast reduction, or tummy tuck. It is also used in fat grafting. This means fat is removed from one part of the body and injected into another, such as the breasts or buttocks.

Tummy tuck (abdominoplasty).

This removes excess skin and fat from the abdominal area and tightens abdominal muscles. When a large weight loss or several pregnancies leave behind extra folds of skin, some people use this surgery for a flatter, smoother stomach. As with liposuction, the purpose of a tummy tuck is to reshape the area rather than to reduce body weight.

Panniculectomy

This removes fat and skin that hang down from the belly. Often the fat and skin come from losing a lot of weight.

Hair transplant surgery.

This reduces the appearance of bald spots or hair loss by moving small pieces of hair-bearing scalp from one part of the head to another. Other types of hair transplant surgery include scalp reduction surgery and tissue expansion surgery.

Common reconstructive surgeries

Reconstructive surgery is done to improve the function and appearance of a part of the body that was damaged by trauma or changed by the treatment of a disease. It can also be done because of a condition that a person was born with or developed later in life. And it may be done to change the look and function of a person's body to align with their gender identity.

Common reconstructive surgeries include:

• Breast reconstruction.
• Burn reconstructive surgery.
• Cleft lip and cleft palate repair.
• Facial trauma repair.
• Gender-affirming surgery.

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Important Considerations

If you are thinking about having cosmetic surgery or a cosmetic procedure, consider the following questions before making a decision.

Why do you want cosmetic surgery?

This is an important question. Take the time to think it through. Cosmetic surgery involves risk and expense. It can permanently change your physical appearance.

What are your expectations?

You are more likely to be happy with the results of cosmetic surgery if you have clear, realistic expectations and a clear understanding of why you want to have surgery. Your doctor can tell you if your goals are realistic and how best to achieve them.

Get the facts about what to expect from a certain procedure. Have your doctor show you photographs and explain the possible results. With some types of surgery, the final results may not appear for several weeks or months after the procedure. It may take several sessions or a combination of procedures to achieve the look you want. And results are not always permanent.

Remember that the effects of time, aging, weight gain or loss, and the sun continue after cosmetic surgery. Getting proper nutrition and regular exercise, using sunscreen, managing stress, not smoking, and limiting alcohol can help you look and feel your best.

Talking with someone who has had cosmetic surgery may help you have a better idea of what to expect. Ask how the person felt about the results, whether the surgery achieved the results hoped for, and what the total experience was like. Doctors who have experience with cosmetic surgery can also provide perspective on the issues involved.

What about cost?

Insurance rarely covers the cost of elective cosmetic surgery done to improve appearance. Unless the surgery or procedure is done for medical reasons, you will probably have to pay for it yourself. Reconstructive surgery may be covered if it will improve your physical function or will correct a problem present from birth (congenital). Or it may be covered if it corrects a problem caused by an accident or an illness, such as cancer.

Examples of reconstructive surgery done for medical reasons that may be covered (or partially covered) by insurance include:

• Treatment of severe scars or disfigurement caused by disease, injury, or birth defects.
• Breast reduction when large breasts cause pain or severely limit your activities.
• Reshaping of the nose (rhinoplasty) to improve breathing and nasal function.
• Breast reconstruction after surgery to remove breast cancer (mastectomy).

Gender-affirming surgeries may or may not be covered by insurance. These surgeries reshape parts of the body to more closely match a person's gender identity. If you are considering gender-affirming surgery, talk to your insurance company to see if they will cover all or part of the cost.

Cosmetic surgery can be expensive, especially when you are paying for all of it yourself. Be sure that you know the total cost of the surgery. This includes the costs of the procedure itself (such as surgeon fees, anesthesia fees, and operating facility fees), any medicine before or after the procedure, follow-up treatments, office visits, and other expenses.

Also be aware that there could be costs resulting from complications during or after surgery or the need for "touch-up" surgery. Insurance may not cover treatment for complications that arise from cosmetic surgery. Some procedures, including skin treatments, liposuction, and breast enlargement, may have to be repeated over time to maintain the results. You will have to pay for these repeated treatments just as you paid for the first treatment.

Choosing a Surgeon and Facility

Finding a cosmetic surgeon that you have confidence in and are comfortable talking to is very important when you are considering a cosmetic surgery or procedure. You and your surgeon can work together to build a treatment plan that is realistic and also meets your needs.

Consider the following things when you choose a cosmetic surgeon.

• Choose a surgeon with special training in cosmetic surgery.

  Ask your surgeon about their training. A surgeon who is board-certified in plastic or cosmetic surgery has special training. They often belong to groups like the American Society of Plastic Surgeons.

• Schedule a consultation with a cosmetic surgeon.

  Many cosmetic surgeons offer free or low-cost consultations. Sometimes a consultation fee is applied to the cost of the surgery.

• Ask about the surgeon's experience with the procedure you are considering.

  How good the results are can depend on your surgeon's level of experience. Request before-and-after photographs of procedures they have done recently.

• Make sure that your surgeon understands what you want.

  You will have a better chance of being happy with the results if you find a cosmetic surgeon who listens to you and understands what you want to achieve. People differ in what they consider an "ideal" face, nose, breast, or body type. Your and your surgeon's vision of what is ideal may not be the same.

• Understand what can and cannot be achieved with cosmetic surgery.

  This may depend on things like your skin or body type, age, medical history, the surgeon's experience, and the limits of technology. A good cosmetic surgeon can help you understand how these things affect your surgery options.

• Consider other sources of helpful information.

  These include consumer health groups, people who have had cosmetic surgery, other doctors, and online resources.

Cosmetic surgery is usually by your choice (elective), so there is no reason to rush into it or feel pressured into making a quick decision. Get as much information as you need to feel comfortable about your decision. Don't be afraid to get a second and even a third opinion, especially if you are not completely comfortable with your first doctor visit.