Otoplasty surgery is a surgical procedure that aims to eliminate or correct the abnormal contour of the ears, i.e., the correction of prominent or “hip” ears, often popularly known as “flap ears”. However, other conditions may also be treated using otoplasty techniques, such as sequelae of trauma, congenital absence of the ears or other types of abnormalities.

These problems can be uni or bilateral and may even involve both ears differently. In either case, the main consequence is psycho-social, as these ear anomalies do not affect hearing. For this reason, insurance companies do not cover these situations in most cases.

Often, this aesthetic problem causes self-esteem problems and can generate anxiety, interfere in the relationship with other people, both in childhood and in adults, and surgery should be considered in these cases.

Indications of otoplasty

Interventions on the ears are performed to reduce defects, correct disparities in the shape, size and angulation of the prominent ears. Otoplasty is also indicated in the correction of malformed ears from birth or suffering from deformities after an injury. This type of procedure can have as its purpose two fundamental objectives, including: to repair, when it tries to correct a defect, and simultaneously to have an aesthetic objective, aiming at the harmony of the shape, volume and position of the ear.

The degree of deformity of the ears in flap may range from the mildest to the most severe degree, however the surgical indication is based on the dissatisfaction that the patient presents. There are patients with small changes and who feel very uncomfortable with the fact. The degrees are based on the amount of anatomical changes of the ear under discussion. There is also another situation that makes the patient quite uncomfortable, which is the macrotia, that is, the patient has ears whose size is quite above normal (very large ears).

Anyone can undergo surgery as long as they meet the conditions. Even people with chronic diseases, such as high blood pressure or diabetes, may be subjected to the operation and should naturally have their chronic disease controlled before undergoing surgery.

What is the minimum age in otoplasty?

The minimum age for performing this surgery is 4 years of age. The child’s ear at this age has already reached the proportions of the adult and it will already make sense to perform a surgical intervention. All patients from this age whether male or female may undergo surgery. That is, there is no maximum age and patients can be operated on at any time throughout their lives.

What are the advantages of otoplasty?

The advantages of otoplasty are several, i.e.:

• Recovery of self-esteem – The vast majority of people who have prominent ears have low self-esteem, ultimately affecting their well-being and quality of life. This surgery allows the patient to regain self-esteem, making him happier and at peace with himself;

• Rapid recovery after surgery – Recovery from otoplasty is relatively faster when compared to other surgeries. The operated area tends to improve significantly, within the first two weeks after surgery.

• Absence of visible scars – The stitches are given behind the ear and the incision is hidden.

How is it done?

The surgical technique used by the surgeon will depend on the objective of the plastic surgery, and it is likely, for example, that there is removal or scraping of cartilage. Points can be given behind the ear or at existing structure creases.

Preparation

Generally, ear surgery is performed under general anesthesia or local anesthesia and sedation. It can be done in the operating room of hospitals or qualified clinics.

As in all surgery, previous tests, fasting and suspending anticoagulant medications, such as aspirin, are necessary, following what the doctor indicates preoperatively.

Duration

The duration of otoplasty is usually from one to two hours, and may extend in more complex cases, such as congenital malformations.

Recovery

Recovery is usually fast and with little pain. In about a week, the patient can return to the usual activities and, around a month, return to physical exercise.

There is a need to use a helmet or bandage dressing – otoplasty bands – in the first few days. Then there is the replacement for a compressive band, which should be used for a month.

Before and after otoplasty

Generally, the result is visible from the first days, with edema (swelling) of the operated area, which usually improves 90% or more in the first two weeks.

After a month, the result is very close to the definitive.

In the case of prominent ears, they are expected to maintain a fairer position to the head. It is also possible to perform the decrease of the ears.

Contraindications

Anyone in good health and with normal preoperative examinations (blood and heart tests suitable for each age group) may undergo otoplasty.

Risks, complications in otoplasty

Otoplasty is a very safe surgical intervention with predictable results, usually free of complications provided that all recommendations made by the plastic surgeon are followed. However, there are always some risks inherent to any surgery or anesthesia, however these will be reduced if some recommendations are followed, namely the indication of appropriate surgery, the surgical technique, postoperative care, the preparation of the surgery, the choice of a specialist in plastic surgery and in a place with adequate resources. After these conditions, risk factors will certainly decrease the rate of complications.

Although rare, as main complications we can refer to bleeding, hematoma, pain, edema (swelling) higher than anticipated, infection, among others.

In the expected results, there is a risk of asymmetry, especially in adult ears, who have the most hard cartilage, tending to lose the angle of correction and return to deformity. These situations can be avoided in most cases, but if they do, they can be corrected with a new surgical intervention.

Facial paralysis correction surgery aims to repair the loss of nerve action by congenital, tumor, traumatic or degenerative factors (pathologies or infections). The non-stimulation of the nerves (partial or total) result in non-stimulation of muscle fibers, consequently, stop of muscle action and loss of movement. Sometimes the nerve is intact, but the muscle atrophied.

If affected by this condition, you probably won’t be able to move your eyebrows, lips, or other muscles on your face.

Facial paralysis can affect your smile and your overall appearance. If you or someone you love has this condition, you should seek help in rebuilding balance, symmetry, symmetrical movements, and the ability to smile.

Facial nerve paralysis leads to deformities in facial expression and thus to major social impacts. The smile is one of the alterations that patients with paralyzed face complain about the most, and this is the most requested correction in this type of reconstruction.

