• In addition to positive aesthetic results, data has shown patients often receive a substantial psychological boost.
• It is often possible to return to work within a week, depending on the nature of your work.
• No scientific evidence that breast augmentation increases the risk of breast cancer, autoimmune disease, or any systemic illness.
• No evidence that breast implants affect pregnancy or ability to breast-feed.

• Every surgical procedure carries some risk. Potential complications may include reactions to anesthesia, blood accumulation that may need to be drained surgically, and infection.
• Changes in nipple or breast sensation may result from breast augmentation surgery, although they are usually temporary.
• When a breast implant is inserted, a scar capsule forms around it as part of the natural healing process. The capsule may sometimes tighten and compress the implant, causing the breast to feel firmer than normal. If the capsular contracture is severe, it may cause discomfort or changes in the breast’s appearance. Additional surgery may be needed to modify or remove scar tissue, or perhaps remove or replace the implant.
• Breast implants can make performing and reading mammograms technically difficult. Placement of the implant underneath the pectoral muscle may interfere less with mammographic examination.
• As with other surgical implants, breast implants cannot be expected to last forever. If a saline-filled implant breaks, its contents are harmlessly absorbed by the body, usually within hours.
• Pregnancy can alter breast size in an unpredictable way and could affect the long-term results of breast augmentation.
• As of May 2000, Federal regulation prohibits breast augmentation for purely aesthetic surgery in women less than 18 years of age.

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• Breasts are firmer and more uplifted. The position of the areolas and nipples is enhanced. Data has shown the procedure can also have a positive psychological effect.
• Significant complications from breast lifts are infrequent.
• Unless the patient gains or loses a significant amount of weight or becomes pregnant, breast shape should remain fairly constant.

• Every surgical procedure carries risks. Potential complications include reaction to anesthesia, bleeding, infection and poor healing.
• Patient may be instructed to wear a support bra for a few weeks, until the swelling and discoloration of the breasts diminish. Incision lines, which will heal and fade over time, will be permanently visible, although they are in locations easily concealed by clothing.
• Breasts may not be perfectly symmetrical or nipple height may vary slightly. Minor adjustments often can be made at a later time, but patients should remember that natural breasts usually show some variation.
• Permanent loss of sensation in the nipples or areas of breast skin may occur rarely.
• Occasional poor healing of incisions may lead to necessary revision surgery.
• Gravity and the effects of aging will eventually alter the size and shape of every woman’s breast, in which case the patient may choose to undergo a second breast lift procedure.

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• Breasts will be more proportional to rest of the patient’s body, and clothes will fit better. Breast reduction often makes a dramatic change in appearance as well as physical comfort. The level of patient satisfaction from breast reduction is among the highest of any plastic surgery procedure.
• Significant complications from breast reduction are infrequent.
• It is often possible to return to work within one or two weeks, depending on your job. Resumption of most normal activities, including some form of mild exercise, is often possible after several weeks.

• Every surgery carries some risk. Potential complications include reaction to anesthesia, bleeding, infection and poor healing.
• Patient may be instructed to wear a support bra for a few weeks, until swelling and discoloration of breasts diminishes.
• Diminished sensation in the nipple and areola areas usually is temporary. However, it may take weeks, months or even more than a year before sensation returns to normal. Permanent loss of sensation in the nipples or breasts may occur rarely.
• Incisions will initially be red or pink in color, and will remain that way for a number of months following surgery.
• Incision lines will be permanently visible, more so in certain individuals than others. The incisions for breast reduction are in locations easily concealed by clothing.
• Following reduction, sometimes the breasts may not be perfectly symmetrical or the nipple height may vary slightly. If desired, minor adjustments can be made at a later time, but patients should remember that natural breasts usually show some variation.
• Revisionary surgery is sometimes helpful in certain instances where incisions may have healed poorly.

