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Cosmetic surgery procedures at a glance
Tuesday, December 29, 1998 Pittsburgh Post-Gazette
Procedure: Flattens abdomen by removing excess fat and skin and tightening muscles of abdominal wall.
Length: Two to five hours. Inpatient or outpatient procedure. General anesthesia or local anesthesia with sedation.
Side effects: Temporary pain. Swelling, soreness, numbness of abdominal skin, bruising, tiredness for several weeks or months.
Risks: Blood clots. Infection. Bleeding under the skin flap. Poor healing resulting in conspicuous scarring or skin loss. Need for a second operation.
Recovery: Back to work: two to four weeks. More strenuous activity: four to six weeks or more. Fading and flattening of scars: three months to two years.
Average cost: $4,050
Procedure: Enhances the size of breasts using inflatable implants filled with saline.
Length: One to two hours. Usually outpatient. Local anesthesia with sedation or general anesthesia.
Side effects: Temporary soreness, swelling, change in nipple sensation, bruising.
Risks: Lack of implant permanence - surgical removal or replacement of the implants may be required to treat problems, including deflation; the formation of scar tissue around the implant, which may cause the breast to feel tight or hard; bleeding or infection. Increase or decrease in sensitivity of nipples or breast skin, occasionally permanent. Mammagraphy requires a special technique. (Note: Some women have reported symptoms similar to those of immune disorders. Ask your doctor about these and other FDA concerns.)
Recovery: Back to work: a few days. Physical contact with breasts: three to four weeks. Fading of scars: Several months to a year or more. Implants may require removal or replacement.
Average cost: $2,909
Procedure: Raises and reshapes sagging breasts by removing excess skin and repositioning tissue and nipples.
Length: One to three hours. Local anesthesia with sedation or general anesthesia. Inpatient or outpatient.
Side effects: Temporary bruising, swelling, discomfort, numbness, dry breast skin. Permanent scars.
Risks: Thick, wide scars, skin loss, infection. Unevenly positioned nipples. Permanent loss of feeling in nipples or breast.
Recovery: Back to work: one week or more. Strenuous activities: one month. Fading of scars: several months to a year. Gravity, pregnancy, aging and weight changes may cause new sagging.
Average cost: $3,480
Procedure: Restores wrinkled, blemished, unevenly pigmented or sun-damaged facial skin, using a chemical solution made of phenol or trichloroacetic acid to peel away skin's top layers. Works best on fair, thin skin with superficial wrinkles.
Length: One to two hours for full face. No anesthesia; just sedation & EKG monitoring may be used. Usually outpatient. Full-face phenol peel may require admission for one to two days.
Side effects: With both solutions: Temporary throbbing, tingling, swelling, redness, acute sensitivity to sun. With phenol: Permanent lightening of treated skin; permanent loss of ability to tan.
Risks: With both solutions: Tiny whiteheads (temporary); infection, scarring; flare-up of skin allergies, fever blisters, cold sores. With phenol: Abnormal color changes (permanent); heart irregularities (rare).
Recovery: With phenol: Formation of new skin: seven to 21 days. Normal activities: two to four weeks. Full healing and fading of redness: three to six months. With TCA: New skin within five to 10 days. Phenol provides permanent results; TCA results are variable.
Average cost: $1,565.
Procedure: Plumps up creased, furrowed, or sunken facial skin, adds fullness to lips and backs of hands. Works best on thin, dry, light-colored skin.
Length: Fifteen minutes to one hour per session. Usually no anesthesia with collagen; fat uses local. Outpatient.
Side effects: Temporary stinging, throbbing or burning sensation. Faint redness, swelling, excess fullness.
Risks: With collagen: Allergic reaction including rash, hives, swelling or flu-like symptoms; possible triggering of connective-tissue or autoimmune diseases. With both: Contour irregularities, infection. Results last a few months to 1 year.
Average costs: For collagen, $312 per injection; for fat, ranges from $791 to $987, depending on part of body involved.
Procedure: Mechanical scraping of the top layers of skin using a high-speed rotary wheel. Softens sharp edges of surface irregularities, including acne and other scars and fine wrinkles, especially around the mouth.
Length: A few minutes to 1 hour. May require more than 1 session. Local anesthesia, numbing spray, or general anesthesia. Usually outpatient.
Side effects: Temporary tingling, burning, itching, swelling, redness. Lightening of treated skin. Acute sensitivity to sun, loss of ability to make pigment (tan).
