A: Plastic surgery is a specialty dedicated to the enhancement of the face and body. For those who wish to improve their appearance, Cosmetic, Plastic surgery offer patients the opportunity to reshape physical features and improve their self-esteem

A: Plastic surgery is named from the Greek word "plastikos" which means "to shape", based on the surgeon re-shaping the form of the patient's form through surgery. It has nothing to do with the types of materials used in the surgery itself. In surgery, many different materials may be utilized, depending on the desired results and the type of surgery. Frequently, the surgeon will make use of the patient's own tissues, including tissues from another location of the body, or by reshaping the existing tissues to achieve a better appearance. Historically, many materials have been used in cosmetic and reconstructive surgery, including ivory, wood, and others. In modern times, hard silicone rubber is a popular material. This should not be confused with the gel silicone which has sparked so much controversy through its use as a filler for breast implants..

A: No. Plastic surgeons are physicians who have trained first in the area of general surgery, and then done additional residency training specifically in plastic and reconstructive surgery. It usually takes about six years after graduating from medical college to train to be a plastic surgeon. You must look specifically for these credentials when seeking a reputable plastic surgeon. The fact of the matter is that the vast majority of cosmetic surgery is done, and appropriately so, by plastic surgeons. The term "cosmetic surgeon", however, was actually coined by physicians and groups of physicians who are not trained plastic surgeons, but have decided to do plastic surgery anyway. We are frequently in the situation of buyer beware when physicians advertise themselves as cosmetic surgeons or even plastic surgeons and claim to be certified when they are in fact not trained in plastic surgery. Do your homework carefully.

Cosmetic surgery is performed to reshape normal structures of the body in order to improve appearance and self-esteem. Cosmetic surgery is usually not covered by health insurance because it is elective.

Reconstructive surgery is performed on abnormal structures of the body caused by congenital defects, developmental abnormalities, trauma, infection, tumors or disease. In general, reconstructive surgery is performed to improve function, but may also be completed to approximate a normal appearance. Generally speaking, if a surgery is done primarily to improve the health of a person, or the function of an organ, it is considered medically necessary. Surgeries such as corrective rhinoplasty to improve air flow through the nose, or eyelid surgery to improve the field of vision by lifting sagging, droopy eyelids might fall into this category. These surgeries may or may not also improve the patient's appearance, but this is a secondary purpose

A: The first, of course, is that your plastic surgeon should be certified Plastic surgeon. Secondly, that the surgeon frequently performs the operation or operations that you are interested in. Thirdly, and of equal importance, is that you feel comfortable with the individual. He or she should be willing to answer all of your questions thoroughly and show you examples of his or her work. Remember that you are putting your only face, your only body, your only life, in the hands of this individual and you want to know that they are going to take good care of you.

There are commonly performed cosmetic procedures for virtually every part of the face, including the neck, nose, eyes, ears chin, cheekbones, forehead, as well as the breasts and abdomen. Additionally, scar revision and liposuction surgeries are potentially possible on most areas of the body.

As with all surgical procedures, there is some level of risk. To reduce your chances of complications, it is important that you follow all of your doctor's pre- and post-operative instructions carefully, and thoroughly discuss any and all medical conditions with your doctor prior to your procedure. This way, you'll be sure you and your plastic surgeon are prepared and that your body is appropriately cared for before, during and after surgery.

Individuals in good general health are typically good candidates for cosmetic surgery. It is very important for prospective patients to have realistic expectations for their surgery results. During your consultation with your plastic surgeon, it is important to openly discuss your previous medical history, plastic surgery goals and any concerns you have so that your surgeon can make an informed and realistic assessment about your candidacy for cosmetic surgery

Among the most frequently performed surgeries are: breast augmentation surgery, rhinoplasty, facelift and blepharoplasty (eyelid surgery).

A: Several things are occurring simultaneously. The skin stretches and loosens, which results in folds of loose skin. At the same time, fatty deposits and normal facial fat contours that give the face its natural areas of fullness and shape are lost. Even bony contours are altered and muscles become slack. In some areas, especially around the lips, mouth, and eyes, deep chiseled and grooved lines result from the breakdown of injection elastic fibers in the skin.

A: There is no ideal age to have cosmetic surgery.Each cosmetic surgery patient is evaluated on a case-by-case basis. During a consultation, your surgeon will take into account individual factors, such as your unique body type, size and age. The time to have an elective procedure is when the desired change will justify the time, effort and the cost involved. Another factor to take in consideration is the potential length of time to enjoy the benefits. For example, if an individual has a facelift earlier in life, the rewards of this surgery can be enjoyed for a greater period of time.

A: There really is no age at which one is too old for any aesthetic procedure. The factors that are involved in patient selection by a reputable plastic surgeon have to do with the candidate being in good health – both physical and mental, having a problem that is correctable by cosmetic surgery, having reasonable expectations, and a willingness to devote the time required for healing.

A complete pretesting series of appointments is done prior to any surgery.

