Suture Lift

Chosen clients on whom this procedure is done are able to achieve significant tightening or lifting of the following areas (i.e.) eye brows, cheek, nasolabial folds, jawls and neck.

A stitch is applied to lift the area desired and anchored to a fixed point with a small incision, when doing a brow lift, nasolabial lift or cheek lift.

When doing a lift of the jawl and neck a small amount of skin may need to be removed. A small amount of folded skin in front of the ear would shrink in about 6 to 8 weeks.

An initial obligation face consultation is required as to ensure the procedure would suit you.

Together with this minimal lift other minimal procedures can be done. Permanent or temporary skin fillers can be used to enlarge the lips fill the nasolabial folds, cheek, chin, corners of mouth and frown lines.

A combination of procedures can also help to improve the face, common procedures being liposuction of the jawl, neck, and chin implant while doing a stitch lift.

Down time is about 4 to 5 days.

Varicose Spider Veins

Imagine wearing shorts without being embarrassed. Imagine not worrying about unsightly facial spider veins. It's all possible at our centre.

You may not realise it, but whether or not you have ugly (and sometimes painful) varicose or spider veins is really up to you. It's a choice, because you can get them removed easily and virtually painlessly.

You can take advantage of the experience we've gained by helping thousands of men and women put an end to these unsightly veins. And you'll feel reassured knowing that over 95% of our patients are more than pleased with the results.

Your varicose and spider veins can disappear without surgery.

In years past, the only way to remove varicose or spider veins was through painful surgical vein stripping and a long hospital stay.

But now our sclerotherapy treatment enables us to remove varicose and spider veins without surgery using just simple injections. The veins fade away in a few weeks, with little discomfort and no surgical scars, so you can get back to doing the things you love to do immediately.

Discover how easy it is to lose those ugly veins with a no risk consultation.

We offer all new patients the opportunity to see the difference we can make to them.

You'll receive results of actual cases, receive a comprehensive medical evaluation of your vein problem, get ultrasound testing if necessary, and get a confidential consultation.

So get the look you've always wanted. It's simple, at our centre.

Facial veins are also successfully treated by our Argon laser.

Aeshetic Plastic Surgery At Turkey

WORLD QUALITY AESTHETIC PLASTIC SURGERY

Years and years Clinic save a lot of person all over the europen country.It’s very prides save yourself.If you are beeing aesthetic operations in Turkey, please you will not determine as you acknowledge with us.

You Enter This Clinic , find another intelegence and be conforted with another clinic…you will see detail in scientific mission and live franchise in technological installalation.You have not only holidays but also change all your life.

ARE YOU READY FOR THE VARITION..?
Especialy price for you…
Rhinoplasty 1500 - 2500 €
Liposuction 1500 – 3000 €
Breast plastic surgery 2500 - 3500 €
Abdominoplasty 2000 €

For Questions MD Phone: 0090 532 527 75 24

Package services includes
Examination
Operation
Chek up examination on the day after the operation
A day of accomadation in hospital

1. pocket
4 star hotel single room 120 €
• room
• breakfast

2.pocket
5 star hotel single room 150 €
• room
• breakfast
• turkish bath
• sauna

**** That’s enough 6 days 5 night accomadation all of the operations.

If you want to airport - hotel – hospital transfer, you will connect with us:

Md Phone: 0090 532 527 75 24

Dermatologic Peeling Dermabrasion

Wrinkles, pigmentations, freckles, acne prone skin or post acne scarring are conditions suitable for skin-resurfacing treatment, either chemically or mechanically. A chemical peel is done to remove the top layers of facial skin. It reduces fine wrinkles and evens out the skin tones, leaving younger looking skin. A peel can be done on the entire face or just specific areas. It does not replace a facelift as it won’t eliminate sagging skin, but many patients benefit from a combination. Usually three different agents in different concentrations and mixtures are used for this purpose: Phenol, Trichloro-acetic-acid or Alpha-hydroxy-acids.
Phenol-peeling: Phenol has a deep penetration and is the most powerful agent. Therefore some disadvantages as depigmentation, pain and hypersensibility to sun-exposure are common.

Trichloro-acetic-acid ( TCA ): TCA does only have a relatively superfical effect but with a pre-peeltreatment with Retin-A and hydrochinone, a sufficiently deep effect is achieved.

Alpha-hydroxy-acids ( AHA ): The AHA-s are since ancient ages in use and have recently gained a renaissance. The active agent is a component in commercially available differnt brands, mostly handed out by cosmeticans, who also usually make superficial peelings, whereas deeper peels should be made by physicians. The AHA´s gives the skin a "polish" but never removes scars or even wrinkles. This procedure takes between 15 minutes and 1 hour depending on how much is being peeled. A general anesthetic will be used if the full face is being done. Patients can expect swelling, and crusting for 1-2 weeks. There is usually almost no discomfort. If the full face is done you can expect to be off work for two weeks. Usually you can begin driving in one week and exercise in two to three weeks.

In dermabrasion, the superficial layers of the skin are planned out with an abrading device, leaving a wound permitting scarless healing. This procedure needs some kind of anaesthetic.

Plastic Surgery of Carpal Tunnel

The major physical findings reflect that pressure is increased in the carpal tunnel. If more information is needed to make the diagnosis, electrical studies of the nerves in the wrist may be requested. Several tests are available to see how well the median nerve is functioning, including the nerve conduction velocity and electromyography (EMG). This test measures how fast nerve impulses are conducted through the nerve.

In the early stages of Carpal Tunnel syndrome, a splint will sometimes decrease the symptoms, especially the numbness and pain occurring at night. It may also help control the swelling of the tenosynovium and reduce the symptoms of carpal tunnel syndrome. If this fails to control your symptoms a cortisone injection into the carpal tunnel may be suggested. This medication will decrease the swelling of the tenosynovium and may give temporary relief of symptoms. If all of the previous treatments fail to control the symptoms of carpal tunnel syndrome, surgery will be required to reduce the pressure on the median nerve.

The median nerve runs into the hand to supply sensation to the thumb, index finger, long finger, and half of the ring finger. The nerve also supplies a branch to the muscles of the thumb, the thenar muscles.
One of the first symptoms of carpal tunnel syndrome is numbness in the distribution of the median Nerve. This may be quickly followed by pain in the same distribution. The pain may also radiate up the arm to the shoulder, and sometimes the neck. If the condition is allowed to progress, weakness of the thenar muscles may occur. This results in an inability to bring the thumb into opposition with the other fingers and hinders one's grasp.
Looking at a cross section of the wrist allows one to visualize the anatomy of the carpal tunnel. The carpal tunnel is an opening into the hand that is made up of the bones of the wrist on the bottom and the transverse carpal ligament on the top. Through this opening, the median nerve and the flexor tendons run into the hand. The median nerve lies just under the transverse carpal ligament. The flexor tendons allow us to move the hand, such as when we grasp objects.

The Tendons are covered by a sheet called tenosynovium. The tenosynovium is very slippery, and allows the tendons to glide against each other as the hand is used to grasp objects. Any condition which causes irritation or inflammation of the tendons can result in swelling and thickening of the tenosynovium. As all of the tendons begin to swell and thicken, the pressure begins to increase in the carpal tunnel because the bones and ligaments that make up the tunnel are not able to stretch in response to the swelling. Increased pressure in the carpal tunnel begins to squeeze the median nerve against the transverse carpal ligament. Eventually, the pressure reaches a point when the nerve can no longer function normally. Pain and numbness in the hand begins.

There are many conditions which can result in irritation and inflammation of the tenosynovium, and eventually cause carpal tunnel syndrome. Different types of arthritis can cause inflammation of the tenosynovium directly. A fracture of the wrist bones may later cause carpal tunnel syndrome if the healed fragments result in abnormal irritation on the flexor tendons. The Key Concept to remember is that anything which causes abnormal pressure on the Median Nerve will result in the symptoms of pain, numbness and weakness of carpal tunnel syndrome.

Evaluation begins by obtaining a history of the problem, followed by a thorough physical examination. Description of the symptoms and the physical examination are the most important parts in the diagnosis of carpal tunnel syndrome. Commonly, patients will complain first of waking in the middle of the night with pain and a feeling that the whole hand is asleep. Careful investigation usually shows that the little finger is unaffected. This can be a key piece of information to make the diagnosis. Other complaints include numbness while using the hand for gripping activities, such as sweeping, hammering, or driving.

