Cosmetic Plastic Surgery Guide

Cosmetic Plastic Surgery Statistics

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glossary of cosmetic surgery terms

Glossary of Aesthetic Plastic Surgery Terms

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

Abdominoplasty ("Tummy Tuck")
Sometimes after multiple pregnancies or large weight loss, abdominal muscles weaken, and skin in the area becomes flacid. Abdominoplasty can tighten the abdominal muscles and, in some instances, improve stretch marks. In both men and women, the procedure will remove excess skin and fat. Generally, an incision is made across the pubic area and around the umbilicus (navel). When skin laxity and muscle weakness is confined to the lower part of the abdomen, a modified abdominoplasty that limits tissue removal and muscle repair to the area below the umbilicus may be performed. This usually leaves a shorter scar and no scarring around the navel.

Alpha Hydroxy Acids
Alpha hydroxy acids are derived from foods, such as fruits and milk, and can improve the texture of skin by removing layers of dead cells and encouraging cell regeneration.

Augmentation Mammoplasty (see Breast Augmentation)

Blepharoplasty (see Eyelid Surgery)

Breast Augmentation (Augmentation Mammoplasty)
Breast augmentation is typically performed to enlarge small breasts, underdeveloped breasts or breasts that have decreased in size after a woman has had children. It is accomplished by surgically inserting an implant behind each breast. An incision is made either under the breast, around the areola (the pink skin surrounding the nipple) or in the armpit. A pocket is created for the implant either behind the breast tissue or behind the muscle between the breast and the chest wall.

Breast Lift (Mastopexy)
Frequently, a woman elects this surgery after losing a considerable amount of weight, or losing volume and tone in her breasts after having children. The plastic surgeon relocates the nipple and areola (the pink skin surrounding the nipple) to a higher position, repositions the breast tissue to a higher level, removes excess skin from the lower portion of the breast and then reshapes the remaining breast skin. Scars are around the areola, extending vertically down the breast and horizontally along the crease underneath the breast. Variations on this technique, in some cases, may result in less noticeable scarring.

Breast Implants (Textured-Surface)
The shell of textured-surface breast implants are made with the same silicone elastomer that is used for the shell of other types of breast implants, but a special manufacturing process creates a textured surface.

Breast Reduction (Reduction Mammoplasty)
Breast reduction is normally classified as a reconstructive procedure, since oversize breasts interfere with normal function and physical activity. However, there is an important aesthetic component to the operation, since the plastic surgeon can improve the shape of the breasts and nipple areas. Breast reduction involves removing excess breast tissue and skin, repositioning the nipple and areola (the pink skin surrounding the nipple) and reshaping the remaining breast tissue.

Buccal Fat Pad
Buccal fat pads are located above the jawline near the corner of the mouth. They can be removed in individuals with excessively round faces to give a more contoured look, sometimes referred to as the "waif look." However, plastic surgeons warn that, in some individuals, removal of the buccal fat pads can lead to a drawn, hollow-cheeked look as aging progresses.

Buttock Lift
Excess fat and loose skin in the buttock area can be reduced by performing a buttock lift in combination with lipoplasty (liposuction). Incisions required for skin removal can often be hidden in the fold beneath the buttocks.

Calf Augmentation
Increased fullness of the calf can be achieved using implants made of hard silicone which are inserted from behind the knee and moved into position underneath the calf muscle.

Cannula
A hollow tube attached to a high-vacuum device used to remove fat through liposuction. The plastic surgeon manipulates the cannula within the fat layers under the skin, dislodging the fat and "vacuuming" it out.

Capsular Contracture
Capsular contracture is the most common problem associated with breast implants. It occurs when naturally forming scar tissue around the implant shrinks and tightens, making the breast feel firmer than normal and sometimes causing pain and an unnatural appearance of the breast.