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• Effects of a phenol chemical peel are long lasting, and in some cases are still readily apparent up to 20 years following the procedure. Improvements in the patient’s skin can be quite dramatic.
• Normal work schedule and other activities can be resumed after 1 to 2 weeks.
• Variants in the phenol peel formula can create a milder solution for broader use.

• Possible postoperative complications can include scarring, infection or abnormal pigmentation. Tends to have a bleaching effect, and patient may need to wear make-up to match treated and untreated areas.
• EKG monitoring is advised.
• Cannot be used on the neck or other parts of the patient’s body.
• Not as effective in treating individuals with dark, oily complexions.
• Some facial skin disorders do not respond to chemical peeling.
• Skin pores may appear larger, and the skin may not tan properly.
• Can activate latent cold sore infections.
• All forms of deep skin peels include the risk of delayed healing and scarring.

The effectiveness of phenol chemical peeling has been proven in clinical studies over the last 30 years. Because they are serious procedures, it is ASAPS’ position that phenol chemical peels should only be performed under the direction of an aesthetic plastic surgeon certified by the American Board of Plastic Surgery (ABPS).

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AHA:

• No anesthesia or sedation is needed, and the patient will feel only a mild tingling or stinging sensation when the solution is applied.
• Sometimes a single treatment will give skin a healthier, radiant look.
• No downtime—patient can immediately resume normal activities.
• Can be mixed with a facial cream or wash in milder concentrations as part of a daily skin-care regimen.

TCA:

• TCA is especially effective in treating darker-skinned patients.
• Can possibly be used to achieve some effects of a deep peel, depending on the concentration and manner of application.
• Generally shorter recovery time than with a deep (phenol) peel.

Both:

• Short, safe procedure.
• No covering or after-peel ointment is necessary.

AHA:

• May require multiple treatments.

TCA:

• May require pretreatment with AHA or Retin-A creams.
• Repeat treatment may be required.
• Deeper TCA peel may result in 2-3 days of restricted activity.

Both:

• Sun block is strongly recommended, especially with TCA treatment. Skin pores may appear larger, and the skin may not tan evenly following a chemical peel.
• Some facial skin disorders do not respond to chemical peeling.

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• Safe, time-tested, effective treatment that provides immediate results.
• No downtime for injectables—patients can immediately resume work and all normal activities.
• No need to obtain tissue from another part of the body.

• Collagen is only temporarily effective. Repeat treatments are needed every three to six months.
• There may be some slight bruising. Pretreatment testing for allergic reactions is recommended. Allergic reactions can cause itching, redness, or other symptoms.

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• Brighter, more alert and rested appearance.
• Incisions will fade over a number of months until they become barely visible.
• Significant complications from aesthetic eyelid surgery are infrequent.
• Usually performed on an outpatient basis. There is little discomfort, and patient will be able to resume most normal activities within 10 days.
• High level of patient satisfaction.

• Every surgical procedure carries some risk. Potential complications include hematoma (an accumulation of blood under the skin that may require removal), infection and reactions to anesthesia.
• Bruising, mild swelling, blurriness and "tight" sensation around the eyes are common, short-lived symptoms following surgery.
• Following surgery, there can be a feeling of dryness or irritation in the eye that requires treatment.
• Possibility of temporary decrease in sensation of the eyelid skin or impaired eyelid function sometimes requires additional surgery.
• High blood pressure, thyroid problems, diabetes, allergies or conditions like "dry eye" may increase the risks associated with eyelid surgery.

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• The patient’s face will appear firmer and fresher. Restores smoother, more pleasing contours to the face and neck. Patient satisfaction is reported for many years following a facelift.
• Significant complications from facelifts are infrequent.
• In many instances, the patient is able to return to work and resume most normal activities within two weeks and may begin to exercise three to four weeks after surgery.
• Incisions can be easily concealed by hair or makeup.