Risks: Abnormal color changes (permanent). Tiny whiteheads (temporary), infection, scarring, flare-up of skin allergies, fever blisters, cold sores.
Recovery: Back to work: Two weeks. More strenuous activities: Four to six weeks. Fading of redness: about three months. Return of pigmentation/sun exposure: six to 12 months. Results permanent.
Average cost: $1,581
Procedure: Sets prominent ears back closer to the head, or reduces the size of large ears. Most often done on children between the ages of 4 and 14 years. (Occasionally covered by insurance.)
Length: Two to three hours. Young children usually require general anesthesia; older children or adults may need general anesthesia or local with sedation. Usually outpatient.
Side effects: Temporary throbbing, aching, swelling, redness, numbness.
Risks: Infection of cartilage. Excessive scarring. Blood clot that may need to be drained. Mismatched or artificial-looking ears. Recurrence of the protrusion, requiring repeat surgery.
Recovery: Back to work or school: five to seven days. Strenuous activity, contact sports: one to two months. Results usually permanent.
Average cost: Not available.
Procedure: Corrects drooping upper eyelids and puffy bags below the eyes by removing excess fat, skin, and muscle. (Upper-eyelid surgery may be covered by insurance if used to correct visual field defects.)
Length: One to three hours. Local anesthesia with sedation or general anesthesia. Usually outpatient.
Side effects: Temporary discomfort, tightness of lids, swelling, bruising. Temporary dryness, burning, itching of eyes. Excessive tearing, sensitivity to light for first weeks.
Risks: Temporary blurred or double vision, infection, bleeding. Swelling at the corners of the eyelids. Dry eyes. Formation of whiteheads. Slight asymmetry in healing or scarring. Difficulty in closing eyes completely (rarely permanent). Pulling down of the lower lids (may require further surgery). Blindness (extremely rare).
Recovery: Reading: Two or three days. Back to work: seven to 10 days. Contact lenses: two weeks or more. Strenuous activities, alcohol consumption: about three weeks. Bruising and swelling gone: several weeks. Duration of results: Several years. Sometimes permanent.
Average cost: $1,664
Procedure: Improves sagging facial skin, jowls and loose neck skin by removing excess fat, tightening muscles, redraping skin. Most often done on men and women over 40.
Length: Several hours. Local anesthesia with sedation, or general anesthesia. Usually outpatient. Some patients may require short inpatient stay.
Side effects: Temporary bruising, swelling, numbness and tenderness of skin; tight feeling, dry skin. For men, permanent need to shave behind ears, where beard-growing skin is repositioned.
Risks: Injury to the nerves that control facial muscles or feeling (usually temporary but may be permanent). Infection, bleeding. Poor healing, excessive scarring. Asymmetry or change in hairline.
Recovery: Back to work: 10 to 14 days. More strenuous activity:two weeks or more. Bruising: two to three weeks. Must limit exposure to sun for several months. Duration of results: Usually five to 10 years.
Average cost: $4,783
Procedure: Changes the basic shape and balance of the face using carefully shaped implants to build up a receding chin, add prominence to cheekbones, or reshape the jawline.
Length: Thirty minutes to two hours. Local anesthesia with sedation or general anesthesia. Usually outpatient. Occasional overnight hospital stay.
Side effects: Temporary discomfort, swelling, bruising, numbness and/or stiffness. In jaw surgery, inability to open mouth fully for several weeks.
Risks: Shifting or imprecise positioning of implant, or infection around it, requiring a second operation or removal, excess tightening and hardening of scar tissue around an artificial implant ("capsular contracture"), causing unnatural shape.
Recovery: Back to work: about one week. Normal appearance: two to four weeks. Activity that could jar or bump face: six weeks or more. Results permanent.
Average cost: cheek augmentation: $2,083
Procedure: Minimizes forehead creases, drooping eyebrows, hooding over eyes, furrowed forehead and frown lines by removing excess tissue, altering muscles and tightening the forehead skin. Most often done on people over 40.
Length: One to two hours. Local anesthesia with sedation or general anesthesia. Usually outpatient.
Side effects: Temporary swelling, numbness, headaches, bruising. Traditional method: possible itching and hair loss.
Risks: Injury to facial nerve causing loss of motion, muscle weakness or asymmetrical look, infection, broad or excessive scarring.
Recovery: Back to work: seven to 10 days.More strenuous activity: several weeks. Full recovery from bruising: two to three weeks. Patients must limit sun exposure for several months. Results last usually five to 10 years.
