Plastic Surgery for Women

https://doi.org/10.1016/j.pop.2018.07.008Get rights and content

Section snippets

Key points

  • Face and brow lifts, eyelid surgery, and rhinoplasty are common facial cosmetic procedures performed on women, most to prevent or reverse the signs of aging.

  • Injections of botulinum toxin and fillers and multiple types of lasers and pulsed light are now often used before surgery to even color and to induce collagen production, producing a smoother-appearing skin.

  • Techniques for breast reconstruction after breast cancer surgery and breast reduction for macromastia are compared with the purely

Facelift

A facelift, or rhytidectomy, is generally undertaken to improve visible signs of aging in the face and neck, including the following:

  • a.

    Relaxation of the skin of the face causing sagging

  • b.

    Deepening of the fold lines between the nose and corner of the mouth

  • c.

    Fat that has fallen or has disappeared

  • d.

    Jowls or the drooping lower portion of the cheeks

  • e.

    Loose skin and excess fat of the neck that can appear as a double chin or "turkey neck"

The number of surgeries performed has been increasing over the last

Brow lift

A brow lift, also known as a forehead lift or forehead rejuvenation, is a cosmetic surgical procedure to elevate the eyebrow region in patients with significant brow ptosis. Glabellar frown lines and forehead wrinkling can also be addressed with this procedure. It can be done through an endoscopic approach or through a larger coronal incision (hidden within the hairline at the junction of the frontal and parietal scalp or just in front of the hairline). A supraciliary (above the eyebrows) or

Blepharoplasty

Eyelid surgery, blepharoplasty, typically involves removing a small strip of redundant or sagging eyelid skin and underlying muscle, along with a variable amount of periobital fat, in order to return the upper and/or lower eyelid to a more youthful appearance.4

Excess eyelid skin, or dermatochalasis, typically accompanies the aging process explaining the high prevalence of this procedure in those over the age of 65. Dermatochalasis is the most common reason for upper lid blepharoplasty. It

Rhinoplasty

Cosmetic surgery of the nose involves both surgery on the nasal tip, primarily through manipulation of the cartilage, and surgery on the nasal bones, primarily narrowing of the nose by controlled fracture and manipulation. Rhinoplasty can also involve surgery on the nasal septum. Incisions can be made inside or outside the nose. Open rhinoplasty involves an incision across the columella. In closed rhinoplasty, the incisions are inside the nose at the level of the internal nasal valve. The

Injectables

Since the onset of the twenty-first century, minimally invasive aesthetic procedures have been championed as mitigating and cosmetically improving age-related facial changes.7

Injectable procedures are effective and tolerable with minimal to moderate discomfort and have a low incidence of adverse effects along with relatively short recovery times and rapid return to normal activity.7 Injectables include botulinum toxin and dermal fillers.

Botulinum toxin (eg, onabotulinumtoxinA, Botox) is a

Minimally invasive procedures

There are several laser treatments and other “minimally invasive” procedures available for patients that help to smooth fine lines and wrinkles and improve skin discoloration and texture. Fractional laser creates thousands of microscopic vertical channels of tissue destruction to induce collagen deposition as part of the healing process. This collagen deposition helps fill in the underlying tissue, producing a more youthful appearance by improving skin tone and texture, fine lines, and

Augmentation

Breast augmentation has been the top cosmetic surgical procedure since 2006.16 The goal for breast augmentation is to increase the size and or change the shape of a woman's breast primarily through the insertion of a breast implant. A successful breast augmentation surgery can boost a woman’s confidence both with and without clothing.

There are several types of implants available in the United States. All have a silicone outer shell and are filled with either saline or a silicone gel. A highly

Cancer

One in 8 women in the United States is diagnosed with breast cancer.24 Surgery for breast cancer extirpation is common. A plastic surgeon is involved with re-creating the breast after a lumpectomy, partial mastectomy, or total mastectomy. The goal for breast reconstruction is to restore a woman's shape and form while in clothing. Restoring her breasts to a natural appearance while disrobed is a secondary goal.

Because of the Women’s Health and Cancer Rights Act of 1998, federal law requires that

Abdominoplasty

The goal for an abdominoplasty is to restore abdominal contour and shape by tightening the skin, correcting rectus abdominus diastasis, and removing adiposity. Reasons that patients seek abdominoplasty include postpartum changes, rectus muscle diastasis, or changes to the abdomen after weight gain or loss. Intra-abdominal adiposity is not addressed with this surgery.

Concurrent with today’s fashion trends, the typical placement of the abdominoplasty incision is low across the abdomen to be

Liposuction

Suction-assisted lipectomy, also known as liposuction, aims at reducing the adipose tissue in the subcutaneous space. In general, this procedure involves instilling tumescent solution into the subcutaneous tissue followed by aspiration of the fat using a blunt-tipped cannula.

The ideal liposuction patient has localized adiposity that has not been reduced by diet and exercise. However, with the safety and efficacy of liposuction, many people will use liposuction to debulk adiposity in large body

Labiaplasty and vulvar reconstruction

Labiaplasty is becoming an increasingly popular cosmetic procedure in the United States with more than 8000 procedures performed in 2016.30 Labiaplasty is defined as reduction of the labia minora. Terms such as “vaginal rejuvenation” are not recommended because it is medically unclear what procedure is being performed. There has been significant debate between the Plastic Surgery and Gynecology communities regarding the medical necessity and safety of such procedures.31, 32 Although most of the

Acknowledgments

Richard J. Bene’, MD; Paul Leahy, MD; Regina Nouhan, MD; Keith Hodge, MD: Monarch Plastic Surgery, private practice, 4801 West 135th Street, Leawood, KS 66224.

First page preview

First page preview
Click to open first page preview

References (39)

  • Available at: https://www.webmd.com/beauty/cosmetic-procedures-eyelid-surgery#1. Accessed November 1,...
  • R. Small

    UCSF

    Am Fam Physician

    (2009)
  • A. Carruthers et al.

    A prospective, double-blind, randomized, parallel-group, dose-ranging study of botulinum toxin type A in female subjects with horizontal forehead rhytides

    Dermatol Surg

    (2003)
  • Available at:...
  • J.B. Wise et al.

    Injectable treatments for the aging face

    Facial Plast Surg

    (2006)
  • S. Fagien et al.

    A brief overview and history of temporary fillers: evolution, advantages, and limitations

    Plast Reconstr Surg

    (2007)
  • K. Belezenay et al.

    Avoiding and treating blindness from fillers: a review of the world literature

    Dermatol Surg

    (2015)
  • 2016 Complete plastic surgery statistics report. Available at:...
  • A. David et al.

    Breast augmentation

    Plast Reconstr Surg

    (2014)
  • Disclosure Statement: The authors have nothing to disclose.

    View full text