SURGERY

Skin scars treatment or revision surgery results in the improvement of scars, either cosmetic or functional. Skin scars are results of earlier surgery trauma, or inflammatory processes, e.g., acne. The injury may be cosmetically distressing or may distort functional anatomy. Thus, the aim of scar revision is the achievement of an aesthetically pleasing or less visible scar. Scars can be categorized by various descriptive characteristics, including contour, shape, length, width, color, and function. Recognition and analysis of these unique characteristics, along with the scars’ location and place, will aid in determining the proper technique or combination of procedures in revising a given scar. Numerous revision procedures are available to correct the various types of injuries. No one treatment or procedure is effective in correcting all types of scars. Therefore, knowledge, understanding, and experience using various techniques are vital to achieving acceptable results.

Hair restoration involves moving hair from one body area to another for cosmetic improvement. The latest advances in the field, such as smaller grafts, follicular unit extraction or FUE, and novel pain reduction methods, make hair restoration treatment successful, safer, and more comfortable. Hair transplantation is most used for male pattern baldness. The second most common use is to treat female pattern baldness. Many women do not experience recession but wish to advance their hairline because of the congenital high hairline, traction alopecia, or previous facial cosmetic surgery. There are several key differences to note in the appearance of the male verse female hairline. It has been previously reported that the male hairline is typically 7 to 8 cm above the glabella and 5 to 7 cm in women. Besides, a variety of conditions can be successfully treated with hair transplantation, such as scalp scarring, facial scars due to trauma or surgery, and hair loss due to traction can be repaired with hair transplantation. Finally, hair transplantation can be successfully used to restore hair to the eyebrows, eyelashes, beard, mustache, or goatee area; and even in areas of the body, such as the pubis or chest. The PRP and growth factors are used pre-operatively, intra-operatively, or post-operatively. The scalp where hairs are transplanted decreases bleeding, and bruising accelerates healing and reduces shock hair loss. The injection of nano fat or enriched micro fat is performed subcutaneously above the galea and in proximity to the hair bulb, which is the region where stem cells exist.

Arms in shape surgery results requires understanding the aesthetic arm deformity and its causes. Brachioplasty, liposuc­tion, and non-invasive body shaping may be used for arm shaping or contouring. Women interested in shaping the arm who would like to improve along the deltoid region and over the triceps are good candidates for liposuction of the arm. Upper extremity liposuction is appropriate for younger patients with fatty collections and good skin quality. Skin is relatively thin in the arm, so skin retraction is less likely in the standard patient than abdomen or back. Skin laxity is possible after liposuction, and if this is anticipated, it is best to discuss the potential need for second-stage skin removal. Liposuction treatment is often weighed against arm lift with the possibility of a visible scar. Weight loss leads to variable degrees of skin redundancy. Some patients receive help from a minimal incision arm lift. In contrast, others receive help from traditional arm lifts, and others have so much laxity that the arm lift needs to be extended beyond the axilla along the lateral chest wall. There is an increasing number of transcutaneous energy delivery devices currently available. They are classified according to the energy they deliver to their target—mechanical (e.g., suction, massage), radiofrequency, ultrasound, cryolipolysis, and laser.

Abdomen in shape surgery results depends on abdominal imperfections. Abdominal alterations may be summarized as: cutaneous (redundancies, stretch marks, scars, flaccidity, and retractions); accumulation of subcutaneous tissue (lipodystrophy); and those affecting the muscular-aponeurotic system (diastasis, hernia, eventration, and convexity. The abdomen is essential to define the younger and more vital physique. The stomach contour is set by the bones, fat, skin, muscles, and the protrusion of the intra-abdominal organs. Surgical treatment will remove excess skin and fat and tighten the muscle to push back internal organs. Surgical treatment will give a contour that approximates the person's ideal self-image. The goal of surgery is to make an aesthetic contour with acceptable scars and the return of full function of the abdominal girdle. There is an increasing number of transcutaneous energy delivery devices currently available. They are classified according to the energy they deliver to their target—mechanical (e.g., suction, massage), radiofrequency, ultrasound, cryolipolysis, and laser. Radiofrequency devices are the most popular for non-surgical skin tightening and fat reduction.

Acne inversa or hidradenitis suppurativa (HS) is a disease that usually begins as pimple-like bumps on the skin. The pimple-like bumps tend to develop in places where everyday pimples do not appear. HS is most common on the underarms and groin. Getting treatment for HS is important. Early diagnosis and treatment can prevent HS from worsening. If HS worsens, the pimple-like bumps can grow deep into the skin and become painful. They can rupture, leaking bloodstained pus onto clothing. This fluid often has a foul odor. As the deep bumps heal, scars can form. Some people develop tunnel-like tracts under their skin. As the skin continues to improve and scar, the scars thicken. When thick scars form in the underarm, moving the arm can be difficult. Thick scars in the groin area can make walking difficult. Because HS can look a lot like acne, folliculitis, or boils, it is best to see a dermatologist for a diagnosis.

Breast implant surgery to enlarge or augment the breast is done by placing silicone breast implants. The exact procedure is tailored to meet a woman’s individual needs. The choices include intravenous sedation and general anesthesia. The filling type, shape, profile, and size of the implants are discussed thoroughly in the pre-operative consultation. The decision of placing the incision and implant will depend on the type of implant, degree of enlargement, and body type. A breast implant will be inserted into a pocket either under or directly over the muscle. Incisions are closed with layered sutures in the breast tissue and with sutures, skin adhesive, or surgical tape to close the skin. Over time, breast implants can change shape, size, or overlying breast tissue. Patients notice that the appearance or feel of the breast is less desirable than the first result; therefore, many women will replace or update their breast implants after10-year.