Procedures
Serbian Association of Plastic Aesthetic Surgeons provides to patients this basic information in order to become familiar with various surgical and non-surgical procedures in the area of plastic aesthetic surgery and anti-ageing medicine. Should you have interest in, or need more information about some of these procedures, the best way for you is to contact and/or schedule the appointment with one of our members, as per your preference.
Face and Head
This operation is performed in cases of the excess skin or fat in the area of upper or lower eyelids.
- Duration of the surgery:
One to two hours
- Anesthesia:
Local infiltrative with or without analgo-sedation
- Surgical procedure:
The excess skin from selected eyelids is removed with or without removing the fat or muscle tissue. Depending on the skin condition the surgery of the lower eyelids could be done through the conjunctiva, without the outer surgical cut, when the fat is removed or rearranged.
Within this surgery it is also possible to tighten or move the eye angle.
- Postoperative recovery:
The stiches are removed after 3 to 5 days. Eyelids are normally swollen for couple of weeks. Sleeping with the half- lifted head, as well as wearing the protective glasses for couple of weeks is advised.
This surgery does not require hospital stay.
- Risks:
Infection, swelling, dry eyes, asymmetry, difficulties in closing the eyes, lowered position of the lower eyelid. All this should be only temporary when surgery is performed with correct techniques.
This surgery is performed when the earlobe is separated from the head, when the ear or its parts are bigger than desirable, or when the configuration of the ear is missing.
- Duration of the surgery:
One to two hours
- Anesthesia:
When performed on children, anesthesia could be either local or general. For adults it is local anesthesia.
- Surgical procedure:
Depending on request, there are various surgical procedures that will provide the natural position of the ear, move the ear toward the head or reshape it.
- Postoperative procedure:
Fixation bandage is removed after seven days. Stitches are removed after seven to ten days. Fixation band is advised for the next four weeks. Contact sports are not advised for at least two months after the surgery. This surgery does not require hospital stay.
- Risks:
Swelling, bleeding, change of the color of the skin on the ear, repeated flap-ear, unnatural look of the ear, hypotrophic and keloid scars.
This surgery is performed when one is not satisfied with the look of his/her nose.
- Duration of the surgery:
From one to three hours.
- Anesthesia:
Local (with or without analgo-sedation) or general
- Surgical procedure:
With this surgery the entire nose could be enlarged or reduced, its length could be increased or decreased, the tip of the nose could be reshaped, the holes of the nose could be reduced, or the angle between the nose and the lips could be corrected. The cartilage of the septum is often used with this surgery, so for the surgeon it is necessary to be familiar with functional nose surgeries as well. Beside the septum, cartilages could be used from the ears or ribs, especially for secondary surgeries. Techniques used for this surgery could be open or closed.
- Postoperative procedure:
Depending on the surgery, external and internal immobilization is necessary for one week, in some cases longer. When operated with the open technique, stitches are removed after seven days. Sleeping should be with half-lifted head.
Contact sports are not advised for two to three months. Mushy food is advised for up to one month after the surgery. For this surgery hospital stay is advised.
- Risks:
Swelling, bleeding, hematoma, asymmetry, repeated deformation, visibility of the scar. If the secondary surgery is necessary, it should not be performed for at least one year after the first one.
This surgery is advised when eyebrows are positioned lower than their anatomical position.
- Duration of the surgery:
One to two hours.
- Anesthesia:
Local, with or without analgo-sedation
- Surgical procedure:
Depending on requirements, there are various surgical techniques. If the forehead is low, it is necessary to lift the eyebrows in their entire length, and tightening of the forehead along with eyebrow lifting and positioning could be done.
If the forehead is normal size, eyebrows could be lifted with the three independent, 2 cm cuts. These techniques provide enduring results.
In some cases eyebrows could be lifted with minimally invasive techniques, like infiltration of non-absorptive or absorptive stitches. This technique provides temporary results.
- Postoperative procedure:
Depending on the surgical technique, stitches are removed after seven to ten days. Sleeping with half-lifted head is advised.
It takes two to three weeks for the Puffiness to withdraw. Exposure to the sun should be avoided for one month.
After this surgery hospital stay is not necessary.
- Risks:
Swelling, hematoma, headaches. Where the scars from the surgery are in the hair area, hair loss is possible.