Cellulite
Cellulite is the dimpled-looking fat that often appears on the buttocks, thighs and hips. While there is no treatment that will eradicate this problem, aesthetic plastic surgeons are exploring new techniques which may improve the condition. One method is to cut the fibrous tissue that binds the fat down in these areas and creates the lumpy appearance, and then to inject fact withdrawn from elsewhere in the body to smooth out the unevenness. Another technique, called the cellulite lift, surgically removes excess skin and fat, leaving a thin scar that may extend around the full circumference of the abdomen but is placed discreetly within bikini lines.

Chemical Peel
Fine lines and wrinkles around the mouth and on the forehead and cheek areas may be improved with a wide range of skin treatments. A chemical peel solution is applied to the entire face or to specific areas to peel away the skin's top layers. Several light to medium-depth peels can often achieve similar results to one deeper peel treatment, with less risk and shorter recovery time. Peel solutions may contain alpha hydroxy acids, tricholoracetic acid (TCA) or phenol as the peeling agent, depending on the depth of peel desired and on other patient selection factors.

Chin Augmentation (Mentoplasty)
Chin augmentation can strengthen the appearance of a receding chin by increasing its projection. The procedure does not affect the patient's bite or jaw. There are two techniques: one is performed through an incision inside the mouth and involves moving the chinbone, then wiring it into position; the other approach requires insertion of an implant through an incision inside the mouth, between the lower lip and the gum, or through an external incision underneath the chin.

Collagen Injections
Collagen is an injectable protein that can be used to treat facial wrinkles. Patients to be treated with collagen should first be tested for any allergic reaction. The results of collagen injections are not permanent, and treatments must be repeated periodically to maintain results.

Dermabrasion
Dermabrasion is a procedure in which a high-speed rotary wheel, similar to fine-grained sandpaper, is used to abrade the skin. It may be recommended when there is extensive sun damage and heavy skin wrinkling. In addition, dermabrasion can be used to improve the texture of pockmarked skin resulting from severe acne or chicken pox. Following treatment, the skin should appear firmer and smoother, but permanent pigment changes may occur.

Earlobe Reduction
A simple, 30-minute procedure, earlobe reduction can be performed in a plastic surgeon's office or at the same time as a facelift operation. The earlobe should not comprise more than 25 percent of the total length of the ear. In cases where it exceeds this dimension, an L-shaped wedge is cut away, the earlobe edges are brought together and sutured.

Eyelid Surgery (Blepharoplasty)
Aesthetic eyelid surgery can brighten the face and restore a more youthful appearance by reducing the fat that causes bags beneath the eyes and removing wrinkled, drooping layers of skin on the eyelids. Blepharoplasty is often performed along with a facelift or with other facial rejuvenation procedures. Incisions follow the natural contour lines in both upper and lower lids, or can be done through the lining of the lower eyelid, providing access to skin and fatty tissue. The thin surgical scars are usually barely visible and blend into the eyes' natural lines and folds.

Facelift (Rhytidectomy)
A facelift can reduce sagging skin on the face and neck. Incisions are placed in the hairline and then pass in front of and behind the ears; the exact design of incisions may vary from patient to patient and according to the surgeon's personal technique. For younger patients, more limited incisions may be appropriate. When necessary, removal of fatty deposits beneath the skin and tightening of sagging muscles is performed. The slack in the skin itself is then taken up and the excess removed. Scars can usually be concealed by hair and makeup.

Fat Injections
Fat withdrawn from one body site can be injected into another -- for example, to smooth lines in the face or build up other features such as the lips. In most cases, a percentage of injected fat is resorbed by the body, and the procedure must be repeated. Injection of fat to enlarge the breasts is a dangerous procedure and is not recommended because of the possibility of dense scarring that may seriously hinder accurate interpretation of both breast self-exams and mammograms.

Fibrel
Fibrel is a synthetic substance which is an alternative to collagen and fat injections for the treatment of facial wrinkles. As with collagen and fat, fibrel treatments must repeated at intervals to maintain correction.

