Aesthetic Surgery

RHINOPLASTY

The first thing one notices when they look at your face is your nose, because it
is the most protrusive part of the face. The harmony of the nose with the other
parts of the face determines your beauty. Moreover, the nose, as the gate of
respiratory system, has many important functions such as breathing,

filtration, heating and humidifying of air, smelling and taking as much air as
needed by the lungs.
The aesthetic or functional disorder in the nose can result from either
congenital or an accident or an injury happened. Rhinoplasty can be performed to
meet aesthetic goals or for reconstructive purposes-to correct functional
defects.

If the patient has complaints about breathing problems resulting from septum
nasi deviation or large concha or polyp, all of these can be healed through
rhinoplasty. In some rare cases, the size of the nostrils may be required to
narrow, as well.Currently, there are two methods employed in rhinoplasty.

1- Classical Method : The incision is made from inside the nostrils. There will
be no incision scar or sutures visible. Part of the sculpting of the structure
of the nose is done through groping without actually seeing it.

2- Open Rhinoplasty: Open rhinoplasty is a technique developed recently and
employed widespread all over the world. In open rhinoplasty the nasal skin is
lifted off by a small incision on columella. By naked eyes, the structure of the
nose made of cartilage and bone is sculpted. Then the nasal skin is replaced on
the reshaped nose structure. Columellar incision leaves 4-5 sutures. The scar of
the sutures disappears in one month.

Before the surgery, the required laboratory test and preparations are made.

The surgery of rhinoplasty should be performed in a fully-equipped hospital
under general anesthesia and sedation plus local anesthesia.

The surgery is takes 1 or 1.5 hours.

After the surgery, you will have splint over the nose and intra-nasal package.

You may stay at hospital for 1 day or return home on the same day of the surgery.

Two days after the operation, intra-nasal package are removed. The package can
be surgical gauze or spongy tissue which allows breathing.

The removal of the nasal package does not cause pain, therefore there is no need
to feel anxious about it.

One week after the surgery, the splint is removed. It is replaced by a bandage
which will stay there for 6 days.

There may be bruising or minor swelling in the eye area for 1 or 2 weeks.

The patient can return to workplace 14 days after the surgery without any
bandage on the nose.

The patient is recommended not to wear glasses for 6 months and avoid excessive
heat and cold and any nasal trauma for three months.

Swellings disappear in about 3 months.

The last and permanent shape of the nose is achieved 6 months after the surgery.

Although rarely if a small (1-5 %), revision is required, it should performed
after six months of the surgery..

6 months after the rhinoplasty surgery, only the people who have close relations
with the patient may notice he/she had a rhinoplasty operation. If a stranger
notices that the person has had a rhinoplasty, it means that the surgery is not
successful.If you believe that you need a rhinoplasty, we recommend you to
select a competent surgeon and provide detailed information on all the risks and
possibilities from the surgeon before the surgery.

Face Lift

What is surgery of the face?

An alternative name given to face lift is Rhytidectomy. With frequent weight
loss and gain and people over 40 years of age the skin loosens and becomes
flabby due to the force of gravity. Ultimate treatment of deep wrinkles formed
in the face and neck and saggy skin is achieved through face lift.

Who are the Best Candidates for a Face lift?

The best candidates for a face lift are men or women whose face and neck have
begun to sag, but whose skin still has some elasticity and who has no other
systemic disorder. Most candidates of face lift are after forty years of age. In
order to make you feel look younger and fresher, the face lift can be done with
rhinoplasty, forehead lift or eyelid surgery(blepharoplasty). For creases that
are not deep, peeling (mechanical or chemical) or injection of fillers (fat or
hyaluronic acid and the like) can be performed.

Before the Surgery: If you plan to have a face lift, you should have decided
what you want and why you want to have this surgery. Discuss your goals and
expectations as well as the details of the operation with your surgeon.If you
smoke, it’s especially important to stop ten days before surgery. Also, aspirin,
aspirin-based drugs and vitamine E, you should stop taking them then days before
surgery. Discuss with your surgeon your habits of sunbathing and skincare. Do
not forget to ask about what you need to do after the surgery, if you want your
surgery to produce positive results. If necessary, discuss with your surgeon
several times. You should enter the surgery room without any hesitation or
question in mind.

