Plastic surgery – FAQ

What is the difference between plastic and cosmetic surgery?

Plastic surgery is primarily for soft tissues, that is: skin and muscles, as opposed to the hard tissues or bones.

It encompasses both reconstructive surgery and cosmetic surgery. The difference between these two surgeries is that the second has no medical purpose and is by no means mandatory unlike the first, which occurs following an accident or cancer.

Indeed, cosmetic surgery aims to embellish either the silhouette, the face or to rejuvenate the appearance by performing, for example a facelift. Restorative surgery aims, as its name suggests, to “repair” what has been damaged. Let us not forget that all the techniques of so-called aesthetic interventions are derived from the techniques of reconstructive surgery.

When did cosmetic surgery start?

In France, cosmetic surgery saw the light of day after reconstructive surgery, which itself appeared after WWI with the “Broken Faces” (gueules cassées in French). For example, the great French surgeon Morestin reconstructed the famous “Broken Faces” after the World War I (1914 – 1918).

They were soliders whose faces had been partially destroyed by shrapnel. At that time, surgeons had tried to put in place new techniques to reconstruct these mutilated faces, in particular the nose, jawline, etc. Unfortunately, since they had poor knowledge of the skin, the results were mostly failures. However, all these efforts gradually contributed to better mastering this type of surgery and gave birth to new techniques which inspired cosmetic surgery.

Cosmetic surgery, for its part, made its appearance after the Second World War in the 1950s, particularly in the United States. However, this new surgery remained reserved for an elite such as actresses and the first operations were mainly focused on the face, such as rhinoplasty (nose operation). In 1960-65, the first breast implants took place.

Who is a plastic surgeon?

A plastic surgeon is a surgeon qualified in plastic, reconstructive and cosmetic surgery. This speciality is recognized by the Medical Order Council and has existed as such since 1989. Before the creation of this specialty, cosmetic surgery was performed by surgeons from different disciplines (stomatology, ENT, general surgery, etc.).

To be a plastic surgeon, you need mandatory training (after 6 years of Medicine) of 2 years in general surgery, as well as a specialization in plastic, reconstructive and aesthetic surgery which lasts for 4 years. A minimum of 12 to 15 years of study are necessary for graduation (DES or DESC).

The qualification in Plastic, Reconstructive and Aesthetic surgery is currently recognized by around 700 plastic surgeons in France, the list of which is available on the Internet: www.conseil-national.medecin.fr or from the Council of the Order in your region.

What happens in a first consultation?

A first consultation should take place exactly like a routine medical consultation. A cosmetic surgery consultation must therefore begin with an examination of the present and past health problems of the person concerned. Next, the doctor must determine what the aesthetic demand is, then he must examine his patient himself (and not leave this task to an aesthetic consultant!). It is during this first consultation that the doctor will give general indications about the procedure and specific information to the person examined.

During this first consultation, the surgeon must give you a precise estimate of price, including all the possible costs, for example, clinic costs, surgeon fees, anesthesiologist fees, implants and products to be used, etc.

In addition, he must – this is in any case recommended – give you a written summary of all the information that has been given to you orally, and finally give you the document called: “Informed consent”.

Is there a mandatory reflection period before an operation?

Not only is there a cooling-off period before any surgical procedure, but this period is all the more mandatory as it precedes cosmetic surgery. Before 2005, it was 15 days with the possibiltiy to reduce this time to eight or even less if the patient expressly requests it.

Since the decree dated 12th July 2005, this 2-week delay can not be changed. This period is very important because it allows anyone wishing to undergo cosmetic surgery to properly think over the procedure and not to make up their minds under any pressure. Indeed, this decree was issued following abuse by certain surgeons, such as patients undergoing surgery on the very day of the consultation without even being prepared to undergo an operation.

Are cosmetic operations safe?

No surgical operation is without risk!