Facial Paralysis Causes

Thermal shock, trauma stemming from accidents, AIDS, herpes, among other problems can cause facial paralysis. It occurs when there is loss of movement of one or both sides of the face, caused by the injury of the nerve of the face. From then on, the smile becomes swayed, the eyes close with difficulty, the eyebrows are paralyzed, and the mouth loses the function of retaining saliva.

In addition to the problem producing a very striking and difficult-to-solve deformity, it can also cause the victim to have the ability to express himself compromised. Depending on what has caused facial paralysis, plastic facial resuscitation surgery may provide, within its limitations, improvement in the patient’s condition and hope for aesthetic and functional improvement.

Facial paralysis correction surgery techniques

The technique of facial paralysis correction surgery has effectively treated facial paralysis resulting from traumatic musculocutaneous amputations or tumors, which include skin, nerve and muscle. These amputated areas, in turn, are replaced by muscles and covered with skin, recovering the functional and sensory part of the skin.

In the reparative surgery of facial paralysis, the skin and muscles are removed from the back and the muscle used is the large dorsal muscle, which allows us to carry more than five to nine muscle subsegments for facial resuscitation, trapped only in the same artery, vein and nerve.

All handling with arteries, veins and nerves is done by microscope and a material specialized in reconstructive surgery is used. Correction surgery for facial paralysis can be performed at any time, as long as it is well indicated. Each case is a case, and the benefit risks should be analyzed.

Other advance techniques

Muscle transfer: This technique involves transferring muscles from one part of the body to another—usually from the face, neck, or leg—to the face. Some of the associated muscles and tendons that are often transferred are temporal, digastric and graceful (gracillis).,

Nerve grafting: This technique includes transferring nerves from different parts of the body to the face to ensure that it can have greater movement—and even sensitivity—on the face, which will allow you to have better control of facial muscles. These may include maseterinnerve graft, a crossed nerve graft, hypoglossal nerve graft for facial nerve, among others.

Facelift surgery

The effects of the passage of time at the facial level are manifested by the loss of elasticity and tonicity of the skin, the deepening of the trenches around the mouth, the appearance of wrinkles and laxity (sagging) of the tissues, the decrease in the volume of the cheekbones due to the resorption of the fat and skeleton, the lowering of the position of the eyebrows and the corners of the mouth. Face lift is the surgical procedure that addresses all these signs of aging.

What is the purpose of facelift surgery?

Face lift aims to rejuvenate the face by removing excess skin from the face and neck, alleviating wrinkles and repositioning deep facial structures. The operation addresses the middle and lower third of the face: if there is ptosis of the eyebrows or eyelid skin, then you can associate operations addressed to these structures: eyebrow lift and / or blepharoplasty.

Before facelift surgery

Preoperative details:

During the preoperative consultation, the surgeon will follow the following aspects:

✓ will assess the quality of the skin, as well as the degree of its laxity (how the skin falls off), the position of the eyebrows and corners of the mouth

✓ will notice any facial asymmetries

✓ will take digital photos

✓ will assess the patient’s health and will obtain information about his medical history. Last but not least, the doctor will recommend performing preoperative investigations (blood tests, EKG) and will adjust or stop the administration of some drugs that increase the risk of bleeding (aspirin, oral anticoagulants, natural medication, etc.),

✓ will recommend quitting smoking at least 2 weeks before the operation.

When is facelift surgery indicated?

Face lift is a strictly individualized surgery, and as a result it cannot be practiced to satisfy someone else’s desires or to copy an ideal image. The platic surgeon, taking into account the patient’s wishes and expectations, will determine which is the most indicated facial rejuvenation procedure

It is indicated when:

• there is a medium-severe cutaneous laxity
• the state of health is good
• the patient’s expectations are realistic
• the bone protrusions of the face are not very obvious

What are the contraindications of the operation?

• patients with unrealistic expectations
• smokers
• patients with vascular diseases (vasculitis), coagulation disorders, diabetes or other diseases that slow healing
• patients prone to the formation of hypertrophic or keloid scars
• in the presence of serious diseases, which contraindicate general anesthesia

How is the surgery performed?

Facelift is generally practiced under general anesthesia, but local anesthesia with associated sedation is also possible. The operation lasts on average 3-4 hours.

There are a multitude of surgical facelift procedures, differentiated according to the size and location of the incisions, as well as depending on the way of removing the excess skin and lifting the deep tissues left.

In fact, the anatomy of the face is very complex, although from the outside it does not look. The facelift operation has a lot of technical details. To explain in a simple way; An incision is made at the edge where the ear and cheek meet, and the excess skin is removed from the cheek area. This incision continues by suturing into the scalp behind the pearly area and into the scalp behind the ear.

Since the incisions made in the facelift operation will be made in the anterior and posterior regions of the ear, small scars remain in these areas. If the incision in front of the ear is passed through the ear, this scar usually remains inside. In this way, it is not visible from the outside. Incisions made in the skin in areas with hair leave no traces.

Post facelift surgery

At the end of the surgery, the wounds will be sutured and will be covered with steri-strips. They will require minimal care until the suture threads are removed, 7 days after the operation. Sometimes it is necessary to place a drainage tube for 24-48 hours, through which excess fluids will be evacuated from the operated area.

The face lift causes a small or moderate discomfort, which, however, can be controlled by regular pain medication. Postoperatively, a supine position is required (the patient lying on her back), with her head slightly raised.

After surgery it is recommended to wear for 1-2 weeks (initially non-stop and then about 12 hours / day) of an elastic and compressive facial band. Sun exposure and intense physical exertion will be avoided 3 months after surgery.

General complications are those common to any invasive procedure, being represented by certain cardio-respiratory complications that can occur due to general anesthesia.

