Plastic Surgery

RHINOPLASTY

Plastic surgery on the nose, known familiarly as a nose job. Rhinoplasty is a facial cosmetic procedure that is usually performed to enhance the appearance of the nose. During this type of rhinoplasty, the nasal cartilage and bones are modified, or tissue is added. Rhinoplasty is also performed to repair nasal fractures and other structural problems. In these cases, the goal is to restore a pre-injury appearance or to create a normal appearance.

PROCEDURE HIGHLIGHTS:

• 5 – hour surgery with general anesthesia
• One day hospital stay
• If nose packing is done, they are removed on the 3rd day
• Stitches are removed on the 5th day
• The cast on the nose is removed or changed on the 7th day
• 8-9 day stay in the country is required
• There will edema in the face and nose with some bruises for 2 weeks
• The results will settle in 12 weeks

UPPER EYELID SURGERY

Upper eyelids begin to elongate and create skin folds drooping over the eyelashes usually after the age of 40. They may be associated with fat bulging in the inner side. Upper eyelid surgery is one of the first aesthetic procedures required both in women and men. It is a pretty simple operation that can be done under local anesthesia and on an outpatient basis. It has very little downtime, very few complications, and almost no scarring!

PROCEDURE HIGHLIGHTS:

• 45-minute surgery
• Local anesthesia (with sedation if required)
• Same day hospital discharge
• Stitches are removed on the 4th day
• 3 to 5 day stay in the country is adequate
• There will be slight edema and some bruises for 2 weeks
• The results will settle in 6 weeks
• The scar stays in the lid fold so it is not visible

LOWER EYELID SURGERY

Lower eyelids develop puffiness towards the end of their thirties and then become more troublesome with the descent of the midface after 40 years of age. The tear trough formed is the stigma of middle age! Lower eyelid surgery should be performed by skilled surgeons. At times the physician may suggest a midface lift combined with lower lid blepharoplasty. If there is only fat bulging with no skin excess, incision (the cut) can be made from inside the lower lid leaving no scars. If there is skin excess in the lower lid and it needs to be removed the incision is done just below the lash line leaving a very faint scar.

PROCEDURE HIGHLIGHTS

• 90-minute surgery
• Performed under either local or general anesthesia
• 1-day hospital stay is recommended
• Stitches are removed on the 4th day
• 3 to 5 day stay in the country is adequate
• There will be slight edema and some bruising for 2 weeks
• The results will settle in 6 weeks

FACELIFT

The face loosens and sags down after 40 years of age. First, the eyebrows come down, then the midface drops around the nose creating tear trough lines under the eyes and folds between the cheeks and lips. If left untouched drooping folds occur on both sides of the mouth on the chin. The facelift procedure is not a single operation, but the name of a group of surgical techniques that redrapes the faces in an upward vector. The technique is chosen according to the patient’s needs. For patients in their 40s, a midface lift can be performed endoscopically together with a brow lift, or from the lower eyelids during a lower lid blepharoplasty. For over the 50s a full facelift is required with incisions (cuts) passing in front of the ears, as the jaw and neck have to be addressed.

PROCEDURE HIGHLIGHTS:

• 5-hour surgery with general anesthesia
• 2-day hospital stay
• Smoking should be avoided 2 weeks prior to surgery
• Stitches are removed on the 5th day
• 7-9 day stay in the country is necessary
• There will be some edema & bruises for 2 weeks
• The results will settle in 6 weeks

ABDOMINOPLASTY

The belly may enlarge due to weight gain and pregnancy. The muscles in the belly may also get loosened and sometimes separated from each other in the midline. With abdominoplasty operation, the skin and fat tissue between the navel and pubic area may be completely removed and the abdomen can be tightened.