Pediatric Surgery

PIGMENTED LESIONS OF THE SKIN
Pigmented lesions in the newborn are frequently difficult to interpret regarding their present or potential malignancy. Early consultation with a plastic surgeon and pathologist initiates (1) planning for surgical removal or other appropriate treatment, and (2) providing treatment options and counseling to the parents. Large congenital nevi pose a significant risk of early malignancy or later malignant transformation. Large and sometimes hairy nevi also are physically uncomfortable and psychologically damaging for child and parents. Surgical excision with skin grafting is often a treatment of choice.

MALFORMATIONS OF THE EAR
Ear malformations such as microtia can severely affect a child's self-image, especially if the condition is allowed to go uncorrected until school age. The importance of well formed ears in overall facial esthetics is reflected in the severe teasing inflicted by schoolmates on a child with malformed ears. Microtia is usually apparent at birth or soon after, seen as a "remnant" ear lobule, concha, acoustic meatus, tragus and incisura intertragica. Microtia is usually unilateral. Bilateral microtia may be associated with severe hearing defects that require consultation with an otologist. As soon as microtia is identified, the plastic surgeon should become a partner with the primary care physician in planning an approach to reconstruction. Consultation with the child's parents will help to plan the age at which reconstruction should begin; usually, reconstruction should be completed before the child enters school. Because autologous rib cartilage is commonly required to form a new ear framework, definitive reconstruction may take place at about age 5 or 6 years when rib growth has been adequate. Parents should be informed regarding potential complications of harvesting rib cartilage. Skin flap techniques are commonly used to mobilize the skin used to cover the new ear framework. The ultimate success of microtic reconstruction depends upon patient selection, adequate counseling of parents, selection of the proper material for an ear framework, surgical skill, and detailed attention in the intraoperative and postoperative periods to prevent complications such as infection, skin flap necrosis, and undue pressure on the operated ear.

MALFORMATIONS OF THE HAND
Hand malformations include syndactyly (webbed fingers), polydactyly (extra fingers), trigger fingers, crooked fingers, absent thumb, short fingers and missing fingers. All congenital hand malformations should raise suspicion of associated deformities of other organs or tissues. Syndactyly, for example, is frequently a readily visible manifestation of Poland's syndrome--congenital absence of thoracic structures in association with hand malformation. Plastic surgery can correct many hand malformations definitively; in other instances, plastic surgery can provide some degree of functional capacity. An example of functional restoration is microvascular toe-to-hand tissue transfer, which offers potential for surgical correction of hypoplastic or aplastic fingers. Consultation with the patient's parents must stress the importance of restoring function to the malformed hand, even if cosmetic appearance must be a secondary consideration. The unique function of the hand throughout life mandates that function be restored as fully as possible--e.g., providing pinch and grip function will be essential to many occupations. The primary care physician has an essential role in working with the patient and family to assure that exercise and rehabilitation regimens are followed, in order to maximize the advantages of surgical reconstruction and prevent debilitating complications such as contracture.

ANOMALIES OF THE BREAST
Congenital breast asymmetry may be a manifestation of underlying congenital anomalies. Poland's syndrome, the most frequent congenital cause of breast asymmetry, is a syndrome of thoracic structure deformities, breast asymmetry, and ipsilateral syndactyly. Computed tomography and magnetic resonance imaging are definitive in identifying the thoracic deformities. Treatment of breast asymmetry due to Poland's syndrome may include prosthetic augmentation, use of a musculocutaneous flap to fill hollow space on the exterior of the chest, or augmentation with tissue from the opposite breast. Definitive treatment includes surgical repair of the chest wall. As in the case of other congenital deformities, Poland's syndrome may be seen in association with anomalies of other tissues and organs.

SOFT-TISSUE INJURIES AND SUPERFICIAL BURNS
Falls, traffic accidents, animal bites, hot liquids, electrical equipment and physical abuse all produce injuries to the soft tissues of children. Treatment in an emergency department is often adequate, but failure to provide appropriate or definitive treatment in the emergency setting may produce permanent injury or disfigurement. It is important for the primary care physician to recognize when consultation with a plastic surgeon is indicated for definitive treatment.

SOFT-TISSUE INJURIES OF THE FACE
Facial injuries require special attention because of their potential for permanent disfigurement. Contusions, lacerations, puncture wounds, tattoos with debris and especially avulsive injuries all have the capacity to permanently disfigure the patient. Inadequate suturing of even small lacerations on the face can result in poor healing and scarring. Definitive repair of facial soft-tissue injuries is best carried out in an operating room rather than an emergency room, and preferably by a plastic surgeon. Should the injuries be complex or severe, the surgeon can perform procedures that will be definitive or will lay the foundation for later revision surgery. Injuries to particularly vulnerable facial features require special attention. Injuries to the forehead and eyebrow, eyelids, ears, nose, cheeks and chin have the most potential to result in disfigurement. In the case of injuries to cheek and chin, injuries also may result in loss of function if facial nerves or muscles are injured. Repair to facial nerves and muscles should be placed in the hands of a plastic surgeon experienced in this type of surgery.

ANIMAL BITES
Animal bites can present special problems--e.g., most dog bite wounds are to the face in children and are typically tearing-type soft-tissue wounds. Aggressive cleaning and meticulous repair by a plastic surgeon can frequently salvage a serious injury cosmetically and functionally. Snakebite presents the possibility of envenomation in addition to bite injury. If the type of snake is unknown, emergency treatment proceeds with observation and suspicion of envenomation. Bites inflicted by rattlesnakes may result in tissue necrosis--often severe--that requires wide dissection and debridement. Skin grafting or reconstruction with skin flap technique may be needed after primary healing of the wound site.

SUPERFICIAL BURNS
Most burns suffered by infants and young children are hot-liquid scalds, and as many as 15 percent of scald burns may be due to child abuse. Scald burns on the buttocks are especially likely to have resulted from abuse--e.g., sitting the child in very hot water as punishment. The immediate concern in scald injury is estimation of the extent of injury. The ratio of head-to-total body burn must be calculated differently in infants and children than in adults, due to inherent differences in relative size of head to body. Estimation of the severity of the burn is dependent upon (1) temperature of the scalding liquid, and (2) amount of time the skin was exposed to the liquid. Good emergency management of a superficial burn--i.e., limited extent, less than full-thickness--should result in healing without complications. Elements of good management include (1) evaluation, (2) rinsing with saline solution and light cleaning with mild soap-and-water solution, (3) debridement of any blisters that interfere with function, such as blisters on the eyelids, (4) instruction to the child's family in how to care for the burn after the patient is released from the hospital, and (5) examination of the patient by the treating physician within 2 days after the first dressing change, to rule out the possibility of wound-site infection. Burns of the ears and hands require special attention. Even superficially burned ears may later develop scarring or deformation. Burned hands can potentially develop scarring and contracture that limit function. A plastic surgeon should be called into consultation for burns on vulnerable sites such as ears and hands.

CONGENITAL ANOMALIES
A deforming birth defect has a devastating psychological impact upon the child's parents, and has the potential for life-long impact upon the physical, psychological and socioeconomic well-being of the child. Plastic surgery can improve or correct many of these birth defects. Because timing of surgery is often an important factor in improving the prospect for successful outcome, early consultation should be sought with a plastic surgeon. The primary care physician and the plastic surgeon work closely together in designing a maximally effective treatment plan for the affected child. Commonly, they work in the context of a multi-disciplinary team. The family physician and pediatrician may work together with the surgeon to help the parents deal rationally with treatment options. The physicians also may counsel the parents regarding the emotional, psychological and financial resources that may be strained by treatment that sometimes requires many months or years to complete.

CLEFT LIP
Anomalies of the heart and other organs are found in a substantial percentage of cleft lip/cleft palate patients, especially in conjunction with bilateral clefts. Every neonate with facial clefting should have a complete pediatric examination for indications of additional anomalies. Cleft lip may occur alone or in conjunction with cleft palate. Its forms range from mildly disfiguring to bilateral complete cleft with nasal deformity and involvement of the hard palate and teeth.

Treatment
Treatment begins soon after birth with pediatric evaluation of the patient for any coexistent anomalies, evaluation of the defect by a plastic surgeon, and consultation with the family regarding treatment options. Nonsurgical treatment may be used early--elastic headcap traction, a nose retainer and preoperative orthodontics if indicated. Lip repair can be performed any time after birth. In general, most repairs are timed according to the "Rule of 10s"--10 weeks old, weight of 10 pounds and 10 grams of hemoglobin. Secondary surgery may be necessary later for repair of a nasal deformity, revision of an earlier repair as the patient grows and develops, or repair of postoperative abnormalities in the scar. Severe bilateral cleft lip requires treatment and on-going coun- seling throughout the patient's childhood and adolescence.