Risks of facelift surgery

Small accumulations of blood called hematomas after facelift surgery can cause some aesthetic problems. For this reason, the drain, which is a tube that absorbs fluid accumulations under the skin, should remain at least a day after the operation.

Although rare, infection can occur after facelift surgery. If the patient smokes, skin loss can become a serious problem. Also, there may be numbness and hair loss on the scalp. But you do not have to worry because the sensation on the hair and skin will definitely return.

The healing process after the facelift surgery

As in other aesthetic surgeries, the recovery period in facelift operations differs from patient to patient. The type of operation affects the healing process of the operated area. After the facelift operation, the patient is discharged on the day of surgery and, depending on the situation, the day after staying in the hospital.

A day after the operation, the risk of bleeding disappears. Thus, the located drain can be removed.

All sutures placed in the operation are not removed at the same time. First, the sutures on the face and eyelid are removed. This is done a week after the operation. On the 10th day after the surgery, the metal sutures from the hair are also removed.

In the first 3 days after the operation, it is normal for edema to appear in the area of the face and neck, in the areas where the seams are applied and in the areas close to these areas. Some swelling can be observed. These swellings begin to subside on the 4th day after the operation, but it can take 3 weeks to disappear completely.

After facelift surgery, loss of sensation, numbness, swelling and changes in skin color in the relevant area for several weeks can be observed, and these observed effects will decrease and disappear within a few weeks. Redness and bruises usually disappear in the 3rd week.

Frequently asked question

Who is suitable for facelift surgery?

Facelift surgery is generally preferred by people aged 50 and over. However, it is okay for people who have wrinkled and sagging skin before the age of 50 to do this surgery at a younger age. This surgery can be a good and permanent solution especially for those who are disturbed by the lassing observed in the neck area.

Is it a permanent face lift?

One of the most common questions about facelift surgery is the permanence of surgery. Permanent results are achieved with facelift surgery. The results of most facelift procedures take a very long time, between seven and 15 years. The duration of the operation may vary depending on the structure of the patient’s skin, the structure of the skeleton, the technique used and the doctor applying the technique.

How many days will I recover from the facelift surgery?

Bruises that appear after facelift surgery will heal in about a week after the operation. Complete healing of swelling occurs after a postoperative period of one month.

What is the success rate of the facelift operation?

The success rate of the facelift operation is among the most curious about this topic. The success rate for achieving the desired result with the first surgery is very high by 95 percent. If the desired result is not fully achieved after the first operation, the desired result is achieved with a complete success rate with the second operation.

Those who also want more voluptuous lips, either to improve the image or to avoid the effects of volume loss due to aging, may want to consider getting a lip augmentation. Most patients who perform this procedure are female, however some men also decide to perform it. The purpose of this procedure is to give more volume and contour of the tight lips to give greater aesthetic appeal.

The lips are one of the most important and striking elements of the facial center when we see someone for the first time. Our faces convey our emotions and therefore play a vital role in communicating with others. The lips can make a smile, a frown or a kiss and you can determine whether we are young or old. The most popular types are the lips of famous people. The lips of these celebrities give a distinctive and desirable.

Benefits of lip augmentation

The benefits of lip augmenting are directly related to one’s own aesthetic image and self-confidence. Thin lips, aged or not provided with all facial can be changed to give a younger appearance, injectable fillers or implants. Thick lips in women are a projection of the biological sign of fertility and youth. For this reason, the edges to be reduced in volume as age progresses, i.e. due to reduced levels of estrogen (hormones).

Characteristics of patients

The ideal candidate for lip augmenting is a person who is in good health, both physically and psychologically and have realistic expectations about the final results. The purpose of wanting to become a lip augmentation can be to offer greater facial symmetry, increased self-esteem, restore volume lost due to aging and improve facial appearance. Your reasons for wanting to undergo this procedure, you should deal with your doctor during the first visit.

Types of lip augmentation

The lips may be small, thin, or unprofiled. They may have small asymmetries or scars, either congenital or caused by injuries or previous treatments. Through the infiltration of certain substances you can get lips with more volume, improve the shape, give symmetry, projection or profile the lips, always maintaining a natural and aesthetic appearance. There are three types of lip augmentation, depending on the expected results. They are as follows:

Aesthetic lip augmentation

Aesthetic lip augmentation is designed for people with thin lips or who have lost volume over the years. As we have already said, the most common form of augmentation lip augmentation is the injection of hyaluronic acid.

Hyaluronic acid is a polysaccharide that is naturally present in human connective tissues, including the skin. In fact, it is the main elastic component of the skin. It contains water (99.5%), and plays an important role in the formation of stable collagen and in the organization of the extracellular matrix. And for that reason, it is perfect both to moisturize the skin and to fill the lips. Hyaluronic acid is also the preferred type of filler because of its natural appearance and its ability to dissolve over time or with the help of the dermis. Hyaluronic acid fillers retain moisture in the skin to increase the volume, shape and structure of the lips.

Reduction lip augmentation

In reduction lip augmentation the goal is to reduce lip volume. The operation removes excess lip tissue to reduce the appearance of overly large lips. The procedure takes between 15 and 20 minutes and can be performed under local anesthesia. Candidates for this surgery are people with overly bulky lips who want to harmonize their facial features.

Corrective lip augmentation

Corrective lip surgery is intended to repair lips that have suffered burns, congenital alterations (such as cleft lip) or injuries of any other type.

Lip augmentation results

The result of a lip augmentation in our clinic is thicker, profiled and hydrated lips; always respecting the naturalness and facial expression. This achieves a more youthful and attractive face. The results can be permanent or temporary, depending on the substance being injected.