Whatever the operation, whether it is light, like an eyelid operation, because it is performed under local anesthesia or more serious, like a tummy tuck that requires several days of hospitalization, there is always an operative risk.

Any operation must therefore be carefully considered and not be requested on a whim. It is for this reason that the law imposes a reflection period of 15 days between the day of the consultation and the day of the operation, as well as the submission of a document called “Informed consent”

Does the surgeon have an obligation of results?

In France, while no surgeon has an obligation of results, there is nevertheless an obligation of information and enhanced resources.

This means that a surgeon is responsible for his actions and that before proposing a surgical intervention he must weigh the pros and cons, the goal being to bring an advantage to his patient. This is all the more true in cosmetic surgery, since unlike conventional surgery, the patient does not suffer from any particular disease!

The cosmetic surgeon therefore has a duty to provide personalized information. A young patient cannot receive, for example, information identical to that which could be given to an older patient! In addition, from one person to another, it is not the same technique that will be used, so the surgeon should always explain his choices to you and that none of your questions remain unanswered.

As for the reinforced means, this means that the surgeon must implement all the ressources necessary so that your operation goes as well as possible, starting with the clinic, which must be appropriate. For example, liposuction even if performed under local anesthesia must be done in an operating room and not in his office. A surgeon who would take the risk of doing this type of act in his office would not meet the obligation of enhanced means. In the case of general anesthesia, the surgeon must refer the future operation to an anesthesiologist. This pre-anesthesia consultation must take place well before the operation and is mandatory.

Hairs do not live in isolation, but in groups of one to four hairs called “follicular units”. These units are invisible to the naked eye, but thanks to the microscope, they can be preserved during the transplant. This technique is only performed by very specialized plastic surgeons who work with the help of a special team. The results are long lasting because the transplanted hair comes from another part of your head; there is therefore no rejection phenomenon.

Which technique ensures better, long-term results?

The fat is first sucked out by liposuction from the abdomen, hips or saddlebags.

It uses a special cannula (very fine which can suck only the ideal tiny particles, which have the greatest chance of working. This fat is sucked with weak suction so as not to damage the fat, which is a very slow and meticulous process.

It employs tiny incisions, but carefully injects only very small amounts (1ml) of fat in hundreds of different levels throughout the desired area of the buttocks. This gives a very normal shape and feel to the buttocks.

Why does this technique take longer?

By putting only small amounts of fat in each tunnel (1ml), it ensures that each fat particle has healthy tissue around it to give it a good supply of blood. It takes about 300 syringes of 1 ml to fill a buttock (equivalent to a prosthesis of 300gr).

This work is long and very meticulous, which requires a team of 3 to 5 people and several hours of work.

How long is the hospital stay?

The average length of hospital stay is 1 day.

What are the post-operative consequences?

The patient should be relieved of any pain or discomfort by simple analgesics (paracetamol) for 7 to 10 days. However, they cannot sit down for 10 days.

The first dressing is redone at 24 hours, and then patients can walk.

A minimum of 20 days is required for you to be able to perform normal daily activities. However, the practice of sports requiring the gluteal muscles should be postponed to 2 months.

What are the risks ?

They are significantly less than with buttock prostheses because there is no foreign body needed.

The possible risks are:

Hematoma, local infection, seroma, local pain or numbness, premature fat loss, asymmetry requiring a retouch procedure.

What is the sensation to the touch?

Once the swelling has subsided, the buttocks appear completely normal because it is your own fat, therefore living tissue.

What is the cost of buttocks augmentation with fat (Lipofilling)?

This intervention is not covered by social security. It requires an operating room and it is a long, rigorous technique. The patient bears all the costs (hospitalization, fees, operating room costs, etc.). We must therefore consider a budget of 3000€ to 4500€.

What is the cost of buttock augmentation with Macrolane?

This intervention is not covered by social security. It is more expensive than fat injections because it is simpler and also quicker to do. We must therefore consider a budget of 3500€ to 5000€.