Mr Simon Mackey, Consultant Plastic, Reconstructive and Aesthetic Surgeon, talks about cosmetic surgery (6 videos)
What is cosmetic surgery?
Cosmetic surgical procedures are those procedures which are designed to improve appearance. Now, there's often a gain in function with a cosmetic surgical procedure. And many of the operations that we use for cosmetic surgery are actually based in reconstructive practice. And likewise, a number of the procedures that we use for reconstruction are based in cosmetic surgical practice. So the two really are interchangeable, but cosmetic surgery is performed by plastic surgeons to improve appearance.
What is the most common plastic surgery?
The commonest cosmetic surgical procedure will really depend upon the expertise of the surgeon. So, as primarily a cosmetic and reconstructive breast plastic surgeon, the majority of my procedures tend to be breast surgical: breast uplifts, enlargements or reductions, but also procedures involving contouring of the body, so abdominoplasty, arm lift and thigh lift. And nationwide, the commonest cosmetic surgical procedure is still pinnaplasty or correction of prominent ears.
Is cosmetic surgery and plastic surgery the same?
Plastic, reconstructive and cosmetic surgery really comes under the same umbrella. And as a qualified Plastic Surgeon from the United Kingdom, I'm actually a member of the British Association of Plastic, Reconstructive and Aesthetic Surgeons or cosmetic surgeons. And also, a member of the British Association of Aesthetic Plastic Surgeons.
Aesthetic surgery and cosmetic surgery are used interchangeably but, overall, a cosmetic surgeon and a plastic surgeon are one and the same.
How many cosmetic surgeries can I have at once?
There are particular combinations of plastic or cosmetic surgical procedures which sit together very nicely. Frequently, breast and abdominal surgery will run together. Arm lifting and thigh lifting may run together well, and facial cosmetic procedures, such as facelifts, eyelids and liposuction to the chin are combinations which fit together very well.
There are some advantages to having combination procedures, in that you're only paying for one anaesthetic. You're only paying for one hospital stay and you only have one period of recovery. So, it can be a slightly more cost effective and efficient way of having multiple procedures performed.
But really your surgeon has to place your safety at the centre of things. And, really, you'd normally be limited to one or two procedures in addition to your primary procedure.
Can cosmetic surgery remove stretch marks?
The skin is rather like a piece of plastic. If you stretch a plastic bag a little bit, it will ping back into shape. But if you stretch the bag or the plastic too much, you go beyond its elastic limit and you develop fractures within the molecular structure of the material, and you get stretch marks. And the skin is exactly the same. If it's stretched too much, either through weight gain or pregnancy, say, then it goes beyond its elastic limit, and you can develop stretch marks.
Now, there is no particularly good treatment for stretch marks, sadly, and there are various devices around which purport to shrink stretch marks down. But so far, none of them has really been shown to work terribly well.
So, one of the major - or one of the main ways - in which we can address stretch marks is to excise the tissue that has the stretch marks within it and close it up directly.
So common areas for this to occur are the tummy with a tummy tuck, but frequently after massive weight loss. Areas such as the underarms or the medial thighs can be treated with brachioplasty - which is an arm lift - or thigh lift. The scars we will then try to hide along natural skin creases, such as the uh crease along the bikini line or the growing crease.
But in some areas there's no natural skin crease in which you can hide your scar. So, brachioplasty - or arm lifts - we just try to hide the scar around the back of the arm.
Can cosmetic surgery remove scars?
Cosmetic surgical techniques can be used to improve scarring. Scars can be tidied up, so, excised and closed directly to try to encourage them to heal in a slightly better way. So, for example, if one has had a wound infection, at the time of primary healing, it will delay recovery and the scar is likely to be stretched or maybe red or raised or itchy or lumpy. And then revising the scar directly may well improve its appearance.
Another example would be scarring of the abdomen following abdominal procedures. So frequently, with a procedure such as a tummy tuck, one can take out caesarean scars, appendicectomy scars or laparoscopy scars, for example - together with stretch marks or tattoos to tidy up the appearance of the abdominal wall.