10 Critical Questions Answered About Cosmetic Surgery

Many men and women are considering cosmetic surgery—or plastic surgery— to enhance their appearance.  Most of us have considered it at some time in our lives and had questions that we needed to have answered. Here are some of those questions answered by Dr. Manish Shah, a plastic surgeon in Denver, CO.

Questions about Breast Implants

How long do breast implants last until they have to be removed and done again?

Although the implants themselves last forever, their structural integrity does not. Over time, the average wear and tear could cause a rupture or leak. In general, saline or silicone implants should be replaced or removed every 10 to 15 years if you notice any changes. A rupture in a saline implant tends to be more noticeable, as the deflation is visible. While that may sound scary, it’s actually quite harmless, as the saline is just absorbed by the body.

However, it is not as easy to notice if a silicone implant has ruptured. For this reason, most doctors will recommend an MRI every 2 years for their patients with silicone implants to check for leaks. Implants may need to be removed or replaced for other reasons too, but in general, should last from 10 to 25 years.

I thought silicone breast implants can rupture, so why are they still used?

Both saline and silicone implants can leak. But, it is much harder to tell when a silicone implant has ruptured over a saline implant. Someone with silicone implants may go months or even years without noticing. This is due to the very thick and viscous silicone filling, moving only at very slow rates. It will generally stay within the capsule of breast tissue surrounding your implant, which makes for a simple replacement. Additionally, silicone is the gold standard against which other implantable materials get compared. It is a safe material when used in the human body.

Can my breast implants pop?

Unfortunately, yes breast implants can “pop”, but it is rare and easily treatable. Both saline and silicone implants have an outer shell that can potentially develop a tear, called a rupture. The rupture could be caused by a variety of things such as normal aging of the implant, trauma caused by a car accident, a needle insertion during a biopsy, or other factors.

If you experience any changes in breast shape and size, and increased pain, firmness, and swelling over a period of weeks, these may be signs that your implant has ruptured. Most corrective surgeries include removing both implants and replacing them in the same surgery. Your surgeon might also recommend that you switch to a different type of implant. In any case, discuss with your doctor in detail the best option to avoid the risk of rupture in the future.

Questions about Liposuction

If I have fat removed through liposuction, will it reappear elsewhere?

Technically, yes, it is possible for the fat to return, but only if you let it come back. If the patient maintains their weight, the fat will not return or appear somewhere else on your body. A little bit of weight gain is fine, such as 5 to 10 pounds, as long as patients stay close to their “post-lipo weight”. Because fat cells accumulate in an evenly distributed manner, weight gain tends to be more noticeable in areas that are untreated than treated. So, even patients who gained a considerable amount of weight post-lipo look better than they did if they had not undergone surgery.

Will liposuction eliminate cellulite?

Although patients used to think liposuction could eliminate cellulite, today doctors are not recommending it for that use. In some cases, liposuction can actually make the cellulite worse by creating more dimples in the skin. While it is true that excess fat can make cellulite worse, it’s not the real cause. Liposuction on the thighs and butt only marginally improve the appearance of cellulite. On the contrary, thin skin in these areas can exacerbate the problem, especially in older women where the skin tends to be less elastic.

Doctors have found that ultrasound and laser-assisted liposuction can effectively reduce cellulite because it tightens the skin as it removes fat. But again, these alone will not rid you of cellulite.

How soon after my lipo can I have sex?

After having a procedure like liposuction or a tummy tuck, you will definitely feel some moderate soreness and swelling. It’s normal. When it comes to resuming sexual activity, your personal level of comfort plays a large factor as there is no specific body structure you can damage after liposuction. This means your soreness or the healing process of your incisions may be the only thing stopping you from being intimate.

As soon as you feel both physically and emotionally ready, you are safe to resume having sex. For most patients, it takes about a week.  But if we removed excess fat on large areas of your thighs, belly, and/or buttocks, you might have to wait a week to ten days. Before then, your body will be tender and that could make the experience painful.

Questions about Botox

After repeated Botox injections, will facial muscles ever lose the ability to frown?

Even though one of the side effects of Botox is difficulty smiling or frowning, the effects of Botox wear off in 3 to 4 months. Repeated use of Botox causes the muscles treated to atrophy and thin out. When they “wake” back up they tend to be weaker and less likely to make wrinkles. This is why many consider Botox a great anti-aging treatment. Botox can be administered in a way in which it does not freeze the muscle completely. This is something you would discuss with your injector.

Discuss with the injector what your goals are. Some people such as actors need to be able to express themselves. In this case, Botox can be administered so as not to freeze the muscle completely. Others want certain muscles not to move at all. An experienced injector has the knowledge to make adjustments. We also have the ability to combine Botox with other treatments to assist your goals.

Questions about Face-lifts

Will I have to wear my hair over my ears to cover face-lift scars?

On average, face-lift scars around the ears take about six months to fade and become almost invisible. You probably cosmetic proceduresare going to want to wear your hair down for the first month for recovery purposes. It’s best to choose a hairstyle within this time that will not apply added pressure to the area of incision while still helping to cover up the scar at the same time. Ask your doctor how soon it is safe for you to wear makeup over the scar as a cover up option until they fully fade.

What is the youngest age you would consider performing a facelift?

When evaluating a patient for facelift surgery, age is only a relative consideration. I’ve performed facelifts on patients under 40 years of age who lost a lot of weight causing their face to deflate and sag. That being said, most facelift or neck lift procedures are performed on patients between 45-70 years old.

If the volume loss can be managed by treatments other than facelift surgery, patients will opt for them. However, once those minimally invasive or noninvasive treatments no longer cut it, a patient can choose to have a facelift. For some patients that may be in their early 40’s.

General Questions

What happens if I’m not happy with my surgical results?

The first step is to be patient. Some patients look good in as fast as three weeks, others three months, and, for some, the full results aren’t apparent until six months after surgery. You should wait for all the post-surgical swelling and bruising to go away completely before fretting over the end result.

With that being said, speak up if you are feeling anxious. At your follow-up appointment, it is perfectly fine to voice to your surgeon that you are feeling disappointed. A good doctor will address your concerns, walk you through the recovery process, and if necessary, talk about the next steps.

Is there a trendy cosmetic procedure that you feel is a waste of money and time?

The procedure that I find a waste of time and money is Kybella. It is so expensive for patients and has significant social downtime. I can get better results, more quickly with neck liposuction. Also, I am still waiting to see if patients can get decent results with Sculptra injections for buttocks augmentation. For doctors that can’t perform surgical procedures, or for patients who want to avoid surgery, these may be their only choices.

About the Author

Dr. Manish Shah is an exemplary Denver, CO board-certified plastic surgeon offering cosmetic surgery procedures for the breast, face, body, and skin. www.drmanishshah.com

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