American Medical Association Family Medical Guide - American Medical Association [779]
Laser resurfacing
During laser resurfacing, a surgeon uses a powerful beam of pulsing light to remove unwanted skin tissue. Both the surgeon and the patient wear protective goggles to shield their eyes from the light. Lasers can vaporize the sun-damaged top layer of skin, removing fine lines, wrinkles, and acne scars.
Surgeons also use pulsed laser beams to remove broken veins in the face, spider veins on the legs, and unwanted body hair. When the laser beam is not pulsed but allowed to flow continuously, it can be used to cut the skin to remove skin cancers and warts and to perform cosmetic eyelid surgery (see page 1081).
The Procedure
Most laser skin resurfacing is performed in an outpatient setting using only a local anesthetic similar to that used in a dentist’s office, although some surgeons prefer using general anesthesia for a full-face resurfacing. Using a wandlike handheld laser instrument, the surgeon burns off the upper layers of damaged skin. The concentration of the laser beam gives the surgeon precise control over the depth of penetration. Laser resurfacing takes about 1 hour.
After the Procedure
When the surgeon is finished, he or she may place a clear dressing over your face or give you an ointment to apply at home to help promote healing. Your doctor will tell you to change your dressings for 3 to 5 days, until your skin regenerates. Your skin may form a crust that will drop off in a few days. You probably won’t have any pain or discomfort, but you may feel self-conscious about the way you look, so you may want to wait about a week before returning to work. Your facial skin will be red and then pink for several weeks to several months. Avoid unnecessary sun exposure and wear sunblock and a wide-brimmed hat when you go outside. The risks of laser resurfacing are low but can include skin color loss and, rarely, scarring.
Breast Surgery
Some women are unhappy about the way their breasts look. Some women feel that their breasts are too small and seek breast augmentation. Other women have breasts that are asymmetrical and want to correct the difference in size or shape. Breasts may lose their shape and firmness and begin to sag with age and after pregnancy and breastfeeding. A breast lift can elevate and reshape sagging breasts. Women whose breasts are overly large can develop back and neck pain and indentations in their shoulders from bra straps. They may also be extremely self-conscious about the size of their breasts. Breast reduction surgery can relieve the physical and emotional discomfort produced by having large breasts.
Be aware that any surgery performed on your breasts will leave scars. However, your surgeon will conceal the incisions as much as possible by making them in the natural creases below the breasts or in other inconspicuous areas. Ask your surgeon to show you photographs of breast procedures he or she has performed so you can see the results. Some types of breast surgery, especially breast reduction, will make it impossible for you to breastfeed. Talk with your surgeon about these and any other questions or concerns you may have before deciding whether to proceed with surgery.
Breast Enlargement
Breast enlargement, medically known as augmentation mammoplasty, increases the size of a woman’s breasts by surgically inserting breast implants for cosmetic purposes. Breast implants are made of a soft, pliable plastic (such as silicone) sac that contains a saline (saltwater) solution. The Food and Drug Administration (FDA) has restricted the use of implants filled with silicone gel to women who are in approved research studies.
Your surgeon will decide the best way to insert the implant after performing a physical examination. Implants can be inserted through an incision in the natural fold under the breast, or through an incision around the areola (the dark skin around the nipple) or in the armpit. The incision site depends both on your anatomy and on the experience of the surgeon. Implants can be located either on top of or underneath the