FAQ’s

A: Breast Reconstruction Surgery deals with replacement of lost tissues (reconstruction of Breast) after Cancer Surgery.

A: Underdevelopment breast- Breast not developed at the age of 16-18 years. Post Location – loose Breasts after feeding of baby.For improvement of body image –Enlargement of breast.

A:Breast Enhancement is done by placing an implant below the breast by small skin incision. The incision for cosmetic insertion most commonly is made along the lower edge of the areola, in the axilla or in the infra mammary fold.

A: In 2006, the FDA approved the sale of silicone breast implant. Numerous studies conducted during the 14years moratorium found no real connection between silicone implant and disease. The implant were deemed safe and effective.

A: Yes, by Fat taken from patient own body.

A: No

A:1. Young girls suffering from excessive enlargement of breast (Virginal hypertrophy of breast) 2. In adult females with abnormally enlarged breast leading to physical disability like pain in shoulder, heavy weight on chest & poor hygiene under the breast & social embarrassment.

A: Excessive tissue is taken out surgically, keeping in mind the shape and symmetry of the breast.

A: Yes, there is possibility of difficulty in lactating after breast reduction surgery. But now with newer techniques like superomedial pedicle the incidence of lactation related problems has decreased.

A: Yes, it can be helpful in patient with moderate enlargement of breasts.

A: Gynecomastia is a condition in which there is abnormal enlargement of breasts in males.

A: Gynecomastia is usually due to imbalance of hormones at the time of development of male sexual characters (puberty). Many times it can be without any reason also (Idiopathic).

A: Once the patient has completed 16-18 years the chances of cure by medicine are negligible. Patient requires surgery for its correction.

A: Usually after 16 Years of age.

A: It is done by a very small incision kept around the nipple complex which is hardly visible after the surgery. Most of the tissue is removed by liposuction & sometimes if gland is large it needs excision.

A: Breast Reconstruction Surgery deals with replacement of lost tissues (reconstruction of Breast) after Cancer Surgery.

A: Yes, it is possible to recreate reasonably normal looking after Cancer Surgery.

A: The breast is recreated from tissue taken from back or lower abdomen. Tissue expenders or breast implant are also used in some cases.

A: 9 Months to 1 year after cancer surgery.

A: General surgery deals with the operations of various diseases and disorders in the body. Plastic surgery is a surgical super-specialty that deals with the healing and restoration of patients with injury, disfigurement or scarring resulting from trauma, disease or congenital defects. A plastic surgeon has the imaginative power to sense the problem and draw the outcome of a surgery and plan accordingly.

A: Plastic is not used in plastic surgery. The word plastic comes from a Greek word “plastikos” meaning “to mould”. However some plastic surgeries involve use of implants made of silicone and titanium and polyethylene that are accepted by the human body.

A: Scarring is a natural consequence of healing. Plastic surgeon understands the nature of healing and involves incisions in the lines of the skin and suturing the wounds meticulously in layers using small stitches and threads. Hence there is only a small line of scar left which eventually becomes inconspicuous.

A: Cosmetic surgeries of the nose are done by making incisions inside the nose hence there is no scar outside. Also surgeries like “liposuction” are done making very small scars which slowly become less visible.

A: Some creams can lighten scars but cannot remove them completely. Only time is the factor which decides when a scar would fade. Plastic surgery can reduce the scar size and make it less visible.

A: Almost 50% of the plastic surgeries are emergencies. Most surgeries like trauma and injuries of various parts of the body and injuries of the vessels and nerves, cases of “replant” (replacing the cut body parts-fingers or hands etc), avulsed scalp are emergency procedures and need to be done as early as possible for good results.

A: Most of the plastic surgeries are comparable to any surgeries in the question of expense. Some cosmetic procedures and procedures which involve use of implants may be a bit expensive. Plastic surgeries like “replant” which involve long hours (up to 8 hrs) and the use of microscope may be expensive depending on the kind of injury and work required.