• Recovery time varies among individuals. Generally, the greatest amount of swelling occurs 24 to 48 hours after surgery, but it may take several weeks before all puffiness is resolved. Most bruising will disappear within two weeks. The patient may also experience numbness in the facial area, which may be present for several weeks or longer.
• Heredity and lifestyle factors influence how long results last.
• A facelift cannot correct conditions such as sagging eyebrows, excess skin and fatty deposits in the upper and lower eyelids, or wrinkles around the mouth. A facelift is frequently combined with a forehead lift, eyelid surgery, nose reshaping or skin treatments such as a chemical peel, dermabrasion or laser resurfacing.
• Every surgical procedure carries some risk. Potential complications may include hematoma (an accumulation of blood under the skin that may require removal), infection, and reactions to anesthesia.
• Injury to underlying structures is possible, though it is usually temporary.
• Facelift incisions are usually inconspicuous, but are not predictable due to individual variations in healing.
• Patient must temporarily avoid exposure to direct sunlight and, for the long-term, be conscientious about the use of a sunblock to protect their skin.

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• Return to work and other normal activity within a week.
• Generally performed in the surgeon’s office or an outpatient surgical center.
• Adds aesthetically pleasing contour to the face.
• Results are essentially permanent.

• As with any surgical procedure, infection may occur. If the infection persists, the implant may have to be removed and replaced at a later time.
• Shifting of the implant is another possibility. Should the implant become slightly misaligned, a second procedure might be necessary to reposition it.
• Postoperative bruising and swelling. Mild/moderate discomfort for 1 to 2 days.
• Strenuous activity and rough contact to the implant area must be avoided for 4 to 6 weeks.
• Patients with gum or dental problems will want to confer with their dentist.

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• Natural, non-allergenic.
• Outpatient procedure that generally takes under an hour.
• Injections may last from several months to permanently.
• Little or no downtime.
• Minimal discomfort, which can be controlled with medication.
• Because fat is from the patient’s own body, no pre-testing is required and the fat cannot be rejected.
• Good alternative if the patient is allergic to bovine collagen.
• Cost effective if combined with another procedure like lipoplasty (liposuction).

• Longevity of results can vary significantly from patient to patient.
• Some swelling, bruising—usually about 48 hours. Patient should avoid the sun until the condition subsides.
• Not every area is appropriate for fat injection. Injecting fat into the breast, for example, makes cancer detection via mammography more difficult and is strongly discouraged (see ASAPS’ Position Statement, "Fat Injection for Breast Enlargement).
• Lasts longest when reinjected in relatively stationary areas (such as the cheeks).

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• Although the aging process continues, patient satisfaction remains high.
• Incisions are designed to be inconspicuous when healed.
• Usually performed on an outpatient basis.
• Patient can typically resume most normal activities within 10 days.

• If there is significant skin overhang in the upper eyelids, or puffy bags beneath the eyes, eyelid surgery may be recommended in addition to a forehead lift.
• Temporary puffiness and discoloration may involve the eyelid and cheek areas.
• Temporary numbness and possibly some itching of the scalp can be expected.
• Recovery time varies greatly.
• Every surgery carries some risk. Potential complications could include reaction to anesthesia, hematoma (an accumulation of blood under the skin that might require removal), and infection.
• Patient should temporarily avoid exposure to direct sunlight and, for the long term, be conscientious about use of a sun block.

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• Procedure is permanent. Once the transplant procedures are complete, there is no further necessity for surgery.
• Restores a natural, more youthful, and vigorous look, with potentially positive psychological effects, such as a boost in confidence.
• Less expensive than other hair-loss treatments, when factored over time.

• Must have availability of healthy hair in donor areas of adequate density. May be combined with other surgical procedures in patients with larger areas of baldness.
• Time-consuming process that may require multiple sessions over 1 to 2 years.
• Procedure involves some degree of minor discomfort, bruising and swelling.
• There may be numbness around the donor or recipient site, which generally disappears within 2 to 3 months.
• Several days are required before normal activities can be resumed.
• Patient should not have unrealistic expectations about the nature and extent of transplanted hair growth. Individual hair characteristics, such as coarseness and curl, can affect the possible density of transplanted hair.
• Survival of transplanted hair is not always predictable.