Forehead Lift (Brow Lift)
The forehead lift is designed to correct or improve skin wrinkling, as well as loss of tone and sagging of the eyebrows that often occurs as part of the aging process. The procedure may also help to smooth horizontal expression lines in the forehead and vertical frown lines between the eyebrows. Incisions are placed behind the hairline above the ear and pass over the top of the head. In some cases, incisions may be placed in front of the hairline. Some patients may have the procedure performed with the use of an endoscope, requiring much shorter incisions. Improvements are made beneath the skin and on the deep muscles; skin and muscle are then tightened to give a fresher, more youthful appearance.

Hydroxyapatite Granules
Hydroxyapatite granules are a bone substitute made from coral that can be used to enhance facial contours, such as forming more prominent cheekbones. The substance also has reconstructive uses in craniofacial surgery.

Lasers
Lasers can be effectively used to eliminate surface blood vessels on the face that become reddened and enlarged due to sun exposure. The problem is most often seen in fair-skinned individuals who cannot tan or have difficulty tanning. The use of lasers for skin resurfacing is effective in reducing the effects of sun damage. Laser resurfacing is an alternative to chemical peel for some patients.

Lip Augmentation
A permanent method of augmenting the lips is accomplished by surgically advancing the lip forward, with incisions placed inside the mouth. A dermal-fat graft, taken from the deeper layers of the skin, may then be positioned under the mucosa (the lining of the lip) to add additional "plumpness." Injecting fat collagen or other substances for lip augmentation is another alternative. The correction is not permanent, and injections must be repeated periodically to maintain results.

Lip Lift
A technique that surgically lifts the corners of the aging mouth can eliminate the pronounced droop and unhappy facial expression that often develops with advanced age. By cutting away small diamonds of skin just above the corners of the mouth, the vermilion (border of the lips) is raised into a slight smile.

Lip Reduction
To reduce the lips, a small strip of the mucosa (the lining of the lip) is surgically removed to narrow the lips to the desired proportion. The small scars on the outside of the lips are barely noticeable.

Lipoplasty (Liposuction)
Lipoplasty allows the plastic surgeon to remove localized collections of fatty tissue from the legs, buttocks, abdomen, back, arms, face and neck using a high vacuum device. The procedure leaves only minute scars, often as short as one-half inch in length or less. The use of refined equipment allows removal from delicate areas such as calves and ankles. Lipoplasty removes fat, but it cannot eliminate dimpling or correct skin laxity. If a patient's skin has lost much of its elasticity, the plastic surgeon may recommend a skin tightening procedure such as a thigh lift, buttock lift or arm lift, all of which leave more extensive scars.

Malar (Cheekbone) Augmentation
The cheekbones may be built up by placing an implant over them. This is usually performed through an incision within the mouth, but it may be done through a lower eyelid or brow lift incision.

Mastopexy (see Breast Lift)

Otoplasty (Ear Surgery)
The ears are positioned closer to the head by reshaping the cartilage (supporting tissue). This is usually accomplished through incisions placed behind the ears so that subsequent scars will be concealed in a natural skin crease. Otoplasty can be performed on children as early as age five or six.

Peel: Buffered Phenol
Buffered phenol offers yet another option for severely sun-damaged skin. One such formula uses olive oil, among other ingredients, to diminish the strength of the phenol solution. Another slightly milder formula uses glycerin. Buffered phenol peels may be more comfortable for patients, and the skin heals faster than with a standard phenol peel.

Phenol
The chemical phenol is sometimes used for full-face peeling when sun damage or wrinkling is severe. It can also be used to treat limited areas of the face, such as deep wrinkles around the mouth, but it may permanently bleach the skin, leaving a line of demarcation between the treated and untreated areas that must be covered with makeup.

Platysma
The muscle which, when tight and firm, gives the neck underneath the chin and jawline its youthful contour. The platysma muscle can be tightened during a facelift or as a separate procedure.

Reduction Mammoplasty (see Breast Reduction)

Retin-A
Retin-A cream or lotion may be applied to enhance the overall texture of the skin and is often prescribed as a pre-treatment prior to a facelift or chemical peel.