Postoperative

The surgical intervention does not have major complications and the recovery is very fast. The most common side effect is swelling of the lips and mild numbness. However, this swelling is temporary and can be easily controlled by local application of ice.

The removal of the stitches is done seven days after the intervention. During those first days it is recommended to follow a soft diet, do not perform physical exercise, do not apply heat to the area and avoid prolonged exposure to the sun. The surgeon will give the patient all the information about the guidelines to follow.

Frequently Asked Questions of Lip Operation

How long does lip augmentation last?

This depends on the type of injection that is performed to get the increase. In the case of injection with hyaluronic acid the effects gradually diminish as the body reabsorbs this substance naturally. It is estimated that the results of the increase are appreciated in all their splendor during a period of 6 months to 1 year. After that it is always possible to apply a new injection.

In summary, the total duration of lip fillers depends on the amount of filler injected, the patient’s metabolism and the substance used.

What are the advantages of hyaluronic acid for lip filling?

As we have already mentioned before, hyaluronic acid is part of the structure of normal and healthy skin. The function of hyaluronic acid is to provide nutrients, moisturize the skin by retaining water and act as a buffering agent. However, its concentration decreases with age. The advantages of this type of filler for lip augmentation are, among others:

• Be a natural, biodegradable and resorbable (temporary) product. The filling can last 1 year, depending on the product used, the infiltrated volume and the injection technique.
• Integrate into tissues naturally, allowing oxygen and nutrients to pass through the skin.
• Maintain an adequate hydration of the skin and a turgor characteristic of youth, so the results, on the lips, are aesthetically evident and above all very natural both in the visual aspect and touch.

Is lip augmentation for you?

Anyone who wants to improve the appearance of their lips can be a good candidate for lip augmentation. This includes:

• Patients with thin lips who want to increase their volume
• Patients with too large lips who want to reduce their volume
• Patients with cleft lips or affected by other congenital alterations.
• Patients whose lips have suffered an injury or burn.
• Patients who previously underwent lip treatment and were not satisfied with the result.

However, there are patients in whom this type of procedure is discouraged. For example, it is recommended not to smoke, and if the person suffers from any autoimmune or inflammatory disease should mention it. In any case, the clinic will do the appropriate examinations to ensure that the patient is an ideal candidate for surgery.

How long does the inflammation of a lip augmentation last?

It is normal for the lips to be somewhat inflamed during the days after the intervention. The normal thing is that it is an inflammation and disappears after a week.

Is lip augmentation reversible?

Lip augmentation with most injectables is temporary, so the effects go away on their own over time. Permanent injectables are more difficult to remove, so keep this in mind when making your decision.

Are permanent or temporary fillers better?

It all depends on the objective that is pursued. Many people prefer temporary fillers because they are reversible and affordable. That means that if the patient wants to maintain the volume of her lips, she only has to make a new injection, and if she wants to recover his original shape, she can also do it easily. If the patient is unhappy with the result of the lip augmentation for any reason, the doctor may inject a solvent enzyme called hyaluronidase to break down the hyaluronic acid particles and speed up the rate of dissolution of the filler.

Rhinoplasty in Mumbai is a surgery performed to correct defects or deformities in the nose in order to harmonize it with the rest of the physical features of the face. Respiratory abnormalities and other functional problems secondary to internal problems of the nasal structure can also be corrected.

The nose is one of the central structures of the face, which makes it one of the most important features. Its relationship with the eyes, cheekbones, forehead and mouth results in the overall appearance of your face.

As you can imagine, the nose has great aesthetic importance.

The procedure and planning of surgery consist of repairs necessary and desired of the patient. These changes are achieved by correcting certain aspects of the inner nose such as the nasal bones, skin, cartilage, and nasal wings.

Benefits of the Procedure

• Raise self-esteem
• The face looks more harmonious
• A natural result is obtained

Reasons to perform a rhinoplasty

• It is performed on patients who want to change the appearance of their nose, such as size and shape. Whether the patient is unhappy with the size of the width of their nose or wings, the structure of the tip, or the presence of a hump on the back.

• In patients who want to correct changes due to injuries to the nose (nasal fractures). Deformities from fractures and nasal deviations can be corrected along with breathing problems.

• Patients with certain breathing problems (deviated sectectomy) can be corrected during a rhinoplasty.

Choosing the right technique for a rhinoplasty in Mumbai

Open Rhinoplasty

During open rhinoplasty, incisions are made along the nasal edges and/or in the columella. The excess cartilage is removed, and the nose is carefully reformed according to the desired changes.

When indicated: when we need to change the shape and projection of the tip.

Proceeds:

• Gives better exposure to all parts of the nose
• Allow for more precise changes
• Scars are almost imperceptible

Closed rhinoplasty

Incisions are made inside the nostrils without having to make external scars, making the changes through small tunnels.

When indicated: In noses where the required changes are usually minimal.

Benefit:

• Leaves no visible scars

Frequently asked questions

How long does the surgery take?

Rhinoplasty in Mumbai usually lasts between 90 and 120 minutes and is performed under general anesthesia.

Patients typically spend an afternoon or evening in the hospital where they will be monitored at all times, so they are comfortable and pain-free.

Remember that each case is different and therefore the duration may vary.

How long do I have to wear the plugs?

I usually remove the plugs after 24 hours if I have not performed a septoplasty and at 72 hours if I have had to correct the nasal septum.

Is the postoperative period painful?

It is usually a very bearable postoperative period that hardly needs analgesics. With mild analgesics such as paracetamol or ibuprofen, pain is perfectly controlled.