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• A non-invasive, gentle technique that eliminates undesirable hair from all parts of the body.
• Leaves skin looking smoother and silkier.
• Treats larger areas effectively because it removes more than one hair at a time.
• Minimal discomfort.
• Replaces waxing, electrolysis and razors.
• Immediate return to normal activities.

• An ongoing process that requires multiple sessions.
• Sometimes there is a temporary slight reddening of the skin or localized swelling.
• May have to use specially formulated skin care products, and/or a prescribed skin care regimen. Sunscreen is recommended for any treated areas exposed to the sun.
• Patients with darker pigmentation may not respond well.
• Blonde, white or gray hairs are less responsive to laser treatments and sometimes cannot be treated.

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A natural or synthetic biocompatible material, or the patient’s own fat, is injected or implanted in the lips. One injection is usually sufficient to produce the desired result, which may be temporary, depending on the material used. Injections may need to be repeated periodically. Proper placement of the injected material is important. AlloDerm, a natural collagen sheet made from donated skin, is inserted through tiny incisions inside the corners of the mouth. Once the AlloDerm implant is in place, it eventually becomes integrated with the natural tissues. Gore-Tex, SoftForm and soft ePTFE are other synthetic implant options. Further options include:

• Autologen—injectable dermal implant material made from the patient’s own skin.
• Dermalogen—injectable Human Tissue Matrix (HTM) procured from donor tissue.
• Fascia—injectable donor tissue made from the dense white connective tissue that supports body structure. Can also be done as a surgical implant.
• HylaForm—injectable donor tissue made up of a molecular component of the human body.
• Restylane—crystal-clear injectable gel; the hyaluronic acid in Restylane is very close to that naturally found in the body.
  Another augmentation choice is laser lip rejuvenation, which tightens the natural collagen and elastic tissue beneath the lips.

• Immediate return to normal activities (one-day return if sedated) for nonsurgical procedures; depending on the procedure and materials used, recovery period is within a week for surgical procedures.
• AlloDerm and Dermalogen do not require patients to provide donor tissue and are not rejected by the body, because they are human tissue. Usually they have a pliable, natural feel.
• Gore-Tex implants are permanent, easily inserted and well tolerated by the body.
• Temporary procedures like collagen or fat injection can be appealing to patients who want to experiment with a fuller-lipped look, but not necessarily commit to it.

• Allergic reactions can range from prolonged redness, swelling or itching, to firmness at the injection site. Other possible complications include bleeding, lip asymmetry, and migration and extrusion of the implant. Normal swelling and bruising lasts from three days to a week.
• Patients with a reaction to the pre-treatment collagen skin test; who have a serious allergy history; or are allergic to lidocaine (a local anesthetic) should not consider lip augmentation. Treatment is sometimes postponed for patients with active inflammatory skin conditions or with infections.
• Collagen injections have a short-lived effect (9-12 weeks); fat injections provide longer-lasting results, but are sometimes unpredictable as to the degree of improvement, can have lumping or scarring effects, and must be harvested from another part of the body.
• Soft-form is a foreign body and may become infected or be rejected.
• While many techniques exist for lip augmentation, none are ideal.

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• Significant complications from lipoplasty are infrequent.
• Results of lipoplasty are permanent, as long as the patient maintains the postoperative weight. Even if a few pounds are gained, weight may be distributed more evenly.
• The patient may be able to return to work in a few days. Resumption of most normal activities is usually possible within one or two weeks and some form of exercise may be possible soon after.

• Every surgery carries some risk. Potential complications include bleeding, infection, poor healing, and reaction to anesthesia.
• Lipoplasty is not a substitute for overall weight loss, and is not an effective treatment for cellulite.
• Healing is gradual: Fluid retention and swelling following surgery may delay the appearance of a slimmer contour. Swelling usually subsides a week or so following surgery, while bruising can last three weeks or longer.
• Because of individual factors, results of lipoplasty vary.

