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Botox

Plastic surgeons have been using Botox for years to treat wrinkles and facial creases. More recently, Botox has been used to ease forehead lines, crow's feet, and frown lines. Botox works by blocking signals from the nerves to the muscles. The injected muscle can no longer contract, which causes the wrinkles to relax and soften.

Botox isn't a cure-all, however. Wrinkles caused by sun damage and gravity will not respond to Botox. This is because Botox works only for wrinkles that are caused by the contraction of the underlying muscle.

The Procedure: Botox is injected with a fine needle into specific muscles. Most people have only minor discomfort. The procedure itself takes only a few minutes and requires no anesthesia. However, you won't see the full effects until three to seven days later.

Common Side Effects: For the first day or two, you may have temporary bruising and possibly headaches. To minimize bruising, it is best to avoid alcohol at least one week prior to treatment and avoid aspirin and anti-inflammatory medications two weeks before treatment. Allergic reactions may occur. It's also possible to develop an immunity to Botox, which means that further injections may not work. In rare cases, there is asymmetry and dimpling due to muscle thinning.

Complications: Botox can migrate beyond the treated area, temporarily paralyzing other nerves. Patients must be careful about rubbing the area or lying down after the procedure.

Recovery: Generally, recovery takes only one or two days before bruising disappears.

Results: The effects of a Botox treatment last from four to six months. As muscle action gradually returns, the lines and wrinkles begin to reappear. However, because the muscles are being trained to relax, the lines and wrinkles often appear less severe over time.

Find out more about Botox treatments.

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WebMD Medical Reference

Reviewed by Michael J. Wheatley, MD, December 10, 2007.

SOURCES: Michael Powell, MD, facial plastic surgeon. WebMD Medical Reference provided in collaboration with The Cleveland Clinic: "Botox."

Chemicals Peels (Chemexfoliation or Derma-peeling)

Chemical peels are a means to help improve the skin's appearance - reducing fine lines and wrinkles, improving mild scarring and age spots, and giving skin a better texture. People with fair skin and light hair benefit most from chemical peels, in terms of smoother, younger-looking skin.

The procedure involves applying a chemical solution to the skin, which causes it to "blister" and eventually peel off. The new, regenerated skin is usually smoother and less wrinkled than the old skin.

The Procedure: Based on your skin condition and goals for treatment, you and your doctor will determine how deep your chemical peel will be. The procedure involves applying the chemical solution - which will trigger blistering and prompt new skin to grow. Most people feel some temporary stinging with this treatment. A deeper treatment may require pain medication. Some peels require bandaging for several days.

Common Side Effects: Since new skin will grow following a peel, it is fragile and more vulnerable to complications. You will need to protect new skin from overexposure to sun. People with a history of cold sores may develop a severe outbreak, but medication can help prevent this. You may need to take an antibiotic or antiviral medication if your peel is medium or deep.

Complications: People with certain skin types have a risk of developing temporary or permanent skin color change. Certain factors can increase this risk: taking birth control pills, pregnancy, or family history of facial discoloration. There is also a low risk of scarring.

Recovery: Depending on the type of chemical peel, a reaction similar to sunburn occurs following the procedure. Peeling usually involves redness, followed by scaling that ends within three to seven days.

Medium-depth and deep peeling may result in swelling, as well as presence of water blisters that may break, crust, turn brown, and peel off over a period of seven to 14 days.

Results: Chemical peels typically require multiple procedures to achieve the desired results. Depending on your skin problems, you may need several mild or medium peels. Mild peels can be repeated at one- to four-week intervals. Medium-depth peels may be repeated in six to 12 months, if necessary. The effects of a series of chemical peels typically last six to 24 months for mild to medium-depth peels. The effects of deeper peels can be permanent.

Find out more about chemical peels.

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WebMD Medical Reference

Reviewed by Michael J. Wheatley, MD, December 10, 2007.

SOURCES: Michael Powell, MD, facial plastic surgeon. WebMD Medical Reference provided in collaboration with The Cleveland Clinic: "Chemical Peel Treatments."

Dermabrasion (Surgical Skin Planing)

Dermabrasion is a type of skin "sanding" procedure first developed to improve acne scars and pox marks. Today, it is used to treat other skin conditions like tattoo scars, age spots, and minor wrinkles.

