Tumescent liposuction involves injecting a mixture of saline solution, lidocaine and epinephrine into areas of the body where fat is to be removed. The swollen, liquid filled tissues become firm and easy to control. The excess fat is then sucked out of the body through a stainless tube, called the cannula.

Because the patient remains awake during the procedure, the surgeon may ask him/her to move to better sculpting positions, helping to improve results.

Liposuction may be performed on one, or several areas of the body. It can also be performed in conjunction with other plastic surgery procedures.

The procedure is popular for both men and women.

Surgery Length: 45 mins – 4 hours
Anesthesia: Local anesthesia
Hospital Stay: —
Stay in Thailand: —
Recovery: 5-7 days
Procedure Cost: —

What Tumescent Liposuction Can Do

Tumescent liposuction, like other liposuction techniques, slims and reshapes specific areas of the body by removing excess fat deposits, improving your body contours and proportion, and ultimately enhancing your self-image.

Tumescent liposuction techniques may be used to reduce localized fat deposits of the:

• Thighs
• Hips and buttocks
• Abdomen and waist
• Upper arms
• Back
• Inner knee
• Chest area
• Cheeks, chin and neck

The best results are obtained in body areas where there is reasonable muscle tone, good skin elasticity, and fat is not excessive.

What it won’t do: All liposuction techniques are designed for removing localized fat deposits that do not respond to diet or exercise, not as a substitute for weight loss. It is also not an effective treatment for cellulite or loose saggy skin.

Best Candidates for Tumescent Liposuction

Ideal candidates for liposuction are:

• Adults within 30% of their ideal weight who have firm, elastic skin and good muscle tone
• Healthy individuals who do not have a life-threatening illness or medical conditions that can impair healing
• Non-smokers
• Individuals with a positive outlook and specific goals in mind for body contouring

Is Tumescent Liposuction Right for Me?

If you are bothered by excess fat deposits – located anywhere on your body – that don’t respond to diet or exercise, liposuction may be right for you. Tumescent liposuction may offer a quicker recovery period compared with traditional liposuction.

Preparing for Tumescent Liposuction

The success and safety of your liposuction procedure depends very much on your complete candidness during your consultation. You’ll be asked a number of questions about your health, desires and lifestyle.

Prior to surgery, you may be asked to:

• Get lab testing or a medical evaluation
• Take certain medications or adjust your current medications
• Stop smoking well in advance of surgery
• Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding

Special instructions you receive will cover:

• What to do on the day of surgery
• The use of anesthesia during your liposuction
• Post-operative care and follow-up

Your plastic surgeon will also discuss where your procedure will be performed. Tumescent liposuction may be performed in an accredited office-based surgical center, outpatient or ambulatory surgical center, or a hospital.

If your liposuction procedure involves general anesthesia, be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery

Tumescent Liposuction Surgery Overview

Anesthesia

The anesthesia is administered using the super wet technique. This involves injecting a mixture of saline solution, lidocaine and epinephrine into the fatty deposits. The swollen tissues make it much easier for the surgeon to control, break down the fat and re-sculpt the body.

The Incision

Like traditional liposuction, tumescent liposuction fat removal is carried out using a cannula, a thin stainless steel suction tube.

The cannula may be inserted into several different incisions in the body. The dislodged fat is then suctioned out of the body using a surgical vacuum attached to the cannula.

Liposuction Surgery Results

Your improved body contour will be apparent when the swelling and fluid retention commonly experienced following liposuction subside. This usually takes around 10 – 30 days.

Improvements will continue for up to one year.

With continued practices of healthy diet and fitness, the loss of excess fatty tissue should be permanently maintained. However, substantial weight gain can alter an otherwise permanent result.

Special note: Tumescent liposuction can be repeated. There is a limit to the amount of fat which can be removed during any one session of tumescent liposuction. In some instances the patient may want to have more removed at another time. If someone has several areas to treat, sometimes it is better to treat them at separate times.

Will There be Scars?

There will be small scars from the incisions made to insert the cannula. These will vary in number depending on how sites fat is removed from. The scars are usually very inconspicuous and measure around

Tumescent Liposuction Surgery Recovery

With tumescent liposuction there is less bleeding and post operative swelling. This allows most patients to get back on the feet again the next day.

You will be given a compression garment or elastic bandages to cover the surgical site and compress the skin to your new body contours.

While some may be back on their feet the next day, it will take around 5-7 days for you to feel fully functional. You should also refrain from strenuous activity for at least two weeks.

You will be given specific instructions that may include: How to care for the surgical site(s), medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in your general health, and when to follow up with your plastic surgeon.

Be sure to ask your plastic surgeon specific questions about what you can expect during your individual recovery period:

• Where will I be taken after my surgery is complete?
• What medication will I be given or prescribed after surgery?
• Will I have dressings/bandages after surgery?
• When will they be removed?
• Are stitches removed? When?
• When can I resume normal activity and exercise?
• When do I return for follow-up care?

When You Return Home

If you experience shortness of breath, chest pains, or unusual heart beats, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment.

The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure and another surgery may be necessary.

Following your physician’s instructions is key to the success of your surgery. It is important that the surgical incisions are not subjected to excessive force, swelling, abrasion, or motion during the time of healing. Your doctor will give you specific instructions on how to care for yourself.

Possible Risks of Tumescent Liposuction Surgery

The decision to have liposuction is extremely personal and you’ll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable.

Your plastic surgeon and/or staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks or potential complications.

Although tumescent liposuction patients typically see fewer skin irregularities, less bleeding, and reduced bruising, the possible risks are similar to those of the traditional liposuction procedure. These risks include:

• Uneven contours
• Rippling or loose skin
• Skin or nerve damage
• Irregular pigmentation
• Infection
• Fat clots
• Blood clots
• Excessive fluid loss or fluid accumulation
• Unfavorable scarring
• Anesthesia risks
• Bleeding (hematoma)
• Change in skin sensation
• Skin discoloration or swelling
• Asymmetry
• Pain, which may persist
• Damage to deeper structures such as nerves, blood vessels, muscles, lungs, and abdominal organs
• Poor wound healing
• Persistent swelling in the legs
• Deep vein thrombosis, cardiac and pulmonary complications
• Possibility of revisional surgery

These risks and others will be fully discussed prior to your consent. It is important that you address all your questions directly with your plastic surgeon.

Note: It’s very important to ask your plastic surgeon questions about your liposuction procedure. It’s natural to feel some anxiety, whether it’s excitement for your anticipated new look or a bit of preoperative stress. Don’t be shy about discussing these feelings with your plastic surgeon.

Tumescent Liposuction Terms and Definitions

• Breast reduction: Also known as reduction mammaplasty, reduction of breast size by surgery.
• Cannula: A thin, hollow tube used during liposuction to loosen excess fat.
• Facelift: A surgical procedure, also known as rhytidectomy, to reduce sagging of the mid-face, jowls and neck.
• General anesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness.
• Hematoma: Blood pooling beneath the skin.
• Intravenous sedation: Sedatives administered by injection into a vein to help you relax.
• Lipoplasty: Another term for liposuction. Liposuction: Also called lipoplasty or suction lipectomy, this procedure vacuums out fat from beneath the skin’s surface to reduce fullness.
• Local anesthesia: A drug injected directly to the site of an incision during an operation to relieve pain.
• Suction lipectomy: Another term for liposuction.
• Sutures: Stitches used by surgeons to hold skin and tissue together.
• Tumescent or super-wet liposuction: Involves an infusion of saline solution with adrenaline and possibly anesthetic prior to removal of excess fat.
• Tummy tuck: A surgical procedure, also known as abdominoplasty, to correct the apron of excess skin hanging over your abdomen.

A specially-designed suction device is then used to gently remove the liquefied fat, while preserving the surrounding connective tissue, blood vessels, and nerves.

The procedure is popular for both men and women.

Surgery Length: 30 mins – 1 hour
Anesthesia: Local, General Anesthesia, or Intravenous Sedation
Hospital Stay: —
Stay in Thailand: —
Recovery: 1 – 4 days
Procedure Cost: —

What VASER Liposuction Can Do

VASER liposuction produces smooth, predictable results with a fast recovery period. VASER liposuction may be performed on many areas of the body including:

• Arms
• Hips
• Chest
• Breasts
• Knees
• Ankles
• Waist
• Stomach
• Chin
• Back
• Buttocks
• Neck
• Thighs

VASER Liposuction can also be performed on multiple body areas at one time.

What it won’t do: VASER liposuction is not intended for excessive weight loss.

Best Candidates for VASER Liposuction

Ideal candidates for VASER liposuction are:

• Healthy individuals with stubborn local deposits
• Those who are not morbidly obese
• Those with firm, elastic skin will see the best results
• Non-smokers
• Those who do not suffer from heart problems, high cholesterol, diabetes and high blood pressure
• Those with firm skin
• Those who are not on medications such wafarin, aspirin or any anticoagulants
• Individuals with a positive outlook and specific goals in mind for body contouring

Is VASER Liposuction Right for Me?

If you are frustrated by the resistance of certain body areas to diet and exercise, VASER liposuction can provide a solution.