CLEFT PALATE TREATMENT
Repair of the palate is directed at producing normal speech, restoring eustachian tube function, attaining closure of oronasal fistulas and minimizing alterations in maxillary growth. Depending on the patient, repairs may start as early as 10 months or as late as 24 months. Planning for primary surgical repair begins in the hospital shortly after the child is born, or soon after discharge. A small or moderate degree of clefting may be repaired by simple closure; a larger defect may require a pharyngeal flap, alveolar arch alignment, orthodontic and dental work, and bone grafting. Dental, orthodontic or prosthodontic consultation is sought when teeth are malformed or missing. Bilateral clefts are the most complex to repair, requiring a spectrum of medical and surgical specialists. In some cases, secondary soft palate (velopharyngeal) surgery may be necessary some months or years after primary palate repair, to correct hypernasal speech. Speech-language pathologists may assist in identifying the specific defect to be repaired. Velopharyngeal repair procedures include (1) palatal pushback plus pharyngeal flap lining, (2) posterior pharyngeal wall implant with Teflon injection, (3) pharyngeal flap, (4) palatopharyngeal flap, and (5) tissue expansion to create a flap. Long-Term Treatment: Some patients require months or years of speech-language training to acquire normal speech. The family members of a cleft palate patient may need long-term guidance and counseling to support them through the years of treatment.

HEMANGIOMAS AND OTHER BENIGN VASCULAR LESIONS OF THE SKIN
Hemangiomas and lymphangiomas, the most common benign tumors of the skin in neonates, may be present at birth or appear in the first months after birth. Some lesions regress and disappear in the first few months of life--e.g., the strawberry hemangioma. Large vascular lesions in critical locations can be life-threatening as well as disfiguring--e.g., multiple hemangiomas of the newborn involving skin, liver and intestinal tract. Consultations with a plastic surgeon may include consults with other specialists such as a hematologist when a lesion is very large or life-threatening. Laser treatment is often a treatment of choice for vascular lesions, including port-wine stain and unregressed strawberry hemangioma. Careful evaluation is required before laser treatment is undertaken.

Whats Cleft Lip Palate

Most children with clefts do not have other birth defects. Most are normal in intelligence and abilities. Children with clefts do have a higher incidence of a problem called serous otitis media-fluid in the ear. If untreated, frequent ear infections and even hearing loss can result. Many children with clefts have abnormalities of the teeth-this can range form crooked teeth to extra or missing teeth.

What is the treatment for cleft lip and palate?
Children with clefts benefit from specialized team care. Cleft teams consist of specialists in Plastic Surgery, Otolaryngology, Pediatrics, Oral and Maxillofacial Surgery, Genetics, Dentistry, babySpeech, Pathology, Audiology, Nursing, and Psychology. These teams work with the child's own pediatrician to provide the best care possible. Excellent care is also available outside of cleft teams, but requires more coordination of various specialists by the parents. Most surgeons repair cleft lip when the baby is 6 to 10 weeks old. Most surgeons repair cleft palate at 6 to 12 months of age. The exact age for repair will depend on the size and health of the child and the surgeon's preference.Some children with cleft palate will require a second operation on the palate to help get better speech. This happens in about 20% of cases, and cannot be predicted at the time of the original palate surgery. Many children with clefts involving the gun line will benefit from an operation to put extra bone in the gum. This is called an alveolar bone graft. This allows the permanent teeth to come in better. This operation is done sometime between the ages of 6 and 10, depending on how fast the permanent teeth are developing. Children with clefts of the lip may need or want touch up operations to improve the appearance of the scars. As teenagers, some need nasal surgery to improve breathing or appearance. In some children with clefts, the jaws are not in good alignment. In these cases, surgery can be done to align the bite.

Blepharoplasty Procedures and Topics

The blepharoplasty procedure will not eradicate the wrinkles around the eyes (crow s feet) nor will it elevate droopy eyebrow. There are other procedures designed for these purposes. Dark circles under the eyes may improve a bit if this is related to large bags , but most often the dark appearance of the lower eyelid skin remains. The best patients are those who are healthy, psychologically stable and well motivated. Some medical conditions may increase the risk of blepharoplasty surgery such as thyroid disease, high blood pressure, and patients who do not make sufficient tears to keep their eyes well lubricated.

Fortunately, when performed by a competent plastic surgeon, complications are infrequent and minor. All patients will experience some bruising and swelling for a few days after the surgery. In addition, a temporary problem with closure of the eyelids is usually seen. Some may have temporary blurring of their vision, usually due to the ointments applied to the incisions post operatively. In rare resiminstances, the lower eyelid may be pulled down causing an ectropion. If this does not resolve on its own, further surgery may be necessary. The theoretical complications of any surgical procedure, such as bleeding, infection, wound disruption and heavy scarring are also possible, but rare.

Eyelid surgery (technically called blepharoplasty) is a procedure to remove fat--usually along with excess skin and muscle from the upper and lower eyelids. Eyelid surgery can correct drooping upper lids and puffy bags below your eyes - features that make you look older and more tired than you feel, and may even interfere with your vision. However, it won't remove crow's feet or other wrinkles, resimeliminate dark circles under your eyes, or lift sagging eyebrows. While it can add an upper eyelid crease to Asian eyes, it will not erase evidence of your ethnic or racial heritage. Blepharoplasty can be done alone, or in conjunction with other facial surgery procedures such as a facelift or browlift. If you're considering eyelid surgery, this information will give you a basic understanding of the procedure-when it can help, how it's performed, and what results you can expect. It can't answer all of your questions, since a lot depends on the individual patient and the surgeon. Please ask your surgeon about anything you don't understand.

Blepharoplasty can enhance your appearance and your self-confidence, but it won't necessarily change your looks to match your ideal, or cause other people to treat you differently. Before you decide to have surgery, resimthink carefully about your expectations and discuss them with your surgeon. The best candidates for eyelid surgery are men and women who are physically healthy, psychologically stable, and realistic in their expectations. Most are 35 or older, but if droopy, baggy eyelids run in your family, you may decide to have eyelid surgery at a younger age.A few medical conditions make blepharoplasty more risky. They include thyroid problems such as hypothyroidism and Graves' disease, dry eye or lack of sufficient tears, high blood pressure or other circulatory disorders, cardiovascular disease, and diabetes. A detached retina or glaucoma is also reason for caution; check with your ophthalmologist before you have surgery.

resimWhen eyelid surgery is performed by a qualified plastic surgeon, complications are infrequent and usually minor. Nevertheless, there is always a possibility of complications, including infection or a reaction to the anesthesia. You can reduce your risks by closely following your surgeon's instructions both before and after surgery. The minor complications that occasionally follow blepharoplasty include double or blurred vision for a few days; temporary swelling at the corner of the eyelids; and a slight asymmetry in healing or scarring. Tiny whiteheads may appear after your stitches are taken out; your surgeon can remove them easily with a very fine needle. Following surgery, some patients may have difficulty closing their eyes when they sleep; in rare cases this condition may be permanent. Another very rare complication is ectropion, a pulling down of the lower lids. In this case, further surgery may be required.

Eyelid surgery is usually performed under local anesthesia--which numbs the area around your eyes--along with oral or intravenous sedatives. You'll be awake during the surgery, but relaxed and insensitive to pain. (However, you may feel some tugging or occasional discomfort.) Some surgeons prefer to use general anesthesia; in that case, you'll sleep through the operation. .

Blepharoplasty usually takes one to three hours, depending on the extent of the surgery. If you're having all four eyelids done, the surgeon will probably work on the upper lids first, then the lower ones. In a typical procedure, the surgeon makes incisions following the natural lines of your eyelids; in the creases of your upper lids, and just below the lashes in the lower lids. The incisions may extend into the crow's feet or laugh lines at the outer corners of your eyes. Working through these incisions, the surgeon separates the skin from underlying fatty tissue and muscle, removes excess fat, and often trims sagging skin and muscle. The incisions are then closed with very fine sutures. If you have a pocket of fat beneath your lower eyelids but don't need to have any skin removed, your surgeon may perform a transconjunctival blepharoplasty. In this procedure the incision is made inside your lower eyelid, leaving no visible scar. It is usually performed on younger patients with thicker, more elastic skin.

