Planning Toolkit

  • Getting Started
  • Questions to ask your plastic surgeon
  • Questions to ask Yourself
  • Understanding Procedure Levels From Most Comprehensive to Least Invasive
  • Laser and Light based energy guide
  • Injectable safety planning guide
  • After care and recovery
  • Complications

Beginning

Begin with some essential data about plastic surgery and recognize what’s in store.
It is critical that one is ready both rationally and health wise for the surgery so to make the entire process less on edge and overwhelming.

Certifications:

The specialist ought to trained in plastic surgery with a degree recognized by the Medical Council of India.

Educated Consent:

Before proceeding with giving the consent for the procedure:

  1. Make sure you understand all the steps of the procedure
  2. Provide your medical history leaving nothing behind, no matter how trivial you may feel it.
  3. Get a thorough relevant examination and diagnostic workup
  4. Understand the information given to you about the advantages, possible complications and post-surgical care.

Follow Up Care:

After the procedure visit the doctor at the recommended intervals, for a checkup and express your concerns regarding your health and the result.

Way of life Factors:

Some people may be considered as a poor match for surgery because of certain life style habits, which can affect their health during and after the surgery. Some important ones include:

  • Smoking and exposure to second hand smoke.
  • Alcohol consumption
  • History of substance abuse
  • Current body weight
  • Dietary habits
  • Excessive sun exposure
  • Sleep habits
  • Mental health: Stress and Anxiety

Procedure-related questions.

  • Am I a good candidate for this procedure?
  • What lifestyle changes should I make to get the best results?
  • How much time should I allocate for recovery and what kind of help would I be needing then?
  • Should take a break from my regular work after the procedure? If yes, then how long?
  • What are the other alternative options, their advantages and disadvantages?
  • Who will be involved in the procedure and what are their qualifications?
  • What are the risks and complications associated with the procedure and how can we tackle them?
  • In the case when I am not satisfied with the outcome, what are my options?
  • Do you have any illustrations regarding the procedure and any before and after pictures which I could see and expect a reasonable result like?

 Injectable-related questions:

  • Is the procedure which I am option sufficient for the cosmetic goals I am looking forward to?
  • After the procedure, what can I expect regarding any discomfort, swelling and recovery time?
  • How long do the results last?

Am I ready for the procedure?

Is the procedure right for you? The following questions will help you in guiding for your readiness for the surgery:

  • Am I taking the right diet, physically healthy and refraining from smoking, recreational drugs?
  • Am I ready and prepared to make the life style changes necessary such as to quit smoking, to have an uneventful surgery and recovery?
  • Are my expectations realistic regarding the procedure?
  • Is my endeavour for this procedure for myself or to fit someone else’s expectations and ideas?
  • Did I put enough effort in gathering relevant and necessary information regarding the procedure and the qualifications of the doctor’s involved?
  • Did I inform my doctor regarding my past and current medical conditions, allergies, treatments that I underwent?
  • Did I inform and review the medications, herbal and vitamin supplements which I have taken in the past and currently with the doctor.
  • Did I inform and review about my past and current history of alcohol consumption, smoking and recreational drug use?
  • Am I ready to be responsible and follow the instructions to the word for an optimal result from the procedure?
  • Do I know the recovery time associated with the procedure and its after-effects?
  • Do I have an adult, who can responsibly take care of me for at least 24 hours (or as long as recommended) after my procedure?
  • Did the plastic surgeon address my concerns and answer all my questions?
  • Informed consent documents: Have I read, understood, and signed them for my procedure?
  1. Surgical- most comprehensive
  2. Moderately invasive
  3. Minimally invasive
  4. Noninvasive cosmetic procedures

1. Surgical – Most Comprehensive

In cosmetic surgery, invasive procedures aim to reposition the tissue, restore lost volume and rejuvenate the facial skin. Body contouring targets to reduce fat deposits, lift sagging skin, and shape our arms, hips, and thighs. Based on the body site the surgical procedures can be classified as follows:

  • Head and Face — Tissue repositioning, volume restoration and correction.
  • Breast — breast lifts, augmentations, and reductions
  • Body Contouring — Arm lift, thigh lift, tummy tuck & liposuction.

Recovery Time: greater than 7 days

Time to heal:

Weeks to months and additional precautions should be observed.

Results:

Results usually last the longest with surgical procedures, with most lasting more than 10 years to some lasting through a person’s lifetime.

2. Moderately invasive

One should keep in mind that procedures which are moderately invasive are neither risk free nor a substitute for surgical methods.
They include:

  • injection therapy: Botulinum toxin, soft tissue fillers
  • Laser skin resurfacing
  • Deep chemical peels
  • Nonsurgical skin tightening
  • Cellulite treatments.

Duration of results: few months to a few years.

These procedures can reduce the appearance of lines and creases, increase the volume of thin lips, and improve shallow contours for a brief period of time. But these don’t give the same results as the surgical methods or the surgical methods combined with non-invasive methods.