The treatment itself involves a high-speed rotary instrument with an abrasive wheel or brush. It removes the outer layers of the skin, which generates the growth of new skin and improves irregularities on the skin surface - resulting in smoother skin. There are a few problems dermabrasion can't help: skin birth defects, most moles, birthmarks, or burn scars.

The Procedure: This is typically done in the doctor's office. Your doctor will first apply a special spray to freeze your skin, then perform the dermabrasion. Depending on how much of the face is treated the procedure can last from 15 minutes to one hour.

Common Side Effects: Side effects are uncommon but they do occur. There may be temporary, uneven changes in skin color and skin darkening. Darkening of the skin usually occurs because of sun exposure in the days and months following surgery.

Complications: In some cases, there may be infection, scarring, or permanent skin color changes.

Recovery: After the procedure, your skin will feel as though it has been severely "brush-burned" for a few days. Your doctor can prescribe or recommend medications to help reduce any discomfort you may have, such as an over-the-counter pain reliever. Healing usually occurs within seven to 10 days.

The newly formed skin, which is pink at first, gradually develops a normal color. In most cases, the pinkness largely fades by six to eight weeks. Makeup can be used as a cover-up as soon as the skin is healed.

Generally, most people can resume their normal activities in seven to 14 days after dermabrasion. Patients are instructed to avoid unnecessary direct and indirect sunlight for three to six months after the procedure and to use sunscreen on a regular basis when outdoors.

Results: The abrasive technique used in dermabrasion helps generate a new layer of skin, producing a smoother appearance. The effects are usually permanent, although new wrinkles may form as the skin ages.

Find out more about dermabrasion.

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WebMD Medical Reference

Reviewed by Michael J. Wheatley, MD, December 10, 2007.

Michael Powell, MD, facial plastic surgeon. WebMD Medical Reference provided in collaboration with The Cleveland Clinic: "Dermabrasion."

Laser Skin Resurfacing

Laser skin resurfacing can help reduce lines, wrinkles, blemishes, or acne scars. It's used to treat a variety of skin conditions and is known by several other names - lasabrasion, laser peel, and laser vaporization. The technique involves concentrated, pulsating light beams that are directed at irregular skin. Layer by layer, skin is very precisely removed to create a smoother skin surface.

Ideal candidates are people with fine lines or wrinkles around the eyes, mouth, or on the forehead, scars from acne, or skin that needs correcting after a facelift.

The Procedure: Both erbium and CO2 lasers used in these procedures can very precisely vaporize superficial, damaged skin cells. Laser treatments involve very short pulsed light energy or continuous light beams that are delivered in a scanning pattern to very precisely remove skin cells.

CO2 laser skin resurfacing is used to treat wrinkles, scars, warts, birthmarks, enlarged oil glands on the nose (rhinophyma), skin cancer, and other conditions. Erbium laser skin resurfacing is designed to remove superficial and moderately deep lines and wrinkles on the face, hands, neck, or chest.

Wrinkles around the eyes, mouth, or forehead may be treated individually, or a full-face laser skin resurfacing can be performed. A partial-face laser skin resurfacing takes from 30-45 minutes and the full-face treatment takes about two hours.

Common Side Effects: Skin will be red, but that generally fades within the first two to three months. However, for blondes and redheads it may take as long as six months to completely disappear.

Complications: Patients with darker skin tones have a greater risk of darker pigmentation after healing. This may be minimized by use of a bleaching agent before laser skin resurfacing as well as continued use of this agent after healing. In some cases, cold sores occur, but these can be prevented by taking an antiviral medication before and after surgery. Scarring is rare but can occur.

Recovery: A bandage is typically applied to the treatment sites and removed within three days. Over the next two to three weeks, the skin must be given special treatment to prevent any scab formation.

It's important to remember that skin treated with laser skin resurfacing may react in different ways. Most commonly, you may feel like you have a mild sunburn. There will be slight swelling and redness of the skin. You may experience itching or stinging for 12 to 72 hours after the procedure. Some people have more severe pain. Five to seven days after laser resurfacing, your skin will become dry and peel.

