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Types of Plastic Surgeries and why people opt for these
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What are the different types of Plastic Surgeries and why people opt for these

We have classified the types of Plastic Surgeries into easily understandable groups, so that we can understand why people are opting for these. These groups are-

1) Antiaging and other procedures for face

The most common procedures are liquid face lift, blepharoplasty, liposuction or injection, thread lift, surgical face lift, hair transplants to improve receding hair lines, forehead lift, brow lift, neck lift and correction of double chin. Liquid face lift consists of fillers and botox. Nowadays, most fillers contain Hyaluronic Acid, which is present naturally in tissues and hence, safe. These are used to correct signs of aging such as under eye hollows, cheek depressions, nasolabial folds, marionette lines etc. Botox is used to get rid of vertical and horizontal lines on forehead and crow’s feet lines around the eyes. Procedures such as rhinoplasty (correction of deviated/ hump/ broad/ flat nose), cheek dimple creation, corrective jaw surgery, genioplasty (chin correction), use of facial implants and bone grafts, are often done as adjunctive procedures to further enhance the looks. People opting for antiaging procedures are typically in late thirties to fifties. They opt for these procedures, to reverse the signs of aging and appear younger. People opting for rhinoplasty are usually in late teens and thirties. The usual complaints are a hump on dorsum of nose, broad nose or tip, deviation of nose etc.
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2) Procedures for hair restoration

As we age, hairline recedes and there is general thinning of hair. In males, there may be male pattern baldness in which hair are lost at font and vertex, while those at sides and back are retained. In females, though the frontal and temporal hairline is maintained, there is a generalized thinning. Follicular Hair Grafting with strip method (FUG) or Follicular Unit Extraction (FUE) can fill in the bald areas, resulting in significant improvement. It is a daycare procedure and is done under local anaesthesia. For generalized thinning and female pattern baldness, a recent procedure is Platelet Rich Plasma Injection (PRP). In this procedure, around 10mls of blood is taken and processed in blood bank to enrich platelets to around 5 times of normal concentration. Platelets are small cells, circulating in blood and contain a number of growth factors. These induce the hair follicles which are producing small villus hair, to produce stronger hair with thick shaft and to enter active growing phase, thus resulting in improvement. People opting for these procedures are usually in mid twenties, finishing their degree courses etc, as the hairline starts to recede at that time. These individuals also plan to get into relationships or to get married and hence, want to look at their best, by having a head full of hair.
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3) Procedures for rejuvenation of body (trunk)

Liposuction is a method, in which narrow calibre cannulae are introduced through small incisions (usually in hidden areas), into the areas of fatty deposits and fat is dislodged and removed with the help of suction. The technique was introduced in early 1980’s and has gained popularity. For several years, it has remained the most commonly performed cosmetic surgical procedure. The technique is typically used for patients, who are within 10-15% in excess of their ideal body weight, are otherwise healthy and have tried dieting and exercise. Liposuction is a body shaping technique that is often mistaken for weight reduction technique, though some weight loss invariably occurs after the procedure. Since, there is a targeted fat removal, post-operatively, the patient appears to be in much better body shape than a similar weight person, who has not had the procedure. Techniques available at FHSB are Tumescent Liposuction, Power Assisted Liposuction and VASER. One of the recent applications is ‘six pack plasty’. Whenever there is excessive body weight, combined with hanging of folds, some form of skin and fat excision is done. Sometimes, liposuction is also combined. Tummy tuck (abdominoplasty), body lift, breast lift, thigh lift etc are procedures, which are used to solve this complex problem. Implants can be used to augment buttocks, pectoral areas (chest) and calf. Buttocks can also be augmented with fat transfer (Brazilian Butt Lift). In this procedure, fat is gently harvested from other areas such as flanks, thighs, hips, abdomen, with the help of thin cannulae, via liposuction. This fat is then refined and injected into desired area with thin cannulae, via droplet technique. This can be done in most patients, except those, who are thin and hence, do not have sufficient fat for transfer. Some of these individuals are ladies, who have completed their families and wish to have a flat abdomen, without and hanging, or to get rid of fat deposits at their hips, abdomen, buttocks and thighs. Men in their thirties also opt for these procedures, so as to get the shape of their twenties back. These men are mostly concerned about pot belly and love handles (fat just above the pelvic bone on either side). Individuals who have lost a large amount of weight either naturally or after bariatric surgery are candidates for tucks and lifts.
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4) Procedures for breasts

