Frequently Asked Questions
Fortunately, more and more people are discovering the truth about plastic surgery. Cosmetic surgery is a worthwhile interaction between the surgeon and patient when done according to the accepted standards of safety and technique. Today's modern techniques and proven procedures can help you, not only to look better but feel better as well. Risks and complications are inherent parts of any cosmetic or aesthetic surgical procedure. Plastic surgeons must be aware of the possible risks and complications of each cosmetic and reconstructive procedure to be able to avoid it as much as possible, and address problems as they arise. There are certain plastic surgery procedures that can be safely performed in an out-patient clinic or hospital. Your surgeon must be knowledgeable about safe out-patient procedures, and the surgical center must be fully-equipped and accredited by the Department of Health. For combined or extensive procedures, patients are best managed in hospitals.
A patient who requires aesthetic surgery poses an unusual challenge to plastic surgeons and anesthesiologists. Some patients are frightened and apprehensive, given the nature and circumstances of the procedure. Patients usually expect a smooth and uncomplicated procedure. It is the anesthesiologist's main goal to provide patients a pleasant and worthwhile experience. Medications for local or general anesthesia are administered for your comfort. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you. Due to increased interest in pain management and patient comfort during and after surgery, there are now new medications or drugs that are available in the market, with US-FDA approval. These drugs have improved efficacy and address patients' anxiety and pain before, during, and after surgery. Minor procedures can be done under local anesthesia. However, for patients who have some anxiety and/or prefer to be more relaxed prior to surgery, IV sedation is recommended. Multiple or extensive cosmetic or reconstructive surgery procedures are best performed under general anesthesia.
A surgeon cannot call himself a plastic surgeon unless he can perform both aesthetic/cosmetic and reconstructive surgeries. The very root of almost all cosmetic procedures can be traced to the early reconstructive procedure. Thus, a surgeon whose main interest is aesthetic/cosmetic surgery must have a firm foundation in reconstructive plastic surgery, to better grasp the basic principle and application of cosmetic/aesthetic plastic surgery. Reconstructive plastic surgery is a prerequisite in training for all plastic surgeons. So plastic surgeons is both a cosmetic/aesthetic and reconstructive surgeon.
It takes 6 to 8 years of training in burn surgery, aesthetic and reconstructive plastic surgery in an accredited institution before physician could call himself a Plastic Surgeon. This formal training will include 3 to 5 years of General Surgery and 3 years of Burns, Cosmetic/Aesthetic and Reconstructive Plastic Surgery Training. In the Philippines, there are only few training institutions with an accredited plastic surgery program and recognized by the Philippine College of Surgeons, this includes the University of the Philippines-Philippine General Hospital (UP-PGH), University of Sto.Tomas (UST), ) University of the East Ramon Magsaysay Memorial Medical Center, Makati Medical Center, Veterans Memorial Medical Center, Rizal Medical Center (comprising CONSORTIUM I), Far Eastern University, St. Lukes Medical Center, Lourdes Hospital and Jose Reyes Memorial Medical Center (comprising CONSORTIUM II). Both the Philippine Board of Plastic Surgeon (PBPS) and Philippine Association of Plastic Reconstructive and Aesthetic Surgeon (PAPRAS) are recognized by the Philippine Collage of Surgeon and Philippine Medical Association to monitor and regulate the practice of cosmetic surgery in the country. With the complexity of cosmetic plastic surgery procedures, it is not enough for a surgeon to just undergo months or even a year of observer ship or training in an unaccredited establishment. To better comprehend all the principles and applications in the field of cosmetic and reconstructive surgery, your doctor must have years of formal training in Plastic Surgery.
It seems that a lot of medical specialists, both surgical and none surgical, claim they can do cosmetic/aesthetic surgical procedure. It takes a minimum of 5 to 8 years of formal training in cosmetic surgery at an accredited institution for a physician to become a plastic surgeon after medical school. Not just a year or less of preceptor course. Always ask your doctor regarding his/her formal training in the field of cosmetic surgery. It is always emphasized that formal training in plastic surgery is very important, it is through this training that your surgeon will have a better grasp of the basic principles and its applications.