After surgery, the surgeon will probably lubricate your eyes with ointment and may apply a bandage. Your eyelids may feel tight and sore as the anesthesia wears off, but you can control any discomfort with the pain medication prescribed by your surgeon. If you feel any severe pain, call your surgeon immediately. Your surgeon will instruct you to keep your head elevated for several days, and to use cold compresses to reduce swelling and bruising. (Bruising varies forn person to person: it reaches its peak during the first week, and generally lasts anywhere from two weeks to a month.) You'll be shown how to clean your eyes, which may be gummy for a week or so. Many doctors recommend eyedrops, since your eyelids may feel dry at first and your eyes may burn or itch. For the first few weeks you may also experience excessive tearing, sensitivity to light, and temporary changes in your eyesight, such as blurring or double vision. Your surgeon will follow your progress very closely for the first week or two. The stitches will be removed two days to a week after surgery. Once they're out, the swelling and discoloration around your eyes will gradually subside, and you'll start to look and feel much better.

You should be able to read or watch television after two or three days. However, you won't be able to wear contact lenses for about two weeks, and even then they may feel uncomfortable for a while. Most people feel ready to go out in public (and back to work) in a week to 10 days. By then, depending on your rate of healing and your doctor's instructions, you'll probably be able to wear makeup to hide the bruising that remains. You may be sensitive to sunlight, wind, and other irritants for several weeks, so you should wear sunglasses and a special sunblock made for eyelids when you go out.Your surgeon will probably tell you to keep your activities to a minimum for three to five days, and to avoid more strenuous activities for about three weeks. It's especially important to avoid activities that raise your blood pressure, including bending, lifting, and rigorous sports. You may also be told to avoid alcohol, since it causes fluid retention.

Healing is a gradual process, and your scars may remain slightly pink for six months or more after surgery. Eventually, though, they'll fade to a thin, nearly invisible white line. On the other hand, the positive results of your eyelid surgery-the more alert and youthful look-will last for years. For many people, these results are permanent.

Reconstructive Surgery Operations

There are two main divisions of Plastic Surgery

* Aesthetic Surgery (Cosmetic Surgery) (Other Topics)
* Reconstructive Surgery ( This Topic )


Hemanjiom(Red Spots)

Usually starts seen one month after the birth. Can be place all over the body with different sizes, usually on the face area. If there is no functional problem, does not recommended earlier operation than normal operation time.

Hypospadias(Prophet Circumcision)

Pissing hole placed down than it has to be on the penis for males. It could be in all levels. Operation could be after the age of 2.5 – 3. Operation must over before the school period. Operation techniques can be change according to area which pissing hole placed. Operation could be only one or several times. There is always a fistula risk in operations.

Syndaktili(Attached Fingers)

Especially could be for fingers and sometimes for toes. Could be on only skin and sometimes until the bones. Separating could be after the age of 2.

Mikroti(Earless ness from birth)

There can be too many of formations. Approximately the age of 6 recondition must over before the school period.

Lip - Palate Split

There are many kind of this anomaly, happens only ones in every 1000 birth. There are Lip Split by it self and Palate Split by it self and many combination of these. The most important subject is if the blood counting is available of children the age of 2.5 – 3 months and over 5kg can operate lip reconstruction. Palate must operate in age of 12-15 months. If you do not pay good enough attention for the operation of Palate Split, there can be a problem about speaking for children. In every condition, only one day is enough to stay at the hospital for patients.

Facial Aesthetic Operation of Nose Surgery

SURGERY

Plans will be made for your admission to the hospital the morning of your surgery for a general physical examination by the anesthesiologist, appropriate blood tests, and occasionally nasal and sinus x-ray films. These are certainly important and necessary preoperative studies to ensure your well being during surgery.The operation is usually performed under general anesthesia. Almost all patients are discharged a few hours following surgery feeling quite comfortable and generally free of pain.

Aesthetic rhinoplasty typically is performed to reduce the overall size of the nose, reshape a tip, remove a nasal hump or improve a poor angle between the nose and the upper lip. In sone patients it is necessary to add tissue in order to improve contour. One or all of these changes can be made during a single operation. (Fig. 1)

You will find your operation essentially a comfortable experience, generally with little or no discomfort. Anesthesiologists will administer intravenous sedatives and tranquilizers before the operation to keep you very comfortable. Happily, little if any pain occurs after rhinoplasty. Pain medication, however, is always available should you find it necessary.

The small bandage protecting the outside of the nose remains in place for 5 to 7 days. We generally don’t place intranasal packs or splints. If they are placed all internal nasal dressings placed at surgery are ordinarily removed the morning after surgery. We will provide you with a detailed list of "do's and don'ts" to optimize your postoperative course. The patients are advised not to take aspirin—it may precipitate bleeding—and take care to not hit your nose in any way and to keep the nasal splint bandage dry.

At approximately 1 week from the date of surgery, nasal splint is removed. Generally patients are able to return to normal activities such as work or school at this time. Strenuous sports, exercises, swimming, or other physical activities should be curtailed for approximately 3 to 6 additional weeks.

Although the new shape of nose is apparent rather quickly after removal of the splint, it takes several weeks for the majority of the swelling to disappear and shrinkage of the new nasal configuration to occur. This is a gradual process that cannot be hurried. Small, subtle, and generally favorable changes take place over a period of several months.

The degree of improvement depends on the extend of the corrective work undertaken and basic struture of your nose and skin. An obviously disfigured nose will show dramatic results. On the other hand, a slight bump and a tip that is a bit too large may be succesfully corrected, yet the results may be subtle. It is common after some types of rhinoplasty for relatives or friends to remark that they do not see a major difference. Do not consider such a reaction an indication of failure. On the contrary, if it looks better and natural, it may go unnoticed. The intention, after all, is not to create a "new" nose that draws attention to itself, but rather one that blends subtly into the overall features of the face in the proper proportions.

Plastic surgery of the nose is an exciting and challenging branch of surgery for the patient as well as the doctor. Rhinoplasty is clearly the most elegant and sophisticated of all facial plastic surgical procedures. With modern surgical refinements, uniformly better results are obtained than were possible in past decades. It is obvious that the best results in rhinoplasty are the nose simply appear naturel and in harmony with the other facial features.

Rhinoplasty surgery is a highly delicate and technical form of plastic surgery and enjoys a very high rate of success and patient satisfaction. Although usually performed on the younger age groups, excellent results may be obtained on patients in their fifties and sixties.

Rhinoplasty surgery is performed from inside the nose by using special delicate instruments. The bone, cartilage, and soft tissues of the nose are reduced in size, rear­ranged, or sculptured to obtain a desirable natural appearing result. No external scars are left, unless excessively large nostrils require reduction in size. If any external incisions are necessary, we will discuss them with you and camouflage them through tiny incisions in natural skin creases.

The resulting improvement in appearance may be psychologically beneficial, almost always bringing increased self-satisfaction and self-confidence. Patients, however, should not always expect universal approval from all of their family members, friends, and acquaintances following surgery since they may not be aware of your reason and motivation for a change in your appearance. It is more important that patient and surgeon be pleased with the eventual surgical outcome. Ethically no surgeon can guarantee the results of any cosmetic surgery he can only promise to do everything possible to do his best to correct the patient's problem.

Plastic surgical correction of the nasal deformities should never be performed without contemplating and analyzing the surrounding facial features. In our discussions we will explain to you how we can best accomplish the changes you desire, always keeping in mind the need to keep the nose in harmony with your particular individual facial features. At times, as your surgical advisor, we may recommend other subtle changes in your face (chin contour, lip shape, etc), to help you look your very best following surgery.

All surgical procedures carry some degree of risk. Fortunately, tile risk factors in rhinoplasty surgery are quite small. The vast majority of patients undergo surgery and postoperative healing with no significant complications of any kind. Rarely and infrequently, complications such as some degree of postoperative bleeding, delayed healing, and small irregularities and slight asymmetries of the nose can occur, since not all of these factors are under the control of the surgeon.

In some patients with badly deformed noses (severely twisted, badly frac­tured, etc.) it is not always possible to correct all nasal deformities in one single operation; occasionally a second "touch-up" minor procedure might be required several months following the initial major operation to improve the result and/or correct inappropriate healing. Generally, small "touch-up" procedures do not require hospitalization and under most circumstances will be performed as an outpatient procedure.

Postoperative Recovery Breastlift or Mastopexy

After surgery, pain that is controlled easily by medication will subside in a day or two. If you have been operated in a hospital, you will be released in the same day. Within the first week, the dressing will be replaced by a soft bra which you will be advised to wear for several weeks.

Swelling and discoloration around the incisions generally will subside in a few days. After surgery, there may be temporary loss of sensation in the nipples and breast skin. If it occurs, this condition will improve with time. Sutures will be removed within two weeks of surgery.

The objective of mastopexy is higher, well-contoured breasts. (Fig.4) Although we make every effort to keep scars as inconspicuous as possible, mastopexy scars are permanent. They often remain highly visible for a year following surgery, then fade to some degree. However, since incisions are made around and below the nipples, scars should not be noticeable even in low-cut clothing.

