nasbdy news: The top 20 cosmetic surgery questions

by LOUISE ATKINSON, Daily Mail

Have you always wanted Botox injections but worried if they will hurt? And what really happens to you after liposuction? Find the answers with our top 20 cosmetic surgery questions.

I have had a face-lift, but now my hands don't match. What can I do?

Weathered hands with signs of liver spots can be improved with laser treatment (one or two treat-ments cost �190) or the more drastic chemical peeling (�800). Protruding veins can be surgically removed or disguised with fat injections - the fat is taken from elsewhere in your body.

If I have fat removed through liposuction, will it reappear elsewhere?

Liposuction completely removes fat cells from a specific area of the body. However, if you gain weight, fat cells in other parts of your body will expand. This means areas that are not normally fat, such as your wrists, may gain weight.

How long does a Botox jab last, and what are the long-term effects of injecting a poison into your body?

Officially, it lasts four to six months. But the effects may fade after just two months if your body metabolises the drug quickly or if too little toxin has been applied to strong brow muscles.

There are no known side effects because the substance is used in minute quantities. But consider the fact that it is believed the botulism toxin never leaves your body.

After repeated Botox injections, will facial muscles ever lose the ability to frown?

No. You may need less Botox over the years, but if you stop having injections, frown lines will return.

Cosmetic surgeon Jan Stanek says: 'Regularly paralysed muscles don't forget how to frown, unless they lose their nerve supply altogether.

'The habit may be modified if it is difficult for the brain to activate these muscles and gradually habitual frowning may diminish simply through lack of use.'

Is there any risk of CJD or foot-and-mouth disease from bovine-sourced collagen?

No. All collagen is extracted from the hides of a single herd of cattle in Pasadena. It is sterilised before use.

I thought silicone breast implants were in danger of leaking, so why are they still used?

These implants are no longer made of liquid silicone in a sac. If you cut them in half, they are gel-like (think Turkish Delight) and therefore cannot puncture, explode or leak into the body.

Though they are banned in the U.S., they have Department of Health approval and most British surgeons prefer to use silicone rather than saline.

Soya bean oil implants (Trilucent) are no longer offered in this country.

If you keep having collagen injected into your lips and then stop, will you get stretch marks?

Under normal circumstances, the answer is no but lips expanded to cartoon proportions will lose their elasticity over time and be more wrinkled than they would otherwise have been.

There are numerous injectable fillers on the market, and some last longer than others.

Liquid silicone is no longer used in Britain (it can remain for ever as knots and bumps in the lips) but human tissue and fat (your own or someone else's) can be inserted, as can combinations of synthetic ingredients - from tiny beads suspended in collagen called ArteColl to strips of Goretex.

Can you become addicted to plastic surgery?

One-off procedures such as a rhinoplasty (nose job) or breast reduction rarely lead people to want more, but once you begin trying to slow the passage of time, you could get hooked. 'Lip-enhancing injectable fillers are the most addictive procedures,' says Dr Tracy Mountford of the Cosmetic Skin Clinic.

'People come in asking for a little collagen in their lips and love the result so much they start wanting them bigger and bigger.'

After a face-lift (which can only smooth out sagging skin), you may hanker after dermabrasion to address sun damage, an eye lift and Botox to smooth remaining lines. And then more face-lifts.

If you start with Botox to erase small lines, you may soon want collagen to fill out the deep lines between your nose and mouth. And after a tummy tuck, many patients go on to have liposuction.

How can facial peels that strip skin make you look younger?

Chemicals or lasers are used to burn off the top layer of old skin to encourage the growth of new skin. The result should be tighter, younger looking, smoother skin.

A chemical peel (�1,450) works like a sunburn, causing redness, and stimulates the skin's natural shedding process. Laser peels (�3,100) are invasive, but more effective, causing the skin to ooze like a graze. The deeper the peel, the greater the risk of a whitening effect, a line of demarcation between treated and untreated areas, and temporary or permanent scarring.

Which procedures can be passed off as down to good genes?

Eyes are the first place to show age. Eye lifts (blepheroplasty) take away excess skin on the upper or lower lids (�3,000). Stitches are removed after four to five days so recovery is quick. People will not be able to detect you've had surgery.

Is plastic surgery painful?

Not really. A tummy tuck is invasive surgery, but it is normally done under general anaesthetic so you don't feel anything. However, recovery can be slow.

On a smaller scale, lip treatments can smart because of the number of nerves around your mouth.

Anaesthetic cream dulls the sensation or a nerve block can numb the whole area.

How long does it take to get over cosmetic surgery?

There is a difference between being back on your feet and complete recovery.

'With make-up, you'll be presentable two weeks after a face-lift, but full recovery can take six months,' says Jan Stanek.

'Most of the swelling with breast reduction disappears within two weeks, but it'll be up to nine months before you're back to normal.'

After liposuction, you have to spend three weeks wearing very tight bandages over the areas treated. This can be hot, uncomfortable and embarrassing - it may even affect everyday activities (such as using the lavatory).

But laser peels require the most dedication. Your face will have been stripped of its top layers of skin and you will be left with a bright red, oozing face.

You have to clean the skin to remove any scabs and re-apply special burn cream many times during the day and night.

Is liposuction the best way to get rid of cellulite?

No. Sadly, there are no truly effective treatments for stretch marks or cellulite.

How many years can you take off your face without looking odd?

You will never look more than 15 years younger than you are, and even that is probably too much to ask. The best to hope for is that you look young for your age, not many years younger than you are.

Will I have to wear my hair over my ears to cover face-lift scars?

No. Most scars heal almost invisibly, but you could opt for keyhole surgery where the incision is made inside your ear.

What's the age limit for a face-lift or liposuction?

THINK about a face-lift at 45 when your skin is still elastic. Once you reach your late 50s, your skin will have lost much of the elasticity that ensures a natural-looking lift. It can be done (think of Julie Christie), but it will be a big job, and may need to be combined with laser resurfacing, eyelid surgery and a brow lift. Surgeons are wary of performing liposuction on the over-50s as skin may sag once fat has been removed.

What's the worst thing that can happen after plastic surgery?

Start with death and work your way down. You could suffer scarring, bleeding, prolonged bruising, delayed healing, skin loss (cells can die at the edges of over-pulled face-lifts), nerve damage, wound infection, paralysis or numbness.

With liposuction, complications include ruptured abdomens and bowels, perforated spleens, serious tissue infection, and death caused by the blood pressure plummeting and the body going into shock if too much fat and fluid is removed.

Which procedures are the riskiest?

Breast reduction carries a risk of nipple loss (they have to be removed and replaced so the body can reject them). A tummy tuck can lead to infection or even gangrene.

Do things go wrong often?

Yes. According to Liz Thomas, of Action for Victims of Medical Accidents: 'We receive letters every week from people who have experienced problems with cosmetic surgery.'

Many others are too embarrassed to complain - they don't want anyone to know they had surgery or feel disfigured.

'We need accreditation of all cosmetic surgeons so people can check they have the qualifications and experience to perform operations,' says Liz.

Check the credentials of your plastic surgeon by making sure he is a Fellow of the Royal College of Surgeons (tel: 020 7405 3474 or visit the website www.rcseng.ac.uk) and that he is on the General Medical Council specialist register (tel: 0207 915 3630; www.gmc-uk.org).