In almost all rhinoplasties, there may be some degree of ecchymosis next to the eyes and it is normal to have edema (swelling), which will remain in the first few weeks. Almost always, the greatest discomfort concerns some degree of obstruction and nasal secretions, which will be present in the first week.

How long do I have to wear the splint or cast?

The splint I usually leave between a week and 10 days to protect the nose and not move for example during sleep.

It is necessary that the first days you sleep with the head of the bed raised 45 degrees. Once we remove the splint, I usually advise you to put it on to sleep for another week to make sure it “welds” well.

Will I see the scar?

In an open rhinoplasty, the scar is concealed in the lower third of the columella.

If the rhinoplasty is closed, the scar is inside the nose and therefore “invisible”.

How do I know if I am a candidate for an open or closed rhinoplasty?

During the first visit, I will explore you and advise you which is the type of technique most suitable for your case. Remember that only an experienced plastic surgeon in Mumbai can offer his patients the most appropriate and optimal in each case.

Do I have to remove the stitches?

No. We put resorbable stitches, so the patient is more relaxed and without fear that stitches have to be removed. These points fall off around 2 weeks.

When will I see the results?

You’re going to see the change almost immediately.

Patients tell me that they spend “hours” looking in the mirror even with the splint or plaster because they love the new shape of the tip or its new profile.

In any case, the final result can be seen around the year.

It is important that you remember that each case is different, and rhinoplasty in Mumbai is a totally individualized and personalized surgery to be able to harmonize the nose with the rest of the features of the face.

The fat graft, also known as lipografting, is the surgical technique that uses the individual’s autologous adipose tissue to correct deformities or fill soft tissues, such as breasts, glutes, facial contour, and inner thighs.

What is fat in human body?

In the human body, the term fat usually refers to triglycerides, since this is how it is stored in adipocytes, a specialized type of cell. They are solid or semisolid at room temperature and can be differentiated into saturated and unsaturated.

There are two types of fats, one of which is termed as brown fat or brown adipose tissue. It is what has thermogenic function, protecting from sudden variations in body temperatures. It is more present in newborns and as we age it decreases. In adult individuals, it corresponds only to about 5% of adipose tissue.

The other type is white fat, in it is stored energy to the body. When in a situation of prolonged exercise or fasting, these fats are recruited and can be used by muscle and liver to produce energy.

It is distributed in almost every subcutaneous region, but mainly in the buttocks, thighs, abdomen and breasts and around various organs, including all hollow viscera such as stomach, intestines and bladder. This type of fat also provides mechanical protection, which means that it protects the organs if there is some kind of stronger impact.

Because it has so much coverage in the human body, white fat has become an important tool in several aesthetic procedures, such as fat grafting or lipografting, liposuction and lipo HD.

Which fat is suitable for fat grafting?

Autologous adipose tissue is the ideal fat for this procedure, since the basic premise for correction of deformity is that the tissue is as similar as possible to what will be corrected, because its light and natural texture applied in a reasonable amount has permanent reintegration capacity and gives a subtle aspect. In addition, the chances of rejection are much lower than in other techniques.

What are the benefits of fat grafting?

The fat graft can promote the restructuring of an atrophied part, worn or even absent in some places of the body, can also serve as a treatment and prevention of skin aging or congenital deformities. Also, it is used for the augmentation and contour of glutes, breasts, thighs, face, among others, when they are not in harmony and there is a desire to change.

Because it is a procedure that collects the person’s own fat by liposuction and fills the desired area, the scars are minimal. The technique of using cannulas makes the passage of fat through the skin subtle, leaving no apparent marks. The fat, after it is integrated to the desired site, gives an aspect of improvement and rejuvenation of the part, still maintaining a soft consistency.

Surgery takes place in a hospital setting and the length of stay in the hospital will depend on the areas that have been operated or if another associated surgery. Recovery is fast and smooth, allowing you to resume normal activities after a few days of rest.

What to expect from the fat graft?

It is important to understand that the fat graft does not have the same aspect of silicone prostheses or even of filling with hyaluronic acid. Lipografting reduces imperfections, corrects some flaws and increases the volume of the desired parts, leaving a natural appearance.

However, sagging and excess skin will not be resolved. If the graft is applied to the face, the expression lines and wrinkles will look younger.

How is the fat graft done?

The procedure is performed by liposuction and lipografting techniques, that is, fat is collected through a small incision (between 3 and 5mm) made in the skin, through which a blunt cannula is inserted, aspiring it by the liposuction technique, making movements of back and going, collecting all the necessary fat.

The collected adipose tissue is placed in a sterile site, where a separation by gravity of elements (decanting) is made.

Then, separate oils and sera are discarded from fat, leaving only the necessary part for lipografting. Adipose tissue is then introduced and applied on site.

What about post-op?

It is essential that the post-operative person is at rest for the first 8 days, but without lying on the operated region. In addition, in the first month it is necessary to suspend physical exercises and any kind of effort.

This pillow avoids the movement of the fat that has been injected and incorrect absorption by the body. And fortunately, with the factor of the fat injected being from the patient himself, there is rarely rejection of the organism.

The operated area should be under pressure most of the time, so that recovery is easier and more effective. Thus, the use of the compressor strap or post-surgical bra is indispensable to achieve the expected results.

It is worth noting that any surgery leaves scars and that they form in different ways in each body, but plastic surgeons always value leaving them in hidden places and with the greatest possible discretion.

What are the contraindications?

Unfortunately, it is not all people who are able to perform the fat graft. See contraindication situations to see whether or not you can operate:

• Be more than 30% above the ideal weight;
• Being committed to health at any level;
• Present emotional and psychological instability;
• Have miraculous expectations that go beyond medical capacity.

