Prime cuts
Double eye-lid operation (upper blepharoplasty) Objective: to create a fold of upper eyelid skin when eye opens.
Procedure: either the buried stitch technique whereby tiny invisible stitches are made on the upper eyelid, or the open technique in which the eyelid is cut and stitched back to form a crease.
Cost: $18,000-$20,000.
After-effects: swelling, bruising, an exaggerated crease, pink scar which should fade with time.
Recovery time: two to three weeks.
How long results last: just three months using the buried stitch technique, indefinitely using the open technique.
Eyelift/eyebag removal (lower blepharoplasty) Objective: to remove bulging fat pads under eyes.
Procedure: incisions are made in the crease above the eye or on the lower eyelid; inside or on the lashline. Excess fat is cut out, the root of the incision is burnt to prevent bleeding and the wound is stitched.
Cost: $20,000-$22,000.
After-effects: bruising and swelling. Can result in excessive weeping, complete lack of tears or, very occasionally, loss of sight. If the lower lid is done incorrectly it can sag forward exposing the white of the eye.
Recovery time: one week.
How long results last: at least 10 years.
Eyebrow/forehead lift Objective: to lift the skin above the eyes, raising eyebrows and removing frown lines.
Procedure: a 38 centimetre incision is made in the upper hairline from temple to temple, skin is dissected off the bone, forehead is pulled up and excess skin cut off. Endoscopic surgery, using fibre optics, is also available which allows four or five 2.5 cm incisions to be made.
Cost: $30,000.
After-effects: prominent scarring. Dry eyes can occur after operation due to exposure of the eyeball during the operation but this settles down as swelling subsides.
Recovery time: one week.
How long results last: five to six years.
Augmentation rhinoplasty Objective: to raise the bridge of the nose.
Procedure: a nasal prosthesis is inserted above the nasal bone via the nostril or upper lip.
Cost: $18,000.
After-effects: black eyes, bruising and swelling; it may take several months before the nose feels normal. There may be considerable pain and discomfort. An unnatural appearance can result if prosthesis is inserted too high, loss of nasal tissue, infection, extrusion (the prosthesis sticks out of the skin.) Recovery time: one week.
How long results last: indefinitely.
Nose-reshaping (reduction rhinoplasty) Objective: to reshape a broad or crooked nose.
Procedure: there are two methods of incision - the conventional one where an incision is made inside the nostril or open rhinoplasty where a 5 mm incision is made across the colomella (the central piece of tissue at the base of the nose between the two nostrils). The cartilage over tip of nose is cross-hatched and bent into the required form. Bumps are chiselled off the bone.
Cost: $50,000.
After-effects: black eyes, bruising and swelling, considerable pain and discomfort. Overnight hospital stay is necesary. Additional surgery may be needed to clear a blocked airway.
Recovery time: three to four weeks.
How long results last: indefinitely.
Cheek remodelling Objective: to create dimples and a slight sunken appearance to cheeks.
Procedure: a pad of fat is cut out from within the mouth. The cheek can be restitched to create a dimple.
Cost: $15,000.
After-effects: swelling. Dimple can be wrongly located and accidental snipping of facial nerves can cause paralysis.
Recovery time: one week.
How long results last: indefinitely.
Ear correction (otoplasty) Objective: to reset prominent ears.
Procedure: incision is made behind the ear and cartilage is reshaped and stitched closer to the head.
Cost: $15,000-$18,000.
After-effects: possible haematoma (blood clots caused by blood leaking into tissue or body cavities); ears may not be totally symmetrical. Children need a general anaesthetic and must stay over night in hospital.
Recovery time: three weeks.
How long results last: indefinitely.
Lip collagen implants (soft tissue augmentation) Objective: to make lips fuller.
Procedure: tiny amounts of bovine skin collagen are injected below the skin using a fine hypodermic needle.
Cost: $3,000-$5,000.
After-effects: bruising, swelling, clots if collagen is accidentally injected into blood vessels.
Recovery time: one day.
How long results last: body enzymes break down the collagen and skin returns to its original state after three to six months.
Face-lift (rhytidectomy) Objective: to pick up sagging skin, loose jowls and loose neck skin in lower part of face.
Procedure: an incision is made from the hairline around the top of the ear, into the ear and then behind the ear. Excess skin is trimmed off and redraped. An additional cut is made below the chin to remove fat in double chins.
Cost: $40,000-$60,000.
After-effects: an overnight hospital stay is necessary; face is bandaged for three days; bruising or swelling lasts about two weeks. Possible skin loss and scarring; loss of sensation in certain areas, usually near the ear. Men may have to shave under their ears because of relocation of facial hair. Partial paralysis can result if nerves are accidentally cut, resulting in a crooked smile.
Recovery time: three weeks.
How long results last: five to 10 years.
Chemical peel/dermabrasion/laserbrasion Objective: to smooth facial wrinkles and remove freckles or pigment spots.
Procedure: a chemical preparation (either phenol-based on phenolic acid, TCA based on trichloroacetic acid or lighter fruit acid) is spread onto the face. This burns and removes the top layer of skin leaving a raw, reddish area until it heals. Dermabrasion and laserbrasion are more precise and controllable than chemical peels. In dermabrasion the skin's outer layers are mechanically sand-papered off and in laserbrasion a ray of light is delivered in rapid bursts vaporising the skin.
