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Old 05-02-2006, 08:24 PM
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Default Cosmetic Surgery What To Know If You're Considering It

Cosmetic surgery: What to know if you're considering it
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By Mayoclinic.com

More on this in Health & Fitness
* Medical Encyclopedia
You've seen it advertised in newspapers, featured on television programs, displayed on the faces of celebrities — cosmetic surgery. It's guaranteed to shave decades off your appearance, right? In some cases, maybe. Cosmetic surgery offers the potential to improve many areas of the body. But as with any surgery, cosmetic procedures involve certain risks and limitations.

To increase the likelihood of a satisfying outcome, first examine your reasons for wanting cosmetic surgery. Then educate yourself about what you can realistically expect, the benefits and risks involved and how to find a qualified surgeon. Understand these issues to make the best decision for you.
Why consider cosmetic surgery?

Cosmetic surgery aims to change your appearance by altering parts of your body that function normally but make you unhappy. This differs from reconstructive surgery, which doctors use to restore the appearance and function of body parts affected by congenital defects, injuries and diseases such as cancer.

If you're dissatisfied with your appearance, you may be interested in cosmetic surgery not only to look better, but also to feel better. Despite possible risks, and though each person's experience is unique, some research suggests that both may be likely following a cosmetic procedure.

Those who seek out cosmetic surgery generally have a positive self-image, despite also being unusually focused on one or more aspects of their appearance. In fact, some may even feel better about their overall appearance than those who are uninterested in cosmetic surgery at all.

Postoperative surveys find that those satisfied with the results perceive benefits including:

* Greater self-confidence
* Improved social lives, sex lives and interpersonal relationships
* Increased enjoyment of leisure activities

No studies have conclusively proved that most people can expect to enjoy dramatic improvements in their psychological well-being, however. If you're struggling with depression, for example, cosmetic surgery is unlikely to relieve it.
Is cosmetic surgery for you?

Cosmetic surgery outcomes are most likely to be successful if you're in good overall health. It's also best if you:

* Have realistic expectations. Anticipate improvement, not perfection. If you expect cosmetic surgery to turn you into a movie star, you're bound to be disappointed. The spectacular results you see in the rich and famous can cost hundreds of thousands of dollars. Also don't count on surgery to save a rocky relationship, gain a promotion or make you the life of the party. If you're in the middle of a very stressful life circumstance such as a divorce, job loss, death of a loved one or an uncontrolled mental illness, you may want to postpone pursuing cosmetic surgery. All of these situations may increase the possibility that you won't be satisfied with the final results.
* Can afford the time and expense. Cosmetic surgery isn't covered by health insurance. The costs vary depending on the procedure performed and may range from a couple hundred dollars to several thousand dollars. The procedures and your recovery also take time. This varies depending on the procedure. Returning to work may take from one day to more than a month.
* Understand the risks. You must be comfortable with the fact that cosmetic surgery, like any surgery, can be a risk to your health and that the results may not be what you anticipate.
What are the possible risks?

The closer you work with your surgeon to establish specific, measurable and achievable goals before surgery, the more likely you are to be happy with the results. Still, dissatisfaction with results is a possible risk. How satisfied you are depends on a number of factors. These include your expectations, the extent and type of surgery, how skilled your surgeon is and your own body's ability to heal. Ask your surgeon how likely a happy outcome is with the procedure you're considering.

Beyond the risk of dissatisfaction, all the usual surgical risks apply. If you have a history of cardiovascular disease, lung disease or obesity, you have a higher risk of developing such complications as pneumonia, stroke, heart attack, and blood clots in the legs or lungs.

Other possible surgical complications include:

* Nausea, dizziness and excessive pain, which may require admission to a hospital if following an office-based procedure
* Numbness and tingling, which sometimes may be permanent
* An accumulation of clear fluid beneath the wound (seroma), which may need to be drained with a needle
* A collection of blood beneath the closed incision (hematoma), which may have to be surgically removed
* Skin breakdown — a separation from healthy skin, which needs to be surgically removed — caused by poor blood circulation, particularly if you smoke
* Significant bleeding requiring a transfusion
* Infection at the site of the incision, which may require additional surgery and leave bigger scars
* Uneven or lumpy appearance (asymmetry), which may be permanent and require additional surgery to correct
* A drop in body temperature (hypothermia) that can result during long operative procedures

You're more likely to have a smooth recovery if you're in good overall health, you see a qualified surgeon, and you practice proper self-care after surgery by carefully following your doctor's instructions.
How to find a qualified cosmetic surgeon

Finding a good cosmetic surgeon isn't as easy as finding a good plumber. To accomplish this challenging task:

* Look for the gold standard in certifications. You're more likely to have a satisfactory outcome if your surgeon is experienced in the procedure and certified in their specialty by an appropriate board recognized by the American Board of Medical Specialties. Examples of specialties include Plastic Surgery, Facial Plastic Surgery, Otolaryngology, Ophthalmology and Dermatology. Each specialist has his or her strengths and weaknesses. Just because that person may have excellent results with liposuction doesn't mean his or her face-lift results are similar or that he or she is even qualified to do a face-lift, depending on specialty and training. For more involved procedures such as a tummy tuck (abdominoplasty), you also may want to consider a surgeon who has hospital privileges to perform that procedure. For procedures requiring full anesthesia, be sure that the operating facility has been accredited by a national- or state-recognized accrediting agency such as the Joint Commission on Accreditation of Healthcare Organizations, is certified to participate in the Medicare program under Title XVIII or is licensed by the state in which the facility is located.
* Beware of misleading certifications. Just because a doctor is "board-certified" doesn't mean he or she has had training in cosmetic surgery. The certification could come from an unrecognized, self-designated board that requires little more than an application fee.
* Know that not all referrals are equal. If you call a hospital to ask for a recommendation, you might be referred to the next cosmetic surgeon on the receptionist's revolving list. He or she may not be best qualified to operate on you. Instead seek recommendations from people you trust, such as your family doctor or a friend who has had a successful procedure.
What to expect during an initial consultation

The initial consultation is an opportunity for you and the surgeon to establish rapport. You discuss your desires and expectations, and your doctor evaluates the part of your body you want treated and takes a brief medical history.

You also discuss any medical conditions that could affect the outcome of the procedure — such as diabetes or blood-clotting problems — and name the medications you take. Certain medications, such as warfarin (Coumadin) and aspirin, or dietary supplements, such as Vitamin E and St. John's Wort, can increase your risk of bleeding during surgery. You may need to stop taking these before the procedure. And if you smoke, since nicotine restricts blood flow and hinders healing, your doctor may suggest you stop using all nicotine-containing products including gums and patches at least two weeks before surgery.

Before choosing a surgeon, ask the following questions:

* Are there other treatments that might work just as well or better for me?
* Am I a good candidate for this procedure? Why or why not?
* How many times have you performed similar procedures, and what were the results?
* Can the desired effect be accomplished in one procedure, or will multiple procedures be necessary?
* What are the pros and cons for each?
* What type of anesthetic will be used and how will it affect me?
* Will I be hospitalized and, if so, for how long?
* What results can I expect?
* What are the possible complications?
* How will you monitor my progress after surgery? What follow-up care will you provide?
* What percentage of people require touch-up surgery, and who is responsible for that cost?
The choice is yours

Even if you have done your homework and found a surgeon you like — at a price you can afford — make sure you feel absolutely comfortable with and committed to your choices. In the end, it's your decision and yours alone.
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