VASER liposuction is an especially good choice for the treatment of specific areas won’t lose fat even for healthy people who work out. Genetics are often the cause of double chins, or “muffin tops” around the waist, and VASER liposuction is a perfect procedure to slim and contour those areas.

Preparing for VASER Liposuction

Prior to VASER liposuction you will be require to have a consultation with your surgeon. During your consultation, you should be very open about your medical history and existing medical conditions. List all of the medications, vitamins and herbs you are taking (even if you don’t think they’re important).

Prior to surgery, you may be asked to:

• Get a medical evaluation
• Adjust your current medications
• Stop smoking well in advance of surgery

Your plastic surgeon will also discuss where your procedure will be performed. VASER liposuction can be performed in-office while the patient is awake, or in a surgery center or hospital under local anesthesia (awake), IV sedation, or general anesthesia.

If your VASER liposuction is performed using anesthesia, be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following the procedure.

VASER Liposuction Surgery Overview

Tumescent Fluid Infusion

To begin the procedure, the physician will inject what is known as tumescent fluid into the treatment area. Tumescent fluid is a mixture of saline solution, lidocaine and epinephrine. The solution helps expand the tissue layer, while the lidocaine numbs the area, and the epinephrine works by shrinking the blood vessels. This will not only help to control bleeding during the procedure, but will help to minimize bruising during your recovery.

Emulsification of Fatty Tissue

Once the physician has injected the tumescent fluid, they will insert a small probe that emits ultrasonic energy. The energy travels in high-frequency waves that are dispersed evenly from all sides of the probe.

This energy causes the VASER probe to vibrate, selectively breaking apart the fatty tissue on contact. The ultrasonic energy actually works by emulsifying, or liquefying the fatty tissue. As the energy is targeted only toward fat, the surrounding connective tissue, blood vessels, and nerves are preserved.

Removal of Fatty Tissue

After the physician has emulsified the fatty tissue in the treatment area, the fat is removed from the body using a gentle suction device or massage. This specialized suction device removes the liquefied fat while minimizing trauma to the surrounding tissues. The VASER liposuction technique preserves these important tissues to promote an enhanced patient experience.

VASER Liposuction Surgery Results

You should begin to see results within the first few weeks. Your results will continue to improve with time as the tissues in the treatment area heal. You skin will begin retract to give you a smooth, natural-looking result with final results apparent between 3 and 6 months.

Because of the non surgical nature of VASER liposuction there is typically less damage, pain, and needed recovery time compare to traditional liposuction.

Will There be Scars?

Usually there will be only two small incisions used for the insertion of the cannula. These scars are typically less than 4 – 10mm long.

VASER Liposuction Surgery Recovery

After the operation you will be given anti-biotic cover to dress the incisions. Most patients are able to go back to work within days after their VASER liposuction procedure, however you should stay away from strenuous activity for at least two weeks.

After the two week mark, you will be required to visit the doctor for a check-up.

When You Return Home

If you experience shortness of breath, chest pains, or unusual heart beats, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment.

The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure and another surgery may be necessary.

Following your physician’s instructions is key to the success of your surgery. It is important that the surgical incisions are not subjected to excessive force, swelling, abrasion, or motion during the time of healing. Your doctor will give you specific instructions on how to care for yourself.

Possible Risks of VASER Liposuction Surgery

The risks of VASER liposuction are very similar to other liposuction procedure risks.

Because VASER liposuction minimizes damage to other body tissues, patients typically experience less pain and fewer side effects than with other forms of liposuction.

Possible risks of liposuction include:

• Uneven contours
• Rippling or loose skin
• Skin or nerve damage
• Irregular pigmentation
• Infection
• Fat clots
• Blood clots
• Excessive fluid loss or fluid accumulation
• Unfavorable scarring
• Thermal burn or heat injury from ultrasound with the ultrasound-assisted lipoplasty technique
• Lidocaine toxicity
• Anesthesia risks
• Bleeding (hematoma)
• Change in skin sensation
• Asymmetry

These risks and others will be fully discussed prior to your consent. It is important that you address all your questions directly with your plastic surgeon.

Note: It’s very important to ask your plastic surgeon questions about your VASER liposuction procedure. It’s natural to feel some anxiety, whether it’s excitement for your anticipated new look or a bit of preoperative stress. Don’t be shy about discussing these feelings with your plastic surgeon.

VASER Liposuction Terms and Definitions

• VASER: Vibration Amplification of Sound Energy at Resonance.
• Cannula : Tube used to loosen fat.
• General anesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness.
• Hematoma: Blood pooling beneath the skin.
• Intravenous sedation: Sedatives administered by injection into a vein to help you relax.
• Lipoplasty: Another term for liposuction. Liposuction: Also called lipoplasty or suction lipectomy, this procedure vacuums out fat from beneath the skin’s surface to reduce fullness.
• Local anesthesia: A drug injected directly to the site of an incision during an operation to relieve pain.
• Suction lipectomy: Another term for liposuction.
• Sutures: Stitches used by surgeons to hold skin and tissue together.
• Tumescent or super-wet liposuction: Involves an infusion of saline solution with adrenaline and possibly anesthetic prior to removal of excess fat.
• Ultrasound-assisted lipoplasty: Uses ultrasonic energy to liquefy excess fat prior to surgical suctioning.

Surgery Length: 3 – 6 Hours
Anesthesia: Intravenous Sedation or General Anesthesia
Hospital Stay: —
Stay in Thailand: —
Recovery: Initial swelling subsides 7 – 10 days.
Procedure Cost: —

What Does Tummy Tuck Surgery Do?

A tummy tuck can correct a loose and sagging skin around the abdomen, often caused by:

• Pregnancy
• Aging
• Significant fluctuations in weight
• Heredity
• Prior surgery

What it won’t do: A tummy tuck is not a substitute for weight loss or an appropriate exercise program.

Although the results of a tummy tuck are technically permanent, the positive outcome can be greatly diminished by significant fluctuations in your weight. For this reason, individuals who are planning substantial weight loss or women who may be considering future pregnancies may be advised to postpone a tummy tuck.

Also, a tummy tuck cannot correct stretch marks, although these may be removed or somewhat improved if they are located on the areas of excess skin that will be excised, generally those treated areas below the belly button.

Best Candidates for Tummy Tuck Surgery

Ideal candidates for tummy tuck surgery include those who are:

• Physically healthy and at a stable weight
• Have realistic expectations
• Non-smokers
• Bothered by the appearance of their stomach.

Is Tummy Tuck Surgery Right for Me?

Tummy tuck surgery is a highly individualized procedure and you should do it for yourself, not to fulfill someone else’s desires or to try to fit any sort of ideal image. A tummy tuck is a good idea if you:

• You have realistic goals about the surgery
• You are physically healthy
• You do not smoking

Preparing for Tummy Tuck Surgery

The success and safety of your tummy tuck procedure depends very much on your complete candidness during your consultation. You’ll be asked a number of questions about your health, desires and lifestyle.

Prior to surgery, you may be asked to:

• Get lab testing or a medical evaluation
• Take certain medications or adjust your current medications
• Stop smoking well in advance of surgery
• Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding

Special instructions you receive will cover:

• What to do on the day of surgery
• The use of anesthesia during your tummy tuck
• Post-operative care and follow-up

Your plastic surgeon will also discuss where your procedure will be performed. Tummy tuck surgery may be performed in an accredited office-based surgical center, outpatient of ambulatory surgical center, or a hospital.

If your abdominoplasty is performed on an outpatient basis, be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.

Tummy Tuck Surgery Overview

Anesthesia

Medications are administered for your comfort during the surgical procedures. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.

The Incision

A full tummy tuck requires a horizontally-oriented incision in the area between the pubic hairline and navel. The shape and length of the incision will be determined by the degree of correction necessary.

Through this incision, weakened abdominal muscles are repaired and sutured and excess fat, tissue and skin is removed.

A second incision around the navel may be necessary to remove excess skin in the upper abdomen.

Closing The Incisions

Sutures, skin adhesives, tapes or clips close the skin incisions.

Tummy Tuck Surgery Results

Your tummy tuck will result in a flatter, firmer abdominal contour that is more proportionate with your body type and weight.

The final results may be initially obscured by swelling and your inability to stand fully upright until internal healing is complete.

Within a week or two, you should be standing tall and confident about your new slimmer profile. However previous abdominal surgery may limit the potential results of a tummy tuck.

Will There be Scars?

In women who have undergone cesarean section, the existing scars may often be incorporated into the new scar.

Tummy Tuck Surgery Recovery

Following your surgery, dressings or bandages may be applied to your incisions, and you may be wrapped in an elastic bandage or a compression garment to minimize swelling and to support your abdomen as it heals.
A small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid that may collect.

You will be given specific instructions that may include: How to care for the surgical site and drains, medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in your general health, and when to follow-up with your plastic surgeon.

Be sure to ask your plastic surgeon specific questions about what you can expect during your individual recovery period:

• Where will I be taken after my surgery is complete?
• What medication will I be given or prescribed after surgery?
• Will I have dressings/bandages after surgery?
• When will they be removed?
• Are stitches removed? When?
• When can I resume normal activity and exercise?
• When do I return for follow-up care?

When You Return Home

If you experience shortness of breath, chest pains, or unusual heart beats, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment.

The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure and another surgery may be necessary.