A:There are always risks associated with surgery and specific complications associated with all procedures. Post-operative complications such as infection and blood clots are rare, but can occur. Infection can be treated with drainage and antibiotics, but will prolong the hospital stay. You can minimize the risk of blood clots by moving around as soon after the surgery as possible. Poor healing, which results in conspicuous scars, may necessitate a second operation. Smokers should be advised to stop, as smoking may increase the risk of complications and delay healing. One can reduce your risk of complications by closely following the surgeon’s instructions before and after the surgery.

A: Plastic surgery can be done as it involves use of incisions in skin lines and layered suturing for minimal scar formation. Some small swellings like lipoma (local fat deposition) may be sucked out by small incisions.

A: Plastic surgery includes the following-

• Birth defects of the face, including splits of the lip and palate,nasal deformities and deformities like asymmetry of theface, small ears, non developed ears and other ear defects.
• Injuries of the face like wound and cuts and severe facial injuries and fractures of the bones of the face and jaws.
• Surgeries of the hands and legs like crush injuries and fractures due to road traffic accidents and factory machines and home accidents, birth defects of hands and legs and surgeries on the vessels and nerves.
• Nail surgeries and repair of damages nails.
• Any type of burns like fire, hot liquid, electricity and chemicals and its skin cover problems and contractures.
• Any wounds after infections and their cover.
• Replantation (replacing back the cut body part like fingers and hands) and reconstruction of body parts.
• All types of reconstruction following removal of tumours and cancer resulting in disfigurement of any part of the body including the face, breasts, and trunk.
• Aesthetic (cosmetic) surgeries like rhinoplasty (nose surgery), breast augmentation and reduction (breast surgery), face lift sand blepharoplasty (face rejuvenations), hair transplants (baldness surgeries), liposuction (fat removal) and scar removal and other surgeries.

A: There are always risks associated with surgery and specific complications associated with all procedures.

Post-operative complications such as infection and blood clots are rare, but can occur. Infection can be treated with drainage and antibiotics, but will prolong the hospital stay. You can minimize the risk of blood clots by moving around as soon after the surgery as possible.

Poor healing, which results in conspicuous scars, may necessitate a second operation. Smokers should be advised to stop, as smoking may increase the risk of complications and delay healing. One can reduce your risk of complications by closely following the surgeon’s instructions before and after the surgery.

A:Patients should check the following-

1. Patients should seek out a doctor who is both trained and experienced.
2. They must make sure that the doctor is board-certified.
3. They must see multiple before and after pictures of patients on whom similar procedures have been performed.
4. These days plastic surgeons specialize in particular areas like hand surgery, micro surgery, facial surgery and aesthetic surgery so one must choose the specialist that does the surgery one wants to have.
5. Don’t base your decision solely on price.

A: Smile Train is a non-profit organization based in New York City with the mission of providing free plastic surgery for children with cleft lip and palate in about 80 developing countries including India.

At Sir Ganga Ram hospital smile train program is conducted as a free OPD every Friday and admitting the children on the same day with specialized paediatric care and with free operations being done every Saturday. This includes primary (first time) as well as secondary (after surgery) defects of the lip and palate correction. There is also provision for speech therapy after the surgery for these children. A record of photographs taken before and after surgery is maintained and the children are followed up accordingly.

A: Common birth defects under plastic surgery are-

A: Plastic surgery can be done as it involves use of incisions in skin lines and layered suturing for minimal scar formation. Some small swellings like lipoma (local fat deposition) may be sucked out by small incisions.

A: Keloids are the excess growth of scar tissue at the site of a healed skin injury. It usually has a smooth top and a pink or purple color. Keloids are irregularly shaped and tend to enlarge progressively.Unlike scars, keloids do not subside over time. They are more common in people ages 10 to 20, and in African Americans, Asians, and Hispanics. In some cases, the tendency to form keloids seems to run in families.

The best treatment is prevention in patients with a known predisposition. This includes preventing unnecessary trauma or 8 surgery (including ear piercing, elective mole removal), whenever possible Treatment methods are intra-lesional corticosteroids, silicone gel sheeting, cryosurgery, radiation therapy, interferon alpha, Pulsed dye laser. Excision of a keloid is usually not done because it may cause formation of larger keloids.