These are general recommendations, but it is important that you talk to your doctor about your condition, ensuring a smooth preparation, a trouble-free surgical session and a comfortable recovery.

Buccal fat removal in Mumbai is a surgical operation performed to make the patient’s cheeks narrower and more contoured. The surgery focuses on removing fat that sits under the cheekbones and behind the facial muscles. Unlike regular adipose tissue that sits under the skin, fat decreases with age. Nevertheless, some people, usually as a result of hereditary factors, have buccal fat that is too large for their face, especially in proportion to other fat layers in the body.

Resistant to diets and exercise

Buccal tissues are often resistant to diets and exercise, and therefore people with too large fat pads can benefit from a buccal fat removal – a procedure that helps to achieve a more refined appearance and narrower cheeks, and which provides symmetry on the face.

Buccal fat removal is a relatively simple operation that takes between 30 to 60 minutes depending on the individual case. The procedure can be performed either with local or full anesthesia. The incisions are made on the inside of the cheeks, not leaving any visible scars behind. Moreover, since the grease pads are minimally connected to the structure around them, it is relatively easy to remove them. It is important to point out that the fat pads are never completely removed as this can lead to cavities in the cheeks.

Who is a suitable candidate for buccal fat removal and when is the surgery needed?

• A buccal fat removal may be right for you if you have a round face due to large fat pads in your cheeks. This is decided by an experienced facial surgeon – sometimes the cheeks can have a round appearance as a result of regular fat or overdeveloped jaw muscles.
• Buccal fat removal may also be necessary if through another operation you have reduced the size of your cheek or jaw and this has led to your cheeks looking bloated.
• Finally, a suitable candidate should be in overall good health and have a stable weight – plans for future weight loss can affect the outcome of a buccal fat removal.

Preparing for a buccal fat removal (medications, smoking, consultation)

A consultation with your plastic surgeon is necessary for the surgery to take place. You should be prepared to discuss your expectations and realistic outcomes of the operation, including the potential risks. Your surgeon will also evaluate your health, take pictures and recommend the best treatment method for you.

You will additionally be asked questions about all types of drugs and medications that you are taking (including over-the-counter medications).

You need to provide information about your smoking habits and previous surgeries, if you’ve had any.

Do not hesitate to ask about the procedure and preparation. It is important to mention that you will be asked to quit smoking for at least two weeks before surgery as well as to avoid taking anti-inflammatory medications that may increase the risk of bleeding.

Recovery after a buccal fat removal operation

Recovery after a buccal fat removal is simple compared to many other cosmetic procedures. However, remaining in the clinic overnight may be required if the operation is performed under general anesthesia. You should also expect some swelling that may persist for up to a week.

You can put ice on your cheeks to reduce swelling. You should also follow all the instructions you receive after fat removal, such as eating liquid food for a few days and using a special mouth cleaner to avoid infections where the incisions are located. Your surgeon may also prescribe additional medications (to reduce the risks of infections or to reduce pain), which can be taken by mouth.

Depending on your unique case, the surgeon may also recommend that bandages be used to put pressure on the area. Finally, it should be noted that the results of a buccal fat removal can take up to three months before it has fully manifested itself as your skin needs time to heal.

Can buccal fat removal be combined with a facelift and other surgeries?

Buccal fat removal is often performed in combination with other facial surgeries as the combination of two procedures can help achieve the desired look and a more natural and youthful face. Therefore, buccal fat removal can be carried out in combination with:

• Facelift: A facelift (a procedure that reduces signs of aging on the face and neck).
• Between facelifts: One between facelifts (a specific operation that grabs the signs of old age in the lower eyelids and cheeks).
• Blepharoplasty: An eyelid plastic (performed to restore drooping eyelids)
• Neck lift: A neck lift (an operation that can remove excess skin, muscle tissue or excess fat to improve the appearance of the throat).
• Chin augmentation: Chin augmentation (an operation performed to re-shape and improve the appearance of the chin).

If you’re considering undergoing any of these surgeries, consult your plastic surgeon to find out which combination would work best for you.

Recommendations for the patient after cheek surgery

After having performed a bichectomy you should take into account the following recommendations:

• In the first postoperative days you may have mild swelling in the area of the cheeks and mild pain.
• The diet should be bland for a week.
• Ice should be placed for 20 minutes every hour in the cheek area for the first three days.
• You should remain at moderate rest at home. Do not make efforts of any kind and avoid serene.
• You can perform your activities of daily living, avoiding sun exposure or exercising.
• Take all medications that are formulated and attend the scheduled check-ups in a complete manner.
• In case of any inconvenience you should call your surgeon.

In the world of aesthetic medicine there are many surgical procedures that promise to improve the physical appearance, either of the body or the face, and thus reach the beauty standards of each person. Such is the case of those who aspire to get a few dimples on the cheeks because they consider them a beautifying element and therefore, undergo a dimplepasty or dimple surgery.

What are dimples?

Dimples are nothing more than marks that appear on the cheeks caused by an anomaly or imperfection in the buccinator muscle, located on the cheek, behind the masseter muscle.

This muscle is very important at an aesthetic level, since it gives us the shape of our face; elongated, round, etc., and is responsible for chewing, salibation, etc.

This genetic defect is transmitted from parents to children, so not everyone can boast of dimples. In fact, it is a rather special trait that only about 20% of the population has; they give attractiveness to their face, beautify their smile and sweeten their face.

What is dimpleplasty?

Better known as the dimple surgery on the cheeks, it is a procedure in which two incisions are made (one on each side of the cheeks) to cause a small sinking and give a dimple-like finish when smiling.