New skin will form after the treated area has been peeled. This skin will at first appear pink. Liberal amounts of sunscreen and moisturizer are necessary to protect this new skin. The pinkness should begin to gradually lighten for up to a year after treatment. Your doctor will not consider retreating the area until it has completely healed.

Results: Depending on the technique used, results can last for many years -- although new wrinkles may form as the skin ages.

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WebMD Medical Reference

Reviewed by Michael J. Wheatley, MD, December 10, 2007.

SOURCES: Michael Powell, MD, facial plastic surgeon. WebMD Medical Reference provided in collaboration with The Cleveland Clinic: "Laser Resurfacing."

Injectable Fillers (Wrinkle fillers)

Injectable fillers, including collagen and other substances, can give your facial skin a plumper, smoother appearance. With age the skin's tone and elasticity suffers and facial lines appear. Injectable fillers help smooth these facial imperfections as well as most types of scars.

Several types of fillers can be used in these injections, including bovine-derived collagen, bioengineered human collagen, synthetic filler material, hyaluronic acid fillers, and your own collagen (from another part of your body). Most are only temporary fixes since the body absorbs it over time. It's possible to have your own body fat (from thighs or abdomen) surgically implanted, which can achieve longer lasting results than some filler. Fillers made of Polymethylmethacrylate beads, tiny round and smooth plastic particles, are not absorbed by the body and have more lasting result.

The Procedure: You should expect to receive a small injection of local anesthesia to numb the area being treated. Your doctor will then inject the filler material. Depending on the substance injected - and your goals for treatment -- you may need additional procedures.

Common Side Effects: There is a possibility of slight bruising, and you may experience puffiness, redness, and tenderness around the treated site.

Complications: Although synthetic materials last longer, there is a risk of allergic reaction. You will need to have a skin test to determine whether you are sensitive to the filler material being used. Most people have no reaction and can have the injections.

Recovery: In most cases, the swelling, redness, or bruising will disappear in a few days to one week, depending on the site injected and the filler used. When fat injections are used, this can take longer.

Results: The type of filler material will determine how long your skin stays smooth. Like natural collagen, most of these replacements lose form over time. Depending on the filler, you may need a few treatments per year to maintain the effects.

Find out more about collagen and injectable fillers.

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WebMD Medical Reference

Reviewed by Brunilda Nazario, MD, February 23, 2009.

SOURCES: Michael Powell, MD, facial plastic surgeon. WebMD Medical Reference provided in collaboration with The Cleveland Clinic: "Collagen and Other Injectable Fillers."

Cosmetic Tattooing (Lips, Eyebrows, Eyeliner)

You can kiss your makeup goodbye forever. It's possible to get your lips, eyebrows, and eyeliner permanently tattooed with color. Cosmetic tattooing is a growing field in the health and beauty industry. Cosmetic tattooing also has more serious applications - like improving the appearance of a nipple after breast reconstruction.

To avoid infections and to ensure professional results, it is important to work with a licensed aesthetician. Make sure the aesthetician uses sterile gloves and sterilized equipment.

The Procedure: You will select the color used based on advice and suggestions from the makeup artist. The technician then sketches the area to be tattooed with a sterile surgical pen. A topical anesthetic gel is applied on the area.

Using a hollow, vibrating needle, the technician applies the pigment into the top layer of the skin. Each time the needle penetrates the skin, a droplet of pigment is released into the hole made by the needle. You will feel a slight stinging.

Common Side Effects: After the procedure, the color will likely look dark and shiny, and the surrounding tissue will be swollen and red. Cold compresses can reduce swelling. Antibiotic ointment must be used to decrease risk of infection.

Complications: Although rare, complications can include infections and allergic reactions to the dye. There usually are no complications, especially if you work with a licensed aesthetician.

Recovery: It takes about three weeks for the color to fade to its permanent shade.

Results: A permanent tattoo will last your entire life.

Find out more about cosmetic tattoos.

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WebMD Medical Reference

Reviewed by Michael J. Wheatley, MD, December 10, 2007.

SOURCES: Jeffrey R. Marcus MD, assistant professor of surgery and pediatrics, Duke University School of Medicine. WebMD Medical Reference: "Cosmetic Tattooing."

