Plastic surgery has two branches, cosmetic surgery and reconstructive plastic surgery. Cosmetic surgery is concerned with improving the aesthetic appearance of a person, while plastic surgery may include this, or just the reconstruction (reconstructive surgery).
Reconstructive plastic surgery is concerned with improving function; however, it may also involve trying to approximate normal appearance, but that is not its primary function. Reconstructive plastic surgery is often referred as simply reconstructive surgery. Some parts of the world completely separate cosmetic surgery and plastic surgery and term cosmetic surgery as elective surgery, non-essential surgery, surgery which the patient chooses to have; while plastic surgery is understood to mean surgery to reconstruct or improve appearance after injury or illness.
News on Cosmetic Surgery / Plastic Surgery
For the latest news and research on Cosmetic Surgery / Plastic Surgery, and to sign up to newsletters or news alerts, please visit our Cosmetic Surgery / Plastic Surgery News Section. This article focuses on cosmetic surgery only. According to official statistics, approximately 65,000 surgical cosmetic procedures were performed in 2008 in the UK – 50% more than in 2003.
Breast enlargement was the most popular procedure, followed by rhinoplasty (nose job, nose reshaping), liposuction, and face-lifts. Cosmetic surgery in the USA is far more popular: Surgical cosmetic procedures USA, 2007 * Liposuction 456,828 Breast augmentation 399,440 * Eyelid surgery 240,763 * Abdominoplasty 185,335 * Female breast reduction 153,087 * Total – 1,435,444 (Source: American Society for Aesthetic Plastic Surgery) Non-surgical cosmetic procedures, USA, 2007 * Botox 2,775,176 * Hyaluronic Acid (Hylaform, Juvederm, Restylane) 1,448,716 * Laser Hair Removal 1,412,657 * Microdermabrasion 829,658 * Laser Skin Resurfacing 647,707 * Total – 7,113,914 (Source: American Society for Aesthetic Plastic Surgery) Experts say that not everybody is suitable for cosmetic surgery.
There may be factors in the patient’s life that may be influencing his/her surgery decisions.
In many cases in Europe and North America surgeons may delay the procedure until the patient has received psychological counseling. As most surgical cosmetic surgery procedures have permanent results, it is crucial that the patient is completely sure about wanting to go ahead. What types of cosmetic surgeries are there? Below is a list of the most common cosmetic surgeries: * Tummy tuck (abdominoplasty) – the abdomen is reshaped and firmed. During this surgical procedure excess skin and fact is removed from the middle and lower abdomen, with the aim of tightening the muscle and fascia of the abdominal wall.
Tummy tucks are more popular among women after pregnancy and people who have lost a great deal of weight and do not like the sagging that sometimes results from this. Sometimes the sagging skin occurs for genetic reasons (the patient inherited the trait). This procedure may also improve the appearance of stretch marks, especially those located below the navel. Ads by Google Study Law – UNSW Will Make A Difference In This World. Apply Now & Study With Us! – www. law. unsw. edu. au KL Aesthetic Laser Centre – Remove acne scars & fine lines. Improve your skin texture.
Visit us – www. MedivironUOA. com Medical Decision Makers – Hospital & clinic procurement. Meet them here! – www. socialwalk. com/medical It is important that malnutrition is identified among patients who have lost a lot of weight. Identifying malnutrition before surgery in massive weight loss patients seeking body contouring will significantly decrease surgical complications, accelerate wound healing, improve scar quality and boost patient energy levels, this study found. * Eyelid surgery (blepharoplasty) – the eyelids are reshaped, or a permanent eyeliner is applied.
This procedure may be either functional or cosmetic, and sometimes both. The aim is to reshape the upper or lower eyelid by removing or repositioning excess tissue. It may also involve reinforcing surrounding muscles and tendons. This article explains how surgery can improve vision for people with drooping eyelids. * Mammoplasty, this may include: * Breast enlargement (breast augmentation; boob job) – the breasts are enlarged. This is one of the most common procedures in cosmetic surgery. This is done either with fat grafting, or with saline or silicone gel prosthetics.