3. Minimally invasive

The available minimally invasive treatments aim to

  • even out the skin tone
  • Stimulate collagen production which helps in reducing the appearance of lines and wrinkles.
  • Increase cell turnover
  • Promote cell growth
  • Remove unsightly veins
  • Remove abnormal growing hair.

Common procedures include

  • Microdermabrasion
  • Light skin peels – Chemical peels
  • Laser hair removal
  • light-based treatments to remove sunspots (e.g., Intense Pulsed Light)
  • Spider vein treatment
  • Leg veins treatment.

These treatments are sometimes are planned in a combination and are not without any risks.

4. Non-invasive cosmetic procedures

These include spa treatments such as facials and deep tissue massages. The results are only temporary.

Common terev and definitions for your procedure and recovery About lasers and light-based therapies The list below defines some common terev often used by laser and light manufacturers and how you should interpret their meaning: Downtime : is the time after which a patient can resume his or her regular lifestyle.
Essentially no downtime Less than 24 hours
Minimal downtime 24 to 72 hours
Moderate downtime Three to seven days
Bruising aka Ecchymosis is the phenomenon where blood from reputed blood vessels passes into subcutaneous tissue giving it a purple discoloration.
Resolves in
Essentially no bruising No ecchymosis/bruising, but patients may have some immediate change in skin tone
Minimal bruising <7 days
Moderate bruising 1-2 weeks
Significant bruising >2 weeks
Redness
Resolves in
Essentially none Skin returns to normal (pretreatment or improved) coloring in less than 24 hours, but patients may have some immediate change in skin tone
Minimal 1-3 days
Moderate 4-7 days
Significant >7 days
Swelling in and around the treated area.
Resolves in
Essentially none <3 days
Minimal 3-7 days
Moderate 8-14 days
Significant >14 days
Pain Any pain or discomfort associated with the treatment.
Resolves in
Essentially none Pre-treatment medication: None

Local anaesthesia during treatment: Yes

Post treatment pain management: Yes

Over-the-counter medications: May be required

Minimal pain Pre-treatment medication: Yes

Local anaesthesia during treatment: Yes

Post treatment pain management: Yes

Moderate pain Pre-treatment medication: Yes

Local anaesthesia during treatment: Yes

Post treatment pain management: Yes

Significant pain Pre-treatment medication: Yes

Intravenous or general anaesthesia during treatment: Yes

Post treatment pain management: Yes

An Injectable filler should only be administered by a trained medical professional in an appropriate setting with sterile instruments.

  1. Don’t choose an injectable product based on its price.
  2. Make sure you understand the associated risks and benefits and have realistic expectations.
  3. During the consultations make sure you give a thorough history of your past illnesses, medications, vitamins and over the counter drugs which you are taking to the doctor. This will help the doctor in planning an optimal course of management.
  4. Get to know the relevant information of the product which you are being injected with.

Injectable Safety Checklist

  1. Doctor
  2. Brand
  3. Safety
  4. Beauty

DOCTOR

My injecting, prescribing and/or supervising DOCTOR is certified in:

  • MCh OR DNB – Plastic Surgery by the MCI
  • MD or Diploma in Dermatology by the MCI
  • Diploma in Medical Cosmetology by the MCI

My injecting, prescribing and/or supervising DOCTOR is a member of one or more of these groups:

  • Indian Association of Plastic Surgeons
  • Indian Society for Aesthetic Plastic Surgery

BRAND

All of these statements are true:

  • My injector has defined the FDA approved BRAND or BRANDs of cosmetic injectable recommended for me
  • My injector has shown me the BRAND packaging identifying the cosmetic injectable that will be injected into me is a genuine product
  • My injector has written on my informed consent documents and in my medical chart the FDA approved BRAND or BRANDs of cosmetic injectable injected into me

SAFETY

All of these statements are true:

  • My injections are being performed in a medical office, by a qualified doctor.
  • My doctor has taken me through the steps of the treatment process and outlined the risks and benefits associated with the procedure.
  • I will follow the post treatment care instructions given to me be the doctor and visit as per the prescribed follow up schedule.

BEAUTY

All of these statements are true:

  • I can clearly define the areas of my facial appearance I hope to improve with cosmetic injectable
  • My injector has analysed the areas of my facial appearance I hope to improve with cosmetic injectable, and my facial appearance overall to recommend the options available to me to meet my goals.
  • I understand that the injectables give only a tempoarary results and that If I do not repeat them as per the prescribed intervals the appearance at the site would return to its prior state.
  • I understand that minor swelling, bruising and redness occur normally for a few days with the use of the injectables.

Aftercare & Recovery

Surgery patients:

After the surgery you will be taken into a “recovery area” where you will be monitored closely.

Outpatient procedures:

Your health and vitals be observed for short period following which you will be permitted to go home.

If you have underwent a procedure under general anaesthesia, you must have a responsible adult as a care giver to assist you with your daily activities for the first 24 hours.

Some procedures require an overnight stay for close observation of your health and for administering the post op medications, in these cases you will be shifted to a recovery room after the procedure.