Brow Lift (Forehead Lift)

Those wrinkles and creases across your forehead -- caused by facial sagging -- can disappear with the help of a brow lift. It's a popular procedure that combines a forehead lift and eyebrow lift to reverse signs of aging. Younger people can also benefit if they have inherited a low brow or have a deep frown, typically an inherited problem.

The Procedure: The procedure involves maneuvering and removing tissues that cause sagging in the forehead, upper eyelids, and eyebrows. This is sometimes done along with a facelift or nose reshaping surgery to create an overall improved appearance.

There are two methods for lifting the forehead and eyebrow areas. The classic lift involves one continuous incision beginning at the ears and going up around the hair line. The endoscopic lift involves a few shorter incisions in the scalp; it typically means far shorter recovery time, and minimal scarring.

Common Side Effects: You will probably experience swelling and bruising for the first week. Most people need a painkiller after surgery.

Complications: Though the side effects are usually minimal, possible complications can include infection, scars, eyebrow movement problems, or the loss of sensation around the incision site. Also, people rarely experience hair loss.

Recovery: Your recovery is going to vary depending upon which procedure you had. In either case, you will have stitches or staples in the incisions that will need to be removed in about a week. If you have temporary fixation screws, which are used to temporarily hold the elevated brow in place, these will be removed in about two weeks. You may also experience itching, which can last for a few months, as well as numbness or tingling, which will subside over time.

Most patients can return to work or school within 10 days, some sooner, depending on which procedure you underwent and your own personal rate of recovery.

Results: The cosmetic effects of this procedure generally last from five to ten years.

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WebMD Medical Reference

Reviewed by Michael J. Wheatley, MD, December 10, 2007.

SOURCES: Michael Powell, MD, facial plastic surgeon and consultant for WebMD. WebMD Medical Reference in collaboration with The Cleveland Clinic: "The Brow Lift."

Cheek, Jaw, and Chin Implants

Facial implants will not give you a "perfect" face. They won't make you look like someone else. But they can improve your cheeks or jaw line. For some people, this is a purely elective cosmetic procedure. For others, it's needed to correct a birth defect or as a follow-up to earlier facial surgery.

Your surgeon will want to discuss why you wish to make changes in your appearance, to determine whether you have realistic expectations about implant surgery. Facial implants are sometimes done along with other cosmetic procedures, such as a facelift, brow lift, etc., depending on the desired results.

The Procedure: Depending on what you're having done, the surgery generally lasts two hours or less. The options:

  • Lower jaw implant - placed inside the lower lip.
  • Cheek implant - placed either via the upper lip or the lower eyelid.
  • Chin implant - placed via the lower lip or under the chin.

Common Side Effects: As with any surgery, you do risk certain side effects and complications. You will experience bruising and swelling, which can last at least two days. Your surgeon will let you know what to watch for, as far as excessive or abnormal swelling or bruising.

Complications: Because you are having an implant inserted into your body, there is a risk of the facial implant shifting. If this happens, you may have to undergo a follow-up operation. Your surgeon will discuss these possibilities with you. You also run the risk of infection; your surgeon will give you antibiotics in this case. There is a risk that your body could reject the implant.

Recovery: The recovery from this surgery is fairly quick. You should need only to take one week off from work, at most. Of course, your recovery will depend on your own personal habits and whether or not you're having other surgery performed.

Results: The results are permanent unless the implant shifts, or the body rejects it, or it becomes infected. In some cases, the implant will have to be removed. The skin will continue to age, but the bone structure, which these implants support, does not change very much.

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WebMD Medical Reference

Reviewed by Michael J. Wheatley, MD, December 10, 2007.

SOURCES: Michael Powell, MD, facial plastic surgeon. WebMD Medical Reference provided in collaboration with The Cleveland Clinic: "Cheek, Jaw and Chin Implants."

Ear Reshaping (Otoplasty)

If you have protruding or misshapen ears, otoplasty can help. This surgery can correct all sorts of ear-related abnormalities -- especially in children from ages 4 to 14, but also in teens and adults.

The Procedure: Surgeons have several options for reshaping the ear. They can cut out a small portion of cartilage in the ear, or they can fold and stitch the cartilage rather than cut it away. In either case, the main incision is behind the ear, so it won't be visible later.