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• Procedure may be gentler for the patient, possibly causing less bruising, swelling and discomfort.
• May provide a more rapid recovery, with quicker return to work and activities.
• Patients may spend less time in the operating room and under anesthesia than with other lipoplasty techniques.

• Higher cost of equipment may translate to higher costs for patients.
• Not yet widely used; therefore, data on effectiveness is incomplete.
  ASAPS Position: Lipoplasty is a safe, efficient, time-proven procedure that enjoys immense popularity with patients. Equivalent results are achieved from using any of the current techniques. PAL appears promising as a technique offering many potential benefits. It is the position of ASAPS, however, that the lipoplasty patient’s most important consideration should be surgeon selection, not the specific technique being used. Prospective patients should choose a plastic surgeon certified by the American Board of Plastic Surgery (ABPS) and, if the procedure is done in an office-based surgical facility, should be sure the doctor has hospital privileges to perform the same procedure in an acute care hospital. In addition, the office-based facility should be accredited by a national or state-recognized agency such as the American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF), or should be state licensed or Medicare certified.

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• Results are permanent (although subsequent obesity can create a gynecomastia-like effect).
• Firmer, flatter, more contoured chest.
• Significant boost in self-confidence.
• Return to work in one week, unless strenuous activities are involved.

• Some postoperative bruising, swelling, burning sensation. Numbness or lack of sensation could last up to a year.
• Infrequent complications may include infection, skin damage, fluid accumulation, bleeding, scarring or pigment changes.
• Patient will wear an elastic pressure garment for 3-6 weeks.
• Must avoid exposing scarred area to the sun for at least 6 months.
• Surgery may be discouraged for overweight men who have not first tried an exercise/diet regimen.
• Postoperative asymmetry, while rare, is possible; a second procedure may be needed to remove additional tissue.

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• Virtually no side effects.
• Gives the skin an overall fresh, healthy-looking glow.
• Non-surgical, safe, effective "lunch hour" procedure.
• Effective on all skin colors and types.
• No anesthetic required.
• Excellent for skin sensitive to chemical procedures.
• Normal activities can be resumed immediately.

• Requires multiple sessions and maintenance treatments.
  Patients with good skin tone will show best results.
• An individualized skin care program may be recommended to maximize results.

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• No downtime and resumption of most normal activities within 24 hours for majority of patients.
• The pigments used are made from safe, generally non-reactive compounds approved by the FDA.
• The process is relatively quick (for example, an upper and lower lash line takes about 30 to 40 minutes).
• Skin returns to normal by the next day. Swelling or redness is generally mild.
• Mild discomfort during procedure is avoided using topical and/or local anesthesia.
• Good alternative for women with make-up allergies (although procedure is designed to enhance features, not replace make-up altogether).
• Pigments are individually mixed for customized results, and designed to look natural. Results can be seen immediately (although full end result will be seen in about three weeks).

• Permanent procedure. Laser surgery is required to remove pigment.
• Patients must avoid direct sunlight, refrain from applying make-up, and wearing contact lenses for a few days, and avoid swimming for several weeks.
• A small number of patients may experience allergic reaction or infection.
• Scarring is possible due to practitioner error. ASAPS recommends this procedure be performed under medical supervision.
• Pigments may cause interference with cranial MRI scans.
• Needles inserted too deeply in the skin can cause bleeding, spreading of pigments, and damage to hair follicles.

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• High patient satisfaction when expectations are realistic.
• Significant complications from rhinoplasty are infrequent.
• Results are permanent, except for changes associated with the aging process.
• Incisions are usually inconspicuous.
• Patients may be able to return to work a week to ten days after surgery. Most normal activities including exercise can usually be resumed within three weeks.