Knowing your doctor is one of the most important thing you have to do before undergoing any cosmetic procedure. Always inquire about your doctor's formal training in the field of cosmetic surgery, the institution and length of time the he/ she took the training. Plastic surgeons are those that completed at least five to eight years of formal training in plastic cosmetic and reconstructive surgery in an accredited training hospital. These include the University of the Philippines-Philippine General Hospital (UP-PGH), University of Sto. Tomas (UST), University of the East Ramon Magsaysay Memorial Medical Center, Makati Medical Center, Veterans Memorial Medical Center, Rizal Medical Center (comprising CONSORTIUM I), Far Eastern University, St. Luke's Medical Center, Lourdes Hospital and Jose Reyes Memorial Medical Center (comprising CONSORTIUM II). This formal training includes three to five years of General Surgery residency and three years of Burn, Cosmetic and Reconstructive Plastic Surgery residency. Reconstructive plastic surgery is a prerequisite in training for all plastic surgeons, since most of the basic principles in cosmetic/aesthetic procedure are derived from early reconstructive surgery. Due to increasing interest in aesthetic surgery by the public and doctors alike, there are a lot of cosmetic procedures being done by non-qualified people. Always review your surgeon's credentials, formal training and qualifications. Try to visit their website; your surgeon must be able to provide you details of their training and affiliations in the field of plastic surgery.
This is the most frequently asked question in any cosmetic surgery consultation. Patients often select their surgeon, base on the lowest price that they can get for a particular procedure. In the Philippines, when compared to other country, the costs of most cosmetic/aesthetic procedure by board-certified plastic surgeon are much affordable. Since the objective of each cosmetic or reconstructive procedure is physical enhancement or improvement in form and/or function, the success in each plastic surgery procedure is also dependent on your choice of surgeon, thus, cost should not be your number one concern. Your surgeon's skills, training and qualification can make a significant difference.
Most cosmetic procedures definitely would require certain amount of time for rest; this will allow patients to recuperate from surgery as well as to relax. The amount of time will greatly depend on several factors, such as, extent of surgery, age of the patient and other medical conditions that may affect the patient's healing process. For major or medium procedure such as e.g. abdominoplasty, face lift, breast augmentation, breast reduction, breast lift/mastopexy, breast reconstruction, arm lift, thigh lift, butt lift, butt augmentation and liposuction, patients may have the option to be confined for 2 to 3 days in hospital or home rest for 2 to 5 days after the surgery. Patients are also allowed to do light physical activity, like walking during the first week after the surgery. Mobility and physical activity is gradually increased as time pass by. Often patients are allowed to resume heavy lifting or work out after 4 to 5 weeks or once all wounds are healed. Swelling will start to subside on the 3rd to 4th day after surgery. Noticeable changes will be observed on the 2nd to 4th week. However, it is advisable to have patience during this period of healing since complete resolution of swelling will be on the 2nd to 6th month post surgery. For minor procedure such as eye bag removal, blepharoplasty, slit eye surgery, rhinoplasty, alar trimming, otoplasty, chin augmentation/genioplasty, chin reduction, cheek augmentation, dimple creation, buccal fat removal, Botox®, chemical peel, fillers and thread lift patients are not required to be admitted in a hospital this procedure can be performed in a outpatient surgical facility. Patient may be required to rest for 1 to 2 days then may resume light physical activity after. Recovery time is much quicker for patients that undergo minor cosmetic procedure. Swelling usually subsides by the 2nd to 4th week after surgery. It is advisable, that patients discuss this extensively with their plastic surgeon.
Majority of the incisions performed in cosmetic plastic surgery procedures are oriented or designed along the natural folds of the body. And surgical wounds are meticulously and gently closed so that the resulting scar will be fine, flat, concealed or lying within the natural lines of the body. The surrounding structure must not be affected in order to maintain the natural form of the body. For each particular cosmetic procedure, result will last for a predictable length of time. For example, face lift and blepharoplasty surgery would rejuvenate the face and eye lids for 10 to 15years. However, this will be affected by a number of factors, like diet and exercise, medical illness, trauma and sun exposure. This may prolong or shorten the beneficial effect of each cosmetic procedure. It is advisable that you discuss this in detail with your plastic surgeon, so that you may be aware of the things that may or may not affect your planned cosmetic procedure.