Usually carried out because the woman feels her breasts are too small (micromastia), but also if one breast is larger than the other, or if the breasts have changed after pregnancy and/or breastfeeding. Breast implants may also be considered by patients who have had their breast removed (mastectomy), as may be the case with breast cancer. Breast implants come in many sizes, shapes and profiles. Women who undergo breast enlargement often see a sizable boost in self-esteem and positive feelings about their sexuality, this researcher from the University of Florida found. Breast reduction – skin and glandular tissue is removed to make the breasts smaller. This procedure may also apply for women who suffer from shoulder or back pain because their breasts are very/too large (gigantomastia). Breast reduction surgery has a much higher percentage of patients who want to relieve a physical discomfort, compared to women who want breast augmentation. This article looks at whether young women undergoing cosmetic breast reduction surgery should be screened for cancer without their informed consent, which is currently what happens.
Breast reduction reduces breast cancer risk among high-risk women, this study found. * Male breast reduction (gynecomastia) – The procedure can also be carried out on men who have abnormally large mammary glands. This condition is much more common than people think – it affects approximately 40% to 60% of the male populations of North American and Western Europe (American Society for Aesthetic Plastic Surgery). This article reveals a figure of 40% to 50% of males, at some point in their lives. Some males may have just one affected breast, while others have both.
In most cases we are not sure why some men have enlarged breasts. We do know that the following factors may have an impact: taking anabolic steroids, medication containing estrogen, alcohol consumption, marijuana consumption, impaired liver function, and some cancers. * Mastopexy (breast lift) – as the skin loses its elasticity, gravity starts taking its toll, plus other factors such as weight loss, pregnancy and/or breastfeeding alter the shape and firmness of the breasts, some women want a breast lift. The breast lift raises the breasts, giving them a more youthful contour.
Sometimes the patient will undergo breast augmentation at the same time. This article revealed six major factors that affect how happy a woman feels with the outcome of her breast surgery. * Lower-body lift – this may include: * Buttock augmentation – this procedure enhances the appearance of the buttocks by making them larger. The surgeon will either graft fat from another part of the patient’s body, or use a silicone implant. * Buttock lift – this procedure lifts the buttocks so that they stick out more and have a tighter, more pert appearance. The surgeon does not lways need to place implants. A scarless technique can be used for buttock lift. May also include procedures to tighten loose, sagging skin in the backs of the thighs, hips, outer thighs, and the front of the thighs. The surgeon will usually utilize incisions which go from the back round the hips to the front of the thighs. The surgeon removes the loose skin as well as some underlying fat tissue so that the remaining skin can stretch and smooth the lower body – especially the thighs and buttocks. * Chemical peel – popular among people with acne or pock, as well as those with scars and wrinkles.
The procedure involves using Phenol (carbolic acid), TCA (trichloroacetic acid), AHA (glycolic acid) or BHA (salicylic acid) as the active ingredient. There are two types of chemical peel: * Deep (phenol) peel – also known as a deep chemical peel. This is for patients with deep wrinkles, usually from exposure to the sun, as well as the skin that wrinkles around the lips and chin. This treatment reduces the appearance of skin damage and imperfections. * Light to medium chemical peel – more suitable for patients with finely wrinkled faces, as well as sun-damaged skin, and uneven pigmentation.
All chemical peels peel away the top layers of the skin. Researchers at the Saint Louis University School of Medicine found that chemical peels using either alpha-hydroxy acid or beta-hydroxy acid are both highly effective in treating mild to moderately severe facial acne. * Labiaplasty – also called labioplasty, labia minor reduction, or labial reduction. This involves surgery of the labia majora or labia minora of the vulva (part of the female genitalia). Labiaplasty reduces elongated labia. This is generally part of a vaginoplasty.
However, this article explains that there exists little clinical or scientific evidence to guide gynecological surgeons as to the safety and effectiveness of different cosmetic vaginal procedures. * Nose job (rhinoplasty) – the surgeon reshapes the patient’s nose. It is usually done by an otolaryngologist (head and neck surgeon, ear/nose and throat specialist), maxillofacial surgeon or plastic surgeon. The aim is to improve the appearance of the nose, and sometimes its function as well if the patient has breathing problems. Surgeon’s say patients should wait until they are at least 15 years of age (boys perhaps even older).
Sometimes rhinoplasty is carried out in conjunction with a facelift. This study found a higher rate of personality disorders among nose job candidates. * Ear surgery (otoplasty) – generally this involves pining the ear closer to the head. However, surgery may involve reducing the size of very large ears, or reshaping various bends in the cartilage. Most commonly, otoplasty is used for patients with: * Protruding ears (ears that stick out) * Large ears * Ears that have an abnormal shape Some patients have surgery done on just one ear, while others have both ears done.