Breast lift, or mastopexy, is a surgical procedure to raise and recontour sagging breasts. In some cases, it can be performed in conjunction with surgery to enlarge the size of the breasts with breast implants.

A consultation with a plastic surgeon is the first step an individual should take it considering inastopexy. You should discuss candidly your expectations about looking and feeling better after surgery, while keeping in mind that the desired result is improvement, not perfection.

We will conduct a routine breast examination and, depending on your age and family history, may determine that mammograms, or breast x-rays, are required. After examining you, we will discuss other variables that influence the decisions involved in the procedure, such as your age, the size and shape ot your breasts and the condition of breast skin. A patient considering breast-feeding following mastopexy should discuss the matter with us at this time.

During the initial visit, we will explain the specific details of your case, including the surgical technique to be used, the anesthesia, where the operation will be performed and what the surgery realistically can accomplish.

Thousands of breast lifts are performed successfully each year. Nevertheless, you should be aware of the potential risks of surgery and specific complications associated with mastopexy. Postoperative complications such as infection or blood clots are rare. Poor healing may necessitate subsequent scar revision. Smokers should be made aware that nicotine can delay healing. Risk of complications can be minimized by closely adher­ing to your surgeon's advice on follow-up care.

The Surgical Procedure

Mastopexy typically is performed to lift sagging, loose breasts or breasts that have lost volume and elasticity after childbearing. It also can reduce the size of the areola, the dark pink skin surrounding the nipple. (Fig. I) The extent of the procedure depends on what changes are desired and what we deem appropriate.

Mastopexy usually is performed under general anesthesia, although local anesthesia may be used in particular cases.

In the operation a keyhole-shaped incision is made above the areola to define the new location for the nipple. Working through incisions, excess is removed skin from the the breast. The nipple, areola and underlying breast tissue are moved up to a new higher position, after the nipple is relocated, flaps of skin formerly above and to the sides of the nipple are brought down, around and together to reshape the breast. (Fig.3) Sutures close the wounds under the breast and around the nipple area. In patients with only minimal sagging, a modified procedure may be used to excise only skin from the large areola and the area immediately surrounding it. When breast augmentation is performed in conjunction with the lift, a breast implant, is placed, in a pocket created either directly under the breast tissue or underneath the chest wall muscle. The prosthesis is a flexible plastic envelope that contains a silicone gel. (Fig. 2). Following surgery, a bulky gauze dressing is wrapped around the breasts, or the patient may be placed in a surgical bra.

Depending on the extent of the surgery, the procedure usually lasts about two hours.

Malar implants and procedure

Augmentation of cheek bones plays a significant role in facial contouring. The patients who present with a generally flat appearance of the midface will benefit from malar augmentation. The results of midface augmentation in the appropiate patient has been very gratifying. It can produce a nice contour to a flat or poorly defined face. Silicon or polyethylene (porex) implants can be used for augmentation of cheek bones. We prefer polyethylene implants in most of our cases. Our preffered way of implantation through the intraoral way. Malar augmentation is usually combined with face lift procedures.

A long sweeping elegant jawline is a most desirable feature in an attractive face and neck Retrognathia, manifested by bony mandibular deficiency and/or loss of muscular skin pad posture, creates facial disharmony and proportion imbalance. Inadequate chin projection is commonly encountered in patients seeking aesthetic facial surgery. Although chin augmentation may be performed as an isolated procedure, it is frequently performed as an adjunct to rhinoplasty or rhytidectomy. Submental lipectomy associated with chin augmentation adds a further refinement to the mandibulocervical definition.

Malocclusion and significant facial skeletal abnormalities are of course not corrected by chin augmentation alone. Patients with major mandibular deficiencies and asymmetries are best treated by orthognathic and orthodontic correction.

In the rhinoplasty patient, augmentation of the chin brings the lower third of the face into improved alignment and harmony with the middle third. The degree of apparent nasal projection is often dramatically changed in appearance by relative changes in chin projection.

The rhytidectomy patient, as a consequence of aging, commonly exhibits poor chin projection associated with an obtuse cervicomandibular angle. Conservative augmentation with a chin implant establishes better projection and increased differentiation of the mandibular horizontal and cervical vertical planes. The implant may also serve to augment the ptotic chin softtissue structures frequently found in the aging chin; significant chin pad sagging, however, requires cephalic repositioning of the ptotic muscle pad to correct an inferior malposition of these tissues.

Chin implants can be placed through an intraoral or a small external incision. External incision is placed under the chin and is not visible. Silicon and polyethylene (porex) implants are available in market for chin augmentation. We prefer polyethylene implants in majority of our applications.

Blepharoplasty Endoscopic Forehead and Eyebrow lift

Blepharoplasty alone is less effective in improving and recoutouring the leateral orbital rhytids ("crow's-feet" or "laugh lines"), which contribute to the aging appearance and thereby displease patients. Oblique and vertical glabellar frown lines remain unchanged without direct surgucal interruption of the involeved animation muscles. Some form of adjunctive "lifting" proceure in the uppper third of the face is thereby required to augment the improvement archieve by blepharoplasty. Most useful among these are the brow-lift (browplasty), temporal (temple) lift, the midforehead lift and the forehead (coronal pretrichal) lift. Specific indications exist for each and will be explored later.

The relentless passage of time combined with gravity inevitably creates forehead and eyebrow drooping and malposition. The aesthetic facial unit comprising the eyelid-orbital region, when flawed by gradual aging, asymetry, or familial abnormaliti, cannot always may compound the problem of redundant upper eyelid skin by crowding the eye and producing an abnornal appearance of both fatigue and premature aging. A temporal quadrant visual defict may develop, furter justifiying interventional surgery to restore lost function. If upper lid blepharoplasty alone i used in attempts as correction, the eyebrow is often drawn nearer the lid margin and adequate delineation of the infrabrowcleft obliterated by sacrificing excessive upper lid skin in a misguided attempt to correct this problem. Incorpatating one of the brow elevation procedures to enhance the resultsant appearance is a perfered approachthat preserves sufficient upper lid skin to achieve a pleasant sweeping delineation of teh upper lid cleft.



Careful patient selection to ensure effective, satisfactory outcomes assumes major importance in all form of aesthetic surgery, especially important in orbital region rejuvenation. Patiens regularly request eyelid surgery when instead or in addition to eyelid surgery they need forehead-, brow-, and temple-lifting. Educating patients about the most effective procedure(s) often requieres superior communication skills and gentle guidance, since few patients are aware that forehead/brow ptosis is responsible for the aging oribtal changes apparent. Clearly more of the surgeons's time must be expended to realize the laudable goals of effective patient understanding and truly informed consent.

Patient selection, particularly from the viewpoint of motivations and ex­pectations, assumes major importance in the caliber and effectiveness of the final outcome. In aesthetic surgery, pure technical excellence will not al­ways result in a happy, satisfied patient. Useful guidelines to patient se­lection (and rejection) exist; each individual, however, requires careful and sensitive screening to identify proper candidates.

Although different regions of the face age at different rates, influenced primarily by genetic factors, the upper facial third possesses its own unique fashion of aging (see Fig 1-6). As elasticity progressively declines, the fore­head, temple, and glabellar skin descends. Ptotic low-positioned brows de­velop, crowd the orbital region, and increase the degree of skin redun­dancy in the upper lid area (Fig 7-1). Fine lines, the result of gravity and repeated orbicularis muscle contraction, appear at the lateral canthus and temple (Fig 7-1). Progressively deep horizontal creases appear in the fore­head, the consequence of repetitive frontalis muscle contraction and hy-pertonicity (Fig 7-2) (their absence in a paralyzed forehead validates this observation). Synergistic actions of the corrugator and procerus muscles produce vertical, oblique, and horizontal creases in the glabella and nasal root (Fig 7-3).

Forehead-lifting procedures may be effectively combined with methods to rejuvenate the middle and lower facial thirds (facelift and necklift). Since the various regions of the face may age at different rates, forehead/brow-lifting is also commonly accomplished as an isolated procedure or as a pre­liminary step to blepharoplasty.

With rare exceptions, the brow elevation procedure should be carried out prior to upper lid blepharoplasty, thereby facilitating judgment as to the precise amount of upper lid skin excised and thus preventing an over-aggressive elevation of the brow-upper lid complex with consequent dif­ficulty in normal upper lid closure.