PROCEDURE HIGHLIGHTS

• 3- hour surgery
• General anesthesia
• One day hospital stay
• Usually, no stitches to remove
• 5 to 6 days stay in the country is adequate
• A special corset should be used for 3 weeks
• Results will settle in 6 weeks
• There will be drains (small silicone tubes draining the blood out) for 2-4 days

LASER LIPOSUCTION COSMETIC SURGERY

Laser Liposuction (also known as Laser Liposculpture) is a new cosmetic surgery procedure that is effective to remove body fat, without requiring a hospital stay (daycare procedure). This technique uses a laser to break up fat before its removal from the body which reduces the need for harsh suction.

PROCEDURE HIGHLIGHTS

• 1-5- hour surgery (Approx)
• Local anesthesia or general anesthesia
• Bruises & edema may last for a few weeks
• 4 days stay in the country is adequate
• One day hospital stay
• A special corset should be worn for 3 weeks
• Results will settle in 2 months
• Cynosure Triplex 1064nm – 1319 nm – 1440 nm laser is used

BOTOX/ FILLERS

The mimic muscle in our faces makes facial expressions possible to convey our feelings. However, some of these muscles may begin to function at a subconscious level with aging. A typical example is the frowning lines. The transverse lines in the forehead, lines around the eyes (goose feet), downward lines around the corner of the mouth (Marionette lines), and the vertical folds in the neck are other examples. Botulinum toxin can locally and temporarily block the action of mimic muscles when it is injected. If botulinum toxin application is done correctly, the facial expression may change towards a restful and contented look. It can be used to elevate the eyebrows and to sharpen the neck’s contour (Nefertiti Lift).

PROCEDURE HIGHLIGHTS

• 15-minute intervention No anesthesia is required
• Can be performed on an outpatient basis
• The patient may return on the same day
• Should be repeated every 5 months
• The effect will start on the third day and settle on 7th day

HEAD & NECK RECONSTRUCTIVE SURGERY

Reconstructive surgery in the head and neck areas can correct congenital deformities, traumatic injuries, and repair following cancer removal. This specialty has the aim of restoring the facial appearance and preserving speech, swallowing, and chewing function in patients treated for head and neck cancer. Advance microsurgery and flap reconstruction techniques are used that can help many patients after they have had tumors of the head and neck removed. Free flap reconstruction is a technique of tissue transplantation from another part of the body to the head and neck. It is a technically demanding procedure that requires suturing small blood vessels with a diameter of 2 to 4 mm.

PROCEDURE HIGHLIGHTS

• 6 to 8 hour’s surgery
• 2 days stay in the intensive care unit
• 5 to 7 days stay in a regular hospital room
• Healing of incisions takes usually 6 weeks
• Surgery leaves scars
• Flap loss or skin loss may occur
• Smoking & obesity delay the healing process

RECONSTRUCTION SURGERY after SKIN CANCER

Skin Cancer: Depending on the type of skin cancer and how much skin and tissue around cancer needs to be removed, doctors may recommend reconstructive surgery to replace the skin and tissue and to minimize scarring. This may include Mohs surgery (Micrographic Surgery), which is known as the most effective treatment for most types of skin cancer. This procedure removes the cancerous tissue and minimizes the loss of healthy tissue. After having Mohs surgery to remove a skin cancer lesion, your surgeon may perform a simple closure himself or you may recommend post-Mohs reconstructive surgery. This type of reconstructive plastic surgery can be performed immediately after any skin-cancer lesions are removed

PROCEDURE HIGHLIGHTS

• 1 to 2 weeks of hospital stay
• 4 to 6 weeks are usually required for the wound to heal
• Depending on the stage, additional treatments may be needed for skin cancer such as Immunotherapy,
• Targeted therapy, Chemotherapy & Radiation therapy
• The wound is closed with sutures (stitches)

BREAST RECONSTRUCTIVE SURGERY

Women who have surgery as part of their breast cancer treatment may choose breast reconstruction surgery to rebuild the shape and look of the breast. Breast reconstruction generally falls into two categories: implant-based reconstruction or flap reconstruction. Implant reconstruction relies on breast implants to help form a new breast mound. Flap (or autologous) reconstruction uses the patient’s tissue from another part of the body to form a new breast.

