How does cosmetic surgery affect your skin?

Cosmetic surgery for women: an overview of the most important procedures

Getting older: Yes. But please stay young and beautiful. New, firm breasts, a facelift, a new nose or less fat on the stomach and thighs? Plastic surgery makes it possible.

Beauty into old age

More and more women are opting for a surgical procedure to correct or completely eliminate imperfections in their bodies, whether they are felt or actually. Almost every fifth patient (17.8 percent) opts for breast augmentation, in second place is the desire for liposuction, the upper eyelid lift takes third place, followed by a nasal surgery and tummy tuck.

There are many reasons. Women want to maintain their youthful attractiveness into their later decades or to harmonize their external appearance with their aesthetic sense of self. "As a rule, these women have high expectations of life, of their environment and, last but not least, of themselves," says the aesthetic-plastic surgeon Dr. Sonja Tomschik.

And they usually live in stable social relationships, as a study by the German Society for Aesthetic Plastic Surgery (DGÄPC) confirms. According to this, around 61 percent of the 1200 participating patients stated that they were married or in a steady relationship. The obvious conclusion is that women also want to keep themselves beautiful and desirable for their partner.

Cosmetic surgery costs are falling

The good news: The cost of cosmetic surgery has decreased significantly over the past few years. This emerges from the so-called "Total Cost Index Cosmetic Surgery", GeKIS for short, of the information portal, which specializes in cosmetic surgery. "The price drop of -3.6 percent is the sharpest drop since records began," says the operator.

Liposuction now costs "only" 3,220 euros, which corresponds to a cost reduction of around 3.6 percent. A rhinoplasty is available for an average of 3,840 euros (-5.7 percent), and wrinkle treatments for 360 euros (-5.3 percent). The cost of a tummy tuck has decreased by around six percent and that for an eyelid surgery by seven percent. Hair transplantation accounted for the largest decrease in costs from over 5,000 euros to 4,670 euros (-8.1 percent).

Breast augmentation: cheers for your bosom

For years, breast augmentation has topped the list of the most frequently performed surgical interventions by aesthetic plastic surgeons. There are two variants to choose from: On the one hand, the use of implants or breast modeling with the help of autologous fat.

Breast augmentation with implants

Implant technology: With this variant, the treating aesthetic-plastic surgeon and the patient decide in advance on the type of implant. You can choose between teardrop-shaped and round implants. "The latter place more emphasis on the upper part of the chest," says Dr. med. Ernst Magnus Noah - chief physician at the Noah Clinic in Kassel.

Access is either through an incision below the breast in the natural fold of the skin, around the nipple or through the armpit. The technique used depends on the shape and size of the breast and the nature of the implant. The surgeon uses the small incision to create a cavity through which to insert the breast implant. The implant can either be filled with silicone gel or saline solution.

A distinction is also made between smooth and rough implants. Implants with a rough surface were developed to prevent capsular contracture. In this condition, a capsule of connective tissue forms around the implant, which hardens and can lead to pain. The latest generation of silicone implants are so-called bi-lites, which contain a gel filling and a mixture of hollow microspheres. Your advantage: They are up to 30 percent lighter than the implants previously used.

Breast augmentation with autologous fat

An alternative to implant technology is breast augmentation with autologous fat. The fatty tissue is first removed like a professional liposuction. The procedure is ideal if you want to "slim down" in certain areas of the body. In plain language: What is too much at the back - that is, on the buttocks - is used at the front as "material" for re-modeling the breast.

As is customary with liposuction, patients must wear compression clothing for several weeks after the procedure. After the fatty tissue has been prepared or cleaned, it is then implanted in the breast. As a result, between 30 percent and 50 percent of the transplanted tissue will be broken down again. What remains of the transplanted fat tissue can be seen after around three months.

Liposuction: less is more

Simply suction off fat deposits around the hips, stomach or thighs? This prospect sounds tempting to many women. Because these stubborn fat deposits often cannot be reduced even with strict diets. With the help of liposuction - i.e. liposuction - the body line that is perceived as aesthetic can be brought back.

The most frequently used method is the so-called "tumescence method". A liquid is injected into the subcutaneous tissue to loosen the fat. The mixture usually consists of a sterile physiological saline solution, a local anesthetic as well as adrenaline and cortisone. After about 30 minutes of exposure, the liquid has distributed itself in the fatty tissue.

The affected part of the body swells strongly (tumescere means in Latin: "swell"). The fat cells can then be detached from the connective tissue and sucked off with cannulas. The advantage of this method: Since it causes long-lasting anesthesia in the respective body region, the procedure can be carried out without general anesthesia. With the help of the tumescent method, around four liters of fat can be removed per session.