Rhinoplasty: Open
The open rhinoplasty technique can sometimes benefit patients who need more complex correction or are undergoing a secondary rhinoplasty procedure. A small incision is made outside the nose across the columella (the tissue that divides the two nostrils). This enables the plastic surgeon to turn the outer tissue of the nose back, providing visualization of the structures inside. Additional incisions, like those used in the traditional closed approach, are made inside the nose as well. The scar resulting from the incision on the outside of the nose eventually becomes barely visible.

Rhinoplasty (Nose Reshaping)
Rhinoplasty is usually performed to alter the size and shape of the bridge and tip of the nose. Reshaping is generally done through incisions inside the nose, but there may also be an incision passing across the central portion of the nose between the nostrils. It is sometimes necessary to narrow the base of the nose or reduce the size of the nostrils, which involves removing small wedges of skin at the base of the nostrils. The nose is reduced, or sometimes built up, by adjusting its supporting structures, which is done either by removing or adding bone and cartilage. The skin and soft tissues then redrape themselves over this new "scaffolding."

Rhytidectomy (see Facelift)

SMAS
The superficial musculoaponeurotic system (SMAS) is a layer of tissue that covers the deeper structures in the cheek area and is in continuity with the superficial muscle covering the lower face and neck, called the platysma. Some facelift techniques lift and reposition the SMAS as well as the skin.

Superficial Syringe Liposculpture
Use of a syringe to withdraw fat, instead of vacuum suctioning pumps, allows for less blood loss and speedier postoperative recovery. Superficial syringe liposculpture is performed on the layer of fat just beneath the skin.

Tattooing (Cosmetic)
Cosmetic tattooing, or micropigmentation, can be used for permanent eyeliner, eyebrows or lip color. It can also be used for permanent blush and eyeshadow, though this is infrequent. Other uses by plastic surgeons include recreating the coloration of the areola around the nipple following breast reconstruction; restoring the color of dark or light skin where natural pigmentation has been lost through such factors as vitiligo, cancer, burns or other scarring; and eliminating some types of birthmarks or previous tattoos. Micropigmentation should be performed only under medical supervision by appropriately trained personnel.

TCA
Trichloroacetic acid is used for peeling of the face, neck, hands and other exposed areas of the body. It has less bleaching effect than phenol, and is excellent for "spot" peeling of specific areas. It can be used for deep, medium or light peeling, depending on the concentration and method of application.

Thigh Lift
A thigh lift can be performed to tighten sagging muscles and remove excess skin in the thigh area. Because a thigh lift leaves noticeable scars in the inner or outer thigh area that some patients find undesirable, it is not a frequently performed procedure.

Tissue Expansion
Tissue expansion is a technique in which skin or other tissue is stretched using inflatable balloons. It can be of particular value in performing breast reconstruction, breast enlargement or treatment of male pattern baldness.

Transconjunctival Blepharoplasty
Transconjunctival blepharoplasty (eyelid surgery) is performed by making an incision from inside the lower eyelid. It avoids any scarring on the lower lid. It is a useful technique when only fat, and not skin or muscle, needs to be removed from the eyelid area.

Source: The American Society for Aesthetic Plastic Surgery (ASAPS) is the leading organization of plastic surgeons certified by the American Board of Plastic Surgery (ABPS) who specialize in cosmetic surgery of the face and the entire body.

2005 statistics
Top 5 Surgical Cosmetic Procedures in 2005
Top 5 Non-Surgical Cosmetic Procedures in 2005
Surgical Trends: 1997-2005
Non Surgical Trends: 1997-2005

Cosmetic Surgery Quick Facts: 2005 ASAPS Statistics January 3, 2000

Highlights of the ASAPS 2005 Statistics on Cosmetic Surgery

There were nearly 11.5 million surgical and nonsurgical procedures performed in the United States, as reported by the American Society for Aesthetic Plastic Surgery (ASAPS). Surgical procedures accounted for nearly 19% of the total with nonsurgical procedures making up 81% of the total.