PROCEDURE HIGHLIGHTS

• 1 to 6 hours surgery with anesthesia
• 1 to 2 days of hospital stay
• Flap procedures may require a hospital stay of 5 to 6 days
• Bruising & swelling is normal
• Results will settle in 6 to 8 weeks

CLEFT LIP & CLEFT PALATE REPAIR

Cleft lip and cleft palate are congenital birth defects of mouth and lip mostly in form of openings or splits in the upper lip, the roof of the mouth, and both as well. This occurs when the process of development of the facial structure of an unborn child is not completed properly. Cleft Lip & Cleft Palate Repair is a common occurrence and can be successfully corrected through surgery enabling a normal function of lip and mouth along with achieving a normal appearance for patients.

PROCEDURE HIGHLIGHTS

• Surgery requires general anesthesia
• It takes about 2–3 hours
• 1 or 2 days in the hospital
• Stitches will dissolve on their own

HAND SURGERY

Hand trauma encompasses a wide range of problems, including amputations, lacerations, nerve injuries and fractures. Because the hand is critical to daily activity and work, restoration of normal function as soon as possible is important to every patient. UCSF surgeons perform a wide range of hand procedures including replantation and microsurgery to give every patient the best possible outcome. In addition to trauma, other hand conditions may affect function as well – these include congenital abnormalities, sometimes with missing thumb or other fingers, and problems of aging such as rheumatoid arthritis.

PROCEDURE HIGHLIGHTS

• Local anesthesia or general anesthesia
• Incisions need to be closed with removable sutures or non-removable sutures
• Results of hand surgery will appear gradually as swelling subsides
• Final outcome may not be realized for several months

FACIAL FRACTURES AND INJURIES

Reconstructive surgery is performed on abnormal structures on the neck, face, and head. In most cases, these abnormalities are caused by disease, birth defects, infection, trauma, and injury. This type of procedure is typically performed to improve function. However, reconstructive surgery is also useful for improving the quality of life by repairing the function that has been affected as well as restoring a normal appearance. It is important to note that traumatic facial fractures commonly involve the brow, eye socket, jawbone, and cheekbone. Reconstructive surgery realigns the bone segments and improves fixation for successful healing.

PROCEDURE HIGHLIGHTS

• 4 to 12 hour’s surgery
• 2 days stay in the intensive care unit
• 1 week stay in a regular hospital room before discharge
• The healing process may take 6 weeks or more
• Initial discomfort, bruising and swelling are expected

LIMB SALVAGE AND AMPUTATION RECONSTRUCTION SURGERY

Traumatic injuries and diabetic foot disease are some of the things that can put people at risk of losing their arms, legs, feet, hands, fingers, and toes either completely or partially. Limb salvage helps in removing a tumor in a limb (arm or leg) without removing the whole limb. The bone and tissue around the tumor may also be removed, and an implant may be used to replace the part of the limb removed. Limb salvage has greatly helped individuals who are affected by malignant tumors from the neck to the hand and from the pelvis to the foot. Limb-salvage surgery helps to save the use and appearance of the limb. It is also known as limb-sparing surgery.

PROCEDURE HIGHLIGHTS

• It is a major operation with a long recovery period
• The continuation of chemotherapy after surgery also prolongs the recovery period
• Wound healing takes about two weeks
• Mostly physical therapy starts about 4 to 6 months after the surgery

Dr. Mamoon Rashid
MBBS, FCPS, FRCS
Consultant Plastic Surgeon

Dr. Muhammad Ibrahim Khan
MBBS, FCPS Plastic Surgery (PAK), FRCS (Ireland)
Consultant Plastic Surgery

Dr. Adeela Hussain Khan
MBBS, FCPS
FRCS – Plastic Surgery (UK)
Associate Consultant, Plastic Surgery