Following your physician’s instructions is key to the success of your surgery. It is important that the surgical incisions are not subjected to excessive force, swelling, abrasion, or motion during the time of healing. Your doctor will give you specific instructions on how to care for yourself.

Possible Risks of Tummy Tuck Surgery

The decision to have tummy tuck surgery is extremely personal and you’ll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable.

Your plastic surgeon and/or staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks or potential complications.

Possible risks of tummy tuck surgery include:

• Unfavorable scarring
• Infection
• Fluid accumulation
• Poor wound healing
• Skin loss
• Blood clots
• Numbness or other changes in skin sensation
• Anesthesia risks
• Skin discoloration and/or prolonged swelling
• Fatty tissue found deep in the skin might die (fat necrosis)
• Major wound separation
• Asymmetry
• Recurrent looseness of skin
• Pain, which may persist
• Deep vein thrombosis, cardiac and pulmonary complications
• Persistent swelling in the legs
• Nerve damage
• Possibility of revisional surgery
• Suboptimal aesthetic result

These risks and others will be fully discussed prior to your consent. It is important that you address all your questions directly with your plastic surgeon.

Note: It’s very important to ask your plastic surgeon questions about your tummy tuck procedure. It’s natural to feel some anxiety, whether it’s excitement for your anticipated new look or a bit of preoperative stress. Don’t be shy about discussing these feelings with your plastic surgeon.

Tummy Tuck Surgery Terms and Definitions

• Abdominoplasty: A surgical procedure to correct the apron of excess skin hanging over your abdomen.
• Diastasis: Condition in which abdominal muscles have separated.
• General anesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness.
• Hematoma: Blood pooling beneath the skin.

Intravenous sedation: Sedatives administered by injection into a vein to help you relax.

• Liposuction: Also called lipoplasty or suction lipectomy, this procedure vacuums out fat from beneath the skin’s surface to reduce fullness.
• Local anesthesia: A drug is injected directly to the site of an incision during an operation to relieve pain.
• Sutures: Stitches used by surgeons to hold skin and tissue together.
• Tummy tuck: A surgical procedure to correct the apron of excess skin hanging over your abdomen.

This procedure is popular for both men and women.

Surgery Length: 1 – 4 Hours
Anesthesia: Intravenous Sedation or General Anesthesia
Hospital Stay: —
Stay in Thailand: —
Recovery: Initial swelling subsides 7 – 10 days
Procedure Cost: —

What a Nose Surgery Do?

Nose surgery can improve the shape of your nose. Surgery of the nose may also correct impaired breathing caused by structural abnormalities in the nose, it can also correct a deviated septum.

Rhinoplasty can change:

• Nose size, in relation to the other facial structures
• Nose width, at the bridge
• Nose profile, with visible humps or depressions on the bridge
• Nasal tip, that is large or bulbous, drooping, or too upturned
• Nostrils that are large, wide or upt

What it won’t do: Rhinoplasty can reshape or correct the nose to enhance your appearance, but it won’t necessarily make you look younger, or change your overall looks.

Best Candidates for Nose Surgery

The best nose surgery candidates simply want to improve the nose appearance, but do not seek perfection. The ideal candidate should not expect rhinoplasty to transform them into someone else. The best candidates are well adjusted and otherwise happy with their lives.

Ideal candidates for nose surgery include those who may:

• Have a nose that he or she feels is too large or too small in comparison with other facial features
• Have a bump on the bridge of the nose
• Have a nasal tip that droops, protrudes, or is enlarged
• Have nostrils that are excessively flared or pinched
• Have been injured so that the nose is asymmetrical
• Have problems breathing due to irregularities with internal nose structure
• Have a deviated septum

Is Nose Surgery Right for Me?

Nose surgery is a highly individualized procedure and you should do it for yourself, not to fulfill someone else’s desires or to try to fit any sort of ideal image.

Surgery of the nose is a good option for you if:

• Your facial growth is complete and you are 13 years of age or older
• You are physically healthy
• You do not smoking
• You have specific, but realistic goals in mind for the improvement of your appearance

Preparing for Nose Surgery

The success and safety of your nose surgery depends very much on your complete candidness during your consultation. You’ll be asked a number of questions about your health, desires and lifestyle.

Prior to surgery, you may be asked to:

• Get lab testing or a medical evaluation
• Take certain medications or adjust your current medications
• Stop smoking well in advance of surgery
• Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding

Special instructions you receive will cover:

• What to do on the day of surgery
• The use of anesthesia during your nose surgery
• Post-operative care and follow-up

Your plastic surgeon will also discuss where your procedure will be performed. Surgery of the nose may be performed in an accredited office-based surgical center, outpatient or ambulatory surgical center, or a hospital.

If your nose surgery is performed on an outpatient basis, be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.

Nose Lift Surgery Overview

Anesthesia

Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation or general anesthesia. Your doctor will recommend the best choice for you.

The Incision

Surgery of the nose is performed either using a closed procedure, where incisions are hidden inside the nose, or an open procedure, where an incision is made across the columella, the narrow strip of tissue that separates the nostrils.

Through these incisions, the soft tissues that cover the nose are gently raised, allowing access to reshape the structure of the nose.

Reshaping The Nose Structure

There are two main options for the incisions that your plastic surgeon can use: closed rhinoplasty and open rhinoplasty.

Closed rhinoplasty involves incision confined to the inside of your nose. Swelling improves soon and recovery is fast. However, your surgeon may have a limited ability to achieve some changes in your nose because of her or his inability to see parts of the inside of the nose.

Open rhinoplasty involves a small incision across the columella, between the nostrils, in addition to incisions on the inside of your nose. Open surgery is usually preferred in more complicated cases.

Surgery of the nose can reduce or augment nasal structures with the use of cartilage grafted from other areas of your body. Most commonly, pieces of cartilage from the septum, the partition in the middle of the nose, is used for this purpose.

Occasionally a piece of cartilage from the ear and rarely a section of rib cartilage can be used.

Nose surgery to improve an obstructed airway requires careful evaluation of the nasal structure as it relates to airflow and breathing. Correction of a deviated septum, one of the most common causes of breathing impairment, is achieved by adjusting the nasal structure to produce better alignment.

If the surgeon is to correct a deviated septum, it is now straightened and the projections inside the nose are reduced to improve breathing.

Closing The Incisions

Once the underlying structure of the nose is sculpted to the desired shape, nasal skin and tissue is redraped and incisions are closed. Additional incisions may be placed in the natural creases of the nostrils to alter their size.

Nose Surgery Results

The new contours of your nose may be apparent as soon as swelling subsides. But although the initial swelling subsides within a few weeks, it may take up to a year for your new nasal contour to fully refine.

During this time you may notice gradual changes in the appearance of your nose as it refines to a more permanent outcome. Swelling may come and go and worsen in the morning during the first year following your nose surgery.

Will There be Scars?

Although scarring from rhinoplasty will be permanent, the incision lines will be hidden completely inside the nose, or tucked in the base of your nose between the nostrils.

Nose Surgery Recovery

After your procedure is completed, a splint, internal tubes or packing will likely be placed inside your nose and a splint or bandages placed on the outside to support and protect the new structures during initial healing.

You will be given specific instructions that may include: How to care for the surgical site, medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in your general health, and when to follow up with your plastic surgeon.

Be sure to ask your plastic surgeon specific questions about what you can expect during your individual recovery period:

• Where will I be taken after my surgery is complete?
• What medication will I be given or prescribed after surgery?
• Will I have dressings/bandages after surgery?
• When will they be removed?
• Are stitches removed? When?
• When can I resume normal activity and exercise?
• When do I return for follow-up care?

When You Return Home

If you experience shortness of breath, chest pains, or unusual heart beats, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment.

The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure. Another minor surgery may be necessary to reach the intended aesthetic goal.

Following your physician’s instructions is key to the success of your surgery. It is important that the surgical incisions are not subjected to excessive force, abrasion, or motion during the time of healing. Your doctor will give you specific instructions on how to care for yourself.

Possible Risks of Nose Surgery

The decision to have nose surgery is extremely personal and you’ll have to decide if the benefits will fulfill your goals and if the risks and potential complications are acceptable.

Your plastic surgeon and/or staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks or potential complications.

Possible risks of nose surgery include:

• Rupture of small surface vessels of the nose
• Infection
• Poor wound healing
• Anesthesia risks
• Bleeding (hematoma)
• Nose asymmetry
• Cardiac and pulmonary complications can occur in longer surgical procedures and may be associated with the formation of, or increase in, blood clots in the venous system
• Change in skin sensation (numbness)
• Nasal airway alterations may occur after a rhinoplasty or septoplasty that may interfere with normal passage of air through the nose
• Nasal septal perforation (a hole in the nasal septum) may develop but is rare; additional surgical treatment may be necessary to repair the nasal septum but in some cases, it may be impossible to correct this complication
• Pain, which may persist
• Unfavorable scarring
• Skin contour irregularities
• Skin discoloration and swelling
• Sutures may spontaneously surface through the skin, become visible or produce irritation that require removal
• Possibility of revisional surgery

These risks and others will be fully discussed prior to your consent. It is important that you address all your questions directly with your plastic surgeon.