Ear surgery can be performed on children because the ears reach their near total development when the child is 5 or 6. A study revealed that cosmetic ear surgery has the youngest age of patients. Cosmetic surgical procedures for children pose ethical dilemmas, this essay discusses. * Facelift (rhytidectomy) – rhytidectomy means to remove wrinkles surgically. The aim is to make the patient’s face look younger. Excess facial skin is removed without tightening underlying tissue – the skin is then redraped on the patient’s face and/or neck.
Face lifts may be done in many ways, however, the most popular one is to make an incision in front of the ear which extends into the hairline and also curves around the bottom of the ear and then behind it. The skin is then separated from the deeper tissues with a scalpel or scissors over the cheeks and neck. The deeper tissues are then tightened with sutures (stitches) – sometimes the excess deeper tissues are removed. The skin is then redraped and some excess skin is removed. The incisions are then sutured or stapled. Facelift procedures are continuously evolving.
This interesting study looked at the surprising high rate of MRSA infections following facelift surgery. * Liposuction (suction-assisted lipectomy) – also known as fat modeling, liposculpture suction lipectomy, or lipo. Fat is surgically removed from various parts of the body – usually the abdomen, thighs, buttocks, hips, backs of the arms, and neck. Liposuction may also be used for male breast reduction. It is crucial for the patient to be told that liposuction is not a weight loss method. If there is a lot of fat, the surgeon cannot remove it all in one go.
How much fat is removed depends on what method is being used, as well as certain aspects relating to the patient – usually the most that can be taken out is about 5 kg (a little over 10 lbs). If too much fat is removed there is a significantly greater risk of complications for the patient. The fat is removed via a cannula (a hollow metal tube) that is passed through the fatty tissue. A pump is attached, generating a vacuum, so that the fat is literally sucked out (suction assisted liposuction). A motor may be attached which makes the cannula vibrate (vacillate back and forth).
An ultrasonic generator may also be used – this produces sound waves that break the fat cells which are then removed. Prior to removal the fat cells may also be broken down with laser. Although complications are uncommon, they can occur, including the accumulation of blood under the skin (hematoma), infection, changes in sensation, allergic reactions, damage to underling structures, and unsatisfactory results. It is important that the patient is aware of the risks and has talked about them with a doctor. Smokers are advised to give up well in advance of the operation and not to resume for at a least a few weeks afterwards.
Smoking can significantly undermine recovery. Liposuction does not reduce the risk of developing diabetes, heart disease or hypertension (high blood pressure), this study revealed. * Brow lift – also known as a browplasty or forehead lift. The aim is to raise drooping eyebrows and/or remove forehead wrinkles (worry lines) – conditions associated with aging. It is often performed in conjunction with other cosmetic procedures aimed at achieving a more harmonious facial appearance. * Chin augmentation – the aim is usually to give the patient a more prominent chin and a better balance of facial features.
An implant is usually placed by the surgeon. Often when the patient has a nose job (rhinoplasty) he/she will include chin augmentation surgery in the same session. Sometimes the surgeon is able to manipulate the jaw bone (without using a prosthetic implant). However, chin augmentation with implants is the more popular option for patients with normally functioning teeth and jaw development. * Cheek augmentation – this surgical procedure is aimed at giving the patient more prominent cheekbones. The surgeon may place an implant at the top of the cheekbones.
Many patients say that weak cheeks make their face seem gaunt and aged. As we age our cheeks may lose their fullness. * Cheek lift – also known as a midface lift. This surgical procedure raises the middle of the face (the cheek) to improve cheek and under-eye fullness and contour. * Hair transplantation – A large percentage of men, especially Caucasian men, and a smaller percentage of women are affected by hair loss. Most hair loss occurs for genetic reasons. Micro-hair transplantation has replaced larger grafts of hair. Patients may require several sessions to achieve desired results.
After six weeks the transplanted hair will fall out and be replaced about three months later when the new hair appears. This article explains how a dermatologist can help patients suffering from hair loss. * Collagen injections – collagen is widely used in cosmetic and plastic surgery for burn patients and for the reconstruction of bone. It is also widely used in dentistry, orthopedics and other surgeries. Collagen injections are also used in treating patients with urinary incontinence. One of the drawbacks is that some patients experience prolonged redness.
