Basic Principles of Cosmetic Surgery Procedures.
The fundamental objective of cosmetic surgery is to improve and enhance one’s appearance and physique through surgical methods, aiming for perfection. This requires cosmetic surgeons to consider not only functional reconstruction and restoration but also postoperative aesthetic improvements for each patient. While there are many factors that can affect the outcome of the surgery, the surgical procedure itself is closely related to the surgical operation.
It has been proven that non-standard surgical operations can cause infections, hematomas, necrosis, wound dehiscence, and delayed healing at the surgical site. Additionally, they can easily lead to excessive scar formation, resulting in deformities and severely affecting the surgical outcome, even leading to surgical failure. Therefore, it is necessary for cosmetic medical personnel to follow the following principles during the surgical operation to achieve satisfactory results.
1.Aseptic Principle of Cosmetic Surgery Procedures.:
Infection of any incision can affect the outcome of cosmetic surgery, making aseptic technique crucial. Aseptic technique is an eternal theme in medical scientific practice and a common principle to be followed in surgical technical operations. As a qualified cosmetic surgeon, one must have a strict concept of asepsis. This means having a thorough understanding of aseptic principles in aspects such as preoperative preparation, postoperative handling and care, disinfection and sterilization of equipment, as well as every detail of the surgical operation. By doing so, the risk of contamination of the surgical field can be minimized.
Cosmetic surgery procedures are delicate and complex, with longer operation times and extensive exposure of the wound area. These factors increase the chances of infection. Infection can negatively impact wound healing and may result in excessive scar formation, affecting both appearance and function, leading to the failure of the cosmetic surgery. This is particularly important in tissues with poor blood supply (such as cartilage), areas where blood supply has not yet been established (e.g., transplanted tissues), and sites where artificial materials are implanted.
While the use of antibiotics can play a role in preventing and controlling infections, it cannot completely replace aseptic techniques. Therefore, strict adherence to aseptic operating techniques remains the most effective method to prevent incisional infections.
2.Non-invasive Principle of Cosmetic Surgery Procedures.:
Surgery itself is inherently invasive, including cosmetic procedures. In the realm of cosmetic surgery, it is paramount to minimize trauma and associated risks while preventing unnecessary harm. This responsibility and pursuit define the essence of a cosmetic surgeon’s career. The non-invasive principle dictates that every aspect of a cosmetic surgery procedure should strive to avoid and reduce unnecessary damage. Each action during surgery must be precise and gentle, treating tissues with care and avoiding unnecessary removal.
While surgery inevitably causes some tissue damage, the concept of non-invasiveness in cosmetic surgery is relative. Excessive tissue damage due to rough handling during surgery can compromise tissue vitality, affecting wound healing, appearance, and even functionality. Therefore, it is crucial to use delicate instruments and execute surgical procedures with precision, stability, gentleness, and efficiency.
It is imperative to refrain from overly pulling, squeezing, or twisting tissues, as well as avoiding prolonged exposure, excessive heat application, improper electrocoagulation, or cutting. The goal is to minimize tissue trauma, reflecting the professionalism of cosmetic surgeons. Adhering to the principles of non-invasiveness and minimally invasive techniques is essential to enhance the outcomes of cosmetic surgery. Emphasizing the importance of achieving minimal trauma and optimal aesthetic results is crucial throughout the process of performing cosmetic surgery.
3.Non-Bleeding Principle of Cosmetic Surgery Procedures.:
Similar to surgeries in other clinical specialties, cosmetic surgery must adhere to the principle of non-bleeding. Therefore, achieving meticulous and thorough hemostasis during the procedure is crucial for minimizing intraoperative bleeding and postoperative oozing, which stands as a key factor in ensuring the success of the surgery. While complete bloodless surgery during the procedure may not be feasible, the focus lies on strategies to prevent and reduce oozing and bleeding. Clinical experience has demonstrated that preventing surgical bleeding or postoperative oozing involves various aspects of preoperative preparation and postoperative care.
