Cosmetic Surgery: Focused on Enhancing Appearance

The procedures, techniques, and principles of cosmetic surgery focus entirely on enhancing a patient’s appearance. Improving aesthetic appeal, symmetry, and proportion are the key goals. Aesthetic surgery can be performed on all areas of the head, neck, and body. Since cosmetic procedures treat areas that function correctly, cosmetic surgery is designated as elective. Cosmetic elective procedures are performed by doctors from a variety of medical fields, including plastic surgeons.

What is Plastic Surgery?

Plastic Surgery: Focused on Repairing Defects to Reconstruct a Normal Function & Appearance

Plastic surgery is defined as a surgical specialty dedicated to reconstructing facial and body defects due to birth disorders, trauma, burns, and disease. Plastic surgery is intended to correct dysfunctional body areas and is, by definition, reconstructive. While many plastic surgeons choose to complete additional training and perform cosmetic surgery, the basis of their surgical training remains reconstructive plastic surgery. In fact, in 1999, the American Society of Plastic and Reconstructive Surgeons changed its name to the American Society of Plastic Surgeons to more strongly communicate the message that “plastic and reconstructive surgeons are the same.

Types of Plastic Surgery Procedures:

• Breast Reconstruction
• Burn Repair Surgery
• Congenital Defect Repair: Cleft Palate, Extremity Defect Repair
• Lower Extremity Reconstruction
• Hand Surgery
• Scar Revision Surgery

Cosmetic Surgery vs. Plastic Surgery

If you have always thought cosmetic surgery and plastic surgery were the same, you are not alone. A significant number of plastic surgeons choose to focus their practice on cosmetic surgery, and as such, the terms are often used interchangeably. However, this is not technically correct. Cosmetic surgery and plastic surgery are closely related specialties, but they are not the same. Cosmetic surgery is where a person chooses to have an operation or invasive medical procedure, to change their physical appearance for cosmetic rather than medical reasons. Non-surgical cosmetic procedures, such as Botox and dermal fillers – typically used to relax or fill crease lines – do not involve surgery. However, there are still risks attached. At the same time, both cosmetic and plastic surgery deal with improving a patient’s body, the overarching philosophies guiding the training, research, and goals for patient outcomes are different.

Types of Cosmetic Surgery Procedures:

• Breast Enhancement: Breast Augmentation, Breast Lift, Breast Reduction, GYNECOMASTIA
• Facial Contouring: Rhinoplasty, Ear Correction Surgery
• Facial Rejuvenation: Facelift, Eyelid Lift, Neck Lift, Brow and Forehead Lift
• Body Contouring: Abdomen, Back, Arms, Thigh Shaping
• Skin Rejuvenation: Laser, Radiofrequency, Skin Peel, Botox®, PRP, and Filler and Fat Treatments

Botox is the most effective tool in cosmetic medicine and should be used first and most often. BOTOX dosing and injection points should be based on an assessment of the patient’s anatomy, goals, preferences, and the physician’s own professional experience with prior treatments. Gender, cultural, and ethnic standards of attractiveness may significantly influence the patient’s preference. Each patient’s treatment should be individualized for the best results. The use of cosmetic BOTOX in the mid and lower face and neck has increased drastically over the past few years. Indeed, there is now a greater appreciation that BOTOX-A is one part of overall facial rejuvenation therapy, in which all aspects of aging are addressed in the same individual.  Finally, new esthetic indications are starting to emerge, including the treatment for scars, the horizontal upper lip line, musculus risorius excessive gingival display (‘‘gummy smile’’), and masseter reduction to improve facial shape. BOTOX is also beneficial with other aesthetic modalities, such as dermal fillers, laser, skin resurfacing, and surgery.  Several more general applications push BTX-A toward an ‘‘art,’’ rather than a clinical procedure.

Our improved understanding of the volume changes in fat and bone tissue that occur over time has revolutionized our conception of facial rejuvenation in the facial region. Today’s aim is not just to correct sagging facial tissue but also to restore the volume lost areas and improve tissue quality. Hyaluronic acid fillers are flexible substances that can be injected into the skin to enhance the appearance of fine lines and wrinkles, plump lips, fill hollow cheeks, repair various facial imperfections, improve scars, and elevate deep folds. This improvement can last from 3 months to 2 years or even longer depend on the type of filler used, how you take care of your skin, and how your face continues to age. Do not confuse filler injection with how Botox works.  Many people get both Botox and filler injections because the combination can produce a remarkably younger-looking face.