Doctors can carry out a patch test before surgery to find out how susceptible the patient might be. Most collagen comes from young beef cattle – they are free of BSE (bovine spongiform encephalopathy – mad cow disease). Collagen may also be derived from pig tissue. These treatments are dermal fillers used in cosmetic medicine to reduce wrinkles, lines and scars, as well as to augment soft tissue contours. Collagen treatments are not permanent – they are degraded by the body and have to be repeated at later date. * Fat injections – also called fat grafting, and has broad applications in cosmetic surgery.
The patient’s own fat is collected from one part of the body and injected into areas requiring volume-enhancement. The results are generally safe and long lasting. Patients are generally more satisfied with this procedure because often two birds are killed with one stone – fat is removed from a part of the body that needs fat reduction, and then added to another part that requires more volume. When the fat is removed it is washed and purified and then carefully re-injected with specially designed needles. Sometimes the procedure needs to be repeated several times for best results.
The hands, face (including lips), and depressions in the skin contour are the most common targets for skin grafting. Rejuvenating newly identified fat compartments in the facial cheeks can help reduce the hollowed look of the face as it ages, according to research by plastic surgeons at UT Southwestern Medical Center. A survey suggests that patients may experience higher complication rates with permanent cosmetic fillers than with other types of cosmetic injections. Choosing a surgeon UK – it is important that the surgeon is registered in two places: * The
General Medical Council and * The British Association of Aesthetic Plastic Surgeons (BAAPS) A BAAPS member must have at least 6 years training in plastic and reconstructive surgery, as well as basic surgical training. It is also advisable that a prospective patient seek surgeons who have a specialism or experience in the type of procedure required. Cosmetic surgeons who work in the National Health Service (NHS) also work privately. Any company in the UK that provides cosmetic surgery must be registered with the Healthcare Commission.
Prospective patients should check their inspection reports and double check that their annual registration is up-to-date. The NHS advises prospective patients to verify what measures the surgeon or company will take to ensure that the surgery progresses as smoothly as possible. The surgeon should explain everything clearly before, during and after surgery. The patient should be told what problems to expect when returning home after surgery or hospital. USA – Ideally, the surgeon should be a member of the American Society for Aesthetic Plastic Surgery (ASAPS).
ASAPS informs that membership is by invitation only and membership is limited to those who are formally trained and experienced plastic surgeons who concentrate their practices in performing cosmetic plastic surgery of the face and body. Membership of ASAPS is an exclusive privilege for surgeons who have the necessary qualifications – only approximately 25% of American Board of Plastic Surgery certified surgeons have been accredited into ASAPS membership. The society does not offer membership to doctors who are trained in specialties other than plastic surgery.
If the surgeon is not an ASAPS member, he/she should at least be certified by the American board of Plastic Surgery. There are many medi-spas in the USA that offer various services. There is no umbrella organization that sets standards for medi-spas, no recognized definition of what constitutes a medi-spa. Guidelines for potential patients of cosmetic surgery: (Source: BAAPS) * There really is only one expert on your appearance and what really matters – that person is you. * The information you are given regarding any treatment you are considering should be impartial and should include all risks and benefits. Do not allow anybody to try to persuade you to do something you had not considered doing before consulting him/her. * Get as much information regarding the considered procedure as possible – and make sure you are fully informed about the limitations and possible risks of any procedure. * Bear in mind that no procedure or surgeon is 100% risk free – this does not exist. * It is vital that you feel completely comfortable with the surgeon, clinic or organization that is going to treat you. * Do not be satisfied with just a surgeon’s word that he/she is a surgeon.