How is dimpleplasty performed?

Dimplepasty is the surgical intervention that consists of crossing the skin, mucosa and zygomatic muscle and then extracting a tiny portion of fat and muscle to create the dimple. After this, a suture is performed from side to side tightening the skin on the muscle, so that smiling will be visualized as a depression in the cheeks. So, in short, dimple surgery consists of producing an adhesion in the tissue.

Type of anesthesia in dimpleplasty

It is a procedure that is performed under local anesthesia and on an outpatient basis, so it is possible to go home once the surgery is over. Dimpleplasty requires a very delicate technique, so like any other surgery, it should only be performed by a professional specialized in plastic surgery.

Recovery after dimpleplasty

As for the recovery, it is very simple, since only a slight inflammation will be experienced that can be controlled with the application of cold compresses, while the sutures must be taken care of with adequate oral hygiene and soft diet. On the other hand, from the second or third day it is possible to resume routine activities.

What are the risks of dimpleplasty?

As in any medical procedure and in this case, aesthetic, it is necessary to know the risks and / or complications that may occur, and although dimplepasty consists of a simple technique, it also requires the care of several details to guarantee a natural, satisfactory and safe result.

The first thing you should know is that when there is an adhesion or what is the same, a scar, this can become a fibrosis or fade over time, so asymmetries could occur between the dimples, since one side could be very pronounced and another not. Similarly, depending on the healing process that occurs, the result can be more satisfactory than another.

Another risk that dimpleplasty entails is the possibility of hurting the Stenon duct, since it is the channel through which the parotid gland secretes saliva and this could cause alterations in the production and distribution of it, with the consequent dry mouth and infections.

Other problems associated with surgery may include:

• Be visible continuously: usually the dimples are shown when smiling, so a natural result would be that these are only marked when the person smiles, however, it may happen that due to the incorrect tension or the scar that is formed, the dimples are marked all the time, giving the appearance of something artificial.
• Pain: being an area with a lot of mucous it is common for tissue regeneration to be slower, so if you do not have the proper care, a very painful infection can originate.
• Alteration of facial expression: it is a surgery that modifies the facial contour so if the expected results are not obtained, it is possible to end up with asymmetrical and disproportionate features.
• Damage to the facial nerve

It is important to note that although there are risks, it is very rare for them to occur. However, precautions must be taken to ensure the desired results. As always we recommend that you go to a specialist if you decide to perform this type of surgery.

A hair transplant helps give you your hair back. The hair is taken from the neck and then put on the head, eyebrows or on the cheeks as a beard. Thus, you can get the look that you want. The transplant is a relatively expensive treatment, but in return you will enjoy it for the rest of your life.

Losing hair or not having hair on your head, missing eyebrows, or not being able to grow a beard can be very stigmatizing in our society. A society where you are largely judged on how you look – and where your appearance will have a great impact on your self-esteem.

Therefore, if you have begun to lose your hair or you lack hair on your face for some other reason, it will be natural that you try to replace it. The most pervasive, but also most durable method for it, is a hair transplant. In this case, hair will be moved from the neck or sides of your head to the place where you have begun to lose it.

The hair is not affected by the hormones that made you lose hair there in the first place. So you can be sure that you will keep your hair once you have it transplanted.

Who can get a hair transplant?

There are no limits to who has the right to want a hair transplant. It can be both for you who have been unlucky to lose some hair already at an early age, or you who have only lost it later on.

Either way, it can be a great loss if you suddenly lose your hair, as for many it is a big part of the identity. So, whether you are 18 or 55, there is the possibility of getting a transplant if you are upset about the hair loss. It is not a surgical procedure, and therefore there are not so many rules in relation to who can get a transplant.

However, there are a number of groups that are not allowed to. These are:

• Diabetic patients
• Epilepsy patients
• People with outbreaks of psoreasis

In addition, you must have written approval from your general practitioner if you suffer from cardiovascular diseases. In order to get the hair transplant, you must not take blood thinners for three days before and two days after the transplant. Your doctor must approve that you can.

If you have lost your hair due to cancer, it will be natural that you would like to have your old look again. But it can’t happen until a year after you’ve completed chemotherapy. In many cases, as a cancer patient, you also need to come up with a doctor’s note if you want a hair transplant.

Hair transplants are both for men and women

In relation to getting a hair transplant, it doesn’t matter if you are a man or a woman. Both sexes have the opportunity to get a transplant and thus get their old appearance back.

For many women, losing hair can almost be even more stigmatizing than for men. After all, it is not something that women do normally, and it can therefore be difficult to live without. Therefore, it is also a really nice opportunity for you that you as a woman have the opportunity to have hair transplanted.

How is a hair transplant performed?

There are generally two different methods of transplanting hair. They are called FUE and FUT or STRIP method. Both have its pros and cons, and therefore it is an individual choice which one will suit you best.

The difference between the two methods lies solely in how the hair is removed from your head and prepared for transplantation. There is no difference in how it is inserted into the scalp in the new place.

FUE hair transplant (The best method)

With FUE hair transplantation, the individual hair folle groups are taken out of your neck. The hairs are taken apart and then placed on your head. The big advantage of it is that you don’t get scar tissue from it, which is a huge advantage over the FUT method. Thus, it takes much less time for you to heal after such a transplant compared to the other.

The method also provides an opportunity to take finer hair and use for, for example, eyebrows, if you need a transplant there.

FUT/STRIP Hair Transplant (Cheaper Alternative)

The FUT/ STRIP method is done by cutting a piece of your scalp in the neck of about 20 x 2 cm. From pieces, the hair groups are removed under a microscope and then inserted into the head. The advantage of this is that it is possible to get hold of far more viable hairs than is possible with FUE.