The Surgery: The surgery is performed in fully equipped hospitals under the
supervision of an anesthesia specialist. It can be performed under general
anesthesia as well as sedation plus local anesthesia. Under normal conditions,
the surgery takes 2 to 4 hours. You can be discharged from hospital on the same
day of the surgery. Additional operations (such as rhinoplasty, blephoraplasty
or filler injection, and the like) may cause the surgery last longer. In that
case, the patient stays at hospital for one day. Rhytidectomy is a surgery that
leaves scar. But this scar is not noticeable and will be invisible in time. The
scars are usually hidden by your hair or in the natural creases of your face and
ears. In any case, they’ll fade within time and should be scarcely visible.

After the Surgery

Early period after the surgery does usually not cause severe discomfort.
A general swelling of your face, some bruising and numbness and tension are
possible.All of these will disappear in 3-5 days.
Bandages are used with openings for nose, mouth and eyes.
Drainage tubes are removed after 2 days.
Similarly, bandages are usually removed after 2 days.
General check and compression change are done.
Patient’s hair is washed.
The sutures are removed after 5 to 7 days.

Getting Back to Normal Life

The results of face lift are generally good or excellent. Very rarely, a
revision may be required. These are simple operations performed under local
anesthesia without any hospitalization. The patient can return to normal in one
week and can wear make-up. The new shape given to the skin of the neck and face
will be affected by the gravity force and living style. Depending on the
patient’s general characteristics, your new face will continue sometimes 5 to 10
years and sometimes for a lifetime.

Eye Brow Lift

It is performed through small incisions in the hairline on temples and the
eyebrows are lifted. You do not need to be hospitalized. You can go back to work
after one day.

Suspension Technique of Face and Eyebrow

Slightly loose facial skin and eyebrows can be lifted through the method of
suspension without any surgical operation. The effect is not permanent with this
method.

MAMMAPLASTY

1-Augmentation Mammaplasty

Breasts are significant formations symbolizing the beauty and feminity. They may
be small for structural reasons. In some cases, there may be only one breast. Or,
one of them may be too small while the other in normal size. (asymmetrical
breast), in which case, the small breast is gone through a surgical operation
order to gain a normal appearance and size. With the purposes above, several
methods have been tried since the beginning of the twentieth century.

In 1904, paraffin was injected into the breast.

In the 1950s and 1960s, liquid silicone was injected into the breasts.

In 1958, Ivalon sponge (polyvinyl alcohol) was employed.

These methods caused extremely bad results due to the foreign body employed.
Later, breast augmentation was performed through using the patient’s own tissues.
Then, dermofat grafts and fat injections were tried, as well as some vacuum
devices, in breast augmentation. Unfortunately these methods were not
satisfactory and permanent.

Today, breast implants (or breast silicone, as widely known) used for this
purpose are the only and the best option for the candidates. They have been used
since 1963 and the quality of the products increase each year. Only in the USA,
more than two million people have been surgically operated using the breast
implant method.

There has been significant research on the breast implants within the last 25
years and novel methods and developments have been introduced. The American
official institution, FDA (Food and Drug Administration) and the European Union
institution EQUAM separately prepared a detailed protocol and published an
announcement on the silicone breast plants. According to the declarations:

1 – Silicone breast implants have not been seen to cause any carcinoma or other
malignant diseases.
2 – They do not prevent pregnancy.
3 – They do not prevent breast feeding.
Breast implants (silicone) are medical devices (similar to a balloon and shaped
like a breast) placed under the breast to support. The capsule contains solid
silicone and polyethylene.

According to the implant filler, they are two types:
a – Gel filled (gel or cohesive silicone),
b – Salin filled.

According to the surface of the capsule, they are two types:
a – Smooth surface
b – Textured

According to the shape, they are two types:
a – Round shaped
b – Tear drop, anatomical shaped, natural shaped

According to the height, they are two types.
a – Low profile
b – High profile, and super high profile . Also, there are one, two or three
layered capsulated types.

Incision types for breast implant :

Inframammary incision
Axillary incision
Transareolar incision, (Mustarde method)
Ä°nferior periareolar incision
Medial periareolar incision

Breast implants can be inserted into one of the following compartments.

1 – Subglandular (over the breast muscle and behind the breast tissue)
2 – Submuscular (beneath the pectoral muscle and on top of the chest wall)

You will want to discuss the pros and cons of these alternatives with your
doctor before surgery to make sure you fully understand the implications of the
procedure your doctor recommends for you. Needless to say, the size of the
implant (in cc) should be decided before the surgery with your surgeon.