Attainment of perky and full looking breasts is now a reality, thanks to the advances in plastic surgery. For those women who desire this, the procedure of breast augmentation makes them feel more confident and complete. The breasts are augmented with the help of cohesive silicone gel filled or saline filled implants. This is a safe procedure and does not interfere with breast feeding. For women, who have larger than normal breasts causing neck, shoulder or back pain and other symptoms, the procedure of breast reduction restores the breast to normal. The sagging and aging breasts can be corrected with breast lift (mastopexy) procedure. Women opting for breast augmentation are typically in their twenties and thirties, nearly the same age for those opt for reduction. The women who desire breast lift are usually in the age range of thirties to fifties.
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5) Male breast reduction

Enlargement of breast in a male is known as gynecomastia. Due to various factors, this is presently, a frequently occurring condition. This can be corrected by a technique, which results in nearly non visible and minimal scar. Males opting for this surgery are usually in their teens or twenties and thirties. They opt for this surgery to get rid of the obvious stigmata of a prominent breast.
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6) Genital Plastic Surgery

Liposuction of pubic area, Lipofilling of Labia, Lifting the sagging pubic area, often in combination with ‘Tummy Tuck’ can restore the female genital area to it’s youthful state. One of the recent procedures is Grafenberg (G) spot augmentation, which can help a woman reach orgasm during intercourse. Reconstruction of Hymen (Hymenoplasty/ Revirginization) and Vaginal Tightening are other commonly done procedures. Males, especially those suffering from impotence, which is refractory to non surgical methods and medicines, can be helped with penile implants.). Apparent penile length and girth can also be improved with plastic surgery procedures. Women opting for hymenoplasty are either in their teens or twenties. The usual age for group for vaginal tightening is twenties and thirties.
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7) Improvement of pre-existing scars

Scars on face and other body areas can be improved with the help of procedures such as revisions, z plasty, tissue expansion, serial excision, injection of adipose derived stem cells and prp, replacement with flap etc. These patients usually belong to either sex, though females are more common. These individuals are usually in their teens through to thirties.
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8) Surgeries of birth defects

birth defects such as cleft lip and palate, hypospadias, polydactyly, syndactyly etc can be corrected with the help of plastic surgery. Dr. Richie and team at FHSB has a special expertise in cleft lip and palate surgery, having operated hundreds of patients under the ‘Smile Train’ programme. The age group for cleft lip surgery is 3 months. Cleft palate is operated between the ages of 8 months to 18 months. Hypospadias, hand anomalies and craniofacial anomalies are usually corrected at preschool age group, some earlier.
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9) Reconstructive, Hand and Burns Surgeries

We are routinely carrying out such surgeries in a large number of patients. These include post cancer resection defects of Jaws, Breast, Post injury defects, free flap transfers, replantations, contracture release and coverage etc. These also include cases of post burn depigmentation and vitiligo. These patients belong to a diverse age group.
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10) Sex Change Surgeries

Sex and Gender are two different things. While sex relates to the outward physical appearance of the individual, Gender relates to the role that this individual wishes to play in society ie boy/man or girl/woman. Since Gender is mind/brain, it cannot be reassigned. However, sex can be changed with the help of Plastic Surgery. In most cases, Sex of an Individual is in sync with gender. However, in some cases, Sex of an individual may be male while the Gender is Female and vice versa. This condition is known as Gender Dysphoria. These individuals are known as Transsexuals. They complain of living in the wrong body, since childhood. Fortis Hospital Shalimar Bagh has a comprehensive Gender Team in place, consisting of Plastic Surgeons, Psychiatrists and Endocrinologists. 6th SOC’s as published by the then Harry Benjamin Association are used as the basis for managing the Transsexuals. Currently, FHSB is one of the leading centres in the country for this condition, treating 30-35 patients per year for medical management and sex change surgeries.
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