Three factors bearing heavily on the surgeon's choice of sequence and combinations of operations are (1) the relative position of the brows, (2) the mobility of the scalp and forehead layers, and (3) the sex of the pa­tient. The male brow classically is heavier in hair content, occupies a more inferior (caudal) position, and is less laterally arched than the female brow, which commonly occupies a transversely horizontal position (Fig 7-4). This effect, although occasionally objectionable in a female, is not usually displeasing in a male. In contrast, the preferred female brow (many varia­tions obviously exist) arches higher laterally than medially, ideally assum­ing its highest point at about the junction of the middle and outer thirds (Fig 7-5). The female brow typically thins as it courses laterally, and this diminishes the ease of potential scar camouflage in the hair-skin junction. Therefore a critical evaluation prior to technique selection is assessment of the eyebrow position, attitude, and shape with the patient sitting and in repose. By manually elevating the brow and forehead with the patient gaz­ing straight ahead, a tentative judgment can be made about the favorable effect of brow elevation on the aesthetic unit of the eye and orbit (Fig 7-6). Individuals with ptotic brows commonly attempt to unconsciously elevate the brow and cause excessive forehead animation. This facial posture is ordinarily an unconscious habit and gives rise to a "surprised" facial ex­pression as the drooping brow is temporarily elevated (Fig 7-7). Preop­erative estimates of the benefits of surgical brow elevation will be much more accurate if all animation is consciously eliminated and the brow po­sition is judged with the patient in complete facial repose. By having the patient close the eyes and open them slowly after allowing the facial muscles to relax, the true brow position in repose may be determined. The individual anatomic situation will then dictate the choice of which of the brow elevation procedures would most favorably complement the planned blepharoplasty operation

Other technique Liposuction Liposelection

The patients usually have explored nonsurgical alternatives to liposuction before their first appointment with aesthetic surgeon. Patients report that they have followed strenous diet and exercise regimens, attempted to hide their appearance, and avoided embarrasing social situations with increasing frustration and lowered self esteem. Disproportionately deposited pockets of genetically determined adipose tissue do not respond even to unhealthy extremes in diet and exercise.

Perceptions of beauty have undergone many changes troughout the millennia. The body types appreciated by the Egyptian and Greco-Roman civilizations have persisted througout the ages, whereas the rounded forms idealized by Rubens are not considered ideal today. Liposuction (suction-asisted lipectomy) can be defined as an aesthetic procedure that removes subcutaneous fatty tissue from the body in an attempt to bring the body into conformity with current perceptions of attractiveness. The focus of body contour procedures is the body unequal distrubition of fat, its overabundance in some areas and absence in others.


Liposuction (suction-assisted lipoetomy) consist of the removal of body fat using a device called a cannula that aspirates fat cells by suction. This procedure is effective in removing exess fat of the face, chin, arms, axillary breasts, abdomen, hips, trochanteric area (saddle bags), thighs, knees and ankles. There are limits to amount of the fat that can be removed and the degree of body sculpturing that can be accomplished with liposuction. However, in patients with abnormal deposition of fat liposuction is extremely helpfull in enhancing appearance.

Liposuction is effective in most patients who have good skin elasticity because the skin contracts after the fat has been removed. In most areas of the body where abnormal collection of fat have developed, liposuction has been beneficial in recontouring the area. Older patients and others with poor tissue elasticity may benefit from liposuction in conjunction with traditional body contour methods, such as facelift, abdominoplasty and thighplasty.

Liposuction is performed through small stab incisions (3 mm) A cannula is inserted into a layer of fat under vacuum extracts fat only while the surgeon strokes the cannula. Today smaller diameter cannulas (1,5mm to 4 mm) are preffered to decrease the probability of irregularities. Recently with the delivery of local anesthetic -epinephrine containing fluids into the fat layers before aspiration, liposuction can be performed with a considerable reduction in blood loss and large amount of fat can be aspirated without necesitatating blood transfer.

Most liposuction is now performed as an outpatient procedure under sedation or general anesthesia. Majority of patients can be sent to home a few hours after the surgery. If large amount of fat is removed (more than 5 liters) the patient is discharged from hospital in the next morning following the operation

With the use of local aneshetic solutions pain is minimal and can be controlled with anargesics. A special elastic girdle or binder is applied at the end of surgery to reduce postoperative edema and bruising. The patient may shower 48 hours after surgery, removing the girdle. The patients are advised to wear the elastic girdle 2-3 weeks. The patient may return to daily activities and work in a few days. Exposure to full sunlight should be avoided and suctioned areas should be covered until bruising has subsided, generally for 6-8 weeks. Sunscreens should be applied liberally.

Facelift Rhytidectomy FAQ

You’ll find basic information about a facelift in this brochure. However, the best way to get complete answers to sprecific questions that relate to your individual needs to have a personal consultation with a plastic surgeon certified by the Board of Plastic Surgery.


Some of the most visible signs of aging first appear on the face. Although the changes appear gradually, there may come a day when you look in the mirror and decide that the face you see doesn’t reflect the way you feel about yourself. If you’d like to look as good as you feel, a facelift can help. Also known as rhytidectomy, a facelift smooths the loose skin on your face and neck, tightens underlying tissues and removes excess fat. As a result, your face will appear firmer and fresher.

Is a facelift right for me?

Facelifts are most commonly performed on patients in the 40-60 age range. However, the procedure can produce good results for people in their 60s, 70s and 80s as well. You may be a good candidate for a facelift if you have any of the following types of conditions :

* A deep line that runs from the corner
* Loss of a well-defined jawline
* Deep wrinkles in the cheeks and sagging skin near the cheekbones
* Loose skin, wrinkles or excess fatty tissue in the neck.

Facelift surgery needs to be approached with extra caution if you have any of the following medical conditions:

* Uncontrolled high blood pressure
* Blood-clotting problems
* The tendency to form excessive scars.

Be sure to alert your plastic surgeon if you are affected be any of these conditions.
a) A facelift can improve the deep cheek folds, jowls, and loose, sagging skin arround the neck that come with age.
What should I expect from the consultation?


A personal consultation is the first step for every patient considering a facelift. During this meting, your surgeon will assess your physical and emotional health and discuss your specific cosmetic goals for surgery.

You should arrive at the consultation prepared to providee complete information about:

* Previous surgeries
* Past and present medical conditions
* Treatments you have received
* Medications that you are taking, including nutritional supplements and herbal remedies.

If you are overweight and have a realistic desire to lose more than 15 pounds, your weight loss could affect your results. It’s important to discuss these plans with your surgeon.

During your physical evaluation, your plastic surgeon will assess your bone structure and the underlying tissues of the face. The thickness, texture and elasticity of your skin and the severity of the wrinkles and folds will also be considered. Your hairline will be examined to determine where incisions can be conisdered in developing your surgical plan.

Your plastic surgeon may explain additional procedures that can be performed along with a facelift to meet your appearance goals. For example, a facelift is frequently combined wih:

* Forehead lift, to correct lines or furrows in the brow
* Eyelid surgery, to eliminate drooping upper eyelids or bags beneath the eyes.
* Nose reshaping
* Skin treatments, such as a chemical peel or laser resurfacing, to minimize fine wrinkles.
* Face contouring with micro fat or tissue cocktail injection.



How is a facelift performed?


The technique chosen for your surgery depends on your features, your surgeons’s perferences and your desired results. There are many variations to the facelift procedure. However, the incision is typically hidden in the natural contour of your ear, and then extends around the earlobe and back into the hairline. Following surgery, the incisions are easily concealed by your hair or with makeup. There also may be a small incision hidden beneath your chin.

Working through these incisions, your plastic surgeon frees the facial skin from its underlying tissues and pulls it upward and back. The excess skin is then removed. In some cases, the deeper tissues may also be repositioned to restore a more youthful contour to your face. If necessary, an incision under the chin allows your surgeon to remove fatty tissue in that area and smooth the cord-like structures of the underlying muscle in the neck.

How will I learn about the safety of facelift surgery?


Each year, thousands of people have facelifts and experience no major complications. However, it is important for you to be informed of the risks as well as benefits.

One of the most important parts of your consultation is the discussion that you and your surgeon will have about the possible complications of facelift surgey. In addition yo listening carefully to what your surgeon tells you, be sure to raise any questions you may have about the safety of the procedure.

By carefully following your surgeon’s advice and instructions – both before and after surgery – you can do your part to minimize some of the risks.
b) Incisions usually begin above the hairline at the temples follow the natural line in front of the ear, curve behind the earlobe into the crease behind the ear, and into or along the lower scalp.
c) Facial, neck tissue and muscle may be separated; fat may be trimmed or suctioned and underlying muscle may be tightened.
d) After deep tissues are tightened, the excess skin is pulled up and back, trimmed and sutured into place.
e) Most of the scars will be hidden within your hair and normal creases of your skin
What can I do to prepare for my surgery?


