Cosmetic surgery is performed to reshape structures of the body and to improve a person’s appearance. Like any form of surgery, cosmetic procedures need recovery time, healing and proper care. Risks include problems related to anaesthesia and surgery, excessive bleeding, infection, scarring and failure to heal.
Choose a qualified surgeon
Choose a qualified and reputable plastic surgeon. Ask them about their specific training and experience in performing the procedure. You may want to ask your doctor for a referral to a suitable professional or hospital.
Ask questions about possible side effects and complications. Think carefully about your expectations – in some cases, the results may not be what you might have anticipated.
Expectations of cosmetic surgery
Before you choose cosmetic surgery, it is important to think carefully about your expectations and get a full explanation of the anticipated results. Ask about possible side effects or complications and what you can expect after the procedure. The technique or procedure may improve your appearance and 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 financial situation, as cosmetic surgery does not usually qualify for rebates from Medicare or private health insurance companies. You should have a ‘cooling off’ period after attending your first consultation. This will give you time to think about your decisions.
It’s natural to feel some anxiety, whether it’s excitement for your anticipated new look or stress about the operation. Don’t be shy about discussing these feelings with your plastic surgeon. If you don’t feel comfortable with the surgeon, seek a second opinion.
Types of cosmetic surgery
In cosmetic surgery, a variety of techniques and procedures are used, including facelift, eyelift, body contouring, dermabrasion, laser skin resurfacing, implants and liposuction. Injections of botulinum toxin Type A (available in Australia as Botox® or Dysport®) or soft tissue (dermal) fillers, such as collagen or fat, may also be used.
The skin is cut in the scalp and around the ear. It is then separated from the underlying tissue, pulled tighter and stitched. Leftover skin is cut away. The operation can be performed under local or general anaesthetic and may take anywhere from two to four hours.
The face will be bruised and swollen for some weeks. Numbness or an uncomfortably tight sensation are common reactions and may continue for months after surgery.
The eyelids are cut along their full length to the ‘crow’s feet’ wrinkles at the outer corners. Excess skin and fat are removed. Laser resurfacing may also be performed to treat remaining wrinkles. This operation may take one to two hours and can be performed under local or general anaesthetic.
The eyes will be bruised and swollen for a few weeks. Side effects include blurred vision, overproduction of tears and changed shape of the eyes (usually only temporary).
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.
A device similar to an electric sander is applied to the face under local or general anaesthetic. The rough surface of the rapidly rotating pad rubs off the skin surface. The healing process promotes new growth. Deep dermabrasion removes the most wrinkles, but also increases the risk of complications such as scarring and infection.
Wrinkles can be reduced using friction or they can be ‘plumped out’ with a variety of technologies. Laser skin resurfacing uses a laser beam to burn the skin. Injectable fillers can be used in small doses to paralyse the underlying muscles responsible for forming the skin wrinkles. This can be a safe and effective temporary treatment for fine facial lines and wrinkles.
Injections of fat or collagen can be piped along wrinkles to smooth them out. Botulinum toxin Type A (available in Australia under the brand names Botox® or Dysport®) is sometimes used to treat frown lines between the eyebrows.
Ear correction (otoplasty)
Ears that stick out from the head 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 operation takes around one hour. Bandages need to be worn for a few weeks to help manage the bruising and swelling.
Nose surgery (rhinoplasty)
In most cases, the 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. This operation takes around two hours. Bruising and swelling may take three or four months to fully subside. Complications such as bleeding or infection are comparatively rare. Sometimes, a chin implant is inserted at the same time to balance the profile.
Implants are used to fill out a receding chin or flat cheekbones. The implant is inserted through a small incision in a concealed place – for example, inside the mouth.
Thin lips can be fattened with a variety of procedures that offer 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 is a procedure that removes fat from 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 operation can be performed under local or general anaesthetic. A pressure garment needs to be worn for some months to help the skin to 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. A lipectomy is an operation that removes extra skin as well as fat.
Tummy tuck (abdominoplasty)
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 minimise the visibility of scarring. This operation is performed using general anaesthetic.
Numbness and sensations of uncomfortable tightness are common and may continue for some months after surgery. Complications include infection and the formation of fluid pockets.
Breast enlargement (augmentation mammoplasty)
Enlarging the breasts 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. It may be positioned either behind or in front of the chest pectoral muscle. There will be bruising and swelling for a few weeks. Complications include the formation of hard scar tissue around the implant, deflation of the implant, and implants that move out of position.
Breast reduction (reduction mammoplasty)
Incisions are made beneath each breast and around the areolae of the nipples. 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.
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