What is rhytidoplasty, facelifting or facial rejuvenation surgery?

When visible signs of facial aging are disturbing you, maybe a facial rejuvenation surgery could be welcome. Technically known as Rhytidoplasty, the operation aims the renewal of eyelids, cheeks and neck areas.

These main signs are :
Malar and cheeks skin flaccidity Eyelids fat bags
Deep creases next to the lips and nose.
Fat deposits below the corners of the lips. ( also called jowls)
Fat deposits below the chin
Neck bands and lost of its elasticity

Upper and lower eyelids are done complimentary to facelifting

Rhytidoplasty is a surgical procedure . Therefore , incisions are expected to be performed. Facial soft tissues are dettached and pulled. But remaining scars are extremely rare. The operation is done under local or general anesthesia and I recommend all my patients to stay one night in the hospital, where they can feel protected and comfortable. One of my assistants will spend the night next to them to assure the best pattern of safety.

There is no an ideal age to undergo the operation. I have done it many times on patients in the forties as well as older like 80 yo. Good health ( mental and physically) is mandatory.

Heavy smokers are not welcome.

In summary : There are many non surgical options capable to promote a certain improvement of the above described facial aging signs, but a complete and long lasting facial renewal can be obtained only trough surgery.

What is breast enhancement or breast argumentation?

Breast augmentation is the surgical procedure that aims to enhance breast volume. In many occasions it is also done to improve shape , upper pole fullness and to correct moderate grade of ptosis ( breast sagging), besides volume enlargement.

A silicone implant is the device that promotes these results. There are different shapes and volumes of prosthesis. I Always try to satisfy patient’s wills but it is my due as a surgeon to inform them about risks of over sizing or support unrealistic expectations.

Recently we have incorporated the technique of fat grafting as an adjuvant procedure associated to silicone implants in order to obtain better symmetry between the breasts . In selected cases it is possible to use only fat grafts ( so called lipofilling ) instead of silicone .

Fat is harvested from patient’s belly or thighs, processed and re injected in the breasts. Of course even a nice result could be expected, volume augmentation doesn’t happen in the same proportion as if an implant is used.

BREAST AUGMENTATION AND PEXY

This is an operation that associates volume augmentation and reshaping. The technique can be employed on breasts with few glandular tissue and excessive uneslastic skin. Skin is proportionally removed , and a silicone implant is added. Impressive results can be shown with this procedure.

BREAST LIFTING

This operation is generally indicated to correct sagging breasts. Sagging or ptotic breasts are classifiend in many levels following the difficulty of each. Cases of extreme ptosis will be better repaired when a silicone implant is added. Surely a precise analisis is necessary before the indication of any technique.

BREAST REDUCTION

The technique of breast reduction has been developped and popularized in our country, following the principles of great professor Ivo Pitanguy.

Massive weight loss , post pregnancy breast hypertrophy, birth defects, are some deformities that motivate patients to search the operation.

The surgery consists of volume reduction and breast lifting, therefore, tranforming an undesirable shape in a young, beautiful and atractive one.

What is breast reconstruction?

The objective of the operations is to restore shape, volume, symmetry and the natural aspect of the breast, damaged when a mastectomy has been undergone.

The best professional to perform reconstructions after mastectomy is a plastic surgeon who is primarily skilled on oncological surgery. So, able to decide what technique will be more appropriate for each case , without neglecting the main issue , or cancer healing.

There are many techniques to restore breast shape and volume. Those are indicated following patient’s individual needs.

Currently, silicone implants can be used in the vast majority of cases. However, some patients may need addition of skin, fat, or both, to accomplish a satisfactory breast volume. In these patients a transplant should be done. It means, part of tissues are harvested from diferent segments of the body, with adequate blood perfusion and positioned on the chest wall in order to substitute the missing breast.

The reconstruction can be scheduled on immediate or delayed basis. The first option is done simultaneously with the mastectomy. The second, when the operation is posponed, in general , for oncological premises. Medical litterature and surgeons experience has proved that post mastectomy immediate reconstruction brings the patient innumerable benefits, including psycho social and self esteem.