A: The process begins with a surgical consultation in order for you to thoroughly understand what the procedure involves, the course of recovery and the ideal outcome. Then, there will be a preoperative surgical interview. During the interview our nursing staff and an anesthetist will review your health history, answer your questions, give you additional instructions on surgery preparation and tell you what to expect. The interview process may take one to two hours, so please plan your schedule accordingly

Apart from routine consultation there are a variety of steps that we recommend in preparing for surgery – physical, spiritual and emotional. From a physical perspective, beginning two weeks before, we recommend stopping aspirin containing medications and certain herbal supplements that can cause problems with bleeding and anesthesia. We recommend stopping smoking at least a month before and after surgery; and not getting a sunburn immediately before an aesthetic procedure. It is also very important to make preparations in advance for getting to and from the surgery center and arranging to have someone stay with you afterwards. From a spiritual perspective, we encourage you to value the power of positive thinking. And emotionally, one of the things that we discourage is asking friends and family if they would do the surgery, if they were you; if they think you need surgery; and so on. Unfortunately, you may be disappointed in their response and then not know what to do. This is your decision and your decision alone. That is as it should be.

There are a number of steps you can take to maximize your surgical results, including:

• Stop taking any non-prescribed supplements (vitamins, minerals and herbal products) seven days prior to surgery.
• Discontinue smoking at least six weeks prior to surgery to avoid healing problems and serious medical complications following surgery.
• Consult with your surgeon if you are taking aspirin or products with anticoagulation properties about when or whether to discontinue them before surgery to minimize the risk of unnecessary bleeding.

Most plastic surgery procedures are performed on an outpatient basis, with some exceptions. Cases where a patient is recommended to stay overnight include:

• When a patient lives alone—surgery patients often require some assistance after their surgery.
• When there are multiple surgeries and it is necessary to monitor the patient's overall condition and pain.
• On the rare occasion that complications arise

On an average, most surgeries take 2-3 hours in the operating room, with the most extensive of multiple procedures lasting several hours. Additional time is often required for preparation before, and rest & recovery time after the surgery itself, particularly when sedation or a general anesthetic is administered

A: Depending upon what is most appropriate for your particular situation, the surgeon will decide what type of anesthesia to use. The different types of anesthesia are local anesthesia, intravenous sedation, general anesthesia and regional anesthesia (nerve blocks). Surgeon will answer any questions you have

A: Patients tolerate postoperative pain in ways that are different from each other. Appropriate pain medications, which minimize discomfort, are prescribed for postoperative patients

This varies greatly depending on the procedure in question. For small, non-invasive procedures, such as laser tattoo removal, or collagen therapy, patients are ready to return to normal activity immediately after treatment. For procedures like laser skin resurfacing or blepharoplasty, patients may be ready for most normal activities in 3-6 days, while more extensive surgeries such as abdominoplasty or extensive liposuction may require a more extended convalescence. The body's complete healing process takes longer than this initial recovery time, and may last from several weeks up to a year or more as incisions heal completely and tissues achieve their maximum recovery.

There are risks associated with any surgical procedures. Find out what they are, how often they occur and how they will be handled if they do occur.Please see the information on the specific surgery, or consult with a qualified surgeon for more detailed information.

Each patient tolerates pain after surgery in different ways.Like every other medical procedure, healing time varies according to the type of surgery chosen and your body's natural healing abilities. Your surgeon will prescribe the appropriate pain medications to help minimize any discomfort. In general, most facial cosmetic operations have minimal discomfort post-operatively.Recovery times are generally longer for major surgeries, including abdominoplasty (tummy tuck), breast augmentation and facelifts, but you can expect to be active in 7 to 14 days.

It depends upon the patient's disease and current medications. Talk to your plastic surgeon about your specific situation

A: Yes, I think it is true of all plastic surgeons across the country. We are seeing more and more men in our practices. I think we all now realize that appearance counts, and in a competitive job market, as well as a competitive social market, you need to look as good as you possibly can. Part of that is eating right and exercising and taking care of one's self, but the other part is considering aesthetic surgical procedures that can enhance one's appearance. In terms of the most popular procedures for men, they include:

• Liposuction
• Rhinoplasty
• Eyelid surgery
• Facelift surgery
• Botox

Any time a cut or incision is made in the skin, there is a scar left behind as part of the normal healing process. Plastic and Reconstructive Surgeons have received special training and have extensive experience with minimizing the size of these scars, creating the least noticeable appearance of then, and locating them in the least conspicuous areas possible. Often the scars will become undetectable to all but the most careful examination over the course of time.

A: There is no precise answer to this question. The results of your plastic surgery depend on the procedure you have. In general, results are long lasting if a healthy weight and overall healthy lifestyle is maintained.

Surgery does not affect the ongoing aging process, which is largely dependent upon genetics. What cosmetic plastic surgery does is turn back the clock. Unfortunately, aging is inevitable. Although you will continue to age, you will always look better than if you had never had anything done.