Implants used in cosmetic procedure come in different material or composition (Silicon, Gortex, Marlex, and Collagen etc.) and physical form (solid, liquid, smooth of rough) depending on the type of procedure it will be use. There are several qualities and characteristics that implants must have, before it can be considered safe for use in any medical or surgical procedures. A good quality implant must be biological compatible to human tissues, don't have any toxic and allergenic reaction, produces no foreign body inflammatory reaction to the body, resistant to in-growth microorganism, non deformable, can be easily removed when need. Most of the implants use for cosmetic procedure nowadays are able to fulfill these strict criteria. However, their use should be guided by clinical study and your surgeon's experience.
Breast implant is the only implant material in the field of cosmetic surgery that had been given too much attention and criticism. Because of the increased in demand and interest for breast enhancement and the need for a good quality breast implant, Silicon Breast Implants had been the subject of a lot of clinical study. It was initially thought, that Silicon Breast implant may cause or stimulate illness like soft-tissue auto-immune diseases and breast cancers. However, clinic study involving thousands of breast-augmented patients showed, that Silicone Breast Implant does not causes any medical illness and is safe for use in cosmetic and reconstructive breast procedures, and in mid 2007, the US-FDA approved its use.
Botox® is a sterile and highly purified protein toxin, initially marketed and use for neurologic problems or illness like neuralgia and headache. Now, it is used in other field of medicine, particularly cosmetic plastic and derma procedure, because of the well documented beneficial anti-aging effect it has. At present, Botox® is approved by the US-FDA for treatment of vertical and transverse frown lines of the forehead. It is a safe treatment modality when used properly in terms of its indications and dosing. Botox is commonly used to treat dynamic fine lines of the face such as transverse forehead lines, frown lines and crow's feet or smile lines. It is not true that Botox® treatment would freeze facial expression; this is a common misconception regarding this treatment modality. Patients are advised to discuss this in details with their doctor.
Aging is an inevitable fact of life. The aging process is affected by multiple factors such as sun exposure, smoking, alcoholism, genetics, familial predisposition, work, stress etc... The age at which patient may initially seek cosmetic enhancement procedure, will depend on the time of onset of any noticeable physical changes that may have significant psychological effect. Aging usually start to manifest as early as 2nd to 3rd decade of life, particularly at the eyelid area. These bodily changes may also be aggravated by any physiologic and pathologic events such as massive weight lost, multiple pregnancy, and premature aging disorder like cutis laxa, abdominal hernia, previous surgeries and others.
The average age of patients receiving cosmetic procedure is 40 years old. But there are certain cosmetic procedures that are commonly requested by the younger age group, like breast augmentation, breast reduction, tummy tuck/abdominoplasty, chin augmentation, cheek augmentation, rhinoplasty, alar trimming, double eye lid surgery, dimple creation, butt augmentation, genioplasty/chin reduction and liposuction. And there are also cosmetic procedures that are commonly requested by the older population, and these are face lift, neck lift, brow lift, forehead lift, thread lift, breast lift/mastopexy, blepharoplasty, butt lift, thigh lift, arm lift/brachioplasty, tummy tuck/abdominoplasty and Botox®
There is no such thing as right or ideal age to undergo a specific cosmetic procedure. This will depend on the specific concern that patients may have and the indication of each procedure. However, each patient must be treated uniquely and management must be individualized, since there is no standard cosmetic procedure that may be applicable to all concerns that patient may have. And surgeons must be knowledgeable of the various indications and contraindications of each cosmetic procedure he/she may offer.
There are cosmetic procedures that can be performed with another procedure to maximize the beneficial effect or result. However, there are certain major cosmetic procedures that is best done alone. The decision on whether to have a multiple procedures or not, will depend on your surgeon's skills, difficulty or extent of the procedure, medical risks or complications, significant medical illness that patient may have and clinic or hospital set up where the procedure will be performed. Multiple procedures are done at the surgeon's discretion. There are also advantages and disadvantages in combining procedures and doing it separately. It would be best for you to extensively discuss this with your plastic surgeon.