This surgery is performed when muscles and skin of the neck and face is limp.
- Duration of the surgery:
Approximately four hours
- Anesthesia:
Most often it is infiltrative local with analgo-sedation; however general anesthesia is an option as well.
- Operative procedure:
Lifting and tightening of the muscles of the face and neck, with defining of the bone structures of the face, such are cheek bones or the jaw.
- Postoperative procedure:
Bandage is removed after five to seven days. Stitches are removed after seven to ten days. Diet with soft food is advised as well as sleeping with half-lifted head.
After this surgery hospital stay is advised.
- Risks:
Puffiness, bleeding, increased scaring, temporary loss of the sensibility or motor functions of some parts of the face, asymmetry, and hair loss.
This surgery is advised for rejuvenation and regaining the volume of the middle part of the face.
- Duration of the surgery:
Up to two hours
- Anesthesia:
Most often local infiltrative with analgo-sedation
- Operative procedure:
Lifting and tightening of the middle part of the face, from lower eyelids to the corner of the upper lip.
- Postoperative procedure:
Stitches are removed after seven to ten days. After this surgery hospital stay is advised.
- Risks:
Puffiness, hematoma, temporary weakness and loss of sensibility of the muscles of the mid part of the face.
This surgery is performed to fill certain parts of the face, and for regaining the vigor and youthful look of the skin.
- Duration of the surgery:
One to two hours
- Anesthesia:
Most often local, or local with analgo-sedation
- Operative procedure:
The fat tissue is taken from some other part of the body, frequently from the abdominal or inner thighs region, with small 2mm cannulas. The fat tissue is then processed, through centrifugation, filtration and washing, and as such is injected into certain parts of the face. This technique enables emphasis or filling the cheekbones, jaw, chin, lips, or filling the nasolabial, glabellar, or marionette folds, and improvement of the quality of the skin of the face.
- Postoperative procedure:
It is necessary that the face is continuously cooled with ice after the surgery. Puffiness starts to diminish after seven to ten days, while the final result is seen after three months.
Percentage of surviving fat tissue is 70-80%.
- Risks:
Puffiness, hematoma, asymmetry, infection.
This procedure entails transferring the hair follicles, most often from the back of the head to where the hair is missing, usually the front of the head, by transferring the grafts containing one to four follicles, with the special instrument.
- Duration of the surgery:
Duration depends on the surgeon and the amount of transferring transplant. Usually it takes a couple of hours.
- Anesthesia:
Local
- Surgical procedure:
One by one grafts are harvested from the back of the head and put in the region where the hair is missing. Both procedures are performed with special instruments. This method is called Follicular Unit Extraction -FUE)
- Postoperative procedure:
Patient does not stay in the hospital. Washing the hair only after five days. Haircut and more demanding physical activities only after one month.
- Risks:
Moderate swelling of the forehead and eyebrows area that disappears after five to ten days. Transplanted hair continues to grow along with non-transplanted hair. Hair shift occurs after three to six weeks.
Changes on /in the skin such as moles, lipoma, atheroma, basocellular epithelioma, planocellular carcinoma - are removed.
- Duration of the surgery:
15- 60 minutes
- Anesthesia:
Local infiltrative or, if malignancy is suspected, general anesthesia.
- Surgical procedure:
After the examination, surgeon decides in which way the change on the skin will be removed. The change is removed entirely, in accordance with surgical principles, and depending on the change itself and its localization. Removal could be done surgically/surgically with radio waves/by laser or electro surgically, and except for the virus polyps and warts, the tissue is sent for histopathology analysis. Depending on the size of the defect after the removal, the issue will be either stitched surgically or closed with surrounding skin tissue or free skin transplant, or in cases of smaller changes it is left to heal self by secondary epithelization.
- Post-operative procedure:
Stitches are removed five to 12 days after the surgery, depending on the localization. Also, depending on the type of the tumor, some require further surgical or radiological treatment. Remaining scars could be treated with various cremes, or, in the active phase of the healing process, with silicone plates. After this surgery hospital stay is not compulsory.
- Risks:
Infection, Swelling, difficulty in healing the wound.
Body
This surgery is usually performed after pregnancy or significant weight loss.
- Duration of the surgery:
Up to two hours.