• Every surgery carries some risk. Potential complications include bleeding, infections and reactions to anesthesia. Numbness of the skin is usually temporary. Noticeable swelling may last for several weeks. Minor residual swelling may continue for many months. Bruising around the eyes and cheeks is most apparent during the first three days following surgery.
• Occasionally additional surgery may be necessary. Since the healing process is gradual, the patient should expect to wait up to one year to see the final results.
• Patients must avoid exposing their reshaped nose to direct sunlight, and must be conscientious about using sun block.

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• No downtime—patients can immediately resume work and all normal activities. But the patient is advised to refrain from vigorous activities for the first 24 hours.
• Little if any discomfort.
• A safe, time-proven procedure.

• Complete correction is not expected on the first treatment. Only about 50 to 70% of the treated vessels will be permanently gone. 3 to 4 treatments are generally required for optimal results.
• Patients may be asked initially to wear heavy-duty stockings to help keep treated veins closed and reduce bruising.
• On occasion, small clots can develop at the site of the injection.
• Color changes can occur in the skin where sclerotherapy has been performed.
• In some cases, laser treatments may be an alternative to sclerotherapy.
• If there is an underlying problem with the venous system, the veins will recur.

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• High level of patient satisfaction.
• In the case of deeper treatments, benefits are relatively long lasting.
• Many patients can benefit from having TCA applied also on the neck and other parts of the body that have been exposed to the sun.
• Sometimes a single treatment with an AHA peel will give skin a fresher, healthier appearance.
• Phenol is particularly useful for minimizing the vertical lines around the mouth.
• Some patients may benefit from the carbon dioxide laser’s mild "tightening" effect on the skin, particularly in the lower eyelid area.

• Infection or abnormal healing are infrequent but may occur with any of the treatments. Deeper chemical peels, dermabrasion or laser skin resurfacing will produce redness and swelling to varying degrees. Depending on the posttreatment regimen selected by the plastic surgeon, a scab may or may not form over the treated area. About 7-10 days after the resurfacing procedure, a new skin will begin to form. After the initial redness subsides, the skin may be pink for several weeks to months.
• Superficial resurfacing procedures, such as light chemical peels, will need to be repeated periodically in order to maintain benefits.
• As the skin continues to age, wrinkles caused by movement of the facial muscles will eventually reappear.
• Patients prone to skin disorders, including allergic reactions or herpes, may find that skin resurfacing can cause eruptions of these conditions.
• Tiny whiteheads may develop on the skin following some procedures.
• The appearance of raised or thickened scars is possible and unpredictable.
• Chemical peels, dermabrasion and laser skin resurfacing sometimes produce unanticipated color changes or skin blotchiness.
• Following all resurfacing treatments, it is important that the patient avoid direct or indirect exposure to the sun until all the redness or pinkness of the skin has subsided. Even after that, it is advisable to protect the skin by regular use of a sun block.
• Superficial treatments require less healing time, but the patient may need to have them repeated to achieve the same results as a deeper treatment.
• Phenol used for spot peeling often has a significant bleaching effect. The patient may need to use make-up to match the treated portions with the skin color of the surrounding areas. Unlike TCA peels, phenol cannot be used on the neck or other parts of the body.

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• Significant complications from abdominoplasty are infrequent.
• Unless there is significant weight gain or the patient becomes pregnant, the abdomen should remain firmer and flatter for many years.
• Recovery time varies among individuals, but patients may be able to return to nonstrenuous work one to three weeks after surgery, and in many instances resume most normal activities, including some mild form of exercise, after a few weeks.

• Every surgery carries some risk. Potential complications include bleeding, infection and reactions to anesthesia. Tissue loss along portions of the horizontal incision is possible when the abdominoplasty is extensive.
• While bruising will disappear over a period of weeks, it may be months before all swelling subsides.
• Numbness over some portions of the abdominal area may persist for several months.
• Incisions lines may take months to fade and will be permanently visible.

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