The platelet-rich plasma (PRP) has been applied in androgenic alopecia in both males and females successfully. Although platelets rich plasma (PRP) microinjection is new in aesthetics, PRP has been recognized as an effective treatment in sports injury, diabetic ulcer treatment, and orthopedics, to name a few. Platelets have essential growth factors that, when secreted, handles tissue regeneration and rejuvenation, increases collagen production, recruit other cells to the site of injury, induces cell differentiation and extracellular matrix formation. It has an anti-inflammatory effect that will speed up healing time and ease recovery time after resurfacing procedure. With PRP therapy, we stimulate long-term collagen growth, eliminating skin wrinkles, rejuvenating the skin, improving the appearance of acne scarring, and hastening the healing process after a facial peel. PRP is injected subcutaneously into the area of alopecia with many growth factors and stem cells. Hair transplantation is no exception, and MSI is at the forefront in developing these applications.

People want to look better with as little as possible downtime. Although a quick fix is not possible for severe wrinkles, newer treatment options such as fractional lasers and fractional radiofrequency are available to slow down the aging aspects that affect the face, neck, décolleté, and the back of the hands. Vampire Facelift is a name for a non-surgical cosmetic procedure involving the injection of platelet-rich plasma (PRP) derived from a patient’s blood back into multiple areas of the skin of their face to treat wrinkles and “rejuvenate” the face. Platelets have essential growth factors that, when secreted, handle tissue regeneration and rejuvenation, increase collagen production, recruit other cells to the injury site, induce cell differentiation and extracellular matrix formation. It has an anti-inflammatory effect that will speed up healing time and ease recovery time after resurfacing procedure. In a new approach, Prof uses fractional ablative lasers to overcome the epidermal barrier and increase topical agents’ penetration as laser-assisted drug delivery (LADD). Prof Moawad offers his patients a full-face fractional CO2 laser or fractional radiofrequency (FRF) to make tiny holes into the skin to overcome the stratum corneum to enhance PRP and /or nanofat. The results are doubles. You will enjoy both the rejuvenating effect of fractional skin resurfacing systems and the regenerative effect of growth factors and stems cells present in PRP and/or nanofat.

Fat transfer is known by various names, of which the commonly used are fat transfer, fat injection, and autologous fat graft. The word autologous means material (fat) is harvested from one area and donated to another in the same individual. Fat transfer has become an increasingly important method of facial rejuvenation both as a standalone procedure and in combination with traditional rejuvenation methods, like face-lifting, brow lifting, and Blepharoplasty. Fat transfer is particularly suited for restructuring the proportion of the face. Typical facial structures can also be aided by adding constructive elements to correct a broad range of perceived facial deficiencies. For example, a stronger jawline creates a youthful, more powerful-looking face; eliminating the hollowness of lower lids helps reduce that tired, sad appearance; and fuller lips create a more youthful, attractive appearance. Fat transfer is also used for augmenting body contours, such as the breasts or buttocks. Other indications include congenital, traumatic defects, or surgical defects and scars. Nanofat is applicable in various indications to improve skin quality; trophic skin changes caused by age and sun damage, pigmentary skin conditions, scarring, and atrophic skin conditions. Non-facial areas such as the neck, the décolleté area, and the hands can also greatly benefit from the use of nanofat grafting, sometimes in combination with microfat.

The basis of microneedling (MN) relies on physical injury. It has been proposed that the trauma generated by needle penetration in the skin induces dermis regeneration. This results in the deposition of collagen by fibroblasts. The technique of microneedling has been well-exploited to increase the penetration of drugs across the skin barrier, including macromolecular biopharmaceuticals and drugs such as minoxidil, tretinoin, and L-ascorbic acid, vitamins and hyaluronic acid (Mesolift), platelets rich plasma (PRP), and nanofat (vampire facelift) and even botulinum toxin microinjection (mesobotox) into the deep layer of skin and subcutaneous tissue. Microinjections and microneedling are successful in skin rejuvenation, hair loss, and scars therapy.