All-round beautiful eyes: the upper eyelid lift ensures an open look

With increasing age, the connective tissue around the eyes loses its elasticity. The skin on the forehead and the eyebrows also sag and the pressure increases the excess skin in the area of ​​the upper eyelid, so that the so-called drooping eyelids arise. Depending on the extent of the drooping eyelids, it is either a purely aesthetic problem, but it can also lead to a restriction of the field of vision.

The extent of the drooping eyelids is determined by the genetic disposition and external influencing factors. An increased level of UV radiation can lead to the skin in the area of ​​the upper eyelids losing its elasticity and resilience at a young age, which means that drooping eyelids appear prematurely.

How is the drooping eyelid correction carried out?

An upper eyelid lift is usually carried out on an outpatient basis and under local anesthesia. If desired, general anesthesia is also possible as part of the upper eyelid correction. Nowadays, an eyelid lift is often performed using what is known as high frequency technology. In contrast to the conventional electric knife, the scalpel or the laser, the high-frequency technology provides an optimal overview of the anatomical structures, which enables precise and safe surgery.

The appropriate frequency is selected for each patient, so that the skin, muscles and fatty tissue of the upper and lower eyelids can be operated on with almost no contact and anemic. The skin incision runs directly in the crease of the eyelid from the outer corner of the eye to the inner corner of the eye, thus avoiding a visible scar. Depending on the extent of the eyelid lift, the procedure takes between 30-45 minutes.

Our eyes appear tired because the skin becomes thinner and less elastic with increasing age ", says Dr. med. Holger Pult, plastic-aesthetic surgeon in Dresden. With the help of the upper eyelid tightening, excess skin is removed, which often appears as a" drooping eyelid " stored in the upper eyelids or on the lower eyelids as a "tear sac".

During the upper eyelid tightening, an incision is made parallel to the edge of the eyelid in the natural fold of the skin. The excess, drooping tissue and any slack muscle tissue are removed. "By detaching the skin from the muscle during eyelid correction, smaller wrinkles can also be repaired," adds Holger Pult. A few hours after the operation, it is advisable to apply cooling pads to actively support the swelling and minimize hematomas. After the procedure, physical exertion and eyelid washing should be avoided.

Nose surgery for a harmonious face

Many women want a "beautiful nose", although the ideal of beauty varies greatly depending on the respective culture. With nasal surgery, also known as rhinoplasty, conspicuous and unfavorable shapes of the nose are corrected. This plastic surgery is very popular because many different nasal deformities can be corrected, for example the so-called "saddle nose", reductions or straightening of the "hump nose".

According to the guidelines of the Society for Aesthetic Surgery Germany e.V. (GÄCD), nose corrections can be performed by ENT, oral and maxillofacial surgeons as well as plastic and aesthetic surgeons. A comprehensive preliminary examination is a must so that breathing and nasal function are not impaired. In general, nasal surgery is possible from the age of 18.

With a complete rhinoplasty, the surgeon removes the unwanted cartilage and bone structure through the nostrils. If the nasal bones do not need to be corrected, a partial rhinoplasty is sufficient. All necessary cuts are made inside to prevent visible scars. For more complex surgical procedures, also known as open rhinoplasty, a small incision is made on the bridge of the nose between the nostrils.

In individual cases, an injection of hyaluronic acid is sufficient. This can be used to compensate for minor corrections such as nasal humps. Injection is an alternative and gentler method compared to surgery.

Abdominal problem zone: New quality of life thanks to a tummy tuck

Slim and still curvy: the ideal image of women is clearly defined. Dissatisfaction, on the other hand, is relatively high, since not every manifested image can be achieved through intensive training and iron discipline. Many women complain of bacon rolls, sagging tissue and excess skin, for example after a significant weight reduction.

Often, women decide to have surgery after they have lost a lot of weight or given birth. During a tummy tuck, excess and slack tissue from the abdomen, the so-called "fat apron", is removed. "I cut out the navel and make a 30 to 35 cm long incision along the pubic border, from hipbone to hipbone. Then I detach the tissue from the muscles and remove excess skin and fatty tissue," says PD Dr. med. Matthias Voigt, renowned expert for breast and body corrections.

Here, too, the surgical methods vary: In the case of larger fat aprons, the "total tummy tuck" is performed under general anesthesia. The aesthetic plastic surgeon lifts the abdominal wall from the abdominal muscle by making an incision above the pubic border. This tightens the abdominal wall and narrows the waist, and finally the navel is sewn back into the skin. The scarring will fade again after about six to eight weeks.

With the "partial tummy tuck", on the other hand, excess skin is removed from below the navel. The advantage is: A smaller incision is made, "only" locally anesthetized and there is no need to move the navel. Overall, the tummy tuck should, if possible, be performed in a specialist clinic that offers postoperative care. Because this aesthetic plastic procedure is one of the most demanding cosmetic operations.