Cost: $4,000-$8,000.
After-effects: raw, pink, blotchy skin for first weeks. Skin becomes very susceptible to sunburn afterwards. A gravelly rash can appear and treated skin may be lighter or darker than surrounding skin.
Recovery time: three to six months.
How long results last: three years.
Hair transplants (mini and micrografts) Objective: to harvest hairy parts of the scalp and replant follicles in bald areas.
Procedure: hair transplant was previously performed using the punch graft method in which a small instrument like a biscuit cutter removed plugs of 12 to 15 hairs from the base of the skull and inserted them into bald areas. Recently a new technique has been developed where grafts are cut into smaller pieces. Mini (two or three hairs) and micrografts (a single hair) are inserted into small slits in the bald area; the result is far more natural.
Cost: $40,000.
After-effects: hair can grow at odd angles if plugs aren't lined up correctly; scalp numbness.
Recovery time: one week.
How long results last: indefinitely.
Breast augmentation (mammoplasty) Objective: to enlarge breasts.
Procedure: there are three methods of insertion: the transareola method in which an incision is made where the dark pigmentation of the areola meets the light pigmentation of the surrounding breast skin; the transaxillary method where the incision is made in the armpit; and the sub mammary method where an incision is made in the crease beneath the breast. An envelope filled with saline is then placed between the breast tissue and the chest wall muscle, or under the chest wall muscle.
Cost: $50,000.
After-effects: two-day hospital stay needed. Swelling and tenderness. Possible haematoma, infection, leaking implants, lop-sided breasts or loss of nipple sensation. An internal scar can form around the implant causing hardening.
Recovery time: two months.
How long results last: indefinitely, as long as the bag doesn't break.
Breast reduction (reduction mammoplasty) Objective: to reduce size of breasts which may relieve back and neck problems.
Procedure: an inverted T-shaped incision is made under the breast and a circular incision is made around the areola. Breasts are reshaped and repositioned after excess breast tissue is removed; nipples are then relocated.
Cost: $50,000-$60,000.
Hospital stay: two days.
After-effects: two-day hospital stay needed. Can result in thick ropy scarring, haematoma or infection. Nipples can look awkward and sensitivity can be reduced or increased.
Recovery time: one to two months.
How long results last: indefinitely.
Liposuction Objective: to suck out fat from under chin, upper arms, stomach, lower abdomen, bottom, inside of knee or outer and inner thighs.
Procedure: Two to three millimetre wide tubes are inserted into fatty areas and a wand is moved vigorously back and forth to break up and remove fat cells. Patient must remain inactive for one or two months to reduce swelling (which can cause scar tissue), wear pressure garments and avoid weight gain.
Cost: $30,000-$40,000 (charges are also made per area or kilo of fat removed).
After-effects: overnight hospital stay needed. Bruising. Rippling in the skin can occur where skin is very slack or excessive fat is removed.
Recovery time: three to six weeks.
How long results last: indefinitely if correctly done.
Tummy tucks (abdominoplasty) Objective: to tighten baggy skin around stomach.
Procedure: an incision is made between the pubic line and the bikini line. A second incision is made around the navel, stretched abdominal muscles are gathered up, excess skin removed and the navel is relocated.
Cost: $50,000-$60,000.
After-effects: two-day hospital stay needed. Long scar above pubis from one side to the other. People have died from haemorrhaging.
Recovery time: three to six weeks.
How long results last: indefinitely if correctly done.
Penis enlargement Objective: to increase length and girth of penis.
Procedure: there are three methods of enlargement; harvesting fat by liposuction from the abdomen or another area and injecting it beneath skin of penis; dermal fat grafting where a deep layer of skin is cut from the buttock and inserted around the penis; and lengthening where the ligament joining the base of the penis to the body is cut and up to four centimetres of penis is pulled out of the body.
Cost: fat-injection method, $48,000 per injection (60 per cent of fat is absorbed into the body and up to six injections may be needed). Dermal fat grafting, $72,000. Lengthening, $60,000. (Prices are based on Australian figures as penis enlargement procedures are unavailable in Hong Kong.) After-effects: one-day hospital stay. The fat injection method is not recommended due to the high risk of complications from infection which can result in fat and penile skin necrosis or even total loss of penis.
Recovery time: How long results last: fat injection method, six months to one year; dermal fat grafting and lengthening, indefinitely.
Leg vein removal (sclerotherapy) Objective: to remove spider veins or telangiectasias of the leg.
Procedure: a sclerosing or hardening solution, called Aethoxysclerol, is injected directly into the veins using a very fine needle. The solution displaces the blood inside the vein, causing it to blanch or turn white. The solution also irritates the vessel making it swell shut, stopping the blood from re-entering the vein. Each vein may require more than one injection.
Cost: $4,000.
After-effects: burning sensation during treatment, bruising, uneven pigmentation, occasionally leads to scarring.
Recovery time: six to eight weeks.
How long results last: indefinitely, although new veins may develop later on.