F.A.Q's Plastic Surgery

Q: What are suspension sutures?

A: Suspension sutures are barbed sutures use for localised lifting of the face and brow. They can usually be placed with a local anaesthetic.

Q: How can I protect from the sun?

A: While we need a certain amount of sun exposure, for example to maintain our vitamin D levels, too much exposure can be harmful.
Unfortunately the visible evidence of sun damage, in the form of photoaging, may take many years to appear while devastating damage to the cells of the skin occurs very early when we are not even aware of it. Photoaging is the result of changes to the skin following sun exposure. The skin becomes dry, scaly, leathery and deeply wrinkled. 
The more medically important result of sun exposure however is the damage that occurs to the cells in the skin. Ultraviolet radiation has the capacity to cause DNA damage to the cells and also to alter their immune response. These cells can then break free of the factors that normally control their behavior and result in malignant tumors.
How can we combat this problem? 
At international government and political level world leaders need to urgently give attention to overpopulation and global warming. Politically this is a very unpopular subject and does not win votes.
At a personal level we can do the following:

  • Avoid sun exposure, particularly in the middle of the day. Some years ago the teaching was to avoid the sun from 10 am until 3 pm. Our radiation levels are so high that we receive significant exposure virtually from sunrise to sunset.
  • Use appropriate clothing, including a hat. Common sense tells us that a hat is an essential part of sun protection. Clothing needs to be thick enough to screen the radiation from our skin. Some thin materials like shirts and blouses may allow significant penetration of the sun’s rays.
  • Apply a sunscreen. A sunscreen needs to be of a high factor, at least factor 30 or over. It also needs to be of a reputable make and to be effective must be reapplied from time to time during the day especially if swimming.
  • Have a regular skin check. See a plastic surgeon or dermatologist for advice about any skin lesions. Babies need to be checked for brown lesions present at birth. It is advisable to have a full skin check at the end of adolescence. Any change in a skin lesion should be checked immediately. Any lesion that enlarges, or starts to look irregular or a sore that does not heal needs to be checked. If there is a family history of melanoma or if an individual has a large number of moles or more than one dysplastic mole regular skin follow-up is recommended.

Q:What is the cellulite and how can be treated?

A : Cellulite is a disorder of fatty tissue caused by a combination of venous and lymphatic malfunction, resulting in poor skin circulation and drainage. Cellulite appears in the subcutaneous level of skin tissue. Fat cells are arranged in chambers surrounded by connective tissue called septae. As water is retained, fat cells held within the perimeters of this area expand and stretch the connective tissue. Eventually this connective tissue contracts and hardens (sclerosis) holding the skin at a non-flexible length, while the surrounding tissue continues to expand with weight, or water gain. This results in areas of the skin being held down while other sections bulge outward, resulting in the lumpy, 'cottage-cheese' appearance. About 90% of women suffer from cellulite irrespective of their weight. Lifestyle changes such as decreasing caffeine and alcohol intake, eating healthily and increasing exercise will improve cellulite.

Mesotherapy treatment is also targeted to remove fibrotic hardened connective tissue, either by injecting or iontophoresis. Today research workers believe that iontophoresis can very often be as effective as injections into the skin or muscles. Diabetics may one day wear only a simple instrument like a watch and in that way dose themselves with enough insulin to keep them healthy. Other powerful medicines can even be taken more than 2 cms. If a positive current is applied to the skin together with appropriate gels, then the positive pole will act exactly like a magnet and repel positive cations and attract negative anions. Therefore, if one wants to facilitate the penetration of a cation then one has to apply a positive charge to the skin. However, if one wants to make an anion penetrate deeper into the skin, then one has to apply a negative charge.

Iontophoresis promises to become a major method for treating cellulite with the application of newer agents like collagenase without the use of injections, but perhaps the future is the aquaporines. The aquaporines assist the water output from the fat cells and treat cellulite, but further studies are needed to establish this hypothesis.

Q: History and Modern Plastic Surgery

A: The history of Plastic Surgery begun more than 4,000 years ago. The Reconstructive Surgery was used in India in 800 BC, but until the 20th century moved very slowly. War played a huge role: World War I and II caused thousands of victims with scores of severe facial wounds and burns. Modern weapons caused types and severity of injuries that were not precedented before. Some of the greatest talent in Plastic Surgery devoted themselves by creating new techniques to treat men maimed by the war.

Aesthetic Surgery took its place in the history of Plastic Surgery at around this time, as Surgeons fully realized the influence of appearance on individual success.

The modern, and more well-known, history of Plastic Surgery begins in the late '60s and '70s. The past few decades have brought enormous advances in treatment and awareness among the public. As the history continues to be written, the ways to improve form and function will continue to expand.

Q: General Directions Before Surgery

A: In your initial consultation the surgeon will discuss the details of the procedure and what you can expect. He will explain the possible complications and the inconvenience afterwards. If you decide to go ahead, he will take photographs of the concerning part of your body so he can compare the result afterwards.

Two weeks before surgery you are not to take any more medication containing aspirin since these products can dilute the blood and therefore enhance bleeding after surgery. This can be annoying during laser treatment as well because blood arrests the laser beams. For possible pain medication you can take paracetamol.

It is in your own benefit to quit smoking, at least two weeks before and after surgery. It is a well-known fact that smoking causes constriction of the blood vessels, which causes a slow healing process. The urge of cough is considerably higher to a smoker, which can be an enormous disadvantage for procedures under general anesthesia.Be sure to inform your surgeon of any medication you take, as well as of possible allergies to certain medication, Band-Aids etc. The ant fertilization medication must be quitted at least 2 weeks prior surgery.

Your surgeon will decide whether a preliminary examination is necessary such as a blood test, an electrocardiogram, x-rays of the lungs, or mammography of the breast.

It is best not to wear loose clothes and no makeup when you come for treatment. The day of the operation you will be accompanied to your room, where you will meet the anesthesiologist who will be present during the entire operation. Do mention any abnormalities during former procedures. Your surgeon will come and see you just before the operation and he will answer to all your questions and remarks.

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