Recovery Expectations:

Recovery period for surgical procedures varies from individual to individual and also depends on the type of procedure performed.

You will be needed to restrict your normal activities for a period of time after your cosmetic surgery.

The First 48 hours:

Post op patients may experience varying degrees of swelling, bruising and discomfort.

Bruising typically takes seven to ten days to disappear. Take care not to take any anti-inflammatory medications such as Aspirin, during this period, as these can make your bruising worse.

Swelling occurs in your body after the surgery and is a normal response. Keeping the operated site elevated will help reduce the swelling to some extent. If specified by the doctor, cool compresses can be used to help decrease the swelling and relieve the discomfort.

Pain and discomfort be more for the first 2 to 3 days after the procedure and you will be given oral medications for the same. By the 4th to 7th day after the surgery the discomfort level decreases rapidly and the medication could be adjusted accordingly.

Please remember that you should stay in regular contact with the doctor after the surgery for an evaluation of your progress during the follow-up visits. If you have questions or concerns during your recovery, or need additional information at a later time, you should contact your surgeon.

Every surgery has some risks associated with it, understanding them should make you feel more comfortable about them. If an incision is necessary for the procedure, it would heal leaving a scar. Similarly, if the skin is cut, there is a possibility for bleeding. Until the incision has healed fully, there is a possibility for contracting an infection.

Precautions at every step

Many steps are employed as a protocol to reduce the risk, but even if everything was performed to the detail, a small chance would still remain that something may occur.

Preoperative

The plastic surgeon and his staff will always aim to make your surgical experience as comfortable and easy as possible. You will be provided with the necessary information regarding the procedure to educate you about its risks and benefits. Some risks associated with the surgery are directly influenced by one’s lifestyle habits such as smoking, alcohol consumption and recreational drug use, these need to be cut down both before and after the surgery for an uneventful procedure and recovery. Certain anti-inflammatory medications like Aspirin can lead to increased bleeding, hence these should be avoided after a consultation with your physician and the surgeon for recommended time period before the surgery.

Day of Surgery

Suitable medications for preventing infection and for haemodynamic stability will be administered to you. Depending on the procedure, your comfort level and pain tolerance either a local anaesthesia, Intravenous sedation or a general anaesthesia will be given. Various electronic monitors for checking your pulse, blood pressure, heart rate and oxygen saturation in blood will be used.

Your body would respond to any surgery with fluid accumulation around the operated site, which is seen as edema. If a cavity is created as a part of the procedure, it can present as a seroma (fluid collection under the skin), in such cases drains may be placed to remove this fluid.

Lifestyle habits such as smoking can influence the healing of your incisions, hence kindly be abstinent from smoking as per the doctor’s recommendation both before and after the surgery.

Formations of Blood clots and their damaging sequelae by migrating to the lung vasculature (pulmonary embolism) is life threatening, necessary steps will be taken and also advised to prevent such instances. The risk is higher with procedures of longer duration and would be managed with compression devices during the surgery. As walking reduces the chance of blood clot formation in the legs, you will be advised to move around after the surgery.

Depending on the procedure either an absorbable suture or a non absorbable suture & staple would be appropriately used to close the incisions.

Recovery

Bruising of varying amounts is a possibility. Surgery carries a inherent risk for bleeding which necessitates additional interventions such as blood transfusions. These issues, if they take place may prolong the recovery period. Variable amounts of bruising are possible, and occasionally there can be significant bleeding after surgery which requires additional operative intervention for treatment. These issues may prolong the visible recovery period (due to more extensive bruising).

Physical activity:

Strenuous physical exercises should be avoided for the first few weeks after the surgery. Some instructions would be specific to each procedure, these should be followed meticulously for an optimal outcome. However, do try to resume minor physical activities like going to the dinner table and walking around the house after the surgery as these help in reducing the chances for clot formation.

Sensation:

It is normal to have some degree of numbness around the scars, as skin incisions can cut small sensory nerves. Depending on the extent to which the body tissues are moved, larger areas may be affected. Typically the small nerve endings would heal eventually and the sensation should return over a period of months.

Suture Removal:

If any of the sutures had to be removed, they will be done so during the scheduled follow-up visit.

Incision site care:

You will be instructed on how to take care of the suture sites. Immediate healing should occur over a period of 2 to 3 weeks after which you need to take care of the scar with creams that can speed up scar maturation and sun block to avoid pigmentation.

Maintaining a Relationship with Your Plastic Surgeon

Please remember that your communication with your plastic surgeon does not end when you leave the clinic. If you have questions or concerns during your recovery, or need additional information at a later time, you should contact your surgeon. You be advised periodic follow-up sessions during which your progress will be evaluated.

Other Considerations

All cosmetic surgeries involve changing the contours of your body. Some of the best ways to maintain these results would be maintain a stable weight and protect the elastic properties of the skin by avoiding smoking and protecting the skin from the sun. Besides helping to prolong the results of the surgery, these are good practices for your overall health.