An extensive journey working at the Brazilian Cancer Institute and visits and fellowships at the most prestigious cancer hospitals , like MD Anderson Cancer Center and Sloan Kettering Memorial in the US and Instituto dei Tumori in Milan, Italy, were determinant to bear a real passion for this issue in my practice.

Abdominoplasty (“Tummy tuck”)

Promotes the removal of excess skin and abdominal fat in addition to the restructuring of the muscular wall of the abdomen, increasing its firmness, invariably affected, especially in women who gave birth more than once.

Frequently asked question

- I exercise a lot. Is this enough to regain the shape and stiffness of my abdomen?

Although essential for good health, exercises directed to the abdominal wall may not be enough to recover the abdominal stiffness, especially when there is skin and muscular flaccidity.

How long does the operation last?

I often tell my patients that abdominal surgery is a procedure for the rest of their lives, even if they get fat and keep away from the exercises, which we obviously do not recommend, The result is still maintained over the years. (Have you ever imagined wearing a bikini at 90?)

Complications

As with any surgery, abdominoplasties present risks, strictly controlled, once performed by a competent professional in a 100% safe environment. Here are some, bruises, infection, unsightly scars, venous thromboses, liquid collections (seroma), all infrequent and strictly controllable.

Combined surgeries

Associations of operations in plastic surgery should be proposed with very selective criteria. If the patient is in good health, abdominoplasty may be associated with liposuction, breast surgery (“mommy makeover”) or other small procedures.

LIPOABDOMINOPLASTY, a technique developed in Brazil, is nowadays, a practically general technique when it comes to abdominal surgery.

Post operative recovery

Among plastic surgery , abdominoplasty is perhaps the one that requires greater rest with no athletic activities for a minimum period of two months. Pain that may predominate in first 48 hours is controllable with medication. Return to work depending on the intensity, should be achived within a two week period.

When can I sunbathe? Not before two months. The abdominoplasty scar is not small and we all want it to remain unappealing. So it's worth the sacrifice!

What is liposuction ?

Also known as liposculpture, liposuction reshapes specific areas of the body, removing excess fat deposits, improving body contour and proportions.

Despite good health and practice of physical exercise, some people may still have a body with disproportionate contours due to localized fat deposits In general, these areas may occur due to genetics, obesity or lack of physical activity.Liposuction can be used to treat fat deposits in various parts of the body including thighs, arms, neck, waist, back, medial part of the knee, chest, cheeks, chin, legs and ankles.Liposuction may be performed alone, or may be associated with other procedures such as facelift, breast reduction or abdominoplasty.

What liposuction won't do

Liposuction is not a treatment for obesity and does not replace the practice of exercise and good eating habits. Individuals with segmented areas of fat deposit in the body who exercise regularly are the best candidates for this procedure.

Is the procedure indicated for me?

If you are bothered by excess fat accumulation - located anywhere in your body - and do not see positive results with diet or exercise, liposuction may be right for you.

Rhinoplasties

Nose Jobs are also called rhinoplasties.Through these operations we can modify the nose size or shape. This modification may be of the whole nose or just a single segment, such as the nasal tip or a hump, in accordance with the patient’s expectations. Deviations can also be corrected with this operation and it is also possible to manage respiratory problems.

Who is a potential candidate ?

Any patient of both sexes who has fully achieved their facial development, which occurs around mid-teens and is in good health.Often young people under 18 can benefit from this surgery and become more socially confident at a stage where this feeling is really importante. Obviously a primary analysis should be conducted by the physician so that expectations are matched.

Anesthesia

May be local or general, depending on the extent of the case.

Scars

Rhinoplasties usually produce no apparent scars. In most cases, incisions are internal although in some cases a small scar between the nostrils may be necessary.

Skin tumor is the most frequent tumor of the body. Both men and women can present them in the same ratio. Despite in the early stages the lesions are perfectly curable and easy to treat, some can have an agressive evolution , giving birth to very complex cases.

Frequent sun exposure is known to be responsible for its genesis, mainly in individuals with very white skin .

Here in Rio, european descentes living under our sunny environment, are ideal candidates to this unfortunate disease.

So , I recommend for everyone , good skin protection and routine visit to a doctor to check any unusual skin eruption.