- Anesthesia:
Most often in general Anesthesia, but it could be done in high epidural Anesthesia.
- Surgical procedure:
The excess skin from below the belly button to upper line of the pubic bone is removed. During this surgery usually the tightening of the abdominal muscles is performed, with forming the new belly button.
- Postoperative procedure:
It is advised that the patient should stay in the hospital for one day. The recovery lasts for two weeks, in which period the patient is advised to walk and sleep in slightly bended position. Wearing the garment is compulsory for four weeks. More demanding physical activities are not advised before six weeks after the surgery. The scar matures and flattens during one year.
- Risks:
Hematoma, swelling, infection, thrombosis, fat embolism, difficulty in healing or not healing the wound, back pain, hypertrophic or keloid scars.
This surgery is usually performed after significant weight loss, when the skin of the arms is limp and hanging.
- Duration of the surgery:
Up to two hours
- Anesthesia:
Block regional Anesthesia, local infiltrative with analgo-sedation or general Anesthesia
- Surgical procedure:
When there is the excess fat on arms, usually various techniques of liposuctions is performed, however, when there is also the excess skin, it is removed together with the excess fat. The scar is in the axillar line, along the inner side of upper arm, to the inner side of the elbow.
- Postoperative procedure:
After this surgery the hospital stay is not mandatory, however it is strongly advised due to general Anesthesia.
Wearing the garment is necessary for one month, so is the active compression of the area for several months
- Risks:
Hematoma, swelling, difficult or not healing the wound, hypertrophic or keloid scars, lymph stasis and prolonged lymph swelling. If the latter occur, lymph drainage is advised.
This surgery is most often performed after significant weight loss, when thighs are limp, not tightened.
- Duration of the surgery:
Two to three hours, depending on how voluminous is the surgery
- Anesthesia:
General anesthesia
- Surgical procedure:
Most often the scar is made in the groin area, along the inner side of the thigh. Excess skin and the fat is removed. The thigh is tightened circularly and vertically.
- Postoperative procedure:
Hospital stay is compulsory for this surgery. Limited movements of legs, such as spreading and bending the legs, is advised. The recovery lasts for ten to 15 days. Wearing the garment is needed for one month.
- Risks:
Hematoma, scars, infection, difficulty in healing or not healing the wound, thrombosis, fat embolism, hypertrophic or keloid scars, lymph stasis, and prolonged lymph swelling on the lower legs and thighs.
This surgery is performed when there is the excess skin on the abdomen and on the back.
- Duration of the surgery:
Two to four hours
- Anesthesia:
General anesthesia or high epidural anesthesia
- Surgical procedure:
The excess skin is removed, from the belly button to the upper pubic line. The skin is removed from the lateral sides of the abdomen and the back. The scar is positioned at the line of the underwear and in the back follows the upper line of the buttocks.
- Postoperative procedure:
Hospital stay is compulsory for this surgery, as well as keeping the half-sitting position of the patient.
- Risks:
Hematoma, Puffiness, infection, difficult or nonexistent healing of the wound, thrombosis, fat embolism, hypertrophic or keloid scars .
With this surgery improved shape and size of the buttocks is achieved.
- Duration of the surgery:
Up to two hours
- Anesthesia:
General or epidural anesthesia
- Surgical procedure:
Special gluteal implants could be round or anatomical, smooth or with texture, the choice is up to the patient. The scar is made in mid gluteal furrow, and implants are most often placed inside the big gluteal muscle. The drainage is compulsory.
- Postoperative procedure:
One to two days hospital stay is advised after this surgery. Postoperatively, the patient is positioned face down, and in the next 72 hours stays either like that or if on his/her back, at the special constructed bridge so that the buttocks does not touch the surface. Sitting is not allowed for several weeks after the surgery, or a special device that enables sitting without implants touching the surface is designated. For three weeks after the surgery excessive walking or climbing the stairs is not advised. Wearing the garment is compulsory.
- Risks:
Hematoma, seromas, infection, moving or dislocation of the implant, capsular contracture, implant’s rupture, “feeling” the implants, difficult of not healing of the wound.
This surgery is performed when calf muscles are not sufficiently developed.
- Duration of the surgery:
One and a half hour.