From 2004-2005, there was a decrease of 4 percent in the total number of cosmetic procedures. Surgical procedures showed an increase of 1% with nonsurgical procedures falling by 4 percent

Since 1997 there has been an increase of 444 percent in the total number of cosmetic procedures. Surgical procedures have increased by 119 percent, nonsurgical procedures by 726 percent.

The top five surgical procedures cosmetic procedures in 2005 were:

2. Breast Augmentation with 364,610 procedures up nine percent from 2004. For the first time, we categorized saline vs. silicone augmentation. 83.4 percent of respondents used the saline device, 16.6 percent the silicone implant.

3. Blepharoplasty (cosmetic eyelid surgery) came in third with 231,467 procedures down 20 percent from 2004

4. Rhinoplasty (nose reshaping) is the forth most common procedure with 200,924 procedures performed, an increase of 21 percent over 2004

5. Abdominoplasty (tummy tuck) reported 169,314 procedures, up 12 percent from 2004.

The top five nonsurgical cosmetic procedures in 2005 were:

2. Laser hair removal at 1,566,909 up 11 percent from 2004

3. Hyaluronic acids (Hylaform, Restylane) at 1,194,222 up 35 percent from 2004

4. Microdermabrasion is the fourth most popular procedure with 1.023,931 performed in 2005, a decrease of 7 percent over last year

5. Chemical peels accounted for 556,172 procedures in 2005, down 50 percent from 2004.

Women had nearly 10,500,000 of the total cosmetic procedures performed in 2005 accounting for 91.4 percent of the total, declining 2 percent from 2004

The top five surgical procedures for women were Lipoplasty (liposuction), Breast Augmentation, Blepharoplasty (cosmetic eyelid surgery), and Abdominoplasty (tummy tuck), and Breast Lift.

Men had 985,000 procedures, approximately 9 percent of the total, down 15 percent from 2004.

The top five procedures for men in 2005 included Lipoplasty (Liposuction), Rhinoplasty (Nose reshaping), Blepharoplasty (cosmetic eyelid surgery), Male Breast Reduction and Facelift.

People between the ages of 35 and 50 had the majority of procedures: 5.3 million and 47 percent of the total. Those between 51 and 64 had 24 percent of the procedures, patient's between 19 and 34 had 24 percent, those 65 and older had 5 percent and 18 and under accounted for 1.5 percent

The most common procedures for those 18 and under were Laser Hair Removal, Microdermabrasion, Rhinoplasty (Nose reshaping), Otoplasty (Cosmetic ear surgery) and Chemical Peel.

Racial and ethnic minorities as last year, had approximately 20 percent of all cosmetic procedures; Hispanics: 9 percent, African-Americans: 6 percent, Asians: 4 percent, all other non-Caucasians: 1.3 percent.

The majority of cosmetic procedures were performed in an office facility, 48 percent, with 28 percent performed in a free-standing surgi-center and 24 percent performed in a hospital.

Americans spent approximately $12.4 billion on cosmetic procedures last year.

Figures and totals have been rounded to the nearest percent.

Source: THE AMERICAN SOCIETY FOR AESTHETIC PLASTIC SURGERY (ASAPS)

2004 statistics

Top 5 Surgical Cosmetic Procedures in 2004
Top 5 Non-Surgical Cosmetic Procedures in 2004
Surgical Trends: 1997-2004
Non Surgical Trends: 1997-2004

2003 statistics

The American Society of Aesthetic Plastic Surgeons (ASAPS) sent out a survey to more than 14,000 doctors and used the results to project national averages for 23,000 medical specialists. The results have an error margin of +/- 3.92% at a 95% level of confidence.

