FAQ

Wong Plastic Surgery.

PLANNING YOUR PROCEDURE

You and your surgeon should carefully discuss your goals and expectations for this procedure. Your surgeon will explain the techniques and anesthesia he will use, the type of facility where the procedure will be performed, and the risks and costs involved.


PREPARING FOR YOUR PROCEDURE

Your surgeon will give you specific instructions on how to prepare for the procedure, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications. Carefully following these instructions will help your procedure go more smoothly.


TYPES OF ANESTHESIA

Local anesthesia: numbs the area around your eyes, along with oral or intravenous sedatives. You’ll be awake during the surgery, but relaxed and insensitive to pain.

General anesthesia: You’ll sleep through the entire operation.


When eyelid surgery is performed by a qualified plastic surgeon, complications are infrequent and usually minor. Nevertheless, there is always a possibility of complications, including infection or a reaction to the anesthesia. You can reduce your risks by closely following your surgeon’s instructions both before and after surgery.


The minor complications that occasionally follow blepharoplasty include double or blurred vision for a few days; temporary swelling at the corners of the eyelids; and a slight asymmetry in healing or scarring. Tiny whiteheads may appear after your stitches are taken out; your surgeon can remove them easily with a very fine needle.


Following surgery, some patients may have difficulty closing their eyes when they sleep; in rare cases this condition may be permanent. Another very rare complication is ectropion, a pulling down of the lower lids. In this case, taping, creams or further surgery may be required.

Breast augmentation is relatively straightforward. But as with any operation, there are risks associated with surgery and specific complications associated with this procedure. The most common problem, capsular contracture, occurs if the scar or capsule around the implant begins to tighten. This squeezing of the soft implant can cause the breast to feel hard. Capsular contracture can be treated in several ways, and sometimes requires either removal or “scoring” of the scar tissue, or perhaps removal or replacement of the implant.


As with any surgical procedure, excessive bleeding following the operation may cause some swelling and pain. If excessive bleeding continues, another operation may be needed to control the bleeding and remove the accumulated blood.


A small percentage of women develop an infection around an implant. This may occur at any time, but is most often seen within a week after surgery. In some cases, the implant may need to be removed for several months until the infection clears. A new implant can then be inserted.


Some women report that their nipples become oversensitive, under sensitive, or even numb. You may also notice small patches of numbness near your incisions. These symptoms usually disappear within time, but may be permanent in some patients.


There is no evidence that breast implants will affect fertility, pregnancy, or your ability to nurse. If, however, you have nursed a baby within the year before augmentation, you may produce milk for a few days after surgery. This may cause some discomfort, but can be treated with medication prescribed by your doctor.


Occasionally, breast implants may break or leak. Rupture can occur as a result of injury or even from the normal compression and movement of your breast and implant, causing the man-made shell to leak. If a saline-filled implant breaks, the implant will deflate in a few hours and the salt water will be harmlessly absorbed by the body.


If a break occurs in a gel-filled implant, however, one of two things may occur. If the shell breaks but the scar capsule around the implant does not, you may not detect any change. If the scar also breaks or tears, especially following extreme pressure, silicone gel may move into surrounding tissue. The gel may collect in the breast and cause a new scar to form around it, or it may migrate to another area of the body. There may be a change in the shape or firmness of the breast. Both types of breaks may require a second operation and replacement of the leaking implant. In some cases, it may not be possible to remove all of the silicone gel in the breast tissue if a rupture should occur.


A few women with breast implants have reported symptoms similar to diseases of the immune system, such as scleroderma and other arthritis-like conditions. These symptoms may include joint pain or swelling, fever, fatigue, or breast pain. Research has found no clear link between silicone breast implants and the symptoms of what doctors refer to as “connective-tissue disorders,” but the FDA has requested further study.


While there is no evidence that breast implants cause breast cancer, they may change the way mammography is done to detect cancer. When you request a routine mammogram, be sure to go to a radiology center where technicians are experienced in the special techniques required to get a reliable x-ray of a breast with an implant. Additional views will be required. Ultrasound examinations may be of benefit in some women with implants to detect breast lumps or to evaluate the implant.


While the majority of women do not experience these complications, you should discuss each of them with your physician to make sure you understand the risks and consequences of breast augmentation.

Side effects may include temporary bruising, swelling, discomfort, numbness, dry breast skin. Permanent scars may also be formed. Risks involve thick, wide scars, skin loss, infection, unevenly positioned nipples and even permanent loss of feeling in nipples or breast.

