Non-Surgical Procedures

Injections

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Botulinum Toxin which is also commonly called Botox is used to weaken specific facial muscles. Since the action of these muscles can wrinkle the overlying skin, the desired effect is smoothing of the skin. Botulinum injections are good for temporary correction of forehead wrinkles, frown lines and crows feet. The effect lasts for about 3 months. After this period the injections can be repeated.

Fillers

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Injectable fillers can be used to fill wrinkles or other depressions in the skin or to improve fullness of lips or other areas. A commonly used chemical is Hyaluronic Acid or HA. This material is naturally found in human tissues and has only a low risk of allergic reactions. It can last up to 18 months. Some of the effect can be permanent. Over-treatment can be corrected with Hyaluronidase which dissolves the agent.

Skin

Excision of Skin Lesions

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Excision refers to removal of a skin lesion by completely cutting it out. Most lesions do not cause serious problems, but you may want to have them removed due to them being painful or unsightly. Examples of benign = non-cancerous lesions are moles, lipomas or cysts. Your operation is performed using a local anaesthetic, which means that the area around your skin lesion will be numb but you will be awake. This is done, by injecting a local anaesthetic around the lesion. Surgery to remove skin lesions is usually a quick and straightforward procedure. If there is a possibility that the lesion is cancerous, the specimen needs to be sent off for testing. If this shows cancer, in some cases more tissue needs to be removed.

Hair Transplantation

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This procedure is done under local anaesthetic and involves removal of a strip of hair-bearing skin from the back of your head. This scar is usually well hidden. The next step involves dissection of individual hair or small follicular units to give the best results. These units are then transferred to the area of hair loss where they are placed into minute cut holes. There will be some swelling and crusting within the first 10 days and there will be a temporary period of additional hair loss (Effluvium Telogen). After about 3 months the results will be visible.

Face

Facelift

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A face-lift or rhytidectomy reverses some of the visible effects of ageing. These are mainly sagging of fat tissues and laxity of skin in the mid- to lower face and neck. Modern surgery aims to lift up deeper tissues and to tighten the skin while avoiding a windblown look. If the main concern is sagging of the deeper tissues but not excess skin, the scars can be reduced (MACS lift) or virtually avoided (Silhouette lift). Although many different techniques have been described, no technique is perfect for all patients. A good surgeon customises the technique to the individual patient.

Neck Lift

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A neck lift is a cosmetic surgery procedure to help improve the appearance of the neck. A neck lift may involve correction of the underlying muscle (platysma), redraping of the skin or liposuction. This is often done in combination with a facelift.

Brow Lift

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Ageing leads to lowering of the eyebrows. The three main surgical methods to achieve this are endoscopic brow lift, open brow lift and excisional brow lift. Endoscopic browlift is popular because it leaves minimal scars and the surgery is mainly under the skin. Open brow lift involves an incision (=cut) along the hairline and elevation (=lifting up) of the forehead skin. This method is advantageous in some cases where a receding hairline should also be addressed because excess skin can be removed. Excisional browlift simply involves removal of some skin above the brow. This is a simple quick procedure which can be done under local anaesthetic, but it leaves a visible scar above the brow.

Ear Correction

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(Pinnaplasty, Prominent Ears, Bat Ears, Antihelical Fold) If your ears protrude or are misshapen, or if your child has misshapen or protruding ears, cosmetic surgery may be an option. The surgery, which doctors call otoplasty, is most commonly done on children ages 4 to 14. It’s never too late, though, to make a change, and adults do undergo this surgery. Otoplasty can correct ear conditions such as protruding ears, abnormally large ear lobes, lop ear (in which the tip folds down and trends forward), and shell ear -- a condition in which certain features of a normal ear are missing. There are several ways the ear can be reshaped. One involves cutting out the cartilage, which is the main structural component of the ear. Another involves folding and stitching the cartilage instead of cutting it away. In either case, your surgeon will begin by making a small cut at the back of your ear. This will allow access to the cartilage for the necessary procedure. After the surgery is complete, the surgeon will close the cuts with stitches.

