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Plastic Surgery is Much More Than Just Nose Jobs

June 17, 2009 06:46:47 PM

According to the cosmetic plastic experts,  more than 12 million people have plastic surgery each year, one of medicine's fastest growing specialties. Patients seek plastic surgeons for everything from removing moles to rebuilding faces. While much of their work is devoted to reconstructive operations, plastic surgeons are perhaps best known to the public for their cosmetic surgery.

These days, celebrities talk — and joke — openly about their operations, although comedian Phyllis Diller's successful face lift killed her classic one-liner, "I have to tip a porter to carry the bags under my eyes into a hotel." Magazine articles point to a boom in the business and the Smithsonian Institution even had an exhibit about plastic surgery called "Noses by Design."

The celebrities and media attention, however, have added to the confusion about plastic surgery, as the surgeons themselves are quick to point out. The distinction between cosmetic and reconstructive surgery is somewhat artificial, imposed on doctors and patients by insurance companies who do not, as a rule, pay for cosmetic surgery.

If the areas are separated, then well-known cosmetic surgeries — eyelid surgery, face lifts, breast augmentation, "nose jobs" or rhinoplasty, hair transplants and "tummy tucks" — comprise less than half of all plastic surgery operations nationwide, according to the American Society of Plastic and Reconstructive Surgeons.

However, plastic surgeons in urban areas, especially New York, Los Angeles, Beverly Hills and Miami, devote very high percentages of their practice to these aesthetic operations. Other procedures, which garner less publicity but often involve more complicated techniques than face lifts or rhinoplasty, include a wide range of reconstructive surgeries for head and neck traumas or cancer, cleft palate, tumor removal, breast reconstruction, congenital defects and hand surgery.

Cosmetic surgery is still the domain of women (about 85 percent) despite recent increases in the number of men seeking such image-enhancing operations as face lifts and hair transplants. Surprisingly, statistics show that the number one cosmetic surgery for women is breast augmentation. Other popular procedures are: eyelid surgery and removal of bags under eyes face lifts, rhinoplasty and suction-assisted lipectomy (fat removal).

Here are before and after shots of a modern cosmetic "rhinoplasty" or nose job. The first written evidence of cosmetic surgery, in 600 B.C., described a nasal reconstruction. Statistics include only operations performed by certified plastic surgeons. Thousands of plastic surgery procedures, however, are performed each year by general surgeons, dermatologists, ear-nose-and throat doctors and other physicians.

Statistics from government sources, on the other hand, count only operations performed in hospitals — but nearly all cosmetic surgeries are done on an outpatient basis. In any case, experts in the field agree that cosmetic surgery, especially face lifts and breast augmentations, is becoming more popular every year.

Face lifts are still the first thing many people think of when they hear the term "plastic surgery." The goal of a "rhytidectomy" is to produce a more refreshed, younger look by removing the signs of aging — wrinkles and sagging skin — on the face.

During the face lift procedure, the surgeon makes an incision on both sides of the face, following the hairline around behind the ears. The skin is pulled up and backward, the excess removed and the incision closed with sutures hidden in the hairline.

Diamonds may last forever, but a face lift does not. Doctors estimate the lifetime of a face lift to be about five to seven years, depending on the person's skin type, smoking habits and exposure to sunlight.