Side effects may include temporary bruising, swelling, numbness, soreness, burning sensation. Risks may involve 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. There may be a need for second procedure to remove additional tissue.

Liposuction is normally safe, as long as patients are carefully selected, the operating facility is properly equipped and the physician is adequately trained. As a minimum, your surgeon should have basic (core) accredited surgical training with special training in body contouring. Also, even though many body-contouring procedures are performed outside the hospital setting, be certain that your surgeon has been granted privileges to perform liposuction at an accredited hospital.


Your doctor must have advanced surgical skills to perform procedures that involve the removal of a large amount of fat (more than 5 liters or 5,000 cc); ask your doctor about his or her other patients who have had similar procedures and what their results were. Also, more extensive liposuction procedures require attentive after-care. Find out how your surgeon plans to monitor your condition closely after the procedure.


However, it’s important to keep in mind that even though a well-trained surgeon and a state-of-the art facility can improve your chance of having a good result, there are no guarantees. Though they are rare, complications can and do occur. Risks increase if a greater number of areas are treated at the same time, or if the operative sites are larger in size. Removal of a large amount of fat and fluid may require longer operating times than may be required for smaller operations.


The combination of these factors can create greater hazards for infection; delays in healing; the formation of fat clots or blood clots, which may migrate to the lungs and cause death; excessive fluid loss, which can lead to shock or fluid accumulation that must be drained; friction burns or other damage to the skin or nerves or perforation injury to the vital organs; and unfavorable drug reactions.


There are also points to consider with the newer techniques. For example, in UAL, the heat from the ultrasound device used to liquefy the fat cells may cause injury to the skin or deeper tissues. Also, you should be aware that even though UAL has been performed successfully on several thousand people worldwide, the long-term effects of ultrasound energy on the body are not yet known.


In the tumescent and super-wet techniques, the anesthetic fluid that is injected may cause lidocaine toxicity (if the solution’s lidocaine content is too high), or the collection of fluid in the lungs (if too much fluid is administered).


The scars from liposuction are small and strategically placed to be hidden from view. However, imperfections in the final appearance are not uncommon after lipoplasty. The skin surface may be irregular, asymmetric or even “baggy,” especially in the older patient. Numbness and pigmentation changes may occur. Sometimes, additional surgery may be recommended.

Side effects may include temporary pain, swelling, soreness, numbness of abdominal skin, bruising, tiredness for several weeks or months. Risks involve blood clots, Infection, bleeding under the skin flap. Poor healing may also result in conspicuous scarring or skin loss. The need for a second operation may also occur.

Side effects may include temporary bruising, swelling, numbness and tenderness of skin. Tight feeling and dry skin may be experienced. For men, permanent need to shave behind ears, where beard-growing skin is repositioned. Risks involve injury to the nerves that control facial muscles or feeling (usually temporary but may be permanent). Infection, bleeding, poor healing, excessive scarring and asymmetry or change in hairline may occur.

Side effects such as temporary discomfort, swelling, bruising, numbness and/or stiffness may be experienced. In jaw surgery, inability to open mouth fully for several weeks. Risks involve 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 may occur.

Side effects may include temporary swelling, bruising around eyes, nose and headaches. Some bleeding and stiffness may be experienced. Risks involve infection, Small burst blood vessels resulting in tiny, permanent red spots, incomplete improvement, and requirement of additional surgery.

Side effects may include temporary stinging, throbbing, or burning sensation. Faint redness, swelling, excess fullness may also occur. Risks for collagen injections involve allergic reactions such as rash, hives, swelling, or flu-like symptoms, as well as possible triggering of connective-tissue or autoimmune diseases. For both types of injections, contour irregularities or infection may occur.

Side effects may include temporary swelling, discomfort, lightening of treated skin, acute sun sensitivity, increased sensitivity to makeup. Pinkness or redness in skin may persist for up to 6 months. Risks involve burns or injuries caused by laser heat, scarring, abnormal changes in skin color, flare-up of viral infections (“cold sores”) and other infections (rare).

Side effects such as temporary tingling, burning, itching, swelling, redness may occur. Lightening of treated skin, acute sensitivity to sun and loss of ability to make pigment (tan) may arise. Risks involve abnormal color changes (permanent), tiny whiteheads (temporary), infection, scarring, flare-up of skin allergies, fever blisters, and cold sores.

Potential side effects are generally mild and may include redness, swelling, blisters, bumps and surface irregularities (rare).