Average cost: $2,429
Procedure: Fills in balding areas with a patient's own hair using a variety of techniques including scalp reduction, tissue expansion, strip grafts, scalp flaps, or clusters of punch grafts (plugs, miniplugs and microplugs).
Length: One to three hours. Some techniques may require multiple procedures over 18 months or more. Usually local anesthesia with sedation. Flaps and tissue expansion may be done with general anesthesia. Usually outpatient.
Side effects: Temporary achy, tight scalp; unnatural look in early stages.
Risks: Unnatural look, infection, excessive scarring, failure to "take," loss of scalp tissue and/or transplanted hair.
Recovery: Back to work: usually two to five days. More strenuous activities: 10 days to three weeks. Final look: may take 18 months or more, depending on procedure. Permanent results
Average costs: Plug grafts - fee per plug, $745; strip grafts - fee per strip, $1,424; Scalp reduction, $2,616.
Procedure: Smooths the face and fine wrinkles using a carbon dioxide laser that treats layers of damaged skin. Softens lines around the eyes and mouth and minimizes facial scars and unevenly pigmented areas.
Length: A few minutes to one hour. May require more than one session. Local anesthesia with sedation, or general. Usually outpatient.
Side effects: Temporary swelling, discomfort, lightening of treated skin, acute sun sensitivity, increased sensitivity to makeup, pinkness or redness in skin that may persist for up to six months.
Risks: Burns or injuries caused by laser heat, scarring, abnormal changes in skin color.
Recovery: Back to work: two weeks. More strenuous activities: four to six weeks. Complete fading of redness: six months or less. Return of pigmentation/light sun exposure: six to 12 months. Results long-lasting, but does not stop aging.
Average cost: Full face, $2,719
Procedure: Improves body shape by removing exercise-resistant fat deposits with a tube and vacuum device. Can be performed using the tumescent technique, in which targeted fat cells are infused with saline containing a local anesthetic before liposuction to reduce post-operative bruising and swelling. Common locations include chin, cheeks, neck, upper arms, above breasts, abdomen, buttocks, hips, thighs, knees, calves, ankles. For larger volumes of fat or for fibrous body areas, ultrasound-assisted lipoplasty (UAL) may be used, in which an ultrasound probe is inserted beneath the skin to "liquefy" the fat before it is suctioned.
Length: One to two hours or more. UAL: 20 percent to 40 percent longer than traditional liposuction. Local, epidural, or general anesthesia. Usually outpatient.
Side effects: Temporary bruising, swelling, numbness, soreness, burning sensation. With tumescent: temporary fluid drainage from incision. With UAL: larger incisions.
Risks: Asymmetry, rippling or bagginess of skin, pigmentation changes, skin injury, fluid retention, excessive fluid loss leading to shock, infection. With UAL: thermal burn injury caused by ultrasound device.
Recovery: Back to work: one to two weeks. More strenuous activity two to four weeks. Full recovery from swelling and bruising: one to six months or more. Use of tumescent technique or UAL may decrease post-operative bruising and swelling. Results permanent with sensible diet and exercise.
Average cost: For single site: $1,842
Procedure: Reduces enlarged, female-like breast in men using liposuction and/or cutting out excess glandular tissue. (Sometimes covered by medical insurance.)
Length: One hour or more. General or local anesthesia. Usually outpatient.
Side effects: Temporary bruising, swelling, numbness, soreness, burning sensation.
Risks: Infection, fluid accumulation, injury to the skin, rippling or bagginess of skin, asymmetry, pigmentation changes (may become permanent if exposed to sun). Excessive scarring if tissue was cut away.
Recovery: Back to work: three to seven days. More strenuous activity: two to three weeks. Swelling and bruising: three to six months. Results permanent.
Average cost: $2,513.
Procedure: Reshapes nose by reducing or increasing size between nose and upper lip. May also relieve some breathing problems. (May be covered by insurance.)
Length: One to two hours or more. Local anesthesia with sedation or general anesthesia. Usually outpatient.
Side effects: Temporary swelling, bruising around eyes, nose and headaches. Some bleeding and stiffness.
Risks: Infection; small burst blood vessels resulting in tiny, permanent red spots; incomplete improvement, requiring additional surgery.
Recovery: Back to work: one to two weeks. More strenuous activities: two to three weeks. Avoid hitting nose or sunburn: eight weeks. Final appearance:one year or more. Results permanent.
Average cost: $3,428.
Costs listed are 1997 national averages of surgeons' standard fees. Fees can vary widely, based on procedures and part of the country where done.
Source: American Society of Plasticand Reconstructive Surgeons.
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