When the date for your procedure has been set, your plastic surgeon will provide you with specific instructions for the days immediately before and after surgery. A number of points may be covered, including:

* Avoiding certain medications that may complicate surgery or recovery.
* Stopping smoking for a period of time before and after surgery
* Arranging for help and special care following surgery
* Letting your hair grow long enough so that it will cover your incisions while they heal
* Hair coloring before surgery if you do usally.



How will I be cared for on the day of my surgery?


Your facelift may be performed in a hospital, an outpatient surgery center or an office-based surgicak suite. If you are admitted to a hospital or surgery center, your stay will be a short one, perhaps just one or two nights. We have arrenged a three days package programme in the hospital that you may benefit.

Medications are administered to keep you comfortable during the surgical procedure. Your plastic surgeon may use local anesthesia and intravenous sedation for your facelift. However, for some patients, general anesthesia may be the best choice. Your surgeon will monitor your physical status throughout the operation and during your recovery.

How will I look and feel right after surgery?


When surgery is complete, you’ll be taken to a recovery area. A bandage may have been wrapped around your face to help control swelling. Sometimes, small drainage tubes are placed beneath the skin to drain away fluids that might otherwise accumulate. Discomfort is usually minimal, but any pain you feel can ce controlled with medication prescribed by your surgeon. Although everyone heals at a different rate, you can expect that your recovery will follow this general time line:

The first day

* In this early stage of healing, you should rest with your head elevated to help minimize bruising and swelling



Within the first week

* Swelling reaches its peak, and then begins to subside.
* Bandages will ve removed and you may shower.
* Stitches will dissolve or be removed.
* You may return to light activity, but continue to sleep with your head elevated.
* You can wear makeup to conceal any discoloration.


Within two weeks

* Most of the bruising will disappear
* You may resume many of your normal activities, including non-strenuous.


After several weeks

* You may resume exercise.
* Swelling and puffiness will continue to subside.
* Numbness in the facial area will diminish; however, some numbness may persist for several months.

Throughout the healing period, you should avoid exposure to direct sunlight and, for the long term, be conscientious about using sun block preparations to protect your skin.
After surgery, you’ll present a fresher, more youthful face to the world.

What should I know about my results?


If you are like most people who have the procedure, you’ll be very pleased with your refreshed and rejuvenated appearance. Although the healing may take some time, you can expect the end result to be woth the wait.

A number of factors, including your heredity and your lifestyle, play a role in how long the results of your facelift will last. Even though the aging process continues, patients are usually happy with their apperance for many years following a facelift. Some patients find that they want to make additional improvements at a later time.

How long will I continue to see my plastic surgeon?


After the initial healing period, you will return to your plastic surgeon’s office for a postoperative foollow-up visit so that your healing and progress can be evaluated. In the following months, your surgeon may ask you to return for periodic checkups. It’s important to keep these appointments so that your surgeon can assess your long-term results and address any questions or concerns you may have.

No matter what type of plastic surgery you’re considering, one of the most important factors in its success is the surgeon you choose. Although it may seen hard to believe, some of the physicians who are performing cosmetic surgery today have had no formal surgical training at all.

It’s advisible to consider the following points before scheduling a consultation:

Find out if he or she is certified by the Board of Plastic Surgery. Surgeons with this certification have completed a minimum of six years of surgical training following medical school, including a plastic surgery residency program. During this intensive program, surgeons learn to perform surgical procedures for the entire body and face. At the same time, they develop their technical skill and aesthetic judgement. After tarining, a surgeon must pass comprehensive oral and written examsbefore being granted certification. It is also very important to find out the post graduate education, experience, competency for specific procedures and scientific status of Plastic Surgeon.

Face Lifting FAQ

The technique chosen for your surgery depends on your features, your surgeon’s surgical preferences and expertise, and your desired results. Extreme emphasis is placed on creating a natural result. Usually the objective is to produce a better you not a different person.

Aging of the face is inevitable. As the years go by, the skin begins to loosen on the face and neck. Crow's feet appear at the corners of the eyes. Fine forehead lines become creases and then, gradually, deeper folds. The jawline softens into jowls, and beneath the chin, another chin or vertical folds appear at the front of the neck. Heredity, personal habits, the pull of gravity, and sun exposure contribute to the aging of the face. As the aging population grows, it is obvious why rhytidectomy has become the third most desired facial plastic surgical procedure.

There are many variations to the facelift procedure. However, the incision is typically hidden in the natural contour of your ear and then extends around the earlobe and back into the hairline. Following surgery, the incisions are easily concealed by your hair or with makeup. There may also be a small incision hidden beneath your chin.

Working through these incisions, the facial skin is elevated from its underlying tissues followed by deep tissue dissection to your smile lines and nasal cheek juncture. The deep structures including the cheek pad is securely tightened in an upwards and backwards direction followed by excision of excess skin. There is no emphasis on placing excessive tension on the skin. An incision is usually placed under the chin that allows removal of the muscle band in your neck. Removal of fat is also performed through this incision.

If you do not have a significant amount of excess skin, you could be a good candidate for an endoscopic facelift. This minimally invasive procedure requires small incisions that are placed inconspicuously according to your individualized surgical plan.

Although most patients report very little pain after surgery, medication will be prescribed. Some swelling and bruising are to be expected and may be minimized with cold compresses. Dressings will be removed at a follow-up examination in one to two days. All sutures are removed between five to ten days. Recovery usually takes about ten days.

The final result is a firmer, younger appearance to the midface and neck area. Though individual results may vary, patients report increased self-confidence in addition to the rejuvenating effects of their face lift.

Procedures For Rohat Kutlay

Depending on the procedure, your recovery period and related results may be relatively short (as in an eyelid surgery) or longer (as in a trunk liposuction). When you see yourself for the first time, postsurgically, remember that there may be swelling, stitches, or discoloration which will decrease over time. You will not see the person you last saw prior to surgery. You need to psychologically prepare yourself.

You have finally decided that you are having the surgery. Your physical appearance will be changing, sometimes drastically and sometimes minimally, within a short period of time. Have you thought about how you will cope with this change? Do you have a good handle on the effect this change will have on you? Have you thought about how family and friends will react to the change?


Patients who are in a personal crisis should postpone surgery until the crisis has ended. Changing your appearance to get "back at" a divorced spouse may not leave you with the desire results. If you have not dealt with the death of a spouse and feel getting a "facelift" will help you feel better, question yourself as to why you are really doing this?

Make sure you have a support person available to you postoperatively. This should be a close friend or relative that you can rely on to discuss any feelings of self-doubt you may have. There may be periods, especially during the post operative period, where you will question yourself. This is especially true of patients who tend to take longer to recover and for procedures where the end result is longer to visualize.

Post operative depression can be mild to severe for some patients. It is normal to feel some mild discontent several days after surgery. This can be attributed to any number of physical or metabolic changes to your system. Try to get "up and out". Do things that usually make you feel good. Talk with your surgeon if you feel you may not be improving after a week.

Keep in mind, this surgery was for you. This is to make you feel and look better.



AUGMENTATION MAMMOPLASTY

By most estimates almost 2 million women in this country have had an augmentation mammoplasty. Breast augmentation has been one of the most gratifying cosmetic operations from the standpoint of both the patient and the surgeon, and until recent controversies over the safety of silicone implants, it was the most common cosmetic surgical operation carried out in the United States. Although every operation involves some risks, breast augmentation is generally not considered to be high risk.

While breast augmentation will enlarge the breasts, it will not alter basic asymmetries in breast shape or form. Major variations may be improved, but will not be corrected. Slight differences in the size or shape of the two breasts are considered normal, and should not be a cause for concern. Long experience with this operation has demonstrated highly satisfactory results for the majority of patients who are considered suitable candidates for the surgery.

Modern silicone prostheses have been in use for thirty years. Both silicone gel and saline filled implants have been available. There have been innumerable media reports, and even some medical reports of patients with implants developing a neurological disease or connective tissue problems, suggesting that there might be a connection between the two; however, we know of no true scientific data to support this causal relationship. Extensive studies have been carried out, and there has, so far, been no evidence that the implants or silicone have any relationship to breast cancer, or systemic illnesses in patients. At the present time, in the United States, surgeons and patients are restricted to the use of saline filled implants for primary augmentations. Many recent studies have confirmed the safety of silicone breast implants. Specifically, patients with breast implants have no higher incidence of auto immune or connective tissue disease such as rheumatoid arthritis, scleraderma or lupus, in comparison with the general population.

