We asked the Surgeon: What are the most requested plastic surgery procedures?
December 2020 Issue - Pink Prescriptions
By E. Ronald Finger, MD
Toxins: The most common procedure performed in the world of plastic surgery today would be toxins such as Botox or Dysport. These actually paralyze muscles, such as the muscles that cause frown lines, crow’s feet, forehead furrows and even bunny lines on the nose. It’s even used to raise the brow and the corners of the mouth. They specifically and temporarily interrupt the nerve supply to the injected muscles.
Fillers: Next would be “fillers,” which are products used to re-volumize areas on the face that have lost volume with aging or weight loss, such as cheeks and hollows under the eyes and even chin and jaw line. Juvederm and Restylane are examples. These can be very effective at turning back the clock non-surgically. A comparison is a deflated beach ball. Inflate it, and it no longer sags.
Fatty or Saggy Neck: A very common minimal-surgical procedure request would be treatment for the fatty or saggy neck from excess skin from heredity, aging, excess sunshine, weight loss or gain, or a combination of the above. For excess fat, often simple liposuction is sufficient. Liposuction only removes fat, which often results in excess skin. There are several ways to treat the excess skin, but I prefer to address it with either surgery (neck and/or facelift), or tightening with the Renuvion® during liposuction, a minimal surgery procedure. The Renuvion tightens skin with very short duration of intense heat just under the skin, creating plasma, which is like micro lightning bolts. It is very effective at tightening the skin most anywhere—arms, abdomen, legs, even lifting breasts. Local or general anesthesia is needed.
Liposuction: The most common body procedure would be liposuction. This is basically vacuuming the fat out of an area through a cannula connected to a suction machine. If there is sagging skin following liposuction of the abdomen, a tummy tuck or mini-tummy tuck may be needed. An excellent procedure is the no-drain tummy tuck, which shortens the recovery time, has reduced risk of complications and has less discomfort post-operatively.
Liposuction is also effective for fat removal in arms, sides, love handles, “muffin tops,” inner and outer thighs, knees and ankles. If it is expected that loose skin will result, surgical skin excision may be necessary, or the Renuvion may be used to tighten the skin. Liposuction requires either general or local anesthesia. Tight garments are worn with liposuction patients post-operatively to more rapidly reduce any swelling that occurs in the first few weeks.
Breast Augmentation: Requested equally as common would be breast surgery, such as an augmentation mammoplasty with implants, or fat grafts from the abdomen or sides. Breast implants can be made of silicone or filled with saline. They can go behind the chest muscles, or just behind the breasts above the muscles. Remember, if there was a best way, then there would only be one way. My personal choice is gel implants behind the muscle because it has a lower incidence of firmness, called encapsulation. However, saline implants and the above the muscle position can still look good and has advantages, as well. Your plastic surgeon will discuss this with you. You must be descriptive about your goals so your plastic surgeon can suggest implant size and profile.
A breast augmentation is often combined with a breast uplift when needed. The simplest rule-of-thumb is if nipples are below the breast crease, an uplift is needed for the most optimal result. Uplifts can result in a variety of scars according to the severity of the sagging. Breast tightening also can be achieved with the Renuvion as a minor procedure for minimal to moderate sagging.
Sagging Eyelids and Cosmetic Nose Surgery: Other commonly requested plastic surgery procedures are sagging eyelids and cosmetic nose surgery. Entire books are written on these subjects, and they are very effective procedures. Eyelid surgery can usually be performed under local anesthesia with or without sedation. Rhinoplasties are done under general anesthesia.
Patience: With plastic surgery you must be patient because of the swelling and bruising that usually occurs. Although the results generally look good after a few weeks, the final result is when healing is complete at about 9 to 12 months.
Dr. E. Ronald Finger was the first board certified plastic surgeon in Savannah. He continues to practice full time, specializing in both surgical and non-surgical cosmetic surgery. Call today: 912-354-4411.