Cosmetic Surgery

Dermatological surgery has been developing rapidly in the last few years. Plastic surgery is competing with ENT surgery and and surgical dermatology regarding nose jobs, ear lobe surgery, cosmetic anti-aging surgery and others. Here are a few examples of what is available (the remainder of this chapter is based on practical experience in medicine and various chapters throughout Ref.10).

Face Lift

Ear reconstruction

Ear deformities can be congenital and cause ear lobes that stand out to the side (=protruding ears) and otoplasty is the name for the corrective surgery. The ENT specialist would do an otoplasty when the ear lobe in the back protrudes more than 2 cm (=4/5 of an inch) from the head. Here are before and after otoplasty pictures.

Eye job (=blepharoplasty)

This type of surgery takes care of a fat pad that often leaks on the bottom of the eye socket and causes baggy looking eyes. The redundant skin of the upper eye lid is also carefully removed. Another add-on to this, the eyebrow lift is eye brow surgery that corrects a sagging eye brow. This changes the appearance back to a more youthful face, but at the same time less depressed face. Here is a link to a more detailed site that explains blepharoplasty with pictures before and after.

Nose job

Some people are born with a "crooked nose", others sustain it after a nose fracture from an accident or a fight. The end result is a nasal septum deviation where the separation wall between the right and left nose is deformed. Patients often snore and complain having difficulties breathing through the nose. This can be surgically corrected in a small surgical procedure, called rhinoplasty surgery . Here is a link, which explains this in more detail and shows before and after rhinoplasty pictures

Infected skin wounds often heal with a skin defect that needs covering. Burn wounds or mole removals are other examples where there may be not enough local skin to cover and close the wound. This is where the plastic surgeon can do a skin transfer or skin graft with the same patient being the donor. The graft is taken from an inconspicuous area with healthy skin.

Z-plasty

This is a surgical procedure is called so because the surgical line looks like the letter "Z". The full surgical name is "triangular flap repairs", but it goes by "Z -plasty", which is much easier to picture in your mind. This technique has a wide application around fingers for repair of stenosing tendinitis cases (De Quervain) with contractures. It is also used for large unsightly scar revisions anywhere in the body and for congenital lip deformities as shown through the link below. The following is a link to a site that shows the use of this surgical technique to repair congenital cleft lip defects. Pictures before and after the use of Z- plasty are shown under this link .

Disclaimer:

This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.

References:

1. Habif: Clinical Dermatology, 3rd ed.,1996, Mosby-Year  Book, Inc.

2. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse  Station, N.J., 1999. Chapter 117.

3. Cotran: Robbins Pathologic Basis of Disease, 6th ed.,1999, W. B.  Saunders Company

4. Noble: Textbook of Primary Care Medicine, 3rd ed., 2001, Mosby,  Inc.

5. Rakel: Conn's Current Therapy 2001, 53rd ed., 2001, W. B. Saunders  Company

6. Goroll: Primary Care Medicine, 4th ed., 2000, Lippincott Williams &  Wilkins

7. Richard J. Lewis, M.D. at the 42nd Annual St. Paul's Hosp. CME  Conf., Nov.1996, Vancouver/BC

8. Jerry Shapiro, Prof. Dermatol., UBC, at 45th Annual St. Paul's Hosp.  CME Conf., Nov.1999, Vancouver/BC

9. D Seager Int J Cosmet Surg Vol 6, No. 1, 1998: 27-31.

10. Townsend: Sabiston Textbook of Surgery, 16th ed.,2000, W. B.  Saunders Company

11. Ferri: Ferri's Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc.

12. Rakel: Conn's Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier

Last Modified: Dec. 11, 2007