7 Year Comparison: 1997 and 2003 Cosmetic Procedures (Surgical and Non-Surgical)
Surgical Cosmetic Procedures: 1997, 2002 and 2003 Comparison
Non-Surgical Cosmetic Procedures: 1997, 2002 and 2003 Comparison
Top Five Surgical Cosmetic Procedures in 2003
Top Five Non-Surgical Cosmetic Procedures in 2003
Top Five Cosmetic Surgeries for Females in 2003
Top Five Cosmetic Surgeries for Males in 2003

BE SMART ABOUT LOOKING GOOD
THE IMPORTANCE OF CHOOSING A BOARD-CERTIFIED PLASTIC SURGEON

John LoMonaco, M.D., F.A.C.S.
Plastic and Reconstructive Surgery
Houston, Texas

People seek plastic surgery for a variety of reasons: improved self-esteem, change in a perceived flaw, or to reverse the effects of aging, pregnancy, or massive weight loss. But regardless of the motivation, patients all share a desire for a safe and predictable result. While many things may affect results, it's the experience, decision-making, and expertise of the surgeon that plays the biggest role in ensuring a favorable outcome. Choosing a qualified surgeon may be the based on recommendations from friends, careful research, and personal compatibility. Choosing a surgeon certified by the American Board of Plastic Surgery is an essential step to ensure the best training and credentials.

While this goal may seem simple, several things must be kept in mind. The laws in most states allow the practice of "medicine and surgery" with nothing more than a state license. In addition, laws governing the advertising of medical services are lax in most states. It is the job of the so-called "specialty boards" to check the training, credentials, and ethical behavior of it's members. They also administer examinations and maintain the certification of the members in the various specialties.

The American Board of Medical Specialties (ABMS) is an organization that keeps track of data for all of the 24 approved medical specialty boards. Their mission of he ABMS is to provide assurance to the public that doctors certified by a Member Board have successfully completed an approved training program and also undergone a thorough evaluation process that assures their ability to provide quality care in their specialty.

But even determining if a surgeon is board-certified can be difficult. Aggressive marketing, plus the dramatic increase in media attention surrounding plastic surgery has resulted in some physicians being less than forthright with their credentials. There are organizations that incorporate the word "Board" in their name, and even issue certificates under that name. Sometimes called "bogus boards," the requirements for becoming "certified" by these organizations may be quite lax. Board "certification" to physicians -and sometimes even nonphysicians - is often done in exchange for an application fee. Such boards lack educational standards and/or requirements, and many of them do not incorporate an examination process. There is no standardization of the credentialing process amongst "bogus boards." Most medical organizations, insurance companies, and regulatory agencies do not recognize non-ABMS boards.

Fortunately, with the advent of the internet, there are several quick and reliable ways to check your prospective surgeon's credentials. The ABMS tracks and accredits all 24 specialty boards and updates the membership status of it's physicians. They can be found online at www.ABMS.org. Another organization open only to board-certified plastic surgeons is the American Society of Plastic Surgery (ASPS). This society promotes the advancement of plastic surgery and promotes patient education. The Society is open only to board-certified plastic surgeons, requires continuing medical education for its members, and also upholds a set of ethical standards.

Plastic surgery should be a life changing experience for the better. As with any big decision, good preparation and careful planning go a long way to ensure the best possible results and the safest outcome. Choosing a surgeon certified by the ABPS is an easy way to "be smart about looking good."

Dr. John LoMonaco is an ABPS-certified plastic and reconstructive surgeon practicing in Houston, Texas.

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Information provided is for general education about breast augmentation, breast reduction, face lifts, liposuction, tummy tucks, rhinoplasty and other cosmetic plastic surgery procedures. This information is subject to change. Smart Plastic Surgery.com does not guarantee that it is accurate or complete, and is not responsible for any actions resulting from the use of this information. General information provided in this fashion should not be construed as specific medical advice or recommendation, and is not a substitute for a consultation and physical examination by a physician. Only discussion of your individual needs with a qualified physician will determine the best method of treatment for you. All board certified plastic surgeons listed are board certified by the American Board of Plastic Surgery and/or the Royal College of Physicians and Surgeons of Canada. Board certified plastic surgeons are verified by the American Board of Medical Specialties.
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