Cosmetic Surgery

Just about everyone has looked in the mirror at one time or another and thought, “I hate my nose,” “my belly is too flabby,” or “wow, I look old!” It’s no wonder, then, that many of us desire to sculpt our forms into fitter, more attractive, younger versions of ourselves. 

The experts at Harvard Medical School — led by a practicing plastic surgeon — have teamed up to publish Cosmetic Surgery, a detailed Special Report to help you make the most educated decision about practically any cosmetic procedure.

In it, you’ll discover all your options, both surgical and non-surgical. You’ll find out what cosmetic surgery can and cannot accomplish. You’ll find out about the pros and cons of dozens of procedures.  And you’ll learn how to find the right doctor and be on the alert for any red flags. And more. 

• Want to reduce wrinkles or tighten up facial skin? Discover the wealth of effective new rejuvenation treatments including injectables, peels, lasers. 
• Tired of “belly pooch” or double chin? Learn the latest options for these conditions that are stubbornly resistant to diet and exercise.
• Concerned about cellulite in your buttocks or thighs? Discover four non-surgical procedures doctors use to treat dimpled skin. 

Better still, you’ll be able to go into each procedure with your eyes wide open, with details about what to expect from the procedure ... color illustrations of how the procedure works ... estimated costs...possible side effects ... recovery time … and more.

In Harvard’s Cosmetic Surgery Special Report, you’ll get the facts you need to make informed decisions about common cosmetic surgical procedures — including face and neck reshaping … body reshaping … and breast reshaping. For example, you’ll discover …

• How a face lift can erase 10 to 15 years from your appearance — but with an important caveat. 
• The pros and cons of two brow lift options that can make you appear calmer, happier, and younger. 
• What a “nose job” can do for you and how to help improve your satisfaction with the results. 
• How liposuction can deliver dramatic and long-lasting results. But beware of what it cannot do! 
• Breast augmentation … breast lifts … breast reduction and more — what to ask your doctor to ensure the results you’re looking for.  
• And more — complete details on dozens of procedures!

What’s more, you’ll find essential help for the most important decision of all — selecting the right doctor. After all, cosmetic surgery is an art as well as a science. A successful procedure can help you look your best and give you renewed confidence. An unsuccessful one can leave you with regret and possibly long-term complications.

Prepared by the editors of Harvard Health Publishing in collaboration with Amy S. Colwell, MD, Professor of Surgery, Harvard Medical School. 53 pages. (2022)

Common surgical complications

When cosmetic surgery is performed by skilled and experienced surgeons, the risk of complications is very low. In one study of more than 26,000 outpatient procedures done between 1995 and 2017, fewer than 1% of surgeries led to a complication within the first 48 hours after surgery. The risk was higher among people undergoing combined procedures.

Most likely, you will heal without a glitch. Still, there is a slight chance you will encounter one or two postsurgical complications. They are usually easy to treat and rarely lead to serious problems, provided you catch them soon enough. If you notice any signs of the following complications, call your doctor.

• Hematoma. This is a pocket of blood that forms under the skin near an incision. Hematomas occur in about 1% of people who undergo breast augmentation or face lift procedures. To treat a hematoma, you may need a procedure to drain the blood. Otherwise, the skin in that area can die, leaving a scar.

• Seroma. A seroma is similar to a hematoma, but the pocket contains serous (clear) fluid. This is the most common complication after a tummy tuck. Seromas usually clear up on their own, but if you have one that is large, your doctor may need to drain it.

• Blood loss. It’s normal to lose some blood during any surgical procedure, but you can also lose blood if the wound begins to bleed again after the surgery. Losing too much can lead to a dangerous drop in blood pressure.

• Infection. Whenever you open the skin, it offers a route for bacteria to slip into your body and potentially cause an infection. Over all, the infection rate from cosmetic surgery is very low—less than 1%. However, some procedures, such as tummy tucks and body lifts, are more likely to

  lead to infection than others. You can reduce your risk of infection after surgery by following your surgeon’s instructions for keeping your wound clean.

• Nerve damage. Nerves run throughout your body, and even a highly skilled surgeon can inadvertently nick one while performing a cosmetic procedure. Numbness and tingling can be normal and expected for a few months after surgery, but it can also be a sign of nerve damage. Often the damage is temporary, but about 15% of women

who undergo breast augmentation will have permanent changes in nipple sensation.

• Blood clots. Whenever you are immobile, such as after surgery, blood can pool in your veins and form clots. When a clot forms in a deep vein—usually in the lower leg, thigh, or pelvis—the condition is called deep-vein thrombosis (DVT). If the clot breaks off and travels to the lungs, it is known as a pulmonary embolism (PE). DVT and PE can be dangerous complications, so report symptoms like warmth or swelling in a leg or shortness of breath to your doctor right away. Blood clots after cosmetic surgery are rare, affecting fewer than one in 1,000 people who have these procedures. To reduce your risk of developing a clot, get up and moving as soon as possible after surgery to keep your blood circulating.

• Scarring. Most cosmetic procedures result in scarring. Some scars are more visible than others. Your appearance will depend on the type of procedure and your surgeon’s skill.

• Skin necrosis (tissue death). This relatively rare complication can occur near an incision that is not healing correctly. You may notice the skin pulling back from the incision’s closure and a reddish, oozing area. If untreated, necrosis can leave an open wound with a visible scar that is hard to treat. Smokers have a higher risk of necrosis, because smoking restricts blood circulation to the skin, which interferes with healing.

  Your doctor may also tell you to watch for other complications associated with your particular surgery. If you notice any of these symptoms, report them to your surgeon right away:

  • persistent and severe pain
  • bleeding that lasts longer than a few days
  • excessive swelling
  • numbness and tingling that does not go away after several weeks
  • bruises that last longer than 10 days, change color, spread, or become hard to the touch
  • warmth around the incision
  • fever
  • discharge from the wound.

• The allure of cosmetic surgery
  • How aging affects the skin
  • Is cosmetic surgery right for you?
• Nonsurgical rejuvenation techniques 
  • Erasing wrinkles and lines 
  • Skin tightening
  • Nonsurgical fat removal 
  • Cellulite treatment
• Face and neck surgery
  • Face lift (rhytidectomy) 
  • Forehead (brow) lift 
  • Eyelid surgery (blepharoplasty)
  • Nose surgery (rhinoplasty) 
  • Lip lift 
  • Chin and cheek implants
  • Neck lift (lower rhytidectomy) 
  • Hair transplant 
• Body reshaping
  • Liposuction
  • Fat grafting 
  • Tummy tuck (abdominoplasty) 
  • Buttock enhancement 
  • Arm lift (brachioplasty)
  • Thigh lift (thighplasty)
  • Labiaplasty
• Breast reshaping
  • Breast augmentation
  • Breast lift (mastopexy)
  • Fat grafting for breast enhancement 
  • Pectoral enhancement 
  • Breast reduction (reduction mammoplasty) for women
  • Gynecomastia correction (reduction mammoplasty) for men
• Finding the right doctor 
  • Choosing a doctor
  • The consultation: What to expect
  • How much will it cost? 
• SPECIAL SECTION: Before and after surgery: Tips for preparation and recovery
• Resources 
• Glossary

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