Although excess fat under the jaw line can be most easily removed by liposuction, when the skin is sagging in folds and a “turkey wattle” has formed, the surgical requirements are greater.

When there is a substantial degree of dependent and folded skin, this will involve not only the neck but also the face, and is most probably going to be treated by a full face lift, undermining the tissues of the face through an incision made around the ear, then drawing up and back the liberated skin to remove the wrinkles, excising the excess at the upper margin, and closing the wound at the ear.

As one ages, everything begins to droop, the skin of the forehead over the orbital margins descends imperceptibly until the previously recognizable upper lid is covered and hidden. Since in normal conversation, persons tend to look into each other’s eyes, this may be the first change a person is told about by their well-meaning friends.

The technique employed varies according to the situation, the patient’s needs and the surgeon’s preferences but in general it is performed under local anesthetic on an out-patient basis.

The procedure is indicated in the patient whose brows have fallen, beginning to overhang the eyes, whose forehead is wrinkled with transverse lines and vertical lines over the bridge of the nose.

It may be accomplished by “open” or “closed” (endoscopic) surgery. The open procedure, obviously the older, has the advantage of easier and direct vision, and if there is substantial excess skin this is the only choice. And endoscopic apparatus is not available to all surgeons in all parts of the world, and even where it is, there are surgeons who prefer to continue with the “tried and true” they have become used to doing.

Rhinoplasty is the term used for reconstructive plastic surgical procedures on the nose, or that part of it which is externally visible. The nose is the central feature of the face, and although there are ethnic variations considered perfectly normal in their own society, a patient might be extremely conscious their nose is different from society’s concept of ideal and wishes to have it altered.

This procedure falls into the realm of liposculpture. It calls for a degree of artistry on the part of the surgeon who is going to remove relatively small quantities of fat from specific areas of the face and may use the removed fat to reinsert it at other areas to build up depressions, such as deep naso-labial folds.

This procedure is distinct from “reconstruction” after an injury or removal of a breast. It is usually performed when the patient is dissatisfied with the size of her breasts, she may have been teased at school, or suffered negative comments from male companions, or may think she would “present” better in the job market if she had a better figure. As in all forms of aesthetic surgery, the surgeon must be aware of the patient’s expectations and psyche.

Breast reduction is also called Reduction Mammoplasty. Overly large breasts have appropriately been described as an “affliction.” Terms have been derived, ranging from macromastia to gigantomastia which may not be etymologically correct but are certainly image-conjuring.

The surgical technique of reduction will depend on the situation, the amount of reduction required, the preference of the patient and the decisions of the surgeon. To the extent possible, wherever the incision is placed, the nipples and areolae will be left attached to functioning breast tissue, thereby retaining normal sensation and the potential for breast feeding.

Otherwise known as a “breast lift,” the procedure is to reposition and possibly reshape the breast into a more desirable position. Although it does not by definition include breast enlargement, that may be performed at the same time.

Anyone who is not satisfied with the position of either breast is a candidate for this operation, but typically it is performed on the woman who was previously satisfied with the position of her breasts, but the Cooper’s suspensory ligaments have lengthened following pregnancy, and/or weight gained then lost, and/or aging, and the nipples are lower than she (or her partner) would wish. The contents of the breast may not be interfered with by the surgery, and lactation in a subsequent pregnancy will remain possible.