In my years of practice in cosmetic plastic surgery, this surgical enhancement procedure is the most popular. In the Philippines and some areas in East Asia, augmentation rhinoplasty is extremely popular. In my own private practice alone, it is the most sought after cosmetic surgery procedure and is increasing in frequency.

A typical Oriental nose has relatively flat dorsum and insufficient tip
projection. It is assumed that there is a desire of “westernization” since a high narrow nasal bridge is aesthetically desirable feature in Asian cultures. Sometimes  flat oriental nose may be accompanied with alar flaring and thick lobular skin(overhanging  alae). Thus augmentation rhinoplasty is  done with alar trimming(marginal/vertical /horizontal /wedge/ sailboat excision) of the excess  tissue and skin to achieve maximum aesthetic benefit.

My years of surgical experience in augmentation/ noselift of Oriental/Asian nose and my observation of results produced by other techniques done by colleagues have convinced me that the use of well custom-crafted silicone implant is a procedure of choice. Even the use of goretex implant for dorsal augmentation and noselift did not impress me because it failed to provide aesthetically well defined lobule/tip projection to asian nose. However “goretex” noselift  can also be a better option for some patients.  I believe that its desirable long term results deserves serious consideration and respect. It is not inherently dangerous when properly planned and executed, as Western dogma has purported.

Augmentation rhinoplasty or noselift using silicone implants has been developed and refined by conscientious, experienced and well-trained Asian plastic surgeons. Majority of complications following any cosmetic nasal operation including augmentation with alloplastic prostheses, are related to technical or judgmental  error.

It is a surgical procedure that is performed to shape or modify the appearance of the eyelids. It may be performed purely to remove bagginess, fatty protrusions, and lax hanging skin around the eyes or to correct a “lazy” or blepharoptotic eyelid. Blepharoplasty also refers to the creation of lid creases  on eyelids that have no visible infolding and a similar operation on eyelids with ill-defined or asymmetric folds. Traditionally, blepharoplasty denotes the remova of skin and perhaps a sliver of muscle from the upper lids, together with protruding or excessive orbital fat. On the lower lid, blepharoplasty suggests an elevation of skin-muscle flaps and removal of skin, muscle, and/or fat.  

Since its inception, traditional blepharoplasty has been touted as the procedure to brighten and refresh the eye region.  Commonly it fails miserably in this quest. Failure comes from two sources: (1) poor design of the blepharoplasty surgical procedure, which was conceived for a static model rather than the dynamic tissues of the human face  and (2) poor patient selection.

In the Phillipines, “ eyebag removal”, “slit eye”, and   “ deep set” also refer to blepharoplasty.

Also, “augmentation mammaplasty”.  The primary indication for augmentation mammaplasty is inadequate volume of the breast, which may be either developmental or involutional. Augmentation also may be performed for psychological reasons, including feelings of inadequacy, low esteem, lack of self-confidence, and sexual inhibition. Three incisions are most often used for augmentation mammaplasty. The periareolar incision is a semicircular incision at the border of the nipple-areolar complex. The inframammary incision is located at the inframammary  fold; it does not extend medially beyond  the medial border of the nipple-areolar complex.

The axillary incision is located in the hair-bearing region of the axilla. Recently the endoscope  been used via the axillary or umbilical incisions, but this technique is not universally performed.  Each of these approaches has benefits and drawbacks. With the periareolar incision, scarring is usually minimal, but there may be an increased incidence of nipple paresthesia.  The inframammary incision offers excellent exposure but may result in a more noticeable scar. The axillary incision leaves no scar on the breast but may provide decreased exposure of the operative field. The implant may be subglandular, submuscular, or subpectoral. Every surgeon believes that his or her technique is the best, and to some extent this is true.

Still a few caveats should be remembered. Ptosis may be better addressed with either a subgladular or subpectoral placement. The implant is generally more camouflaged with submuscular or subpectoral placement. Regardless of the technique, the surgeon should listen to what the patient desires; in turn, the patient deserves to be well informed about the possible limitations of the procedure. Multiple studies have failed to show any increased induction or increased incidence of breast cancer in augmented patients with silicone gel implants.

Also, “Reduction mammaplasty”.  Many women choose to undergo breast reduction surgery not only to reduce the size of their breasts but also to help ease the physical and emotional burdens often associated with large breasts. Breast reduction surgery removes fat, glandular tissue and excessive skin from the breast, while simultaneously lifting the breast, making it smaller, lighter and firmer.

A reduction is most common with women between the ages of 40 and 70, when they are sick of suffering from back pain and other conditions. Teenage girls who have experienced significant growth of breast tissue can also benefit from breast reduction/reduction mammaplasty.