- Anesthesia:
Regional block, epidural or general Anesthesia
- Surgical procedure:
The cut is made at the back of the knee, where smooth implants are positioned into the sub-fascia layer of the medial calf muscle. There are three sizes of implants, chosen based on the muscle length.
- Postoperative procedure:
For this surgery 24 hours hospital stay is advised. It is compulsory too wear the garment or compressive socks for three or four weeks. Legs should be elevated. Physical activity is not advised for at least six weeks.
- Risks:
Hematoma, seromas, infection, moving or dislocation of implants, capsular contracture, implant’s rupture, “feeling” the implants, difficult of not healing of the wound.
Contemporary techniques of transferring the fat from one part of the body to another gave us the possibility to enlarge some parts of the body so that the entire body is reshaped, or better to say contoured. Fat transfer enables lifting or contouring the buttocks, upper leg, lower leg, breasts. The percentage of surviving tissue is 40 to 90%, depending on the surgeon and his/her technique.
- Duration of the surgery:
From one hour up to several hours, depending on the part of the body on which the surgery is performed
- Anesthesia:
Depending on the area in which the surgery is performed, it could be local infiltrative Anesthesia, with or without analgo-sedation, or in general Anesthesia.
- Surgical procedure:
Most often the fat s removed from the abdominal area, or from the back, arms, hips. The infiltration is done through 3.5mm cut, and then the fat is harvested with special cannulas. The fat is then processed (centrifugation, filtration, washing) and as such inserted in the millimeter holes in the area that is to be enlarged (buttocks, breasts, upper leg, lower leg.)
- Postoperative procedure:
After this surgery hospital stay is advised. The region in question is bandaged, and adequately compressed. Garments are compulsory for one month.
- Risks:
Swelling, hematoma, fat embolism, thrombosis, asymmetry, infection, fat reabsorption.
This surgery is performed when we want to harvest the fat tissue for fat transfer, or when we want to contour the body or remove the excess weight. Depending on what the aim is, different techniques are selected.
- Duration of the surgery:
Depending on the surgery, from one to several hours.
- Anesthesia:
For smaller regions it is local infiltrative Anesthesia with analgo-sedation; for bigger regions it could be epidural or general anesthesia.
- Surgical procedure:
There are different techniques – for fat harvesting and fat transfer usually liposuction with syringes and small vacuum is used. There are: standard, UAL, ultrasound, laser liposuction. First the region on the body is infiltrated with physiological solution with adrenalin in order to diminish bleeding. The quantity of infiltration is different with various techniques liposuction could be performed on all parts of the body - chin, breasts, arms, legs, abdomen, back. The choice of the technique is in accordance with surgical skills and possibilities.
- Postoperative procedure:
Postoperative hospital stay is mandatory for bigger liposuctions. It is compulsory that the patient is in motion and wears garment for four weeks. Returning to regular activities could be possible in a week or two.
- Risks:
Swelling, hematoma, infection, fat embolism, thrombosis, bumps on the skin, wrinkled skin, hyper or hypo- pigmentation, blood loss.
This is the procedure for rejuvenating female reproductive organs. It entails several procedures, reduction and reshaping labia minor and labia major, narrowing the vagina or vaginal entry.
- Duration of the surgery:
One to three hours.
- Anesthesia:
For the convenience, patients usually require general anesthesia however in could be done in the local anesthesia with analgo-sedation
- Surgical procedure:
On labia minor, the excess skin and mucous membranes is removed. Also, at the same time, hanging clitoris could be shortened, by removing the excess skin. This surgery entails the reduction of labia major as well. The vaginal entry is narrowed by infiltrating POR-8 for diminishing the bleeding, and then resecting the part of mucous membranes and vaginal muscles, after which the entire length of the vagina is stitched in two layers.
The vagina could be also narrowed by the transfer of one’s own fat cells, or with hyaluronic acid for deep fillings.
- Postoperative procedure:
Depending on the volume of the surgery, hospital stay is advised. The wounds are healed in seven to ten days, and one could be back at work in two weeks. Sexual activities are forbidden for four to six weeks.
- Risks:
Hematoma, Puffiness that could last for three to four weeks, difficulty or not healing the wound, loss of sensibility.