Hence, prior to cosmetic surgery, patients should undergo relevant preoperative assessments, such as coagulation function tests and platelet counts. During the surgery, strict, careful, and comprehensive hemostasis is required, including the use of hemostatic medications and medical biological protein adhesives, meticulous tissue closure, placement of drainage if necessary, negative pressure drainage, appropriate postoperative compression bandaging, among other measures. These approaches are effective in preventing and reducing the formation of hematomas, as well as postoperative bleeding or oozing from the incision.
4.No Dead Space Principle of Cosmetic Surgery Procedures.:
The presence of dead space during surgery can lead to the formation of hematomas or fluid accumulation postoperatively, increasing the risk of infections. Even if the incision heals, the occurrence of hematomas or fluid accumulation can still result in surgical site infections and noticeable scarring, significantly impacting the surgical outcome. This is especially critical in cases of subcutaneous hematomas after skin grafting, as it can cause skin flap necrosis and infection, ultimately leading to surgical failure.
Therefore, it is crucial to ensure thorough hemostasis during surgery to prevent postoperative bleeding, oozing, or hematoma formation. Additionally, it is important to meticulously address dead spaces according to the normal anatomical structures and layers, completely eliminating them. If necessary, drainage may be placed, and appropriate postoperative compression bandaging should be applied. These measures are reliable methods to prevent the formation of hematomas or postoperative infections.
5.Principle of Tension-Free Closure of Cosmetic Surgery Procedures.:
The tissue suturing in cosmetic surgery, including the choice of needles, sutures, and suturing techniques, is a highly meticulous process. One crucial principle in this process is the tension-free closure. Failing to adhere to this principle can significantly impact the effectiveness of the surgery. Therefore, it is essential to prioritize the principle of tension-free closure during cosmetic surgical procedures.
Forcing the closure of a wound under tension can lead to adverse consequences such as poor local blood circulation, tissue necrosis, wound dehiscence, delayed healing, and even infection, resulting in noticeable scar formation. To avoid these complications, it is crucial to ensure that the wound closure is performed without tension. This is a vital step in guaranteeing the desired outcome of the cosmetic surgery.
To achieve tension-free closure, it is generally necessary to carefully design the incision before the surgery, ensuring precision and thoroughness. If there are diseased tissues that cannot be completely removed at once, they should be excised in stages. In cases where there is significant tension at the incision site, it is advisable to perform local subcutaneous tissue release or transfer adjacent skin flaps. In some situations, skin grafting may be necessary to cover the wound instead of forcibly suturing it.
By following the principle of tension-free closure, cosmetic surgeons can optimize the effectiveness of the surgery and minimize the risk of complications.
6.Principle of Pain-Free of Cosmetic Surgery Procedures.:
The principle of pain-free is a fundamental principle followed in medical procedures and treatments, including cosmetic surgery. It serves as a basic criterion for respecting human rights. Individuals undergoing cosmetic procedures often carry varying degrees of psychological burden. They seek to improve or enhance their appearance and body shape, as well as reconstruct or restore the function of certain body parts.
Some have even undergone multiple surgeries, leading to feelings of tension, complexity, numerous concerns, high expectations, heightened pain sensitivity, and potential psychological barriers. Additionally, the majority of these individuals are women or children, who have higher demands for surgery and anesthesia compared to regular patients. Therefore, it is crucial to prioritize the selection of safe, effective, and reliable anesthesia methods during surgery.
In general, for quiet, cooperative individuals undergoing minor surgeries or surgeries of relatively short duration, local anesthesia is the preferred choice. However, for significant surgeries involving anatomical, functional, and psychological abnormalities, as well as individuals who have undergone multiple surgeries and anesthesia, and have high expectations for the surgery but may find it challenging to tolerate simple local anesthesia, general anesthesia may be considered. Therefore, comprehensive anesthesia and effective pain management are not only beneficial for the surgical procedure but also aid in postoperative recovery and achieving optimal surgical outcomes.
In conclusion, ensuring the safety of the individual undergoing the procedure and providing appropriate anesthesia and effective pain management to avoid and reduce adverse pain stimuli are essential pursuits for cosmetic surgeons. These practices are not only necessary for the pursuit of cosmetic excellence but are also fundamental principles that must be followed in cosmetic surgical procedures.