Also” Liposculpture”, “Suction assisted lipoplasty/lipectomy”. This treatment is suitable for patients whose weight is within the normal range but whose figures appear disproportionate due to fat deposits in areas such as the abdomen, upper buttocks, love handles, thighs, upper arms and chin. These stubborn fat deposits typically do not respond to dieting or exercise. Best results are obtained from liposculpture if the  skin has enough elasticity to achieve a smooth contour after  fat removal.  

Liposuction is not a substitute for weight loss, nor  a cure for obesity. If a person has loose skin, liposuction can actually make it worse. If the patient has true skin laxity, liposuction can be combined with some skin-tightening or lifting procedure.

Liposuction has been refined and is quite safe. It removes localized deposits of excess fat from specific areas of the body by using small cannulas, or tubes introduced through small incisions. Liposuction has been around for some time now. It is usually performed in day surgery under general anesthetic or intravenous sedation, depending on the amount of fat being removed. The fat is literally sucked out from the body. Patients are required to wear a compression garment on the treated area for  at least four weeks after the procedure to assist in skin retraction and body contouring during the healing process. The following are some  techniques in liposculpture;

1.Tumescent liposuction

The tumescent technique involves infusing the target area with saline and anesthetic before the fat and fluid are suctioned out. This technique is best suited for first-time liposuction patients who have specific fatty deposits they are looking to eliminate.

2.LASER-assisted liposuction

This type of liposuction utilizes a laser fiber that is directed right to the fat cells to help dissolve them instantly. The process is more targeted than traditional suctioning with a cannula, making it more appropriate for localized fat deposits. The procedure only requires local anesthesia. One study comparing standard and laser-assisted liposuction found no difference between the two modalities in swelling, bruising and overall results.

3.Ultrasound-assisted liposuction

The ultrasound waves help break up the fat before it is suctioned out, and many surgeons find this approach to be gentler and better for precise sculpting. Ultrashape is a brand name version of ultrasound-assisted liposuction, and it can be appropriate for patients who have had previous liposuction procedures or those with fat deposits located on the back or other hard-sculpt areas. It may also have an added skin-tightening benefit.

4.Power-assisted liposuction

This is essentially traditional liposuction with the addition of an oscillating cannula head that moves back and forth.  According to professionals, each pass of the cannula achieves the equivalent of 40 or more passes with traditional liposuction.

Lipodissolve

This is also a fat-reducing procedure that can help create a more harmonious body shape. Multiple injections of measured amounts of phosphatidylcholine are injected in a grid directly into the area of concern. This is suitable for treating small problem areas. Another one is the use of external ultrasound. Ideal candidate for this is one with the right weight and with good skin elasticity. Usually, they just need contouring in certain areas such as the abdomen or thighs. This method does not change weight, it just breaks down fats.

Chin augmentation and reduction-  A balanced facial appearance depends partly on the shape and size of your chin in relationship to your nose. Chin surgery can reduce (mentoplasty) or augment (genioplasty) the chin to give your face a more balanced appearance.
Chin surgery is usually performed in an outpatient surgical center or hospital. The procedure may be performed under local anesthesia (sedated, numbed, and awake). For more complicated cases, general anesthesia may be used (asleep). Patients usually return home within hours of the procedure. Some patients require an overnight stay. Depending upon the extent of the case, time in surgery may be one or more hours.
To decide how to proceed, the surgeon will examine your chin and jaw, and weigh factors that could influence the outcome of surgery, such as your age, skin type, and whether you are psychologically prepared for treatment.
During mentoplasty surgery, the surgeon makes an incision in one of two possible locations:

• under the lower lip inside the mouth

• under the chin in an inconspicuous location

The surgeon will then use an electrical instrument (a bone burr or a drill) to reduce and reshape the bone to create a more natural appearance. The surgeon will stitch the incision closed and apply tape to the chin area.
Genioplasty can be performed by the use of silicone implant to augment a receding chin, or by the surgical advancement of the bone itself. Once you and your surgeon decide whether to use a silastic chin implant or to advance your own bone, the incision will be chosen.
If you choose a chin implant, the incision is in one of two possible locations:

• under the lower lip inside the mouth
• under the chin in an inconspicuous location

The implant is placed in an appropriately sized pocket. Sizers are used to achieve the best appearance; then the actual implant is carefully placed and the incisions are closed.
If you choose to advance bone in the chin, the surgeon makes an incision under the lower lip inside the mouth using a powered saw with a special blade to separate the edge of the chin bone. The surgeon moves the separated chin-bone tip forward and positions it with wires or special bone plates and screws. Finally, the surgeon stitches the incision closed and applies tape to the chin area.