Eyelid Surgery

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(Blepharoplasty, Ptosis Surgery) Eyelid surgery (also called an eye lift or blepharoplasty), reduces bagginess from lower eyelids and removes excess skin from the upper eyelids. This surgery is usually done for cosmetic reasons. It's also an effective way to improve sight in older people whose sagging upper eyelids get in the way of their vision. An eye lift will not eliminate dark circles under the eyes, crow's feet, or other facial wrinkles. It is often done along with other procedures such as filler injections, or forehead lifts.

Rhinoplasty

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(Nose Job or Nose Reshaping) A nose job (technically called a rhinoplasty) is surgery on the nose to change its shape or improve its function. It can be done for medical reasons -- such as to correct breathing problems related to the nose or correct disfigurement resulting from trauma or birth defects. It can also be done for cosmetic reasons, which will change the nose's shape and appearance. During an operation, the surgeon makes cuts within the nostrils. In more difficult cases, the surgeon may also make cuts across the base of the nose. The surgeon then reshapes the inner bone and cartilage to produce a more pleasing appearance.

Breast

Breast Enlargement

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(Boob Job, Impants, Breast Enlargement) During surgery to enlarge the breasts, an implant is placed under the breast tissue or under the chest muscle beneath the breast. An implant is a soft silicone shell filled with silicone gel or a saline (saltwater) solution. To position the implant, an incision is made in the bottom crease of the breast, the armpit, or along the lower edge of the areola (the colored area surrounding the nipple). The implant is inserted through the incision and may be placed under either the breast tissue or the chest muscle beneath the breast. After the implant has been carefully adjusted to the correct shape and position, the incision is closed with stitches.

Breast Reduction

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(Boob Job, Gynaecomastia, Breast Hypertrophy, Large Breasts, Pendulous Breasts) Breast reduction surgery (reduction mammoplasty) removes some of the tissue and skin from the breasts to reshape and reduce the size of the breasts. It can also make the area of dark skin surrounding the nipple (areola) smaller. To remove tissue and skin from the breast, the surgeon first makes one or more cuts in the breast. After the excess tissue and skin have been removed, the skin is closed with stitches. Sometimes the nipple and areola have to be removed and repositioned. Sometimes liposuction is used along with surgery. If most of the breast is fatty tissue and if excess skin isn't a problem, liposuction alone may be enough for breast reduction. Breast reduction surgery is done in a hospital or surgical center, typically with general anesthesia. The surgery usually takes 3 to 5 hours. An overnight stay is not usually required. For smaller reductions, the surgery may be done with local anesthesia.

Breast Lift

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(mastopexy) A breast lift can raise sagging or drooping breasts and can pull up the nipple and the colored area around it (areola). To lift the breasts, the doctor removes excess skin from the bottom of the breast or from around the nipple. The remaining skin is sewn together. This tightens and lifts the breast.

Gynaecomastia

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Surgical options for enlarged breasts are to get liposuction to remove fat and scalpel surgery to remove glandular tissue. A plastic surgeon does the surgery, which takes 60-90 minutes. It's an outpatient procedure, meaning no overnight stay, and it often dramatically improves appearance.

Contouring

Abdominoplasty

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(Thigh Lift, Abdominoplasty, Apronectomy) Body lift surgery is one of the most common procedures used to improve the body's appearance after weight loss surgery. It’s also long-lasting, if you keep your weight stable. The surgeon makes one cut along the abdomen and removes excess, sagging skin. The surgeon also lifts and tightens the buttocks, abdomen, waist, hips, thighs, and arms in the same procedure. Liposuction is often used to remove fat and improve body contour. Buttock augmentation may be done since buttocks often flatten with extreme weight loss. Body lift surgery can dramatically change your appearance, and the results are permanent, except for a little natural firmness that's lost with age.

Thigh Lift

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(Thigh Lift, Abdominoplasty, Apronectomy)A medial inner thigh lift is usually performed under general anaesthesia. Liposuction is often used as an adjunctive procedure and can be performed either before, after, or during the operation. The patient is usually placed in the frog position, and an incision made as depicted in Figure 22-3. The excess skin and fat is then removed, and the patient’s incision is closed with supportive sutures that dissolve after about four months.