Breast implants are available in a round or teardrop shape, with a smooth or textured surface. The procedure may be performed using intravenous sedation with local anesthesia, or with general anesthesia. The incision may be placed in one of three locations: Under the breast in the inframammary crease, under the areola (the pigmented skin around the nipple), or in the axilla (armpit). The implant is placed under the breast tissue and on top of or under the pectoralis muscle. You and your surgeon will make the final decision regarding which approach, or which placement to use.

After the procedure, you will be advised regarding wound care, bra selection, and follow-up. You may be asked to take it easy and remain quiet the night of surgery as bleeding around the implant can occasionally occur. It usually takes about 2-4 weeks for swelling and discoloration to subside, and for you to return to a normal activity level.

Postoperative bleeding is one possible complication. If this occurs, it will usually be within the first couple of days, and may require another operation to remove a collection of blood (hematoma). Infection is very uncommon, but should it occur adjacent to the implant, it might be necessary to remove the implant to resolve the infection. A fairly common problem that can occur with breast implants is related to the natural tissue capsule that forms around the implant within the body. Even though a capsule forms most of the time, only occasionally does it thicken or contract causing unnatural firmness and/or shape to the breast. In severe cases, it can also cause pain or discomfort and can lead to the formation of fine calcium deposits. In early cases, capsule formation can be corrected by gentle external massage, but in more severe cases, further surgery is required. This condition is called capsular contracture. In the past, surgeons often recommended firm compression to treat capsular contractures, a maneuver called closed capsulotomy. This is no longer recommended in most situations, because of the risk of breaking the outer shell of the implant. After augmentation mammoplastv, many patients have breast fed without difficulty, and occasionally, stretch marks can develop.

Breast implants have never been shown to cause any form of cancer in women. Implants do make mammography somewhat more difficult to interpret. This was true more pertinently with silicone gel filled implants. If you are having a mammogram, advise your radiographer about your implants so that the mammogram technique can be modified to include the extra views recommended.

Recently, some health insurance providers are excluding coverage for breast disease if a patient has had breast implants. There is no medical substantiation for this at the present time. In spite of the potential problems, most women who have had this surgery are very happy with the results. They report feeling better about themselves, and having improved self-esteem.

REDUCTION MAMMOPLASTY

Large breasts can be the source of problems in many aspects of a woman's life. Women with large, heavy breasts may have symptoms caused by the size, weight and position of the breasts. They may have back and neck pain, grooves in the shoulders from bra straps and rashes under the breasts due to moisture collection and heat. Some women with arthritic conditions of the back and shoulders may have more symptoms than usual because of the added weight and pull of the breasts. These symptoms may contribute to limited performance in certain occupations and in sports.

Some full-breasted women may appear heavier than they really are and may have difficulty obtaining stylish clothing. In some cases, it may even be difficult to find a properly fitting bra. Often, women with large breasts feel very self-conscious. Teenagers may not develop proper poise and posture as they try to hide the fullness of their breasts, a subject they may be unlikely to discuss freely with their parents.

Finally, large breasts may be difficult to assess for lumps or masses, thus making cancer detection much more difficult for the patient or for her physician. This may well be a source of further anxiety in a patient who is already embarrassed about her condi-tion. Breast reduction can eliminate or minimize these problems. Because of these medical problems, in many cases, medical insurance will cover the cost of breast reduction.

The goal of reduction mammoplasty is to reduce and recontour the breasts. The excess skin and tissue can be removed and the mounds reshaped into smaller, more attractive breasts. The procedure is performed in the ambulatory surgery unit or hospital under general anesthesia. The nipple areola complex is repositioned upward, and if indicated, reduced in size. Excess skin and breast tissue is removed from the lower and/or outside portion of the breast. A preoperative plan is made which allows both the surgeon and the patient to share in the decision as to the proposed size of the breast after surgery. The surgeon will attempt to make the breasts as identical as possible, but some asymmetry often remains. It is also not possible to pre-dict exactly how large the breasts will be after surgery, as there is some contraction, swelling and tissue reorganization after surgery. The incisions are designed so that the scars will not be visible with normal clothing. In time they fade and become less noticeable. Drains may be left in at the time of surgery and removed in a few days. The patient is usually up and about the day of or the day after surgery. With the advent of managed care, this surgery is performed more and more on an outpatient basis. Sutures are removed in approximately one week following surgery.

Potential complications include postoperative bleeding, infection and healing problems, which may result in heavy scars. When the nipple/areola complex is transferred to its new position, it may not 'take' or heal, and a portion or all of it may be lost. This is uncommon; smoking may contribute to this problem. As the nipple is repositioned with the breast tissue during the procedure, this can lead to disturbance of the superficial nerves to the nipple, and a decrease in sensation may occur. Ability to breast-feed will also be lost in most women undergoing this operation. Since these conditions are usually expected side effects of breast reduction surgery, a woman should consider these factors seriously before deciding to have the surgery. Although every attempt is made to obtain symmetry, there may be some irregularities in the size and shape of the breasts and in the position of the areola and nipple.

Most women report that their back and neck pain is reduced. They have fewer problems finding suitable clothes and are able to become more involved in sports. There is always a time of adjustment, and breast reduction usually results in the quickest body-image change. Therefore, most women need time to adjust to their new look. Most women are very pleased with the results.

RHINOPLASTY

Rhinoplasty, or cosmetic nasal surgery, is one of the most common cosmetic procedures performed today. The operation is usually carried out because a patient desires to improve his or her appearance. It is also frequently requested for repair of injuries, or correction of disfigurement from trauma. In addition, patients may also be influenced in their desire for surgery because of breathing obstruction, or other related functional problems. As this is a common procedure, and has been carried out for many years, technical refinements have allowed consistently good results, which are considerably better than they were 25 to 50 years ago. Nevertheless, patients must understand that the goal of this operation is improvement, and that perfection usually cannot be achieved. Patients who expect too much may be disappointed. Cosmetic nasal surgery is performed to bring the nose into harmony with the face, thereby improving overall appearance.

There is no standard operation for rhinoplasty. The plastic surgeon takes into account the patient's nasal features that need to be changed, carefully examining the nasal structure and the overlying skin covering. With this information, the surgeon and patient discuss the realistic modifications that can be made to obtain the desired result. Often there is an underlying deviation of the nasal septum, which causes difficulty in breathing. This can be corrected at the same time.

The surgery is usually performed through incisions inside the nose, and if any external incision is made, it is usually small and inconspicuous. The surgeon separates the skin of the nose from the underlying bone and cartilage, re-shapes the cartilage skeleton, then redrapes the framework with the skin. The skin, with its natural elasticity, usually re-shapes nicely over the new-formed framework. This surgery can be done under local anesthesia with intravenous sedation, or general anesthesia, usually in an outpatient surgical facility. The various procedures during the reshaping include removal of the hump on the bridge of the nose, narrowing the nose, refinement of the nasal tip, and correction of the deviated septum. Chin augmentation may or may not be suggested to further enhance the facial profile. The nose is usually splinted for support and to reduce swelling. A dressing may be placed inside the nose. This dressing is usually removed within the first day or two after the procedure.

Swelling and bruising around the nose and eyes is expected for two to four weeks. Although most of the swelling subsides by six weeks, some long-term swelling may take six months to one year to resolve. Complications related to this operation include bleeding, infection, diminished sense of smell, scarring and minor irregularities. These problems are rare and resolve in time. It is important to remember that healing after this operation continues for up to a year, as the skin shrinks and adjusts to the new framework. Occasionally, the final result may be different than what was anticipated by the patient and/or the surgeon. Minor irregularities can be corrected with a revision procedure after all healing is complete.

Following rhinoplasty, the nose has an improved esthetic appearance, in harmony with the other facial features. The improved appearance of the nose is long lasting. Most patients are highly satisfied with the results of their rhinoplasty.


ABDOMINOPLASTY (TUMMY TUCK)

Abdominoplasty is an operation designed to remove the excess fat and skin of the abdomen, and at the same time, tighten the muscles of the abdominal wall. Following pregnancy, or loss of weight, a patient may have residual excessive skin and/or fat on the abdomen, along with stretching of the abdominal muscles. When the only problem is excess fat in this area, and the skin and the muscles are not stretched, this can be corrected by liposuction alone. More commonly, the problem involves stretching of the skin and muscles, along with the excess of fat, and an abdominoplasty has to be performed to correct all three problems.

This operation is usually performed under general anesthesia in an outpatient surgical center. Though, some surgeons may have the patient spend one or more nights in a post surgical facility