A: The fact of the matter is that reputable plastic surgeons frequently say "no". What we are simply saying to such a patient is that it is not possible to produce the absolute perfection they desire. The sad part is that if they try hard enough, they will probably find someone to operate on them. Shopping for somebody who will say "yes" is not the right way and can only lead to disaster.

A: The techniques used by Dr. Ramesha create a natural, non-surgical appearance. Every effort is made to improve your appearance in the most natural view

Plastic surgery can achieve impressive results for a patient with realistic expectations and goals. To many, the results may even seem 'miraculous', however to think you can be made over so completely as to look just like another person entirely is still the stuff of Hollywood movies and fiction novels Cosmetic plastic surgery's primary focus on refining a person's appearance, rather than changing it entirely.

A: The length of time for recuperation after plastic surgery varies depending on the procedure performed and the person operated on. Most patients will require assistance for the day or so and then will be able to care for themselves. We will discuss with you in detail your postoperative care and recovery instructions. The techniques offered today allow patients to return to work fairly soon following surgery

A: Depending on the procedure performed determines when a patient may resume physical exercise. All patients are encouraged to start a slow walking routine and hold off on anything more strenuous until after consulting with Dr. Ramesha.

Each cosmetic procedure page offers more specific frequently asked questions. Access a full list of cosmetic procedures

The decision is based on a number of factors, including the patient's desires, reasons for the surgery and overall health. For example, are you doing it because you feel your breasts are too small relative to your body contour or are you unhappy with the size and firmness of your breasts following pregnancy, breastfeeding or major weight loss? Unevenness between the breasts can also be a motivating factor. Your surgeon can help you make the right decision during your pre-surgical appointment(s).

This can only be determined after you are evaluated by a plastic surgeon, but any kind of plastic surgery in this area should improve your appearance.

The available options can only be discussed after having an evaluation with a plastic surgeon. In general, recovery time from a mini face lift is approximately two weeks.

The facelift is somewhat more expensive because more surgery is performed. A neck lift is a more limited procedure

No, they do not

A few patients notice small change in their voice after rhinoplasty but this is uncommon. Professionals who rely on their voice, such as singers, should share any concerns with their surgeon, however, because the nose does play a role in how we sound.

Yes, tumescent liposuction, a new technique that results in less bruising, less swelling and a quicker recovery than older traditional methods of liposuction, is routinely performed. Tumescent liposuction uses a large volume of dilute epinephrine to cause intense constriction of the small blood vessels, which leads to less bleeding, less bruising and less swelling.

A: A tummy tuck or abdominoplasty, as it is more formally known, is an operation meant to rejuvenate the abdominal area by a combination of tightening the muscles that may well be stretched out (usually through pregnancy), and removing the loose excess skin of the abdomen as well. In the operation, an incision is made in the bikini line. The skin and fat of the abdomen is lifted, the belly button is left in place and then the muscles are tightened and the skin and fatty tissue are pulled tightly. The excess is removed, and the incision is closed usually with dissolvable sutures

A: BOTOX® Cosmetic is a purified byproduct of a medically grown bacteria. BOTOX® Cosmetic temporarily weakens any muscle in which it has contact. It is used to eliminate unwanted furrows between the eyebrows or on the forehead. BOTOX® Cosmetic also has been used on "crows feet" or on the vertical lines on your upper lip. BOTOX® Cosmetic is safely performed in the office and there is minimal down time.

Yes. Depending upon what the procedure, it might make sense to sleep in a reclining (not horizontal) position for one week following surgery to minimize the collection of fluids in the face and eyelids.

Follow the instructions you will be given about making and administering your cold and warm compresses. These will not only reduce bruising and swelling, but they will also maximize and promote healing

If the surgery is for reconstructive purposes, insurance may cover your procedure. For cosmetic surgeries, insurance is usually not involved. Your surgeon can help you determine if, and to what extent, insurance will be able to help.

It is worth noting that these lines are often blurry, especially in terms of coverage by medical insurances. As an example, a scar revision for an automobile accident injury may be covered by an auto insurance policy, yet another surgery, identical from a medical standpoint that resulted from an accident fall injury might not be covered by insurance. Another example is breast reconstruction following breast cancer surgery -- some insurance companies will cover this, while others consider this primarily cosmetic in nature. It goes without saying that this is a hotly contested issue between those insurance companies and the affected patients.

The following links will be helpful in learning about different cosmetic and reconstructive procedures. We encourage patients to visit these sites.

• www.surgery.org
• www.plasticsurgery.org
• www.breastimplants411.com
• www.implantinfo.com

The endoscope is an instrument which allows the surgeon to utilize a very small incision and still see the actual surgical location deep under the tissues. This means that a minimal scar in the axilla can be made, without compromising

the results of the surgery. To achieve an equivalent degree of visibility and control without an endoscope, the surgeon would need to make a larger incision in a more visible location.

For comparative purposes, this type of procedure is similar in nature to orthoscopic surgeries that have become popular in the media recently for joint surgeries on athletes.

This is not to say that a good result cannot be achieved without an endoscope, but it is more challenging for the surgeon, who is operating solely 'by feel'.