However, the wound that is left on the scalp takes time to heal and you are going to get a scar afterwards. Therefore, FUE is clearly the most gentle method. With FUT/STRIP, you should expect that 2-3 days pass after the procedure, where your scalp hurts outright, a week when it is sore, and 6-10 weeks when you feel that the skin tightens.

Despite that, FUT/STRIP is still the most popular way to get hair transplants. This is due solely to the price. The treatment can typically be obtained for about half of what a FUE treatment costs.

How long does a hair transplant take?

How long a hair transplant lasts depends on which method you choose. The FUE method takes much longer than FUT/STRIP. This is because it takes much longer to move the hairs individually. If you need to cover a large area of hair, it may therefore require that you get several treatments.

At the same time, however, your skin should not heal when you get a FUE hair transplant. You can therefore get the treatments close to each other. If you need several treatments with the FUT method, wait a year. Otherwise, you may have problems with the scar tissue due to the previous treatment.

The time after a hair transplant

After a hair transplant, it’s also important that you take care of your new hair. In doing so, it can get the best start in life on another part of your head, and you can curb side effects like swelling and infections.

You do this primarily by sleeping with your head raised in the days after the hair transplant. In this way, fluid will not accumulate in the head as much, and you can therefore avoid swelling, which is a relatively normal side effect.

Do I feel pain after treatment?

Depending on the treatment you get, you may well be in pain afterwards. A FUE treatment will hardly be noticeable afterwards, but with a FUT treatment you will be able to feel for six to ten weeks after you have had some skin removed in the neck.

In the first two days you may be in direct pain, then you will be sore for about a week, and in the end you will just be able to feel the procedure as a tightening of the skin.

These things to avoid after a hair transplant

To counteract infections after a hair transplant, it’s important that you make sure to wash your hands before touching your new hair. In general, the hair is very sensitive in the first two weeks after. Therefore, you should also refrain from washing it in the first two days after transplantation.

In addition, it is important that you stay away from alcohol, vitamin pills, headache pills and sleeping pills that can affect the hair.

You should also avoid playing sports in the days right after the transplant. All kinds of activities that form sweat on the scalp, you should completely avoid. To protect your scalp and new hair, you should also not expose it to sunlight for three weeks after the transplant.

When does hair usually grow after a hair transplant?

It takes between three to six months before the hair starts to grow after a hair transplant. It is therefore something that is going to take some time and require some patience. Only after between 9-12 months will you really start to see the result of your hair transplant.

It is quite normal that at some point you lose the hair that you have had transplanted. It typically happens after two to eight weeks. It’s called a shock loss and isn’t something that you should be upset about. Although, understandably, it can be difficult.

The loss of hair is due to the fact that your hair goes into hibernation. Then it will slowly begin to grow again, and you will after some time get the hair splendor that you dream of.

Ear reconstruction consists of a surgery that is performed in the pavilion of the ear with the purpose of recovering the conventional shape when it suffers from a defect either congenital or pathological (birth deformities) or traumatic injuries.

Ear reconstruction is considered a variant of otoplasty and usually demands a high level of expertise from the surgeon. Usually, the ears are not included in the general aesthetic lines, but a deformation in it can generate self-rejection and low self-esteem to those who suffer from the problem.

The main reasons that are causing a reconstruction are:

• For acquired deformities.
• Auricular trauma.

However, the main cause of ear reconstruction is microtia, when a child has microtia there are 3 possible options:

1. Do not do treatment and leave the ear as it is, although then the ear canal will not open to improve hearing.
2. Surgical reconstruction with own tissues.
3. Prosthetic reconstruction.

Microtia means small ear and can affect one or both ears, in case of being bilateral the risk of hearing loss is very high consists of a congenital lesion that can occur approximately in 10000 born.

Ear reconstruction surgery can greatly solve the hearing problem generated by this defect that usually has three levels of severity.

HOW THE PROCESS OF PERFORMING AN EAR RECONSTRUCTION?

First of all, it is necessary to carry out an assessment on the part of the specialist to the patient:

The specialist should perform an examination of the head and neck. In this study, the following factors are taken into account:

• Facial asymmetry
• Malocclusion
• And other studies of creneofacial microsomia.

The main purpose in an ear reconstruction surgery is to be able to achieve symmetry and for this an estimate of what should be the position and size of the contralateral ear must be made.

Before surgery it is essential that the surgeon develops a preoperative project where he studies what are the elements that will be needed to achieve the results.

In case of prosthesis: the surgeon forms a silicone mold as an exact copy of the other ear, in case the injury is bilateral the mold is made taking as a guide a relative of a similar age and then the area is marked to place the graft.

STEPS OR STAGES THAT ARE CARRIED OUT IN AN EAR RECONSTRUCTION

First stage: In case of not using prostheses, the first thing that is done is to obtain healthy cartilage from the ribs and then insert the prepared cartilage into a pocket of skin under the deformed or damaged ear.

Second stage: The new lobe is created. This outpatient surgery takes about an hour and the sutures are removed a week after the operation.

Third stage: The ear that has been formed (the cartilage frame and lobe) is lifted from the side of the head and then a skin graft is applied to the bottom of the ear.

Fourth stage: The specialist creates an opening in the shell (to make it look like a natural ear canal) and works to achieve symmetry and balance in the contours of the ear.

RECOVERY

Postoperative care is essential for optimal results.

It is very important that after each stage of reconstruction the practice of sports is avoided for about a month, in addition you must be very attentive to the progress of the recovery from surgery to monitor the presence of any side effects.