A: It is possible to re-attach some parts like fingers, wrist and forearm. This is called “replant” this involves long hours (up to 8 hrs) and the use of microscope for suturing of small vessels, nerves and muscles depending on the kind of injury. Such surgeries should be done immediately because the success rates go down with delay in presentation of the patients.

A: Transplant is possible from another donor. In some life threatening cases parts can be used from the dead or living, but they would require use of steroids and other strong drugs like immunesuppressors life long.

A: Home accidents managed by plastic surgeons include-

1. Scalds and burns
2. Chemical burns like acid.
3. Falls
4. Crush injuries
5. Wounds and cuts

A: The first response in a burn situation is

• Stop the heat source or break contact between the heat source and the skin.
• You can cool the burn with water.
• If blisters form, they should not be broken because they protect the burn from infection.

For heat or thermal burns

• Rinse the burn (without scrubbing) or immerse the affected area in cool water until the pain is gone.

For accidents involving drenching by a hot liquid

• Place clothed victim in water bath or shower.
• Never peal stuck clothing from a burn.

In cases of electrical burns

• Turn off the electric power at the source.
• Do not touch the victim until all wires are clear.
• Make sure the victim’s breathing and heartbeat are regular.
• Check places where the electricity entered and exited the victim’s body
• Make sure they get medical attention
• Treat minor burns with cool water and have the victim seek medical attention.

With chemical burns

• Locate the chemical container and follow the label directions for emergencies.
• Remove any contaminated clothing.
• If the eyes have been affected, flush them for 30 minutes. For acid chemicals, immediately flush the affected area for 15-20 minutes.
• For dry chemicals, brush the chemical off the skin then flush the area for 15-20 minutes.
• Make sure the victim seeks medical attention.

A: Initially, after grafting, the skin is darker in colour for a few weeks, but eventually it gains the same colour and looks very much normal. In some this takes longer and the graft may never be exactly the same colour as the rest of the skin.

A:Skin grafting is necessary for treating burns. A skin graft will:

• Help to heal the affected area quicker.
• Help to reduce any pain and discomfort when dressings are changed.
• Help to reduce the risk of infection and scarring.
• Help to stop limited movement (contracture) if the burn is on a joint.
• Cover an area that has lost skin. If grafting is not done, there is a risk of infection, scarring contracture and prolonged morbidity.

A: A skin graft is a piece of healthy skin, which is taken from one area of the body and placed over the affected area. The area where the skin is taken from is called a donor site.

A flap is a piece of tissue that is still attached to the body by a major artery and vein or at its base. This piece of tissue with its attached blood supply is used in reconstructive surgery by being set into a recipient site (injured area onto which a flap or graft is placed).

A: "Free flap" implies that the tissue, along with its blood supply, is detached from the original location ("donor site") and then transferred to a new location ("recipient site"). This is in contrast to a "pedicled" flap in which tissue is left attached to the donor site.

A:An implant is a medical device manufactured to replace a missing biological structure. The surface of implants that contact the body might be made of a biomedical material such as titanium, silicone or apatite depending on what is the most functional. In some cases implants contain electronics e.g. artificial pacemaker and cochlea implants. Some implants are bioactive, such as subcutaneous drug delivery devices in the form of implantable pills or drug-eluting stents.

A:Silicone is a chemical polymer derived through a heating and refining process from the element silicon-- the sand on the beach is made from a combination of silicon and oxygen called silica. In plastic and reconstructive surgery, silicone is the material of choice for many types of solid implants used to enhance or reconstruct the cheeks, chin, and jaw. Semi-solid (cohesive) silicone implants are also used for the augmentation of the breasts, male chest (called pectoral implants), calves, biceps, and even sometimes the buttocks.

A:Male breast enlargement that arises in puberty often resolves on its own, within a matter of months, as hormone levels normalize. When the condition arises in adulthood, it tends to persist. As men age, they tend to lose testosterone and gain weight. The former contributes to gynecomastia (which is actually defined as enlargement of glandular tissue within the breasts), the latter to a related condition known as pseudogynecomastia, in which enlargement is caused by deposits of fatty tissue under the breasts,

The surgery of choice is liposuction to remove fat and scalpel surgery to remove glandular tissue, both done by a plastic surgeon.

A: Baldness can be treated, but not cured.