Note: It’s very important to ask your plastic surgeon questions about your nose procedure. It’s natural to feel some anxiety, whether it’s excitement for your anticipated new look or a bit of preoperative stress. Don’t be shy about discussing these feelings with your plastic surgeon.

Nose Surgery Terms and Definitions

• Cartilage: Connective tissue that forms the structure of the nose.
• Columella: The narrow strip of tissue that separates the nostrils.
• Deviated septum: Cartilage that separates the nostrils is misaligned which may cause partial nasal airway obstruction.
• General anesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness.
• Hematoma: Blood pooling beneath the skin.
• Intravenous sedation: Sedatives administered by injection into a vein to help you relax.
• Local anesthesia: A drug injected directly to the site of an incision during an operation to relieve pain.
• Rhinoplasty: Surgery to reshape the nose.

There are 5 types of injectable fillers including Collagen, Hyaluronic Acid, Hydroxylapatite, Human fat, and PMMA.

What is Collagen?

Collagen is a natural protein that supports the skin. Injectable collagen formulas derived from human dermis include Cosmoderm® or Cosmoplast®. Zyderm® and Zyplast® are forms of bovine collagen that, unlike human derived collagen, require prior allergy testing. The results may last 2 to 4 months.

What is Hyaluronic Acid?

Hyaluronic Acid is a natural substance found in our bodies. It is well suited to plump thin lips and fill facial creases such as nasolabial folds. It may also be appropriate for some surface wrinkles and concave scars. The results may last 6 months or longer.

What is Hydroxylapatite?

Hydroxylapatite is a mineral-like compound found naturally in human bones, suspended in a gel-like formulation. It is the heaviest of facial fillers and is recommended to fill deeper creases such as nasolabial folds, marionette lines and frown lines, as well as to enhance fullness of the cheeks and other facial contours.

What is Human fat?

Human fat, harvested from your own body, can be reinjected to enhance facial fullness, fill deep creases and to build up shallow contours. Fat injection requires a more extensive procedure than other injectable fillers because it uses liposuction techniques to extract the fat prior to injection.

What is PMMA?

PMMA (polymethylmethacrylate) fillers contain 20% tiny PMMA microspheres suspended in 80% purified collagen gel. An FDA-approved PMMA filler is recommended for the correction of facial wrinkles known as smile lines.

Treatment results last up to a year or more in some cases and are highly variable. (Fat can be stored for your own future treatment. The duration of results from preserved fat is not as favorable as fat used at the same time it is harvested.)

Surgery Length: 10 – 30 Minutes
Anesthesia: Anesthetic Agent or Local Anesthetic
Hospital Stay: —
Stay in Thailand: —
Recovery: 5 – 10 Days
Procedure Cost: —

What Tissue Augmentation Can Do

Injectable fillers can:

• Plump thin lips
• Enhance shallow contours
• Soften facial creases and wrinkles
• Improve the appearance of recessed scars

There are several main areas of the face injectable fillers can help to rejuvenate. Line filling can help get rid of wrinkles around the mouth; Lip augmentation can enhance the lips; and Nasolabial Folds can smooth out wrinkles between the nose and mouth. Tissue augmentation can also be performed to ehance the cheeks.

What it won’t do: Soft tissue augmentation does not stop the aging process. If you wish to change the elements of your face, surgery such as a facelift, brow lift or eye lift may be the answer.

Non-surgical rejuvenation treatments such as injectable fillers cannot achieve the same results, but may help delay the time at which a facelift becomes appropriate.

Best Candidates for Tissue Augmentation

Tissue Augmentation is a good option for you if:

• You are physically healthy
• You don’t smoke
• You have a positive outlook and specific, but realistic goals in mind for the improvement of your appearance

Are Injectable Fillers Right for Me?

If you would like to restore facial contours, or reduce the appearance of lines and creases, injection therapy with soft tissue fillers may be right for you.

While not as involved as surgical cosmetic procedures, soft tissue augmentation is a medical procedure. You should do it for yourself, not to fulfill someone else’s desires or to try to fit any sort of ideal image.

Preparing for Tissue Augmentation

The success and safety of your soft tissue augmentation procedure depends very much on your complete candidness during your consultation. You’ll be asked a number of questions about your health, desires and lifestyle.

Prior to surgery, you may be asked to:

• Get lab testing or a medical evaluation
• Take certain medications or adjust your current medications
• Stop smoking well in advance of surgery
• Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding

Special instructions you receive will cover:

• What to do on the day of surgery
• The use of anesthesia during your surgery
• Post-operative care and follow-up

Your plastic surgeon will also discuss where your procedure will be performed. Injectable fillers may be performed in an accredited office-based surgical center, outpatient or ambulatory surgical center, or a hospital.

If your procedure is performed on an outpatient basis, be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery

Tissue Augmentation Procedure Overview

Step 1. Your plastic surgeon will carefully evaluate your facial appearance and skin tone, and examine the areas of your face to be augmented with injectable fillers.

Step 2. Strategic points on your face may be marked as guides to the appropriate injection sites for the filler.

Step 3. The injection sites will be cleansed with an antibacterial agent and icing or a topical numbing agent may be offered to make more sensitive patients comfortable.
In some cases, the filler itself will contain an anesthetic agent. In other cases local anesthetic may be administered to the treatment site.

Step 4. Injection takes only a few moments per site and a few minutes for a course of treatment.

Step 5. Following injection, any markings will be cleansed and icing may be offered to alleviate any temporary, minor discomfort. Makeup may be carefully re-applied so long as care is taken not to apply pressure to the treatment area.

Filling wrinkles or recessed scars involves multiple injections. In some cases where deeper injection of fillers is required, a local anesthetic may be used prior to treatment.

Common sites for deeper tissue fillers are the nasolabial folds and marionette lines, or to enhance fullness in the cheeks.

Tissue Augmentation Results

An improved appearance is visible almost immediately, although minor swelling or bruising may appear at the injection sites.

With some fillers, a slightly “over-filled” appearance may be initially present. These conditions will resolve within a few hours, or at most a few days. The duration may be as long as a few weeks with injection of one’s own harvested fat.

The results of soft tissue augmentation with injectable fillers are not permanent, even though a filler substance may be considered permanent. The continued aging of your face and variables in the absorption of fillers will affect how long your results last.

Should you choose not to repeat treatment, your appearance will return to its original condition. Plumped lips will lose volume and improved wrinkles, creases and scars will visibly recess and fully reappear in time.

Will There be Scars?

No, there should not be any scarring, injectable fillers and tissue augmentation are generally used to fill recessed scars.

Tissue Augmentation Recovery

The results of soft tissue augmentation using injectable fillers are apparent immediately. Your initial appearance after treatment with any filler may include:

• Mild swelling or bruising
• Temporary numbness or redness
• An “over-filled” appearance to treated areas

These conditions can be alleviated with topical icing and will improve within a matter of hours or just a few days.

Where fat is the injected filler, these conditions may persist for a few weeks. If you require subsequent follow-up procedures, these may take only a few minutes

You will be given specific instructions that may include: How to care for the surgical site(s), medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in your general health, and when to follow up with your plastic surgeon.

Be sure to ask your plastic surgeon specific questions about what you can expect during your individual recovery period:

• Will I be prescribed medication after the procedure?
• Will I have dressings/bandages after procedure?
• When will they be removed?
• When can I resume normal activity and exercise?
• When do I return for follow-up care?

When You Return Home

The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure and another surgery may be necessary.

Following your physician’s instructions is key to the success of your procedure. It is important that the surgical areas are not subjected to excessive force, swelling, abrasion, or motion during the time of healing. Your doctor will give you specific instructions on how to care for yourself.

Possible Risks of Tissue Augmentation

The decision to have soft tissue augmentation is extremely personal and you’ll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable.

Your plastic surgeon and/or staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks and potential complications.

Possible risks of injectable fillers include:

• Fillers derived from non-human sources may require a pre-treatment allergy test
• Infection at the injection site
• Fillers that are not completely fluid and contain microscopic granular substances carry a risk of “clumping” as a result of facial movement and the natural aging process. Over time, these can result in lumps or nodules that may require surgery to treat
• Acne-like skin eruptions
• Antibodies to filler material may reduce the effectiveness of future injections
• Asymmetry
• Bleeding, bruising and swelling
• Filler material may migrate from the original site and produce temporary paralysis of other muscle groups or other unintended effects
• Skin might die (skin necrosis)
• Skin rash, itching and swelling
• Skin redness
• Skin sensitivity
• Under or over correction of wrinkles

These risks and others will be fully discussed prior to your consent. It is important that you address all your questions directly with your plastic surgeon.

Note: It’s very important to ask your plastic surgeon questions about your tissue augmentation. It’s natural to feel some anxiety, whether it’s excitement for your anticipated new look or a bit of preoperative stress. Don’t be shy about discussing these feelings with your plastic surgeon.

A special note about the FDA and injectable fillers: The U.S. Food and Drug Administration reviews and approves pharmaceutical fillers in the same manner as medical devices. However, some fillers may be used on an off-label basis, meaning they are approved medical treatments but not directly reviewed for a specific application. The options discussed in this brochure are among the current fillers preferred by plastic surgeons. Some are available for general use, others are not; regulatory status may be subject to change.

