Overview

The goal of cosmetic surgery is to improve a person's appearance, self-esteem and self-confidence. Cosmetic surgery can be performed on any part of the face and body.

Why it's done

Because cosmetic surgery can bring lasting and dramatic changes to your outside appearance, it is important to understand how these changes might affect you on the inside. Before making an appointment to see a cosmetic surgeon, consider your motives for wanting to change how you look.

Many physical characteristics can be successfully changed through cosmetic surgery; others cannot. Good candidates for cosmetic surgery:

• Have realistic expectations about what can be accomplished
• Understand the medical risks, physical effects during healing, how the surgery will affect them personally and professionally, what lifestyle changes may accompany the recovery period, and the expenses involved
• Have chronic medical conditions under control
• Have no history of smoking or commit to abstain from smoking and nicotine products, including chewing tobacco and nicotine patches, gums, or lozenges for four to six weeks before and after surgery
• Have had a stable weight for six to 12 months, for certain procedures

Risks

All surgeries, including cosmetic procedures, carry risk. If your body mass index is 30 or higher (obesity) or you have diabetes, you might be at higher risk of developing complications such as blood clots in the legs or lungs. Smoking also increases risks and interferes with healing.

You'll meet with your surgeon to discuss these risks and others related to your health history.

Possible complications for any surgical procedure include:

• Complications related to anesthesia, including pneumonia, blood clots and, rarely, death
• Infection at the incision site, which may worsen scarring and require additional surgery
• Fluid buildup under the skin
• Mild bleeding, which may require another surgical procedure, or bleeding significant enough to require a transfusion
• Abnormal scarring due to skin breakdown
• Separation of the surgical wound, which sometimes requires additional procedures
• Numbness and tingling from nerve damage, which may be permanent

How you prepare

Questions to consider before pursuing cosmetic surgery:

• What are my motives for wanting to change how I look?
• What are the specific parts of my appearance that I want to change?
• Do I have realistic expectations about the results of the surgery?
• What aspects of my life will be affected, such as family, work, travel and social obligations?
• Is this a good time in my life to have cosmetic surgery?
• Have I talked about my concerns and questions openly with my doctor?

Questions to ask the cosmetic surgeon:

It is a good idea to bring a notepad to write down answers.

• What are your qualifications?
• How long have you been board-certified?
• How many procedures have you done similar to the one I'm considering?
• What other health care professionals will be involved in my care?
• What results can I expect?
• Will I need a physical examination prior to surgery?
• Are there risks unique to my health history?

Questions to ask about a procedure:

• What does the procedure do? What does it not do?
• Is this the right treatment for me? Are there other procedures I should consider?
• What are the risks and complications associated with this procedure?
• How long is the recovery period?
• Can I expect much discomfort? What are my pain management options?
• Will I have any scars and if yes, what will they look like?
• If my procedure requires stitches, when will they be removed?
• What kind of activity restrictions will I have following surgery?
• How long before I can go back to my regular routine?
• How long before I see the final results of my surgery?
• How long will the results last?
• How much does the procedure cost?

What you can expect

It's important to have a clear understanding of what will happen before, during and after the procedure, and what results to expect. Many physical characteristics can be successfully changed, while others cannot. The more realistic your expectations, the more likely you will be satisfied with the results.

Before the procedure

Your surgeon will explain how cosmetic surgery can change your body and what you can expect as a result. This is an opportunity for you to explain what you hope to achieve with surgery. Understanding the options and possible outcomes will help you make the best decision.

You will be informed about specific procedures, what to expect, the benefits, risks and possible complications, as well as other alternatives. The doctor might recommend additional procedures to enhance your overall result.

The concept of asymmetry will be explained. The human body is asymmetric, meaning one side of the body looks naturally different from the other. Consider the image reflected in the mirror — a photographic image is a true image, the opposite of the mirror image. The surgeon helps patients understand this so they can fully appreciate their true appearance and how this may change with cosmetic surgery.

The surgeon also will explain the concept of balance — how changing one part of the body may affect overall appearance and how additional surgical procedures may bring greater balance.

Nurse review

You will also meet with a nurse, who reviews general questions about health, current medications — including aspirin, vitamin E, over-the-counter medications and supplements — and lifestyle issues, such as smoking history.

The nurse will review what you can expect following surgery, including pain, medications, diet, activity and work restrictions, and details such as the need to arrange for a ride home following the procedure.

By listening and following instructions from the surgeon and health care team, you can minimize the risks and complications of surgery.

Consent form

You'll likely be asked to sign a consent form so that photographs can be taken before and after surgery. Photographs serve as a reference for the surgeon during the procedure and become a part of your medical record.

Estimate of costs

You'll be given an estimate of surgical fees. Insurance typically doesn't cover cosmetic surgery procedures. Payment is generally required before surgery.

Preoperative examination

You might be scheduled for a preoperative examination to check your general health prior to surgery.

During the procedure

Cosmetic surgery procedures requiring general anesthesia or IV (intravenous) sedation are performed in the hospital under the care of an anesthesiologist/nurse anesthetist team. Other procedures, such as injections of facial fillers, may be performed in an outpatient setting or physician's office under local anesthesia. Prior to surgery, you will see the surgeon (or a member of your health care team) one more time to answer any remaining questions.

After the procedure

Prior to outpatient surgery or before discharge from the hospital, you will receive:

• Instructions for post-surgical care specific to your procedure
• Medication instructions and prescriptions, such as for pain medications and antibiotics
• Contact information if you have questions

Results

Despite being informed and prepared, you might be surprised by the bruising and swelling that follow cosmetic surgery and how long they last. Bruising might take a minimum of three weeks to lessen; swelling might take even longer.

You might experience a brief period of "the blues" or low spirits during recovery. Prematurely judging the results of your surgery or waiting to return to normal activities may contribute to feelings of disappointment and frustration.

Realistic expectations are key — the goal is improvement, not perfection. Each person will have a different result. Keep in mind that:

• Bruising and swelling are temporary. Surgical scars are permanent.
• Recovery times vary by person and procedure, but a minimum of six to 12 weeks is typical for many cosmetic surgeries.
• Follow-up surgeries may be needed to achieve your goals.