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Aesthetic surgery
The aesthetic surgery patient not only selects the timing of the operation, but actually seeks out surgery and chooses the specific operation. Patients range from frightened and apprehensive teenagers to hard-driving, aggressive business people accustomed to being in control. Additionally, given the nature and circumstances of the procedure, the patient expects a smooth and uncomplicated operation and anesthetic. The anesthesiologist experienced with aesthetic surgery recognizes all of these aspects and plays a major role in providing the patient as pleasant an experience as possible.
Many aesthetic surgery patients have devoted considerable time and effort to the selection of their surgeon. By the time they have scheduled surgery they have established rapport and trust.
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Facial Aging
he process of facial aging represents a combination of gravitational effects and aging of the skin itself. Gravity affects all tissue layers, resulting in brow ptosis, hollow infraorbital regions, nasolabial folds, jowls, and submental skin excess. Aging of the skin itself is manifested by fine wrinkles and irregular pigmentation.
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Facelift
A facelift (technically known as rhytidectomy) can't stop this aging process. What it can do is "set back the clock," improving the most visible signs of aging by removing excess fat, tightening underlying muscles, and redraping the skin of your face and neck. A facelift can be done alone, or in conjunction with other procedures such as a forehead lift, eyelid surgery, or nose reshaping.
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Medical History
The same compulsive medical history that is indicated before any surgical procedure is required when evaluating a patient for aesthetic facial surgery. One must inquire specifically about and document any medications, allergies, medical problems, previous surgeries, and smoking and drinking habits. Because hematoma is the most common complication of facelifting, the history focuses on any factor that predisposes to postoperative hemorrhage, specifically hypertension and aspirin use. Surgery is postponed until blood pressure is under consistent control and until 2 weeks after any aspirin-containing medications are discontinued. Because of the risk of skin slough the smoking history is critical; if the patient smokes, the procedure is postponed until 2 weeks after smoking is discontinued. Aesthetic surgery is elective, and therefore whenever there is a question about a preoperative medical condition, the operation is postponed until appropriate consultations have been obtained and all issues settled.
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Reasons of Surgery
Sixty percent of the patients provided a different reason postoperatively than preoperatively, suggesting that many patients harbor secret or unconscious motivations for undergoing the procedure. Many patients who have realistic expectations preoperatively, such as wanting to look younger and perhaps to get a better job, state after the operation that they had hoped to avoid abandonment by husbands and friends or hoped the surgery would make them a "different person."
Patients who have difficulty delineating the anatomic alterations desired or in whom the degree of deformity does not correlate with the degree of personal inadequacy or misfortune ascribed to that deformity are not candidates for aesthetic surgery. Patients who are not considered good candidates for face lifting are given a thoughtful, but honest, explanation.
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Liposuction
Liposuction, or vacuum-aspiration of subcutaneous fat through small incisions, was first performed in the late 1970s. This new and revolutionary concept in surgery diminished body contour through miniscule incisions. Over the ensuing years, liposuction proved so safe and effective that it has become the single most frequently performed aesthetic surgery procedure in the United States
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Osseous genioplasty
Osseous genioplasty is an autogenous method for changing the size or shape, or both, of the mandibular symphysis. Although by strict definition it may involve merely recontouring the chin by burring away bone or by adding bone graft material, the term has become almost synonymous with an osteotomy of the anterior mandible in the horizontal (transverse) dimension below the mental foramina |
The advantages of the osseous genioplasty:
More predictable and stable soft tissue response.
Improvement in the cervicomental angle that cannot be achieved with an implant.
less prone to infection.
The option of three-dimensional movement.
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