Make sure you find out yourself. Go to national organizations or boards and find out whether the supposed surgeon really is qualified. * Chose the right moment to have surgery. There are events in life which merit postponement of surgery, such as changing job, recent surgery, the death of a loved one, having a baby, or moving house. * Beware of non-refundable deposits and free consultations. * Ideally you should not have to travel far for your treatment. If you do, make sure you are completely happy with the arrangements, especially if you have to travel abroad. Ask your GP (general practitioner, primary care physician) for advice. It is probably the most impartial medical advice around. * In the UK and many countries the patient has the right to cancel right up to the time he/she goes to sleep for surgery. One of the main purposes of cosmetic surgery is for the patient to feel better about himself/herself – if that feeling is no longer there, the surgery should be cancelled. A reputable surgeon will respect that, and not penalize the patient. * Do not rush into undergoing surgery. http://www. medicalnewstoday. com/articles/180450. php
What Is Liposuction? Liposuction Risks And Benefits Editor’s Choice Main Category: Cosmetic Medicine / Plastic Surgery Article Date: 08 Mar 2012 – 0:00 PST email to a friend printer friendly opinions Ads by Google Most Advanced Liposuction – New Technique Simple Safe Effective Faster Recovery Free Consultation – HealthPathwayIntl. Com Weight Loss Made Simple – Find A Natural Cure To Weight Loss Reduce Body Weight Without Rebound! – www. s-recipes. com Bladder Weakness – Understand Incontinence Management And learn How TENA Can Help you – Tena. com. my/Info Current ratings for:
What Is Liposuction? Liposuction Risks And Benefits Patient / Public:| | 4. 73 (22 votes)| Healthcare Prof:| | 4. 75 (4 votes)| Article opinions:| 10 posts| | Liposuction, also called lipoplasty, liposculpture suction lipectomy, or lipo, is a type of cosmetic surgery which breaks up and “sucks” fat from various possible parts of the body, most commonly the abdomen, thighs, buttocks, neck, chin, upper and backs of the arms, calves, and back. The fat is removed through a hollow instrument – a cannula – which is inserted under the skin. A powerful, high-pressure vacuum is applied to the cannula.
Liposuction is the most common cosmetic operation in America and the United Kingdom. Over 400,000 procedures are carried out in the USA each year. Patients who undergo liposuction generally have a stable body weight, but would like to remove undesirable deposits of body fat in specific parts of the body. It is not an overall weight-loss method – it is not a treatment for obesity. Liposuction does not remove cellulite, dimples or stretch marks. The aim is esthetic – the patient wishes to change and enhance the contour of his/her body. Liposuction permanently removes fat cells from the body. It can alter the shape of a body.
However, if the patient does not lead a healthy lifestyle after the operation there is a risk that the remaining fat cells grow bigger. The amount of fat than can be safely removed is limited. Liposuction has a number of possible risks, including infection, numbness and/or scarring. If too much fat is removed there may be lumpiness or dents in the skin. Experts say that the surgical risks are linked to the amount of fat removed. Some medical conditions may benefit from liposuction, including: * Lipomas – benign fatty tumors. * Gynecomastia – where fatty breast tissue has developed in men. Lipodystrophy syndrome – a lipid (fat) metabolism disturbance in which there is too much fat in some parts of the body and partial or total absence of fat in other parts. Sometimes a side effect of some HIV medications. Liposuction – a short history Liposuction was invented in 1974 by two Italian-American surgeons – Doctors Giorgio and Arpad Fischer. The roots of liposuction date back to the 1920s. Dr. Dujarier, a French surgeon performed a fat removal procedure on a model in 1926 which tragically resulted in gangrene in one of her legs; consequently, interest in body contouring receded for several decades.
In the late 1960s Leon Forrester Tcheupdjian, a European surgeon used primitive curettage techniques to remove fat – however, results were patchy, there was a lot of bleeding and morbidity was high. What we know as ‘modern liposuction’ started with a presentation in 1982 by Dr. Yves-Gerard Illouz, a French surgeon. He started what became known as the ‘Illouz Method” – a technique of suction-assisted lipolysis (breakdown or destruction of fats) after infusing fluid into tissues using blunt cannulae and a high-vacuum suction. Illouz demonstrated both reproducible good results and low morbidity.
During that decade several US surgeons experimented with liposuction, developing some variations from the Illouz Method, with mixed results. In 1985 the tumescent technique was described by Drs. Jeffrey Alan Klein (USA) and Patrick Lillis (USA), which added elevated volumes of liquid containing a local anesthetic, allowing the technique to be carried out in an office setting under intravenous sedation, rather than general anesthesia. There were concerns about the high volume of fluid and lidocaine toxicity potential with tumescent techniques, which eventually led to the concept of lower volume super wet tumescence.