Breast implant is performed at hospital under proper medical conditions.
The surgery lasts 1,5 hours.
Breast augmentation is performed under general anesthesia.
You can stay at hospital for one day or you can return home the same day of the
operation.
After the surgery, the patient is worn a surgical bra.
Within 2 days, the gauze dressings will be removed. And mini hemovac drains are
removed, too.
The removal of drainage is painless, there is no need to be anxious.
If the implant is inserted under the muscle, you may feel pain for 2 or 3 days.

The patient can return to normal life after 4 or 5 days.

Because the breast implants inserted into the body are actually foreign objects
to human body, typical reactions of the body will be seen after the surgery. In
other words, the body will try to expel the foreign substance (reject phenomenon).
When it cannot do so, the body insulates it by surrounding collagen tissue
around the surface of the implant. This is a normal reaction to any foreign
body. If the newly created collagen tissue of it reaches a few millimeters in
thickness, it will contract, the breast becomes harder and gets a rounded shape.
This results in a firmer or hardened breast and discomfort or pain. This is
called capsule formation. The implant will never harden itself. And, no human
body accepts the implants as a natural object.

The number of capsular contracture cases decreased considerably due to the
improvements in products and techniques.
I would like to clarify a point on a common myth. Some people may have developed
a sort of phobia or antipathy against silicone. The real story of the
misinformation is as follows. Silicone is the third most common substance in the
world. In nature, it can be found either a solid, gel or liquid. In the past,
liquid silicone used to be employed as a filler injection to acquire fuller lips
or to fill in the holes in the skin. Due to terrible results of these
applications, they are forbidden to employ in Turkey for years. I can never
imagine a surgeon who would try to inject liquid silicone into human body. Yet,
this substance may sometimes be imported into the country illegally. Or, more
horribly, some unauthorized and irresponsible persons use some commercial baby
oils as filler. The victims who gain a better look for 1 or 2 years go through
enormous problems which may last lifetime.
Breast implant ( Silicone) consists of solid or gel silicone. These types of
silicone do not harm to the body because they cannot leak into the tissues. As a
matter of fact, silicone exists in many types of daily products: For example,
lipsticks, hair sprays, deodorants, cake forms and many industrial products and
medical materials, etc.

As a consequence, we can say that:

Breast implant (silicone) is harmless.
Implants do not prevent pregnancy and breastfeeding.
Surgeries performed by qualified surgeons have 90% good or excellent results.

They can be easily removed whenever desired and harmlessly.

2- Mastopexy (Breast Lift )

Semicircular incision is made around the areola and a 5 -6 cm.incision is made
from the inferior part of the areola vertically up to inframamary sulcus. So,
the pythotic breasts are repositioned and reshaped. It leaves a small vertical
scar and around the areola.
Your breast lift will be performed in a hospital under general anesthesia,
sedatives plus local anesthesia.
Mastopexy usually takes two or three hours.
Patients may leave hospital on the same day or can stay in hospital for one day.

Patients can return to their normal life after one week.
The scars will be invisible after 6 months.
The effects of the surgery is permanent.

3- Reduction Mammaplasty

It is performed just like as in mastopexy. The excess breast and fatty tissues
are cut and removed, therefore, it lasts more than breast lift and causes a bit
more discomfort.
Patients will stay in hospital for 2 or 3 days.
Patients can return to their normal life after two weeks.
Depending on the size of the breast, postoperative scar can be reversed T shape.

In some cases, a revision surgery may be needed.
There may be limitation in breast feeding.

ABDOMINOPLASTY

The natural ability to give birth is a holy property given to women. However,
one or more pregnancies may cause undesirable changes in women’s breasts,
genital organs and abdomens. During pregnancy, women gain considerable amount of
weight. Part of this weight is lost after the birth, whereas some of it remains.
Abdominal muscles become flubby, stretched out and have marks called stria.

Besides, muscle weakness may have occured in abdominal wall. Flubby abdominal
skin is particulary noticeable in women who, through multiple pregnancies, have
stretched their abdominal muscles and skin beyond the point where they can
return to normal. Due to gravity force, the deformity may have increased even
more. Abdomen is part of the body where excessive fat is deposited.