Arm Lift

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The procedure of an arm lift is relatively easy. The operation is done under IV (intravenous) sedation or general anaesthesia and lasts anywhere from two to four hours. The surgeon simply excises the excess skin and fat. These incisions are usually hidden in the inner arm area and extend from the elbow to the armpit. The incision is made with some curvature and in the shape of a "Z" to decrease the possibility of scar contracture or puckering. A curved Z-shaped incision also heals better than a straight line. The incision stops at the elbow and does not proceed down towards the wrist because the arm has numerous nerves, arteries, and tendons that need to be protected.

Liposuction

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Liposuction removes fat from your body using suction. During liposuction, small, thin, blunt-tipped tubes (cannula) are inserted through tiny cuts in the skin. Fat is suctioned out through these tubes as the doctor moves the tubes around under the skin to target specific fat deposits. Liposuction is usually done as an outpatient procedure in a properly equipped surgery centre, or hospital. In general, it does not require an overnight hospital stay unless a large volume of fat is being removed. Local anesthesia is used in some cases. And you may or may not be given a sedative to help you relax. If a large area or volume of fat is being treated, general anesthesia or deep sedation with a local anesthetic may be used.

Genital Surgery

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(Genital Surgery, Designer Vagina, Labia Reduction) A procedure in which the surgeon reduces the size of the inner lips or reshapes them. The most common complaints about the appearance of the female genitals involve the labia, with women feeling that they need to be 'neatened' or 'tidied up'. If the inner lips of the vulva are oversized or elongated, they may become uncomfortable while wearing certain clothes or can interfere with sexual intercourse. Cosmetically, some women prefer not to be able to see the inner lips.

Hand

Carpal Tunnel Syndrome

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Surgery is usually recommended for cases of CTS, when other treatments have failed to relieve symptoms. Surgery for CTS is known as carpal tunnel decompression or carpal tunnel release surgery and is performed on an outpatient basis, which means you will not have to stay in hospital overnight. During surgery the roof of the carpal tunnel, known as the carpal ligament, is cut to reduce pressure on the median nerve in the wrist. A local anaesthetic is used to numb your hand and wrist, but you will remain awake throughout the operation. The surgery can be performed as open surgery, which involves making a single cut in the wrist, and is the traditional type of operation. This surgery can be done under local anaesthetic without a tourniquet which means you will not have to stay in hospital overnight and can have this operation even if you are medically not fit enough for a general anaesthetic.

Dupuytren’s

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A needle fasciotomy is also known as a needle aponeurotomy or a percutaneous needle fasciotomy (percutaneous means "performed through the skin"). It is usually performed as an outpatient procedure. This means you will not need to be admitted to hospital. You will be given a local anaesthetic that will numb your hand without making you lose consciousness. During the procedure, a sharp blade or a very fine needle will be inserted into the fibrous bands in the palm of your hand or your fingers. The blade or needle will be used to divide the cord under your skin. By dividing the thickened tissue, your surgeon will release the tightness in your hand that is forcing your finger to bend. The benefits of needle fasciotomy include: your fingers are less deformed, you recover more quickly compared to more extensive surgery, it is suitable for people who are unable to have more extensive surgery, such as the very frail or elderly, it has a low risk (around 1%) of complications. This surgery can be done under local anaesthetic without a tourniquet which means you will not have to stay in hospital overnight and can have this operation even if you are medically not fit enough for a general anaesthetic.

Trapeziectomy

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This surgery involves removal of a wrist bone (trapezium) for osteoarthritis (=wear and tear of joint) and sometimes involves reconstruction of one of the ligaments with a tendon graft. Surgery is done when other treatments have failed to relieve symptoms. Activity modification, splintage, pain-killers, steroid injections and physiotherapy are usually tried first. This surgery can be done under local anaesthetic without a tourniquet which means you will not have to stay in hospital overnight and can have this operation even if you are medically not fit enough for a general anaesthetic.