Common Side Effects: You should expect pain and swelling, but your surgeon can prescribe a painkiller. There may be some temporary numbness.

Complications: In rare cases, there may be infection or a collection of blood under the skin that may need to be drained. There may be asymmetry or mismatched ears, possibly requiring more surgery. A stitch can be rejected or break, causing the ear to lose some of the correction. There can also be a recurrence of the protrusion. Scarring can occur behind the ear, although it is usually not visible.

Recovery: Plan to stay home at least one week after the surgery. You will have to wear a bandage for five to seven days and a headband-type dressing for up to three weeks to promote proper healing. If you have stitches that need to be taken out, your surgeon will do this about one week after the surgery. Scars at the incision site will fade over time.

Results: Usually the results are permanent, unless a complication occurs and causes loss of correction.

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WebMD Medical Reference

Reviewed by Michael J. Wheatley, MD, December 10, 2007.

SOURCES: Michael Powell, MD, facial plastic surgeon. WebMD Medical Reference provided in collaboration with The Cleveland Clinic: "Ear Reshaping (Otoplasty)."

Eyelid Surgery (Blepharoplasty)

Blepharoplasty won't erase dark circles or crow's feet. But it can correct other vexing problems -- bagginess in lower eyelids, or sagging upper eyelids. For some people, blepharoplasty is part of an overall facial rejuvenation that includes laser resurfacing and a forehead lift.

The Procedure: To work on your upper eyelids, the surgeon will make incisions following their natural lines. Through these incisions, the surgeon works to separate the skin from underlying tissue and remove excess fat, skin, and muscle.

A similar surgery of the lower eyelids can be done two ways - either through an incision inside the eyelid, or underneath the eyelid. The incision line will fade fairly quickly.

Common Side Effects: Some patients experience dry eyes after surgery, but the condition rarely lasts more than two weeks. Swelling, bruising, tightness of eyelids, and excessive tearing are also common.

Complications: These are rare but do occur: bleeding, infection, dry eyes, abnormal discoloration of eyelid skin, abnormal folds in eyelid skin, inability to fully close the eyes, a pulled-down lower lid lash line. Temporary blurred vision or double vision from swelling can occur. In extremely rare situations, there has been postoperative bleeding into the eye that has not been recognized and treated immediately, causing blindness.

Recovery: Plan to stay home from work and limit your activities for several days after surgery to give your eyelids a chance to heal.

Results: Blepharoplasty will not stop your eyes from aging. However, the results are usually very long lasting. Upper eyelid surgery can last from five years to an entire lifetime. Lower eyelid surgery rarely needs to be done more than once. If your upper lids begin sagging again as you age, it is usually related to sagging of the brows and a forehead/brow lift can help.

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WebMD Medical Reference

Reviewed by Michael J. Wheatley, MD, December 10, 2007.

SOURCES: Michael Powell, MD, facial plastic surgeon and consultant for WebMD. WebMD Medical Reference provided in collaboration with The Cleveland Clinic: "Eyelid Surgery."

Facelift (Rhytidectomy)

The facelift is a popular procedure, aimed at helping people look (and feel) younger. Once, the typical patient was age 60 or so. Today, people in their 40s and 50s are getting face lifts.

A facelift involves removing sagging skin -- as well as tightening facial muscles and removing excess fat -- in the lower face. A facelift can improve the contour of your lower jaw and jowls. It can soften any deep lines from your nose to the corners of your mouth.

Some people opt to have a brow lift, too, to rejuvenate the upper half of the face. A neck lift can correct sagging muscles that often form bands as we age. These may be done during the facelift procedure or separately.

The Procedure: During the classic facelift procedure, the incisions are made in front, behind, and above the ear and into the scalp line. This allows the surgeon to access muscle and connective tissue beneath the skin to make the appropriate manipulations. Facelifts can take from two to six hours. Your surgeon will close the incision site with sutures and your face will be bandaged. Most patients can go home a few hours after the facelift procedure. Some will need to be hospitalized overnight.

Common Side Effects: Bruising, swelling, numbness, tightness, and dry skin typically last from two to three weeks. In some cases, however, these can linger for several months.