Hair transplant is done by a plastic surgeon. This involves using small grafts of naturally-occurring units of one to four hairs, called follicular units, to move hair-producing follicles to balding areas of the hair restoration patient's scalp. A strip of skin containing many follicular units is extracted from the patient and then dissected under a stereoscopic dissecting microscope. Once dissected, they are implanted into the recipient sites of the patient's scalp.

A:The field of hand surgery deals with both surgical and non-surgical treatment of conditions and problems that may take place in the hand which can be dealt by plastic surgeons.

The following conditions can be indications for hand surgery:

• Hand injuries
• Carpal tunnel syndrome
• Carpometacarpal bossing
• Rheumatoid arthritis
• Dupuytren's contracture
• Congenital defects

A: The cancer surgeon and plastic surgeon will be working together to reconstruct the cancer defect after surgery. Surgery for oral cancers can involve removing a part of the tongue, the floor of the mouth, and even a part of the jaw in more advanced cases. The role of a plastics or reconstructive surgeon is to help repair these areas once the surgery to remove the cancer is completed. Reconstructive surgery can involve moving tissue from one part of the body to another. This type of surgery may involve “free flap” and cover.

A: Facial trauma can involve soft tissue injuries such as burns,lacerations and bruises, or fractures of the facial bones such as nasal fractures and fractures of the jaw. Facial injuries have the potential to cause disfigurement and loss of function.

Plastic surgeons are surgical specialists trained in thev comprehensive management of trauma to the lower, middle and upper face and facial injuries.

A: Problems related to the interior of the eye are dealt by ophthalmologists but procedures like eye lid reconstruction and repair are done by plastic surgery.

A: Breast reconstruction is the rebuilding of a breast, Often this includes the reformation of a natural-looking areola and nipple. This procedure involves the use of implants or relocated flaps of the patient's own tissue.

There are many methods for breast reconstruction. The two most common are:

• Tissue Expander - Breast implants
• Flap reconstruction- This procedure may be performed by leaving the donor tissue connected to the original site to retain its blood supply. Ex-The latissimus dorsi muscle flap and abdominal flaps (DIEP flap and free-TRAM flap)

A: The term "laser" originated as an acronym for Light Amplification by Stimulated Emission of Radiation. They are used in the following surgeries

• Fine Lines and Wrinkles
• Skin Tightening
• Pigmented Lesions
• Precancerous Lesions
• Vascular Lesions
• Tattoos
• Hair Removal
• Acne and Acne Scars

A: Facial fillers are injections which fill out wrinkled or uneven areas of the face. They include Restylane, Collagen, Perlane, Sculptra and even your own tissues taken from another part of your body. The filler is injected into the skin itself to plump up the depressed line in the skin.

A: BOTOX is a drug that uses Botulinum Toxin Type A to treat wrinkles. It is used for the temporary improvement in the appearance of moderate to severe facial lines (frown lines and cheek lines).

A: Liposuction removes pockets of fat from troublesome areas such as the thighs, abdomen, and upper arms.The basic procedure involves a few steps:

• Local or IV sedation or GA will be used, depending on the type and number of procedures undergone
• A few tiny incisions are made near the area to be treated
• Tumescent fluid (fluid that decreases pain and bleeding) is injected.
• A small, tube-like instrument called a cannula is inserted through the incisions in order to reach the fat deposits
• The cannula then breaks up and vacuums away unwanted fat
• The procedure is finished with the incisions usually being sutured or allowed to heal.

A: Liposuction is more of body contouring procedure and weight loss by surgery as such can only be achieved by bariatric surgery. However large volume liposuction (removal of more than 5 L of total volume from the patient) can help to some extent for reduction of weight.

A: Liposuction in an obese patient, after massive weight loss by bariatric surgery or exercise,is reasonable when the goal is to improve a troublesome body contour area. It can be combined with abdominoplasty. It is not reasonable to use liposuction as a surgical technique for weight loss.

A: Nerve compressions and nerve injuries can be treated by plastic surgery by end- to end suturing or nerve transfer and grafting.

Surgeries of the brachial plexus, sciatic nerve, nerves of hands, legs and feet come under plastic surgery.