Breasts
This surgery is performed for enlarging or re-contouring the breasts. Silicone or polyurethane implants are used, smooth or textured. The shape is chosen by the patient, or is advised by the doctor. Shapes of the implant may vary, from round ones, to those with low, medium, high or extra high profile, then anatomical ones that are short, medium or high, and low, medium or high in projection.
- Duration of the surgery:
Up to two hours.
- Anesthesia:
General Anesthesia.
- Surgical procedure:
The access is by cut either through the under the breast furrow, armpit or a nipple. The position of the prosthesis could be under the muscle, dual-plane (half under the muscle half under the gland) or sub-fascia.
- Postoperative procedure:
Duration of hospital stay is advised as per the length of Anesthesia. The recovery depends on the type of the surgery and lasts from seven to 15 days. Wearing the garment is compulsory for one month.
- Risks:
Hematoma, seroma, infection, moving or dislocation of implants, capsular contracture, ruptures of implants, changed sensibility, difficulty or absence of healing the wound.
This surgery is used for lifting and reshaping the breasts, with or without implants.
- Duration of the surgery:
Two to three hours.
- Anesthesia:
Local with analgo-sedation or general Anesthesia
- Surgical procedure:
Depending on how much the breasts are hanging it could be round-block technique – removing the skin around the nipple circularly, or removing the skin around the nipple vertically or vertically and horizontally (inverted T). If used, the implant could be positioned under the muscle, dual plane or sub-fascia.
- Postoperative procedure:
Hospital stay is advised. Without implants, the recovery is five to seven days, while wit implants it lasts seven to 15 days. Wearing a garment for four to six weeks is advised.
- Risks:
Hematoma, seromas, infection, moving or dislocation of implants, capsular contracture, rupture of implants, changed sensibility, difficulty or not healing the wound, prolapse of implants, asymmetry.
Sometimes the breasts that are too big could jeopardize the spine and the bra could cause wounds under the breasts or on shoulders. In these cases lifting and the reduction of the breasts could be performed.
- Duration of the surgery:
From two to four hours
- Anesthesia:
General Anesthesia, smaller breasts could be operated in local infiltrative anesthesia with analgo-sedation.
- Surgical procedure:
Depending on how much the breasts are hanging, the surgery is planned either by cut around the nipple and vertically (key hole) or by cut around the nipple, vertically and horizontally (inverted T) Removed tissue is sent to histopathology analysis.
- Postoperative procedure:
For this surgery hospital stay is advised. The wound will heal in seven to 15 days. Wearing a garment for four to six weeks is advised.
- Risks:
Hematoma, swelling, infection, thrombosis, fat embolism, difficulty or not healing the wound, loss of sensitivity on nipples or breasts skin, impossibility of breast-feeding, hypertrophic or keloid scars.
This surgery is done for beautifying the men breasts. Prior to the decision about the surgery, it is necessary that the patient is examined by the endocrinologist.
- Duration of the surgery:
One to two hours.
- Anesthesia:
General or local infiltrative Anesthesia with analgo-sedation
- Surgical procedure:
Depending on the type and the size of enlarged men breasts, the surgery could be done in two ways: if the breasts are without ptosis and mainly fat type, a liposuction could be performed. If it is the case of enlarged gland or enlarged nipple, the gland is removed by reduction of the nipple, leaving the scar around the nipple. The gland is sent for the histopathology analysis, and the patient is monitored by the endocrinologist.
- Postoperative procedure:
For this surgery hospital stay is not mandatory. The recovery lasts five to seven days, while wearing the garment is advised fo one month.
- Risks:
Uneven skin, nipples asymmetry, remaining gynecomastia, changed sensibility, hematoma, infection.
Non-surgical procedures and anti-ageing treatments
These are non-surgical procedures from the family of anti-ageing treatments. It is not advised to undergo this procedure when the surgeon or dermatologist is using permanent non-encapsulated materials for filling such as liquid silicone, biopolimero, metacrill etc.
- Duration of the intervention:
Up to 30 minutes
- Anesthesia:
Anesthetic cream or block local anesthesia
- Procedure:
There are different hyaluronic acid products used for filling the lips, face wrinkles, or correction of deep face contours. Hyaluronic acid lasts for three to 18 months.