Complications: In rare cases, infection, bleeding, or injury to facial nerves can occur. Other complications include heavy scarring, skin loss, or abnormal appearance of the earlobe.

Recovery: You should begin to feel better a few days after surgery. However, you may not feel like going out in public. Most people can return to work in two weeks. You must avoid sun exposure for several months.

Results: The effects of a facelift generally last five to 10 years.

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WebMD Medical Reference

Reviewed by Michael J. Wheatley, MD, December 10, 2007.

SOURCES: Michael Powell, MD, facial plastic surgeon. WebMD Medical Reference provided in collaboration with the Cleveland Clinic: "Facelifts." WebMD Medical Reference from "The Plastic Surgery Sourcebook."

Lip Augmentation

Lip injections and implants can give you fuller, plumper lips. Most materials used for injections will break down within a few months and thus are temporary fixes. Certain implants are more permanent fixes -- but there is a higher risk of allergic reaction.

The Procedure: Your surgeon will perform either the injection or implant after giving you a local anesthetic. There are numerous types of materials used in injections and implants.

The injections can involve a synthetic material, your own collagen, fat from your thighs or abdomen, or gels made from hyaluronic acid (a natural body substance).

Implants utilize natural collagen, fat, synthetic materials, or tissue flaps taken from inside your mouth. Your doctor will help you determine which is best for you.

Common Side Effects: Swelling and bruising usually last for one or two days after injections and for a week after an implant. Chewing food or brushing teeth may be uncomfortable.

Complications: Complications are infrequent, but as with any surgery, there are risks. You can have allergic reactions to implants or an allergic reaction to anesthesia. You can experience bleeding or an implant that hardens, which may require removal. You also risk infection or even nerve damage. Certain diseases such as diabetes can increase your chances of complications. If you are a smoker, this may also be a complicating factor.

Recovery: If you are having injections, your recovery can take just a couple days -- although swelling and bruising can last longer. Elevate head and limit smiling for one week. Use cold compresses and limit chewing for 48 hours.

If you are having surgical implants, your recovery typically takes little more than one week. It may be necessary to take some time off work. You will need at least three days off from work. If you are physically active, you will not be able to exercise for a few days after injections and perhaps for a few weeks after surgical implants.

Results: When synthetic implants are used, the results are considered permanent. When your own fat is used, the results are permanent in 50% of cases. All the others will either break down or be absorbed by the body in time. Talk to your doctor about the various options and which is right for you.

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WebMD Medical Reference

Reviewed by Michael J. Wheatley, MD, December 10, 2007.

SOURCES: Michael Powell, MD, facial plastic surgeon. WebMD Medical Reference provided in collaboration with The Cleveland Clinic: "Lip Augmentation."

Liposuction (Under Chin)

When dieting and exercise just won't shrink fat deposits, some people turn to liposuction. It's an option to remove small fatty areas like under-chin fat.

The procedure involves a suction device that is inserted into fatty areas between skin and muscle. The best candidate for liposuction is a person under age 50, of average or only slightly above average weight, in good health, with firm, elastic skin, and with a localized area of fat that just won't go away.

The Procedure: The surgeon will first inject a solution made up of saline, a mild painkiller, and epinephrine, a drug that contracts your blood vessels. It helps the surgeon remove the fat more easily, helps reduce blood loss, and provides pain relief during and shortly after surgery.

After small incisions are made, the suction device is inserted into fatty areas between skin and muscle, and the fat is gently removed. A compression dressing is usually applied.

Common Side Effects: You should expect bruising, swelling, and soreness for seven to 10 days. However, every person's outcome will vary based on factors such as volume of fat cells removed.

Complications: Although rare, risks include infection and skin discoloration. If there is loose skin, a skin tightening procedure may be necessary.

Recovery: Under most circumstances, recovery is quick. Most people can return to work within a few days and to normal activities within about two weeks.

Results: The fat cells are removed permanently, but weight gain after the procedure can cause fat to accumulate again in the treated area. To keep your new shape and new weight after liposuction, you must follow a proper diet and exercise plan.

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WebMD Medical Reference

Reviewed by Michael J. Wheatley, MD, December 10, 2007.