Injectable Fillers Terms and Definitions

• Collagen: A natural protein used as an injectable filler for soft tissue augmentation.
• Cupid’s bow: The middle portion of the lip which has the upturn.
  General anesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness.
• Human fat: Fat harvested from your own body and used as an injectable filler for soft tissue augmentation.
• Hyaluronic acid: A natural substance found in the body used as a filler.
• Hydroxylapatite: A mineral-like compound found naturally in human bone used as a filler.
• Injectable fillers: Substances used to restore volume and a more youthful appearance.
• Intravenous sedation: Sedatives administered by injection into a vein to help you relax.
• Liposuction: Also called lipoplasty or suction lipectomy, a procedure that vacuums out fat from beneath the skin’s surface to reduce fullness.
• Local anesthesia: A drug injected directly to the site of an incision during an operation to relieve pain.
• PMMA: A widely used implant material formed into tiny microspheres and suspended in a collagen gel for use as a wrinkle filler.
• Soft tissue augmentation: The use of injectable fillers to restore volume and your youthful appearance.
• Vermillion: The red pigment of your lips.

In some cases, liposuction is performed alone, in other cases it is used with plastic surgery procedures such as a facelift, breast reduction or a tummy tuck.

The procedure is popular for both men and women.

Surgery Length: 30 Minutes – 4 Hours
Anesthesia: Intravenous Sedation or General Anesthesia
Hospital Stay: —
Stay in Thailand: —
Recovery: 5 – 10 Days
Procedure Cost: —

What Liposuction Can Do

Liposuction slims and reshapes specific areas of the body by removing excess fat deposits, improving your body contours and proportion, and ultimately, enhancing your self-image.

Liposuction techniques may be used to reduce localized fat deposits of the:

• Thighs
• Hips and buttocks
• Abdomen and waist
• Upper arms
• Back
• Inner knee
• Chest area
• Cheeks, chin and neck
• Calves and ankles

What it won’t do: Liposuction is not a treatment for obesity or a substitute for proper diet and exercise. It is also not an effective treatment for cellulite, the dimpled skin that typically appears on the thighs, hips and buttocks, or loose saggy skin.

Best Candidates for Liposuction

Ideal candidates for liposuction are:

• Adults within 30% of their ideal weight who have firm, elastic skin and good muscle tone
• Healthy individuals who do not have a life-threatening illness or medical conditions that can impair healing
• Non-smokers
• Individuals with a positive outlook and specific goals in mind for body contouring

Is Liposuction Right for Me?

If you are bothered by excess fat deposits – located anywhere on your body – that don’t respond to diet or exercise, liposuction may be right for you.

Preparing for Liposuction

The success and safety of your liposuction procedure depends very much on your complete candidness during your consultation. You’ll be asked a number of questions about your health, desires and lifestyle.

Prior to surgery, you may be asked to:

• Get lab testing or a medical evaluation
• Take certain medications or adjust your current medications
• Stop smoking well in advance of surgery
• Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding

Special instructions you receive will cover:

• What to do on the day of surgery
• The use of anesthesia during your liposuction
• Post-operative care and follow-up

Your plastic surgeon will also discuss where your procedure will be performed. Liposuction may be performed in an accredited office-based surgical center, outpatient or ambulatory surgical center, or a hospital.

If your liposuction is performed on an outpatient basis, be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery

Liposuction Surgery Overview

Liposuction Surgery Techniques

There are three common variations to the procedure:

• Traditional liposuction is surgical suctioning of excess fat deposits
• The tumescent or super-wet technique requires an infusion of saline solution with adrenaline and possibly anesthetic prior to removal of excess fat
• Ultrasound-assisted lipoplasty uses ultrasonic energy to liquefy excess fat prior to surgical suctioning

Anesthesia

Medications are administered for your comfort during the surgical procedures. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.

The Incision

Liposuction is performed through small, inconspicuous incisions.

First, sterile liquid solution is infused to reduce bleeding and trauma. Then a thin hollow tube, or cannula, is inserted through these incisions to loosen excess fat using a controlled back and forth motion.

The dislodged fat is then suctioned out of the body using a surgical vacuum or syringe attached to the cannula.

Liposuction Surgery Results

Your improved body contour will be apparent when the swelling and fluid retention commonly experienced following liposuction subside.

It may take several months for this swelling to fully dissipate. But as it does, your new contours and enhanced self-image should continue to develop.

With continued practices of healthy diet and fitness, the loss of excess fatty tissue should be permanently maintained. However, substantial weight gain can alter an otherwise permanent result.

A special note: Secondary procedures may sometimes be recommended to reduce excess skin. Special considerations are needed when large amounts – usually more than 5 liters of fat – are suctioned.

Will There be Scars?

There will be small scars, however the incisions generally made to perform liposuction are very inconspicuous.

Liposuction Surgery Recovery

Once your procedure is completed, a compression garment or elastic bandages may cover treatment areas. These help to control swelling and compress the skin to your new body contours.

In addition, small temporary drains may be placed in existing incisions beneath the skin to remove any excess blood or fluid.

The recovery period for most patients who have undergone liposuction is relatively quick, ranging between 5 – 10 days.

You will be given specific instructions that may include: How to care for the surgical site(s), medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in your general health, and when to follow up with your plastic surgeon.

Be sure to ask your plastic surgeon specific questions about what you can expect during your individual recovery period:

• Where will I be taken after my surgery is complete?
• What medication will I be given or prescribed after surgery?
• Will I have dressings/bandages after surgery?
• When will they be removed?
• Are stitches removed? When?
• When can I resume normal activity and exercise?
• When do I return for follow-up care?

When You Return Home

If you experience shortness of breath, chest pains, or unusual heart beats, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment.

The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure and another surgery may be necessary.

Following your physician’s instructions is key to the success of your surgery. It is important that the surgical incisions are not subjected to excessive force, swelling, abrasion, or motion during the time of healing. Your doctor will give you specific instructions on how to care for yourself.

Possible Risks of Liposuction Surgery

The decision to have liposuction is extremely personal and you’ll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable.

Your plastic surgeon and/or staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks or potential complications.

Possible risks of liposuction include:

• Uneven contours
• Rippling or loose skin
• Skin or nerve damage
• Irregular pigmentation
• Infection
• Fat clots
• Blood clots
• Excessive fluid loss or fluid accumulation
• Unfavorable scarring
• Thermal burn or heat injury from ultrasound with the ultrasound-assisted lipoplasty technique
• Anesthesia risks
• Bleeding (hematoma)
• Change in skin sensation
• Skin discoloration or swelling
• Asymmetry
• Pain, which may persist
• Damage to deeper structures such as nerves, blood vessels, muscles, lungs, and abdominal organs
• Poor wound healing
• Persistent swelling in the legs
• Deep vein thrombosis, cardiac and pulmonary complications
• Possibility of revisional surgery

These risks and others will be fully discussed prior to your consent. It is important that you address all your questions directly with your plastic surgeon.

Note: It’s very important to ask your plastic surgeon questions about your liposuction procedure. It’s natural to feel some anxiety, whether it’s excitement for your anticipated new look or a bit of preoperative stress. Don’t be shy about discussing these feelings with your plastic surgeon.

Liposuction Terms and Definitions

• Breast reduction: Also known as reduction mammaplasty, reduction of breast size by surgery.
• Cannula: A thin, hollow tube used during liposuction to loosen excess fat.
• Facelift: A surgical procedure, also known as rhytidectomy, to reduce sagging of the mid-face, jowls and neck.
• General anesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness.
• Hematoma: Blood pooling beneath the skin.

Intravenous sedation: Sedatives administered by injection into a vein to help you relax.

• Lipoplasty: Another term for liposuction. Liposuction: Also called lipoplasty or suction lipectomy, this procedure vacuums out fat from beneath the skin’s surface to reduce fullness.
• Local anesthesia: A drug injected directly to the site of an incision during an operation to relieve pain.
• Suction lipectomy: Another term for liposuction.
• Sutures: Stitches used by surgeons to hold skin and tissue together.

Tumescent or super-wet liposuction: Involves an infusion of saline solution with adrenaline and possibly anesthetic prior to removal of excess fat.

• Tummy tuck: A surgical procedure, also known as abdominoplasty, to correct the apron of excess skin hanging over your abdomen.
• Ultrasound-assisted lipoplasty: Uses ultrasonic energy to liquefy excess fat prior to surgical suctioning.

Facial implants can be used to enhance the chin, jaw and cheek.

What are Chin Implants?

Chin implants can increase the size and projection of a chin that does not project in proportion with the forehead and mid-face. A small or recessed chin can also be described as one that seems to disappear into the neck of an individual of normal weight, rather than appearing as a distinct facial feature.

What are Jaw Implants?

Jaw implants increase the width of the lower third of your face. Much like the chin, a weak jaw can be thought of as one that is not well-defined and distinct from the neck, or one that slopes rather than angles from the ear to the chin. In some cases, both the chin and jaw can contribute to facial imbalance.

What are Cheek Implants?

Cheek implants increase the projection of the cheekbones. They add volume to areas which may be recessed or flat.

If symmetry among facial features is part of your goal, facial implants may be recommended to augment more than one facial region. It’s important to remember that all of our faces are asymmetric to some degree and your results may not be completely symmetric. The goal is to create balance and proportion. Your procedure may be performed alone, or as a complement to other facial contouring procedures such as nose or ear surgery.

Surgery Length: 1 – 2 Hours
Anesthesia: Intravenous Sedation or General Anesthesia
Hospital Stay: —
Stay in Thailand: —
Recovery: Swelling reduces greatly within first few weeks. Several months to fully heal.
Procedure Cost: —

What Facial Implants Can Do

Facial implants bring balance and better proportion to the structural appearance of your face. They define your face by increasing projection and creating more distinct features.

Facial implants can improve proportion and profiles and correct imbalance caused by injury or hereditary traits.

Best Candidates for Facial Implants

Plastic surgery with facial implants is best performed on people whose head and skull have reached physical maturity, which generally occurs in late adolescence. This procedure is a good option for you if:

• You are physically healthy
• You do not smoke
• You have a positive outlook and specific goals in mind for improvement of facial contours

Are Facial Implants Right for Me?

If you are bothered by a small chin, weak jaw or lack of facial contour, plastic surgery with facial implants may benefit you. While any area of your face can be augmented with implants, the cheekbones, chin and jaw are the most common sites for facial implants.

Preparing for Facial Implants

The success and safety of your facial implant procedure depends very much on your complete candidness during your consultation. You’ll be asked a number of questions about your health, desires and lifestyle.

Prior to surgery, you may be asked to:

• Get lab testing or a medical evaluation
• Take certain medications or adjust your current medications
• Stop smoking well in advance of surgery
• Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding

Special instructions you receive will cover:

• What to do on the day of surgery
• The use of anesthesia during your procedure
• Post-operative care and follow-up

Your plastic surgeon will also discuss where your procedure will be performed. Facial implants may be performed in an accredited office-based surgical center, outpatient or ambulatory surgical center, or a hospital.

If your Facial implants are performed on an outpatient basis, be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.

Facial Implant Surgery Overview

Anesthesia

Medications are administered for your comfort during the surgical procedures. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.

The Incision

The chin: For a chin implant, the incision may be inside your mouth, along the crease that joins your lower lip and gums. An incision just beneath the chin is an alternative.

The jaw: These implants are generally placed through the mouth with incisions inside the mouth, further back along the jawline, at the crease where the inside of your cheek and gums meet.

The cheek: The specific area to be augmented in the cheek determines where an implant will be positioned on the cheekbone. Cheek implants are most often placed through incisions in the mouth. When performed with other procedures, alternate incisions may be recommended including placement through an incision inside the lower eyelid or one within the hairline.

Closing the Incisions

Your incisions will be closed with absorbable sutures or stitches that will be removed within 1-2 weeks following your surgery.

Face Implant Surgery Results

The final results of your facial implant surgery will be long-lasting, however the initial healing phase may include localized swelling, discoloration, numbness or discomfort.

Will There be Scars?

In most cases the scars from facial implants will be well hidden. Incisions will either be made inside the mouth, under the jaw, or the hairline.

Facial Implant Surgery Recovery

While the initial outcome of plastic surgery with facial implants is noticeable almost immediately, it will be obscured by visible swelling. It may take several months for swelling to fully dissipate.

In addition, facial movements may be temporarily restricted or impaired. These are common conditions.

You will be given specific instructions that may include: How to care for the surgical site, medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in overall health, and when to follow up with your plastic surgeon.

Be sure to ask your plastic surgeon specific questions about what you can expect during your individual recovery period:

• Where will I be taken after my surgery is complete?
• What medication will I be given or prescribed after surgery?
• Will I have dressings/bandages after surgery?
• When will they be removed?
• Are stitches removed? When?
• When can I resume normal activity and exercise?
• Will I receive specific dietary instructions?
• When do I return for follow-up care?

When You Return Home

If you experience shortness of breath, chest pains, or unusual heart beats, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment.

The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure. Another surgery may be necessary.

Following your physician’s instructions is key to the success of your surgery. It is important that the surgical incisions are not subjected to excessive force, abrasion or motion during the time of healing. Your doctor will give you specific instructions on how to care for yourself.

Possible Risks of Facial Implant Surgery

The decision to have facial implant surgery is extremely personal and you’ll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable. Your plastic surgeon and/or staff will explain in detail the risks associated with surgery.

You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo, the alternatives and the most likely risks and potential complications.

Possible risks of facial implant surgery include:

• Unfavorable scarring
• Bleeding (hematoma)
• Infection
• Poor healing of incisions
• Anesthesia risks
• Change in skin sensation
• Damage to deeper structures — such as nerves, blood vessels, muscles, and lungs — can occur and may be temporary or permanent
• Allergies to tape, suture materials and glues, blood products, topical preparations or injected agents
• Excessive scar tissue formation
• Firmness around the implant
• Shifting of implants and pressure on surrounding structures
• Skin contour irregularities
• Skin discoloration and swelling
• Skin sensitivity
• Deep vein thrombosis, cardiac and pulmonary complications
• Blood clots
• Pain, which may persist
• Possibility of revisional surgery

These risks and others will be fully discussed prior to your consent. It is important that you address all your questions directly with your plastic surgeon.

Note: It’s very important to ask your plastic surgeon questions about your Facial Implant procedure. It’s natural to feel some anxiety, whether it’s excitement for your anticipated new look or a bit of preoperative stress. Don’t be shy about discussing these feelings with your plastic surgeon.

Facial Implant Surgery Terms and Definitions

• Biocompatible materials: Synthetic or natural material used in facial implants and designed to function along with living tissue.
• External incisions: Surgical incisions made on the surface of your skin.
• General anesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness.
• Intraoral incisions: Surgical incisions made inside the mouth.
• Intravenous sedation: Sedatives administered by injection into a vein to help you relax.
• Local anesthesia: A drug injected directly to the site of an incision during an operation to relieve pain.

Surgery Length: 1 – 3 Hours
Anesthesia: Intravenous Sedation or General Anesthesia
Hospital Stay: —
Stay in Thailand: —
Recovery: 1 – 2 weeks swelling greatly reduces, 2-3 weeks to completely heal.
Procedure Cost: —

What Facelift Surgery Can Do

Facelift surgery can treat:

• Sagging in the midface
• Deep creases below the lower eyelids
• Deep creases along the nose extending to the corner of the mouth
• Fat that has fallen or is displaced
• Loss of muscle tone in the lower face may create jowls
• Loose skin and excess fatty deposits under the chin and jaw can make even a person of normal weight appear to have a double chin

What it won’t do: As a restorative surgery, a facelift does not change your fundamental appearance and cannot stop the aging process.

A facelift can only be performed surgically; non-surgical rejuvenation treatments cannot achieve the same results, but may help delay the time at which a facelift becomes appropriate and complement the results of surgery.

Best Candidates for Facelift Surgery

Ideal candidates for facelift surgery include:

• Healthy individuals who do not have a life-threatening illness or medical conditions that can impair healing
• Non-smokers
• Individuals with a positive outlook and specific goals in mind for rhytidectomy

Is Facelift Surgery Right for Me?

If you are bothered by the signs of aging in your face, a facelift may be right for you. Technically known as rhytidectomy, a facelift is a surgical procedure to improve visible signs of aging in the face and neck.

A facelift is a highly individualized procedure and you should do it for yourself, not to fulfill someone else’s desires or to try to fit any sort of ideal image.

Preparing for Facelift Surgery

The success and safety of your facelift depends very much on your complete candidness during your consultation. You’ll be asked a number of questions about your health, desires and lifestyle.

Prior to surgery, you may be asked to:

• Get lab testing or a medical evaluation
• Take certain medications or adjust your current medications
• Stop smoking well in advance of surgery
• Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding

Special instructions you receive will cover:

• What to do on the night before and morning of surgery
• The use of anesthesia during your face lift
• Post-operative care and follow-up

Your plastic surgeon will also discuss where your procedure will be performed. A facelift may be performed in an accredited office-based surgical center, outpatient or ambulatory surgical center, or a hospital.

If your facelift is performed on an outpatient basis, be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.

Facelift Surgery Overview

Anesthesia

Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.

The Incision

Depending on the degree of change you’d like to see, your facelift choices include a traditional facelift, limited incision facelift or a neck lift.

• Traditional Facelift: A traditional facelift incision often begins in the hairline at the temples, continues around the ear and ends in the lower scalp. Fat may be sculpted or redistributed from the face, jowls and neck, and underlying tissue is repositioned, commonly the deeper layers of the face and the muscles are also lifted.

  Skin is redraped over the uplifted contours and excess skin is trimmed away. A second incision under the chin may be necessary to further improve an aging neck. Sutures or skin adhesives close the incisions.

• Limited Incision: An alternative to a traditional facelift uses shorter incisions at the temples, continuing around the ear and possibly within the lower eyelids or under the upper lip.
• Neck Lift: Sagging jowls, loose neck skin and fat accumulation under the chin may be corrected with a neck lift. The neck lift incision often begins in front of the ear lobe and wraps around behind the ear ending in the lower scalp.

Closing the Incision

Once healed, the incision lines from a facelift are well concealed within the hairline and in the natural contours of the face and ear.

Facelift Surgery Results

The visible improvements of a facelift appear as swelling and bruising subside. Your final result should not only restore a more youthful and rested appearance, but also help you feel more confident about yourself.

Life-long sun protection will help to maintain your rejuvenated appearance by minimizing photo-aging or sun damage. In addition, a healthy lifestyle will also help extend the results of your rejuvenated, more youthful appearance.

Will There be Scars?

Because of their placement, face-lift scars are hardly noticeable. Incisions around the ear and earlobe are quite inconspicuous.

All scars fade with time and should fade completely within a year.

Facelift Surgery Recovery

When your procedure is completed, a bandage could gently be placed around your face to minimize swelling and bruising. A thin tube may be present to drain any excess blood or fluid that may collect under the skin. It may take several months for swelling to fully dissipate and up to 6 months for incision lines to mature.

You will be given specific instructions that may include: how to care for the surgical site, medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in overall health, and when to follow up with your plastic surgeon.

Be sure to ask your plastic surgeon specific questions about what you can expect during your individual recovery period:

• Where will I be taken after my surgery is complete?
• What medication will I be given or prescribed after surgery?
• Will I have dressings/bandages after surgery? When will they be removed?
• Are stitches removed? When?
• When can I resume normal activity and exercise?
• When do I return for follow-up care?

When You Return Home

If you experience shortness of breath, chest pains, or unusual heart beats, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment.

The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure. Another surgery may be necessary.

Following your physician’s instructions is key to the success of your surgery. It is important that the surgical incisions are not subjected to excessive force, abrasion, or motion during the time of healing. Avoid wearing any clothing that must go over your head. Your doctor will give you specific instructions on how to care for yourself.

Possible Risks of Facelift Surgery

The decision to have a facelift is extremely personal and you’ll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable.

Your plastic surgeon and/or staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks and potential complications.

Possible risks of facelift surgery include:

• Unfavorable scarring
• Bleeding (hematoma)
• Infection
• Poor wound healing
• Anesthesia risks
• Correctable hair loss at the incisions
• Facial nerve injury with weakness
• Facial asymmetry
• Skin loss
• Numbness or other changes in skin sensation
• Fatty tissue found deep in the skin might die (fat necrosis)
• Fluid accumulation
• Pain, which may persist
• Skin contour irregularities
• Skin discoloration, sensitivity or swelling
• Sutures may spontaneously surface through the skin, become visible or produce irritation that require removal
• Unsatisfactory results may include asymmetry, unsatisfactory surgical scar location, unacceptable visible deformities at the ends of the incisions (It may be necessary to perform additional surgery to improve your results)
• Deep vein thrombosis, cardiac and pulmonary complications
• Possibility of revisional surgery

A special note about the use of fibrin sealants (tissue glue)

Fibrin sealants (made from heat-treated human blood components to inactivate virus transmission) are used to hold tissue layers together at surgery and to diminish post-operative bruising following surgery.

This product has been carefully produced from screened donor blood plasma for hepatitis, syphilis, and human immunodeficiency virus (HIV). These products have been used safely for many years as sealants in cardiovascular and general surgery. This product is thought to be of help in diminishing surgical bleeding and by adhering layers of tissue together.

Note: It’s very important to ask your plastic surgeon questions about your facelift procedure. It’s natural to feel some anxiety, whether it’s excitement for your anticipated new look or a bit of preoperative stress. Don’t be shy about discussing these feelings with your plastic surgeon.

Facelift Surgery Procedure Terms and Definitions

• General anesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness.
• Hematoma: Blood pooling beneath the skin.

Intravenous sedation: Sedatives administered by injection into a vein to help you relax.

• Tear trough: Deep creases below the lower eyelids.
• Nasolabial fold: Deep creases between the nose and cheek.

Jowls: A jaw line that sags into the neck, usually caused by loss of muscle tone in the lower face.

• Local anesthesia: A drug injected directly to the site of an incision during an operation to relieve pain.
• Rhytidectomy: A surgical procedure also known as facelift, to reduce sagging of the mid-face, jowls and neck.

Cosmetic eyelid surgery, can help improve the appearance of the upper eyelids, lower eyelids, or both, and give a rejuvenated appearance to the surrounding area of your eyes, making you look more rested and alert.

Surgery Length: 1 – 3 Hours
Anesthesia: Intravenous Sedation or General Anesthesia
Hospital Stay: —
Stay in Thailand: —
Recovery: 7 – 10 Days.
Procedure Cost: —

What Eyelid Surgery Can Do

Eyelid surgery can treat:

• Loose or sagging skin that creates folds or disturbs the natural contour of the upper eyelid, sometimes impairing vision
• Excess fatty deposits that appear as puffiness in the upper eyelids
• Bags under the eyes
• Droopiness of the lower eyelids, showing white below the iris (colored portion of the eye)
• Excess skin and fine wrinkles of the lower eyelid

Best Candidates for a Eyelid Surgery

Ideal candidates for eyelid surgery include:

• Healthy individuals who do not have a life-threatening illness or medical conditions that can impair healing
• Non-smokers
• Individuals with a positive outlook and specific goals in mind for blepharoplasty
• Individuals without serious eye conditions

Is Eyelid Surgery Right for Me?

Eyelid surgery is usually performed on adult men and women who have healthy facial tissue and muscles and have realistic goals for improvement of the upper and/or lower eyelids and surrounding area.

You should do it for yourself, not to fulfill someone else’s desires or to try to fit any sort of ideal image.

This procedure is a good option for you if:

• You are physically healthy and of relatively normal weight
• You have realistic expectations
• Your breast development has stabilized
• You are bothered by the feeling that your breasts are too large

You must tell your doctor if you have any of these medical conditions:

• Eye disease such as glaucoma, dry eye or a detached retina
• Thyroid disorders such as Graves’ disease and under or overactive thyroid
• Cardiovascular disease, high blood pressure or other circulatory disorders or diabetes

Preparing for Eyelid Surgery

The success and safety of your eyelid surgery procedure depends very much on your complete candidness during your consultation. You’ll be asked a number of questions about your health, desires and lifestyle.

Prior to surgery, you may be asked to:

• Get lab testing or a medical evaluation
• Take certain medications or adjust your current medications
• Stop smoking well in advance of surgery
• Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding

Special instructions you receive will cover:

• What to do on the night before and the morning of surgery
• The use of anesthesia during your procedure
• Post-operative care and follow-up

Your plastic surgeon will also discuss where your procedure will be performed. Blepharoplasty may be performed in an accredited office-based surgical center, outpatient or ambulatory surgical center, or a hospital.

If your eyelid surgery is performed on an outpatient basis, be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.

Eyelid Surgery Overview

Anesthesia

Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation or general anesthesia. Your doctor will recommend the best choice for you.

The Incision

The incision lines for eyelid surgery are designed for scars to be well concealed within the natural structures of the eyelid region.

Droopy conditions of the upper eyelid can be corrected through an incision within the natural crease of the upper eyelid allowing repositioning of fat deposits, tightening of muscles and tissue, and/or removal of excess skin.

Conditions of the lower eyelid may be corrected with an incision just below the lower lash line. Through this incision, excess skin in the lower eyelids is removed.

A transconjunctival incision, one hidden inside the lower eyelid, is an alternate technique to correct lower eyelid conditions and redistribute or remove excess fat.

Closing the Incision

Eyelid incisions typically are closed with:

• Removable or absorbable sutures
• Skin adhesives
• Surgical tape

Your surgeon may use a laser chemical peel to erase dark discoloration of the lower eyelids.

Eyelid Surgery Results

The results of eyelid surgery will appear gradually as swelling and bruising subside to reveal a smooth, better-defined eyelid and surrounding region, and an alert and rejuvenated appearance.

Your final results will appear within several weeks, but it may take up to a year for incision lines to fully refine.

Will There be Scars?

Your eyelid surgery scars will eventually fade, becoming virtually invisible. As you heal, your scars will be pinkish and somewhat plump. The pinkness can persist for six months or longer.

Eyelid Surgery Recovery

After your procedure is completed, lubricating ointment and cold compresses may be applied, and in some cases your eyes may be loosely covered with gauze.

Initial healing may include some swelling, bruising, irritation or dry eyes and discomfort that can be controlled with medication, cold compresses and ointment. Irritation at the incision sites also is possible.

The recovery period for eyelid surgery is relatively quick, ranging from around 7 – 10 days.

While eyelid surgery can be expected to correct certain conditions permanently, you will continue to age naturally. Life-long sun protection will help to maintain your results.

You will be given specific instructions that may include: How to care for your eyes, medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in your overall health, and when to follow-up with your plastic surgeon.

Be sure to ask your plastic surgeon specific questions about what you can expect during your individual recovery period:

• Where will I be taken after my surgery is complete?
• What medication will I be given or prescribed after surgery?
• Will I have dressings/bandages after surgery?
• When will they be removed?
• Are stitches removed? When?
• When can I resume normal activity and exercise?
• When do I return for follow-up care?

You must practice diligent sun protection and use darkly tinted sunglasses until the healing process is fully complete.

When You Return Home

If you experience shortness of breath, chest pains, or unusual heart beats, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment.

The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure. Another surgery may be necessary.

Following your physician’s instructions is key to the success of your surgery. It is important that the surgical incisions are not subjected to excessive force, abrasion or motion during the time of healing. Your doctor will give you specific instructions on how to care for yourself.

Possible Risks of Eyelid Surgery

The decision to have eyelid surgery is extremely personal and you’ll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable.

You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks or potential complications.

Possible risks of eyelid surgery include:

• Unfavorable scarring
• Temporarily blurred or impaired vision
• Dry eyes
• Difficulty closing your eyes
• Lid lag, a pulling down of the lower eyelid may occur and is often temporary
• Ectropion, rolling of the eyelid outwards
• Bleeding (hematoma)
• Poor wound healing
• Infection
• Fluid accumulation
• Blood clots
• Numbness and other changes in skin sensation
• Anesthesia risks
• Eyelid disorders that involve abnormal position of the upper eyelids (eyelid ptosis), loose eyelid skin, or abnormal laxness of the lower eyelid (ectropion) can coexist with sagging forehead and eyebrow structures; brow lift surgery will not correct these disorders; additional surgery may be required
• Pain, which may persist
• Skin discoloration and swelling
• Sutures may spontaneously surface through the skin, become visible or produce irritation that require removal
• Deep vein thrombosis, cardiac and pulmonary complications
• Possibility of revisional surgery
• Loss of eyesight

These risks and others will be fully discussed prior to your consent. It is important that you address all your questions directly with your plastic surgeon.

Note: It’s very important to ask your plastic surgeon questions about your eyelid procedure. It’s natural to feel some anxiety, whether it’s excitement for your anticipated new look or a bit of preoperative stress. Don’t be shy about discussing these feelings with your plastic surgeon.

Eyelid Surgery Procedure Terms and Definitions

Blepharoplasty: Eyelid surgery to improve the appearance of upper eyelids, lower eyelids or both
Ectropion: When the lower eyelid is rolled outward after eyelid surgery; often a temporary condition.
General anesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness.
Hematoma: Blood pooling beneath the skin.
Intravenous sedation: Sedatives administered by injection into a vein to help you relax.
Local anesthesia: A drug injected directly to the site of an incision during an operation to relieve pain.
Transconjunctival incision: Incision hidden inside the lower eyelid.
Skin resurfacing: Treatment to improve the texture, clarity and overall appearance of your skin.
Sutures: Stitches used by surgeons to hold skin and tissue together.

Surgery Length: 1 – 2 Hours
Anesthesia: Intravenous Sedation or General Anesthesia
Hospital Stay: —
Stay in Thailand: —
Recovery: 5-10 days
Procedure Cost: —

What a Ear Surgery Can Do

Ear surgery creates a natural shape, while bringing balance and proportion to the ears and face. Correction of even minor deformities can have profound benefits to appearance and self-esteem.

Specifically ear surgery can treat:

• Overly large ears — a rare condition called macrotia
• Protruding ears occurring on one or both sides in varying degrees — not associated with hearing loss
• Adult dissatisfaction with previous ear surgery

Best Candidates for Ear Surgery

Children who are good candidates for ear surgery are:

• Healthy, without a life-threatening illness or untreated chronic ear infections
• Generally 5 years old, or when a child’s ear cartilage is stable enough for correction
• Cooperative and follow instructions well
• Able to communicate their feelings and do not voice objections when surgery is discussed

Teenagers and adults who are good candidates for ear surgery are:

• Healthy individuals who do not have a life-threatening illness or medical conditions that can impair healing
• Non-smokers
• Individuals with a positive outlook and specific goals in mind for ear surgery

Is Ear Surgery Right for Me?

Ear surgery is a highly individualized procedure and you should do it for yourself, not to fulfill someone else’s desires or to try to fit any sort of ideal image.

Preparing for Ear Surgery

The success and safety of your procedure depends very much on your complete candidness during your consultation. You’ll be asked a number of questions about your health, desires and lifestyle.

Prior to surgery, you may be asked to:

• Get lab testing or a medical evaluation
• Take certain medications or adjust your current medications
• Stop smoking well in advance of surgery
• Avoid taking aspirin and certain anti-inflammatory drugs and herbal supplements as they can increase bleeding

Special instructions you receive will cover:

• What to do on the day of surgery
• The use of anesthesia during your procedure
• Post-operative care and follow-up

Your plastic surgeon will also discuss where your procedure will be performed. Depending on the type of surgery you will undergo, your procedure may be performed in your plastic surgeon’s accredited office-based surgical facility, an ambulatory surgical facility or a hospital.

If your ear surgery is performed on an outpatient basis, be sure to arrange for someone to drive you home after surgery and to stay with you for at least the first night following surgery.

Ear Surgery Overview

Anesthesia

Medications are administered for your comfort during the surgical procedure. The choices include local, intravenous sedation or general anesthesia. Your doctor will recommend the best choice for you.

The Incision

Correction of protruding ears uses surgical techniques to create or increase the antihelical fold (just inside the rim of the ear) and to reduce enlarged conchal cartilage (the largest and deepest concavity of the external ear). Incisions for otoplasty are generally made on the back surface of the ear. When incisions are necessary on the front of the ear, they are made within its folds to hide them. Internal, non-removable sutures are used to create and secure the newly shaped cartilage in place.

Closing the Incisions

External stitches close the incision. Techniques are individualized, taking care not to distort other structures and to avoid an unnatural “pinned back” appearance.

Ear Surgery Results

Ear surgery offers near immediate results in cases of protruding ears, visible once the dressings that support the new shape of the ear during initial phases of healing are removed. With the ear permanently positioned closer to the head, surgical scars are either hidden behind the ear or well-hidden in the natural creases of the ear.

Will There be Scars?

The scars are hidden behind the ear and hence are not easily visible. However, if you are prone to scarring problems such as keloids, you should discuss this with your surgeon before the procedure.

Ear Surgery Recovery

After surgery, bandages or dressings will be applied to keep your surgical site clean, protect it from trauma and to support the new position of the ear during initial healing.

Discomfort immediately following ear surgery is normal and can be controlled with pain medication. There may be an itchy feeling under bandages. It is essential that bandages remain intact and are not removed, for any reason. Failure to do so may result in loss of some of the correction and may require a secondary surgery.

You will be given specific instructions that may include: How to take care of your ears following surgery, medications to apply or take orally to aid healing and reduce the risk of infection, and when to follow-up with your plastic surgeon.

Be sure to ask your plastic surgeon specific questions about what you can expect during your individual recovery period:

• Where will I be taken after my surgery is complete?
• What medication will I be given or prescribed after surgery?
• Will I have dressings/bandages after surgery?
• When will they be removed?
• Are stitches removed? When?
• When can I resume normal activity and exercise?
• When do I return for follow-up care?

When You Go Home

Should any complications occur, notify your plastic surgeon who will determine if any additional treatment is needed.

Following your physician’s instructions is key to the success of your surgery. It is important that the surgical incisions are not subjected to excessive force, abrasion, or motion during the time of healing. Your doctor will give you specific instructions on how to care for yourself.

It’s very important to follow your plastic surgeon’s instructions and attend follow-up visits as scheduled.

Possible Risks of Ear Surgery

The decision to have ear surgery is extremely personal and you’ll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable. Your plastic surgeon and/or staff will explain in detail the risks associated with surgery.

You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo, the alternatives and the most likely risks and potential complications.

Possible risks of ear surgery include:

• Bleeding (hematoma)
• Blood clots
• Asymmetry
• Infection
• Poor wound healing
• Change in skin sensation
• Skin contour irregularities
• Skin discoloration/swelling
• Anesthesia risks
• Unfavorable scarring
• Allergies to tape, suture materials, glues, blood products, topical preparations or injected agents
• Pain, which may persist
• Possibility of revisional surgery

These risks and others will be fully discussed prior to your consent. It is important that you address all your questions directly with your plastic surgeon.

Note: It’s very important to ask your plastic surgeon questions about your procedure. It’s natural to feel some anxiety, whether it’s excitement for your anticipated new look or a bit of preoperative stress. Don’t be shy about discussing these feelings with your plastic surgeon.

Ear Surgery Terms and Definitions

• Antihelical fold: A fold that is just inside the rim of the ear.
• Conchal cartilage: The largest and deepest concavity of the external ear.
• Constricted ear: Also called a lop or cup ear, has varying degrees of protrusion, reduced ear circumference, folding or flattening of the upper helical rim, and lowered ear position.
• Cryptotia: Also called hidden ear, occurs when the upper rim of the ear is buried beneath a fold of scalp secondary to abnormal folding of the upper ear cartilage toward the head. The folding is the reverse of that commonly seen in the protruding ear.
• Ear axis: The main line of ear growth.
• General anesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness.
• Intravenous sedation: Sedatives administered by injection into a vein to help you relax.
• Macrotia: Overly large ears; a rare condition.
• Microtia: The most complex congenital ear deformity when the outer ear appears as either a sausage-shaped structure resembling little more than the earlobe, or has more recognizable parts of the concha and tragus or other normal ear features. It may or may not be missing the external auditory or hearing canal. Hearing is impaired to varying degrees.
• Otoplasty: A surgical procedure also known as ear surgery to improve the shape, position or proportion of the ear.
• Stahl’s ear: An ear that is distorted in shape due to an abnormal fold of cartilage.