When the excessive fat amount is reduced through losing weight, the abdominal
muscles may become flabby. The fat deposited here is resistant to diet and
physical exercise. Despite the absence of pregnancy, the same disorders are seen
in men, too.
Abdominal surgery is a surgery that improves the appearance of flabby, stretched-out
abdominal muscles and skin. Excessive fatty tissue and loose skin are removed.
Abdominoplasty is performed on males, as well. If required, liposuction may be
performed as a complementary action.

The surgery is performed in the operating room at hospital under general
anesthesia.
The surgery takes 1,5 or 2 hours. You may have to stay hospitalized for 1 or 2
days.
Sutures will be removed in seven to ten days.
The dressing may be replaced by a support garment for six weeks.
The post-surgery period is generally unproblematic.
Some slight pain, swelling, numbness inside the abdomen, some bluish colour may
occur.
Yet, all of these disappear in a short time.
Small flat tubes (drains) will be inserted to allow fluid to drain out of the
incisions
Which are removed in two days after the surgery.
You can return to your normal life in 2 to 4 weeks.

Abdominoplasty may leave some scars. Yet, the scar will not show under your
bathing suits or underwears. The place of the scar can be planned beforehand in
accordance with the type of the underwear the patient uses. There will be a scar
around the umbilicus, too. Yet, in time, they will flatten out and lighten in
colour.

Apart from the classical abdominoplasty, there is another type called “Mini
Abdominoplasty”. This surgery is performed to remove persistent excessive fats
and flabby look in the lower part of the abdomen. There is no scar left over the
umbilicus. It is an easier surgery compared to the other one. You may be leave
hospital within a few hours.

Abdominoplasty is an operation with permanent effects.

Brachioplasty – Armlift

A brachioplasty (also known as an arm lift), is a surgical procedure to remove
and tighten the loose skin. When you age, the upper arm skin characteristically
loses its elasticity and becomes loose and flabby. Looseness of the skin that is
altered in time increases when the fat, muscle and bone tissues dissolve under
the skin.

Loose skin that can be seen in the rear and interior arm part (Bat Wing
Deformity), occur by old age, periodical weight loss and/or force of gravity. (The
size of loose skin and the amount of fat tissue deposited there may change from
individual to individual). The Brachioplasty surgery usually lasts an hour. The
patient may have local or general anesthesia.

The scar is hidden in the axillary area and cannot be seen clearly. It heals
well in about 10 days.
When the skin quality is high without any looseness, that is, in the cases of
too much fat deposits, it may also be suggested that liposuction be used to
remove the excess fat deposits. However, when excess fat deposits are
accompanied with loose skin, a brachioplasty surgery is required. As long as
good candidates are selected, the results of the brachioplasty make happy both
the patient and the surgeon.

Inguinal Lifting (Leg Lift)

Inguinal Lifting is performed through an incision into the inguinal part of the
leg, Principally, the surgery is the same as brachioplasty. The recovery after
the surgery is the same as-or a little bit more than-that of brachioplasty.

LIPOSUCTION, LIPOSCULPTURE

Liposuction is the removal of persistent fat deposited in certain areas of the
body and which is impossible to lose by diet or physical exercises. The purpose
of the operation is certainly not weight reduction. It is a body contouring
operation.

The fat in human body is usually deposited in two compartments:
1- Superficial fat layer
2- Deep fat layer.

The fat deposited in the deep layer has a loose structure whereas the
superficial fat is surrounded by collagen tissue straps and hard in structure.
Cellulite is best defined as the shrinkage of the collagen tissue band in which
fat is deposited in the chambers.The number of the fat tissue cells does not
change after the adolescence. Through gaining weight the volume of the fat cells
increases. By means of liposuction operation the excessive fat is removed from
the persistent fat deposits and the number of the fat cells in these parts of
the body decreases. In case you gain weight after the liposuction operation,
there will be an even distribution of fat in the body. In other words, there
will not be so much deposit and swelling in the persistent fat deposits.

Liposuction, which was first performed in the 1970s, is one of the most
important innovations of the last three decades in the aesthetic surgery. In the
early phases, due to the use of too thick hollow steel tubes called cannulas,
underdeveloped medical techniques, inadequate devices and inexperienced
practices led to undesirable and unpleasant and even bad results. Skin
irregularities and undulations, change in skin colour, loss of feeling or
numbness or shocks resulting from excessive blood and electrolyte loss or even
deaths used to be listed among the complications of liposuction. However, with
the developments in technology, operational techniques and experience these bad
consequences have become part of history.