SOURCES: Michael Powell, MD, facial plastic surgeon and consultant for WebMD. WebMD Medical Reference in collaboration with The Cleveland Clinic: "Liposuction."

Microdermabrasion (Power Peel)

If dermabrasion is a skin "sanding" procedure, microdermabrasion is a softened sandblasting. The cosmetic surgeon utilizes tiny crystals to gently treat skin as opposed to freezing and sanding the skin with a rotary instrument as with dermabrasion.

Microdermabrasion (also known as "power peel") works on all skin types and colors. It produces subtle changes, causing no skin color change or scarring -- improving or eliminating very superficial skin problems like fine lines, dull skin, brown spots, and acne. However, it is not effective for deeper problems like scars, stretch marks, keloids, or deep acne scars.

With microdermabrasion, there is less down time than with dermabrasion; skin fully recovers within 24 hours. It's ideal for people who cannot afford to take time off from work or social activities for healing.

Another benefit: Microdermabrasion is a nonsurgical procedure. Therefore, there are none of the risks associated with even minor surgery like dermabrasion, where anesthetics are used and skin bleeds.

The Procedure: The technique combines gentle abrasion (using microcrystals) with suction to remove the dead outer layer of skin. It is basically an exfoliation and skin rejuvenation procedure.

Most patients have microdermabrasion treatments once a week for a period of four to twelve weeks. Age spots and fine lines can be erased, creating softer, smoother skin that has a younger feel to the touch.

Common Side Effects: Redness of skin, dry and tight like "sunburn" or "windburn" for about 24 hours.

Complications: There are virtually no complications. In rare cases, a few crystals may get into unprotected eyes causing irritation for 24 hours.

Recovery: Within 24 hours or so after the procedure, skin has completely healed. You can then safely apply makeup.

Results: Skin is softer and smoother to the touch -- it has a fresh, healthy glow. For optimal results, a number of treatments are required (once a week for several weeks). To maintain results, occasion touch-up treatments are necessary.

Find out more about microdermabrasion.

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WebMD Medical Reference

Reviewed by Michael J. Wheatley, MD, December 10, 2007.

SOURCES: Michael Powell, MD, facial plastic surgeon. WebMD Medical Reference provided in collaboration with The Cleveland Clinic: "Dermbrasion and Microdermabrasion."

Neck Lift

A neck lift can help people who have a "turkey wattle" neck, excess fat, or too much skin.

A neck lift is actually a series of procedures to enhance the neck's appearance. Through surgery, excess skin can be removed or neck muscles altered. Liposuction can remove excess fat. Botox injections can improve the look of "bands." Some people have a neck lift along with a facelift, brow lift, or other surgery -- all dependent on their goals.

The Procedure: Specific procedures can address turkey wattle neck (neck bands), excess fat, and excess skin.

  • Turkey wattle: Platysmaplasty surgery is the procedure for the weakened or loose neck muscles of turkey wattle. This involves incisions under your chin and behind your ears so that the neck muscles can be manipulated and some removed. A newer, less-invasive form of this surgery involves smaller incisions and use of an endoscope (a small camera attached to a thin tube). In some cases, Botox injections can substitute for the surgery or be used in addition to it.
  • Excess fat: Liposuction can take care of this. This involves a small incision below the chin to remove the fat with a suction device.
  • Excess skin: Cervicoplasty surgery involves incisions under the chin and behind the ears. This allows the surgeon to trim skin and lift it into place.

Common Side Effects: You will have swelling and bruising that can last for several days. You may feel tightness or tingling, and different sensations including burning or pulling. You also will experience numbness. These are all very normal in the first few weeks following surgery and should not be cause for concern.

Complications: As with any surgery, you run the risk of infection or unusual discharge from the incision site, such as pus. Although it's very rare, you could have an allergic reaction to the anesthesia. That's why it's very important to tell your doctor about any drug allergies. When incisions are made, scarring is possible, although rare. Also, there may be blood under the skin flap (a hematoma), which requires drainage.

Recovery: Most people can return to work in 10 to 14 days. If you participate in other sports or are physically active, you will have to wait at least three weeks or longer.

