Plastic surgery for the face

If you’re not happy with the face and body that nature has given you, plastic surgery might make improvements that are more to your taste. As with all surgery, there’s a risk involved, but for some people the outcome can mean greater confidence and a changed outlook on life. According to plastic surgeon Dr Amorn Poomee, more people are opting for surgery these days. "Many people already look good, but they want to be happier with the way they look, and more self-confident."

The most popular procedures in Thailand done on the face depends on the age group. For younger people, the two most popular categories of procedures are blepharoplasty – a reshaping of the eyelids – and rhinoplasty, a reshaping of the nose. For older people, rhytidectomies (facelifts) are the most requested procedure.

Blepharoplasty on younger people most commonly involves changing a single to a double eyelid – occasionally called an "Asian eyelidplasty". Most Asians have upper eyelids that are taut from eyebrow to lashes, rather than being interrupted by a crease. The approximately one-hour procedure uncovers a portion of the eye’s natural contours, and increases the size and roundness of the eyes. Makeup can be applied more easily, and more of the eyelashes are exposed. During the procedure, the surgeon makes a single incision along the upper eyelid and cuts away a crescent-shaped piece of skin. A portion of the underlying fat is removed, and then the incision is closed. Dr Amorn says that complications are very rare. "It’s not a serious operation," he says, adding that the usual risks involved with any surgery should be considered. "Excess bleeding is the most common complication, but it’s not much of a problem."

There are two types of rhinoplasty: reduction and augmentation. Thai patients generally request augmentation. The patient is given either a local or general anaesthetic for this hour-long procedure, and then incisions are made inside the nose to avoid visible scarring. A dissection along the nose is done to make room for an "I" or "L" shaped silicone implant, which will make the profile of the nose higher. A splint may be worn for a few days after the operation. Complications are infrequent, but there is a possibility of the implant moving, the skin thinning if the implant is too big, or infection.

The second group of people are those aged over forty who are trying to recapture their youthful looks. People in this group most commonly request a rhytidectomy. As people get older, the skin on the face and neck loosens, crow’s feet appear, forehead creases get deeper, the jawline droops and the skin around the neck sags; by having a facelift, patients can on average turn the clock back by ten years. And those wanting to turn back time are getting younger. "Ten years ago, most patients were aged 50 to 55. Nowadays their age is lower – from their late thirties, but on average they’re aged 45 to 50," says Dr Amorn.

A full facelift takes around four hours and begins with an incision being made in the area just above the ear, which follows the natural curve around the ear, and then goes about an inch or two into the hairline, making scarring less visible. The skin is raised while the surgeon repositions and tightens the underlying muscle and connective tissue, removes any excess fat and trims excess skin. The incisions are then closed. Swelling and bruising will follow, but only mild painkillers are usually required. A general anaesthetic may be used, or just a local with sedation. The operation can be done on an outpatient basis, but admission may be preferred by some surgeons.

Complications are infrequent, but nevertheless, do occur. Hematoma, a collection of blood under the skin that must be removed by another surgical procedure, is one possible risk, as is an injury to the nerves that control facial muscles. These muscles are located close to where the incisions are made, but if a problem develops, it’s usually temporary. Infection is another possibility.

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