Today, liposuction is regarded as one of the safest and most effective types of
operation when it is performed by a qualified surgeon on good candidates. It is
considered to be so safe that according to a research conducted by the
International Society of Aesthetic Plastic Surgery (ISAPS), liposuction has been
found to be the most frequent cosmetic operation in the world.

At one session about 3-4 liters of fat can be removed. If the limit is required
to be exceeded, the levels of blood and electrolytes must be checked and, if
required, blood transfusion must be performed. In the cases such as morbid
obesity with young (between 20-30 years of age) and overweight patients (more
than 120-130 kg), the greatest amount of fat removal performed in one session
has been about 28 liters. (MEGALIPOSCULPTURE ).
LiIPOPLASTY is a term used for the cosmetic operation on the fatty tissue.

LIPOSUCTION is a surgical procedure designed to sculpt or contour one or more
areas of the body, by removing localized deposits of fat. LIPOINJECTION or
LIPOFILLING is a process by which fat is harvested from one area of the body (usually
the periumbilical region, thigh or buttock) through a thin cannula and injected
into the region contour deformity. These are the basic terms. All other terms
used to describe fat tissue plastic surgery have been derived from these terms.

In ultrasound-assisted Liposuction, also called ultrasonic liposuction, a
special cannula is used. This transmits ultrasound vibrations to the area of
excess fat in order to break up and emulsify (liquefy) the fat cells. However,
because the thickness of the cannula is too much and the risk of burning and
leaving scars, this method is not popular in Turkey as well as in the world.

The international terms usually used for Liposuction are:

Liposuction
Suction Assisted Lipectomy ( SAL )
Superficial Liposuction
Multiple All Layer Liposuction (MALL)
Liposcalpture
Ultrasound Assisted Lipectomy (UAL)

We strongly recommend that people who use some other made-up terms and attempt
to deceive candidates as if they invented a new method or technique only to make
profit, should be strictly avoided, as they do not comply with professional
ethics. Some of these people may even claim that they can remove fat at lunch-breaks,
without pain, blood or anesthesia.

The fact should be very well known that there is no operation can be made
without pain. However, local anesthesia can of course be employed not to feel
pain.
It should be known that a bloodless operation is impossible. Research
demonstrate that 1 liter of removed fat contain 70 cc blood. This shows that
those who claim to conduct a bloodless operation do not tell the truth about the
operation.

If the fat is to be removed from a small and limited area of the body, through
vacuum injection and local anesthesia, fat can be removed and the patient can
return to his/her job in a very short time. Yet, this is a very restricted
application.
There are claims that there won’t be any scar after operation; this is usually
connected to the vacuum injectors sometimes employed by us, the plastic surgeons.
In short, those false claims announced as breakthroughs are nothing but
liposuction technique used for years by plastic surgeons for limited areas of
the body.

Liposuction is performed in hospital under local anesthesia (for small areas),
sedatives plus local anesthesia or general anesthesia.

Before the liposuction operation, the surgeon measures the amount of deposits
while the patient is standing and marks the more extensive areas of fat deposits
on the patient’s skin.

After the anesthesia, the marked area to remove the fat is injected a specially
prepared fluid to swell so that that the fat deposits can be removed easily and
with much less blood loss.

After the surgery, the patient is dressed in elastic compressive bands or
garments.

The garment is recommended to be worn for 4-6 weeks.

The bruising or swelling that may occur after the operation will disappear in
two or three weeks.
As in all medical operations, patients of liposuction should select a qualified
surgeon after a careful research. Patients are strongly recommended to get
information about all the risks and complications and to avoid so-called “experts”–the
profit makers–who try to deceive people with false advertisements.

Calf Augmentation

Calf Augmentation is performed in order to achieve a smooth appearance of the
weak calves.

Special silicone gel implants (in the shape of a cigar) are employed for this
purpose.

The surgery is performed under general anesthesia, spinal anesthesia or sedation
plus local anesthesia.

It takes 1 hour.

You don’t have to stay at hospital after the surgery.

You can return professional life within 4-5 days.

Surgical bandages are recommended to be used for 2-3 weeks.

The scar of the incision is hidden on popliteal area (beneath the knee).

Scars become invisible in time.