Plastic Surgery Surprises

May 10, 2017

When most people think about plastic surgery, they imagine the transformative end result. But there is a lot that happens before the final reveal—including scarring, bloating, and bruising—that may surprise you. There are also many misconceptions about what is possible with plastic surgery. So that you’re not caught off guard, Sidhbh Gallagher, M.D., a plastic surgeon at Indiana University Health, sheds light on what you might expect from these plastic surgery situations.

Surprise: After liposuction, the fat may come back in other places

When surgeons perform liposuction, they extract fat cells from a particular area (or areas) of the body so that fat can no longer be stored there. “After liposuction, the fat cells are gone in that region, so it’s basically a permanent solution,” says Dr. Gallagher. What people may not realize, however, is that if they gain weight after liposuction, the fat cells in other parts of the body will expand even more. “You have a finite number of fat cells, so if you put on weight after liposuction, the fat has to go elsewhere,” she adds.

Surprise: Your body may heal a scar better than surgery would

Before rushing to a plastic surgeon to fix a scar, wait at least a year after its appearance. “With any scar—whether it’s the result of surgery or trauma—it typically evolves and improves over the course of a year until healing plateaus,” says Dr. Gallagher. “We spend a lot of time reassuring patients that their own body will do a better job of healing the scar than any surgery. After a year, if the scar is still a problem, we can consider surgery.”

Surprise: Fillers and injectables may be more effective than a facelift

“People are often surprised to hear that the combination of fillers and injectables can be more powerful than a facelift—and the combo can certainly be more appropriate for younger patients,” says Dr. Gallagher. Two of the markers of aging are a loss of volume and lines around the face. Fillers add volume and Botox helps eliminate facial creases. The solution is not everlasting (Botox lasts for about three months while fillers last for six to 18 months) but the procedure is much less invasive than a full facelift and requires much less recovery time.

Surprise: Expect to look like you’ve gained weight right after liposuction

“We tell patients to disregard the scale for several weeks immediately after liposuction because they will bloat everywhere after surgery,” explains Dr. Gallagher. “Patients are always disappointed at first, but the surgery is a trauma so the body responds by retaining water.” What’s more, patients will have bruising for at least one month and they may experience numbness or soreness for up to six months post surgery. “Patients should not expect to see their final result for three to six months,” she adds.

Surprise: A facelift is not forever

While a facelift is an extensive procedure, it won’t stop time. The skin on your face will gradually continue to age, lose volume, and sag after the surgery. “We think facelifts last between 10 and 20 years,” says Dr. Gallagher. This means that if you go under the knife too early in life, you may find you need a second facelift several years down the road.

Surprise: A bright pink scar is better than you think

“The less pigment in your skin, the better the scar healing,” says Dr. Gallagher. “People with pale skin tend to have bright pink scars that look dramatic but plastic surgeons know that bright pink scars tend to heal well.”

Surprise: Buttock implants are often poorly tolerated and rarely used

“People think that buttock implants are the norm but the truth is that they are rarely tolerated. The better result comes from using a patient’s fat from another part of the body—usually by contouring the lower back and abdomen—and putting it into the buttocks,” says Dr. Gallagher. “We used to think if we injected a patient’s own fat, the fat cells would die but now we know that 50 to 80 percent of the fat cells will stay.”

Surprise: Scar creams aren’t going to help

“Patients are always asking about topical treatments to improve the appearance of scars, but there is very little evidence that any of those products work in minimizing scars,” says Dr. Gallagher. “What we do know is that sunscreen is essential for protecting wounds and reducing scaring.” Dr. Gallagher does suggest massaging scars to improve healing and tissue elasticity. But wait for the wound to fully heal before massaging the area.

-- Rachel Rabkin Peachman

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