Near the end of the last century ultrasound was introduced to assist in the removal of fat, which was initially liquefied through the application of ultrasonic energy. However, there was an increase in reported cases of complications. In recent years laser tipped probes – which induce thermal lipolysis – have been introduced. How beneficial they are over traditional techniques still remains to be determined. Over the last three decades, advancement in liposuction techniques have meant that a larger number of fat cells can be removed with less blood loss, risk, discomfort, and shorter recovery periods.
Fat can also be used today as a natural filler (autologous fat transfer), where fat is taken from one part of the body, cleaned, and then injected into another area of the body – for example, to enhance the shape of the buttocks or reduce wrinkles. What are the uses of liposuction? Liposuction is mainly used to improve how a person looks, rather than providing any physical health benefits. In many cases, the patient would probably achieve the same results, and sometimes better ones if they adopted a healthy lifestyle – good diet, regular exercise and a good night’s sleep every night.
Experts say that liposuction should ideally only be used if the individual did not achieve the desired results with a lifestyle change. For example, if some obstinate areas of fat that are resistant to exercise and diet. When you gain weight each fat cell increases in size and volume. Liposuction reduces the number of fat cells in isolated areas. How much is removed from a specific area depends on its appearance and the volume of fat. Contour changes resulting from liposuction can be long-lasting, as long as the patient’s weight does not increase.
Liposuction is only done in relatively small areas of the human body, and is in no way a treatment for obesity or long-term weight loss. It should not be used if the person wants to get rid of stretch marks, cellulite, dimpling, or other skin surface irregularities. Patients should discuss the pros and cons of liposuction with their GP (general practitioner, primary care physician) before deciding on whether to proceed. If the individual still wants to go ahead, they should talk to their surgeon sincerely about why they want to do it, what they hope to gain out of it personally, and what their expectations are.
Liposuction should only be carried out after a lot of thought. Results are never dramatic; they are subtle. The following body areas are commonly targeted for liposuction treatment: * Abdomen * Back * Buttocks * Chest * Inner knees * Hips * Flanks (love-handles) * Neckline and the area under the chin (submental) * Thighs – saddlebags (outer thighs), and inner thighs * Upper arms According to the American Society of Aesthetic Plastic Surgery, liposuction is performed more commonly on the thighs and abdomen of women, and the abdomen and flanks (sides, love-handles) of men.
Experts say that the best liposuction candidates are those who have good skin tone and elasticity, where the skin molds itself into new contours. People whose skin lacks elasticity may end up with loose-looking skin in areas where the procedure was done. The patient needs to be in good health – people with circulation (blood flow) problems, such as coronary artery disease, diabetes, as well as those with weakened immune systems should not undergo liposuction. Candidates should be over the age of 18 years.
Liposuction is sometimes used to treat certain conditions, including: * Lymphedema – a chronic (long-term) condition in which excess lymph (fluid) collects in tissues, causing edema (swelling). The edema commonly occurs in the arms or legs. The fluid accumulation occurs faster than it can be drained away. Liposuction is sometimes used to reduce swelling, discomfort and pain. However, doctors tend only to use liposuction with patients who have severe symptoms. After the operation patients have to wear a compression bandage for several months, sometimes up to a year after the operation. Gynecomastia – sometimes fat accumulates under a man’s nipples. Liposuction can remove some of the fat, reducing the swelling. * Lipodystrophy syndrome – fat accumulates in one part of the body and is lost in another. Liposuction can improve the patient’s appearance by providing a more natural looking body fat distribution. * Extreme weight loss after obesity – if a morbidly obese person has lost at least 40% of his/her BMI (body mass index) after perhaps a gastric band or bypass procedure, excess skin and other abnormalities may need treatment.
Sometimes liposuction is used to correct abnormalities. Ads by Google Men’s Skin Centres – Enjoy Power Tummy Sculpting @RM190. Tough ABS the easy way, Sign Up Now – www. MenSkinCentre. com. my/Body Ladies Wellness Spa – Feel the Heavenly Refreshing Touch Luxury Spa start from RM 77 – www. veqish. com/html/veq_summ Weight Loss Treatment – Very Effective, Safe & Affordable. At Klinik Mediviron Wisma UOA, KL – www. MedivironUOA. com What happens before and during the liposuction operation? Before the operation – patients will need to undergo some health tests to ensure that they are fit for surgery.
The medical team will ask the patient to: * Stop taking aspirin and anti-inflammatory drugs for at least two weeks