Results: The results of this procedure last five to 10 years and may require a touch up. The doctor can tell you the results you can expect to achieve and how best to maintain your new look.

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WebMD Medical Reference

Reviewed by Michael J. Wheatley, MD, December 10, 2007.

Michael Powell, MD, facial plastic surgeon. WebMD Medical Reference: "Neck Lift."

Nose Job (Rhinoplasty)

There are many reasons for a nose job -- to enhance its look, improve a breathing problem, or correct abnormalities caused by trauma or a birth defect. The nose's overall size, the tip, the bridge, and the nostrils can all be altered.

If aesthetics are your goal, however, keep your expectations realistic. Any nose job should simply enhance your natural facial features and emphasize your unique look. There is no "perfect" nose.

The Procedure: To reshape the nose, incisions are made within the nostrils and in more difficult cases may also be made across the base of the nose. The inner bone and cartilage are then manipulated into the desired shape. The surgeon may remove a little bone and/or cartilage or add a cartilage graft. Because only a small amount of bone and/or cartilage is removed, the nose's overall structure is preserved -- ensuring the proper shape and an adequate structural support over time.

Common Side Effects: You can expect swelling and some bruising around the eyes after surgery. It will begin to improve after the third day but may last up to two weeks.

Complications: Uncommon complications include bleeding, infection, difficulty breathing, nasal perforation, and difficulty smelling (usually temporary due to swelling). In some cases, there is an abnormal appearance that requires additional surgery.

Recovery: You will wear a nasal splint for the first week after surgery. The majority of swelling will decrease during the first month, with more subtle swelling over a six-month period. The final shape of your nose will be apparent after it has healed completely.

You should avoid strenuous activity for three to four weeks after surgery. You may return to your social activities in as soon as two to three weeks without any recognizable appearance that you had surgery.

Results: This is considered a permanent "fix" -- although it won't prevent the effects of aging. Also, realize that reinjury or subsequent fracture of the nose will require additional surgery -- which becomes increasingly difficult each time it is done.

Find out more about nose jobs.

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WebMD Medical Reference

Reviewed by Cynthia Haines, MD, September 2005.

SOURCE: WebMD Medical Reference provided in collaboration with The Cleveland Clinic: "Nose Job."

Reconstructive Surgery

Injury, disease, a birth defect -- or a surgery like mastectomy -- can all leave the body disfigured. Through reconstructive surgery, however, those physical problems can be corrected.

Breast reconstruction or reduction, foot or hand surgery, burn wound care, limb reattachment, and facial correction like cleft lip surgery are just a few examples. Reconstructive surgery can help repair any part of the body.

The Procedures: There are many surgical methods to achieve the desired results. Your surgeon will help you weigh all the options. The two of you can decide together which one best suits you. Reconstructive surgeries are typically used for:

  • Breast reconstruction or reduction - for women who have undergone a mastectomy or who have very large breasts; men also undergo breast reduction.
  • Surgeries for feet and hands - for people with tumors (cancerous and noncancerous); webbed toes or fingers; extra fingers or toes; or carpal tunnel syndrome.
  • Wound care - for severe burns or cuts.
  • Microsurgery or flap procedures - to replace parts of the body affected by injury or disease - like a finger lost to amputation or a leg lost to cancer.
  • Facial surgeries - to correct structural problems causing cleft lip (a birth defect) as well as breathing problems, sinus infections, and snoring.

Common Side Effects: The side effects will depend on the procedure used. Your doctor can provide more information on common side effects to expect from your procedure.

Complications: There is always a risk of infection at the surgical site. Other complications depend on the procedure.

Recovery: Healing from these procedures generally takes several months. Once you are released from the hospital, you will recuperate at home. It is important to follow your doctors' instructions regarding wound care and infection prevention.

Results: The results of reconstructive surgery will last your entire life. They will be affected by the changes of aging, but the basic structural changes will remain intact.

Find out more about reconstructive surgery.

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WebMD Medical Reference

Reviewed by Cynthia Haines, MD, September 2005.

SOURCES: Christopher K. Livingston, MD, professor of plastic surgery, University of Texas Medical School, Houston. WebMD Medical Reference provided in collaboration with The Cleveland Clinic: "Reconstructive Surgery."

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