- Post-intervention procedure:
Cooling the face with ice packs as the face will be a bit puffy for up to 48 hours
- Risks:
Hematoma, infection, possible asymmetry which can be corrected as soon as puffiness stops.
Lasers are used for improvement of the quality and the structure of the skin.
- Duration of the procedure:
Half an hour to two hours
- Anesthesia:
Local or analgo-sedation
- Procedure:
This procedure removes freckles, spots, scars, wrinkles, the skin quality is improved and production of collagen is stimulated. Lases could also be used for the rejuvenation of vagina.
- Post-intervention procedure:
Avoiding sun exposure and using the sun block crèmes is advised; often some cream for quick epithelialization is used.
- Risks:
Hyper or hypo pigmentation, puffiness, redness, allergy, creation of milia
It is used for blocking some muscle groups that are engaged in face expressions, causing wrinkles.
- Duration of the procedure:
Up to 30 minutes
- Anesthesia:
Topical local anesthetic cream
- Procedure:
Botulin toxin is applied to certain spots on the forehead or around the eyes, so te muscles are less contractible, and the effect is that the skin is polished while wrinkles become less visible or invisible. This treatment could also be used to treat excessive sweating on palms, soles of the feet, or armpits.
- Post-intervention procedure:
Small spotty hematoma, or red spots that will disappear in few hours that
- Risks:
Double vision, ptosis, eye dryness, botulin toxin resistance; all complications are rare and disappear in two to four weeks.
These treatments are used for improving the skin quality, hydration, thickening the derma by putting in the hyaluronic acid, amino acids, and vitamins into the mid layer of the skin.
- Duration of the procedure:
Up to 30 minutes
- Anesthesia:
Topical local anesthetic cream
- Procedure:
Hyaluronic acid for superficial wrinkles filling is mixed with vitamins, minerals, amino acids; the effect is softer, shiny, hydrated, thicker, youthful skin.
- Post-intervention procedure:
The face should not be washed or touched immediately after the intervention.
- Risks:
Hematoma, allergy.
This is non-surgical aesthetic procedure performed with specifically designed threads - 3D Meso threads or type 3D Cog threads, usually combined. The threads are stimulating synthesis of the new collagen and elastic fibers in the skin and neo-vascularization; the effect is tightened skin with better quality, lifting of certain areas of the face or the body.
- Duration of the procedure:
30 to 60 minutes
- Anesthesia
Topical local anesthetic cream, local infiltrative, block anesthesia
- Procedure
The threads are placed sub-cutaneous with special cannulas or needs, into the regions that need tightening, lifting, revitalization or strengthening. Your doctor will determine the number of threads needed their length and thickness, depending on which area of the face or the body is treated.
- Post-intervention procedure
Avoiding physical activities and sun/heat exposure for ten days. It is advised that mimic expressions are minimal, and sleeping on the back is advised.
- Risks
Puffiness, bruises, sense of tightening in the face, mild pain in treated areas, threads migration.
This is the procedure that improves the texture and the look of the skin.
- Duration of the intervention:
30-60 minutes.
- Anesthesia:
Surface and mid-deep skin layers of the skin are treated together with the machine for skin- cooling. Deep skin layers are treated in local infiltrative anesthesia, analgo-sedation, or general anesthesia.
- Types of chemical peeling:
With various agents - glycolic acid, salicylic acid, lactic acid, fruit enzymes, tartaric acid, malic acid, TCA or trichloroacetic acid, carbolic acid (phenol peels) or various combinations on different concentrations.
- Procedure:
Chemical peeling in particular concentration is applied on the skin, for several minutes. After that, neutralization (cream) is applied, in order to stop the peeling agent to be in effect longer than desired. The process is followed by application of the hydrating cream and SPF 30 cream.
- Post- intervention procedure:
Every day face wash with lukewarm water and soap. Every day application of hydrating cream and SPF cream, for a month. The recovery lasts for seven to 15 days, and in case of deep skin peelings, for up to two months.
- Risks:
Chemical peelings are most often done during the fall or winter. Any sun exposure could lead to hyperpigmentation on the skin. If the procedure done by a non-expert, chemical peeling could leave permanent scars, and hypo or hyper- pigmentations.
- Duration of the surgery:
- Anesthesia:
- Surgical procedure:
- Postoperative procedure:
- Risks:
