Glossary of terms

Abdominoplasty is a surgical operation on the abdomen in which excess skin and subcutaneous fat are removed and a slack abdominal wall is tightened. It is performed under general anaesthesia and addresses a condition that neither exercise nor diet can improve — typically after significant weight loss or pregnancy.

Depending on the extent, a full abdominoplasty involves an incision from hip to hip and repositioning of the navel, while a mini-abdominoplasty corrects only the lower abdomen. The operation may include repair of separated abdominal muscles (diastasis recti). The scar is placed low so that underwear conceals it.

Aesthetic surgery is the part of plastic surgery whose aim is to improve the appearance of healthy tissues — the shape of the nose, breasts, abdomen or eyelids, or the signs of ageing. Unlike reconstructive surgery, it is not driven by medical necessity but by the client's wishes; it is therefore not covered by health insurance.

The broader term aesthetic medicine also includes non-surgical treatments such as botulinum toxin or dermal fillers. Aesthetic operations are performed by a plastic surgeon with the same techniques and the same safety standards as reconstructive operations — the difference lies in the reason, not the method.

Blepharoplasty is plastic surgery of the upper or lower eyelids. It removes excess, loose skin and protruding fat pads that give the eyes a tired appearance. It is one of the most common aesthetic operations of the face.

The procedure is usually performed under local anaesthesia and takes about an hour. On the upper eyelids the incision runs in the natural crease; on the lower eyelids just below the lashes, so the healed scars are practically invisible. Upper and lower eyelids can be operated on separately or at the same time.

Body contouring is an umbrella term for procedures that shape the figure by modifying fat, skin and subcutaneous tissue. It includes liposuction, abdominoplasty, lipofilling and the removal of excess skin after major weight loss — on their own or in combination.

Surgical body contouring addresses what exercise and diet cannot: localised fat deposits and loose skin. It is not a treatment for being overweight — it is suited to people whose weight is stable. The term is also used for non-invasive device-based methods, but these have a limited effect compared with surgery.

Breast augmentation is an operation in which the breasts are enlarged with a silicone implant or, alternatively, with the patient's own fat (lipofilling). The word augmentation simply means enlargement of a part of the body; in everyday language it is used almost exclusively for breast enlargement.

The implant is inserted through a short incision — most often in the crease beneath the breast — either under the breast gland or under the chest muscle. The operation is performed under general anaesthesia. Besides volume, it can also correct the shape, a marked asymmetry, or loss of volume after breastfeeding.

Reduction mammaplasty is an operation in which overly large breasts are made smaller. The surgeon removes part of the breast gland, fat and skin, reshapes the breasts and moves the areola and nipple to a natural position. The result is smaller, lighter and firmer breasts in proportion to the figure.

The procedure often also relieves the physical complaints that come with large breasts — back and neck pain, pressure marks from bra straps or soreness in the crease beneath the breast. It is performed under general anaesthesia with a short hospital stay. The technique and incision pattern are similar to those of a breast lift.

A facelift is surgical rejuvenation of the face and neck. The surgeon releases and lifts the loose skin and the deeper subcutaneous tissues, tightens slackened muscles and removes excess skin. The aim is to restore the face's original contours, not to change its expression.

The incision runs from the hair-bearing temple in front of the ear, around the earlobe and behind the ear, where the healed scar is barely noticeable. The procedure is performed under local or general anaesthesia depending on its extent. A facelift does not treat the quality of the skin itself — fine wrinkles and pigmentation call for other methods.

Labiaplasty is plastic surgery of the labia minora (the inner lips of the vulva) in which their size is reduced or their shape corrected. The reasons are not only aesthetic but often practical — chafing during sport, irritation from clothing, or discomfort during intercourse.

The procedure is performed under local anaesthesia, takes about an hour and is closed with dissolvable stitches that do not need removing. You go home the same day. Sensation and function are not affected by the operation; thanks to the good blood supply, healing in this area is quick.

Lipofilling is the transfer of the body's own fat from one area to another. The fat is harvested by liposuction — most often from the abdomen or thighs — processed, and then injected through a thin cannula into an area lacking volume: the breasts, face or buttocks.

Because it is the body's own tissue, there is no risk of rejection; part of the transferred cells is, however, reabsorbed, so the final volume is smaller than the amount injected. The method suits modest enlargement with a very natural result, for example as an alternative to a breast implant.

Liposuction is an operation in which excess fat is suctioned from beneath the skin through a thin cannula. It is used to shape the body in areas where fat deposits resist exercise and diet — the abdomen, hips, thighs, knees, arms or under the chin. It is not a weight-loss method.

Removed fat cells do not grow back, so the result is permanent provided body weight does not change substantially. Several techniques exist; in aesthetic surgery the standard is tumescent liposuction under local anaesthesia. After the procedure a compression garment is worn to help the skin adapt to its new shape.

Mastopexy is an operation that restores the shape and position of sagging breasts. The surgeon removes excess skin, reshapes the breast gland and moves the areola and nipple to a higher position. The volume of the breasts is essentially unchanged — unlike in augmentation or reduction.

Breast sagging (ptosis) most often follows pregnancy and breastfeeding, weight loss or ageing. The extent of the incisions depends on the degree of sagging — from an incision around the areola to an inverted-T pattern. A mastopexy can be combined with an implant when volume is lacking as well.

Mesotherapy is a non-surgical skin treatment in which active substances are delivered with a very fine needle in tiny doses into the middle layer of the skin — where creams cannot reach. The product is usually based on non-cross-linked hyaluronic acid, often combined with vitamins and amino acids.

Unlike a dermal filler, mesotherapy does not add volume; it deeply hydrates, smooths and brightens the skin. Treatments are usually repeated in a series. At Estela the product used for mesotherapy is Neauvia Hydro Deluxe.

Microsurgery is an operating technique in which the surgeon works under an operating microscope with instruments and sutures finer than a human hair. It makes it possible to join blood vessels and nerves one millimetre in diameter — for example when transferring tissue from one part of the body to another, or when reattaching fingers.

It is the most demanding area of plastic surgery, typical of reconstructive procedures after injuries and cancer. A surgeon trained in microsurgery has an exceptionally gentle and precise operating technique, which shows in aesthetic operations too. Estela's doctors are microsurgeons.

Otoplasty is plastic surgery of the external ear, most often the correction of prominent ears. Through an incision behind the ear the surgeon reshapes the ear cartilage and brings the ear closer to the head; the scar stays hidden in the fold behind the ear. The shape and function of the ear are otherwise unchanged.

The procedure is performed under local anaesthesia and takes about an hour. It can be done in childhood, from about six years of age, once the cartilage has finished growing and the child is able to cooperate. After the operation a bandage is worn for several days, followed by an elastic headband that protects the new shape.

Plastic surgery is the medical specialty that restores, corrects or improves the form and function of the body's tissues. The name comes from the Greek plastikos — "to mould" — and has nothing to do with plastic. It comprises two broad areas: reconstructive surgery and aesthetic surgery.

A plastic surgeon is a doctor who, after medical school, has completed several years of specialist training concluded by board certification in plastic surgery. Board certification is the fundamental proof of qualification; in the Czech Republic the doctor is also registered with the Czech Medical Chamber.

Reconstructive surgery is the part of plastic surgery that restores the form and function of tissues damaged by injury, cancer, infection or a congenital defect. Examples include breast reconstruction after tumour removal, coverage of extensive wounds, and cleft surgery.

Reconstructive operations are performed in hospitals and covered by health insurance. For an aesthetic surgery client, what matters is that a surgeon with reconstructive practice works daily with demanding tissues and complications — experience that carries over into aesthetic operations. All of Estela's doctors also practise reconstructive surgery at a university hospital.

A revision is an additional procedure that adjusts the result of a previous operation. It may be a minor adjustment of a scar or an irregularity under local anaesthesia, or a more extensive revision operation — for example an implant exchange or reshaping of the nose.

The need for a revision does not necessarily mean something went wrong: tissues heal individually and the final shape settles over months, which is why a revision is considered only after complete healing. In aesthetic surgery a certain proportion of revisions is a normal part of the field, and the surgeon discusses this in advance.

Rhinoplasty is plastic surgery of the nose that changes its shape or size — removing a hump on the bridge, narrowing or lifting the tip, refining the nostrils or reducing the nose overall. It can also correct a deviated septum at the same time, and with it the breathing.

By approach, a closed technique uses incisions inside the nose, while an open technique adds a small incision on the columella. The operation is performed under general anaesthesia. Afterwards the nose is supported by a splint and the nostrils by packing; the final shape settles over many months, and at the tip even longer.

Tumescent liposuction is a fat-removal technique in which the treated area is first infused with a large volume of diluted solution containing a local anaesthetic and a vessel-constricting agent. The tissue swells and firms up — the Latin tumescere means "to swell" — and can then be suctioned gently through a thin cannula with minimal bleeding.

The solution also numbs the whole area, so the procedure takes place under local anaesthesia without the need for a general anaesthetic. Lower blood loss means less bruising and faster healing. It is an established standard in aesthetic surgery and the method used at Estela.

Anaesthesia is a state in which a person feels no pain, allowing a surgical procedure to be performed. It is achieved by giving drugs — anaesthetics — either to the area being operated on or to the whole body. The word comes from Greek and literally means "without sensation".

In plastic surgery two basic types are used: local anaesthesia, in which the client is awake and only the operated area is numbed, and general anaesthesia, in which the client sleeps while an anaesthetist monitors their vital functions. Which one the surgeon chooses depends on the extent and location of the procedure.

An anaesthetic is a drug that produces anaesthesia — it temporarily blocks the transmission of pain signals along the nerves. Local anaesthetics, such as lidocaine, are injected into the tissue or applied to the skin as a cream; general anaesthetics are given intravenously or inhaled and induce sleep.

A local anaesthetic is often combined with adrenaline, which constricts the blood vessels, reduces bleeding and prolongs the effect. In the tumescent solution used for liposuction the anaesthetic is heavily diluted, so a large area can be numbed safely. An anaesthetic cream is also used before dermal filler treatments.

An anaesthetist is a doctor specialising in anaesthesiology and intensive care who administers general anaesthesia. Before the operation they review the pre-operative examination results and choose the appropriate approach; during the operation they give the drugs and continuously monitor vital functions; afterwards they oversee the waking-up.

For operations under general anaesthesia there are therefore always two doctors in theatre — the surgeon and the anaesthetist. Concerns about anaesthesia are best discussed with them: they explain what to expect and tailor the anaesthesia to your state of health. For procedures under local anaesthesia an anaesthetist need not be present.

Clinical photography consists of standardised photographs of the operated area taken before and after the procedure. They form part of the medical records: the surgeon uses them to plan the operation, to compare the result with the starting point, and as a record of the course of treatment.

The photographs are taken in the same lighting and from the same angles so that the comparison is objective. They remain in the client's records and are not published anywhere — a photograph may be used on the website or for any other purpose only with the client's explicit written consent, which can be withdrawn at any time.

Fasting means not eating, drinking or smoking before an operation under general anaesthesia — usually for at least six hours beforehand. The reason is safety: as sleep is induced, the protective reflexes relax and the contents of a full stomach could enter the airways.

Instructions on fasting and on taking regular medication are given in advance, and it is important to follow them; failure to fast is a reason to postpone the operation. Before a procedure under local anaesthesia, by contrast, you should not fast — a light meal beforehand helps prevent faintness.

General anaesthesia is a controlled, drug-induced sleep during which the client perceives and feels nothing. Anaesthetics are given intravenously and through the airways; throughout the operation and afterwards an anaesthetist monitors breathing, heart function and other vital signs.

It is used for larger operations — of the breasts, nose or abdomen. It requires a pre-operative examination and fasting, and after the operation you usually stay one night at the clinic. In healthy people modern general anaesthesia is safe; the most common side effects are temporary nausea or drowsiness.

A hospital stay is a period spent in a bed at a medical facility after an operation. In aesthetic surgery it is usually a single night after a procedure under general anaesthesia — breast, abdominal or nose surgery — during which the nursing staff monitor the client, manage pain and carry out the first dressing change.

You go home the following day after being checked by the doctor, always accompanied. After procedures under local anaesthesia no hospital stay is needed. At Estela the stay after an operation is included in the price of the procedure.

Local anaesthesia is the numbing of a defined area of the body by injecting an anaesthetic directly into the site of the procedure. The client stays awake, breathes unaided and feels at most touch and pressure, not pain. The effect sets in within minutes and wears off after a few hours.

It is used for smaller and medium-sized procedures — eyelid surgery, ear correction, labiaplasty, liposuction or a facelift. It requires neither fasting nor a pre-operative examination, and you go home shortly after the procedure. The most uncomfortable part is usually the injection itself.

An outpatient procedure is one after which the client goes home the same day and does not stay at the clinic overnight. It is usually performed under local anaesthesia and takes from tens of minutes to a few hours. Typical examples are eyelid surgery, ear correction, labiaplasty, and botulinum toxin or filler treatments.

Being an outpatient procedure does not mean lower safety standards — it takes place in an operating theatre under the same conditions. The client should, however, arrange to be accompanied and driven home, as after some procedures, such as eyelid surgery, driving is not possible straight away.

A pre-operative assessment is a set of examinations carried out before an operation under general anaesthesia to confirm that the client's health makes the procedure safe. It includes a consultation and physical examination by a GP or internist, blood tests and, depending on age and health, an ECG or further tests.

The results are valid for a limited period, usually a few weeks, and the anaesthetist uses them when planning the anaesthesia. For procedures under local anaesthesia a pre-operative assessment is normally not required. Where and when to have it is explained when the operation date is arranged.

Premedication is medication given before an operation, usually one to two hours beforehand. Its purpose is to calm, reduce anxiety and prepare the body for anaesthesia; it may also include a painkiller or an anti-nausea drug.

It is given as a tablet or injection, and its composition is decided by the anaesthetist according to the client's health and the type of operation. After premedication the client feels relaxed and drowsy and should no longer get up unaccompanied. For procedures under local anaesthesia premedication is usually not given.

A cannula is a thin hollow tube used to deliver something into tissue or to draw it out. Unlike a needle it has a rounded, blunt tip, so it passes through tissue more gently and causes less damage to blood vessels and nerves.

In liposuction a cannula is used to infuse the tumescent solution and then to suction out the fat; the thinner the cannula, the smoother the result. In hyaluronic acid filler treatments a blunt cannula allows a larger area to be treated from a single entry point with less risk of bruising. Cannula is also the everyday name for the plastic intravenous line through which drugs are given during an operation.

A compression garment is a special elastic garment that applies even pressure to the operated area after surgery. It reduces swelling, limits bleeding into the tissues, helps the skin adapt to its new shape and makes movement more comfortable. Versions exist for the abdomen, thighs, arms and face.

It is worn after liposuction, abdominoplasty or a facelift — continuously for the first weeks, then as instructed by the surgeon. The right size is essential: the garment should compress, but never pinch painfully. You buy it in advance as recommended by your doctor; at Estela it is not included in the price of the procedure.

Dissolvable stitches are sutures made of a material that the body breaks down on its own over weeks to months. They therefore do not need to be removed — an advantage for stitches placed deep in the tissue and in areas where removal would be unpleasant, for example after labiaplasty.

How long they take to dissolve depends on the material and thickness of the thread; the stitch loses its strength before it disappears completely. Occasionally the end of a dissolvable stitch works loose at the surface or a small area of redness appears — this is normal, and the doctor can trim it at a check-up. For facial skin, non-absorbable stitches that are removed are more often chosen.

A drain is a thin tube placed in the wound at the end of an operation through which blood and tissue fluid, which would otherwise accumulate, can flow out. It reduces the risk of a haematoma or seroma and speeds up healing. The outer end is connected to a collecting container, often with gentle suction.

Drains are used in more extensive procedures — for example after a facelift, breast or abdominal surgery — and are usually removed after one to several days, once they are draining only minimal fluid. Removal is brief and almost painless. Smaller procedures do not require a drain.

A dressing change is the inspection and care of the surgical wound combined with replacing its covering — a bandage or dressing. The nurse or doctor examines and cleans the wound, removes stitches or a drain if due, and applies a fresh sterile dressing.

The first dressing change is usually done the day after the operation, with further ones at intervals of days depending on the procedure and healing. Dressing changes take place at the clinic and are a good opportunity to ask about anything that surprises you during healing. At Estela, dressing changes and post-operative check-ups are included in the price of the procedure.

A follow-up appointment is a visit to the operating surgeon after the procedure at which healing and recovery are monitored. The surgeon assesses the wound, swelling and bruising, removes stitches or a splint, adjusts the care instructions and answers questions.

The first follow-up is usually within the first days to two weeks after the procedure, with further visits at intervals of weeks and months until the result has settled — for some operations up to a year. Follow-ups are also important for detecting complications early; if any problems arise between visits, contact the clinic straight away.

A headband is a wide elastic band that holds the ears against the head after prominent-ear correction. It protects the reshaped cartilage from being bent — especially during sleep — and replaces the bulky bandage worn in the first days after the procedure.

It is put on once the bandage and stitches have been removed, about a week after the operation; for the first week it is worn continuously, and for the following weeks only at night. An ordinary elastic sports or tennis headband, bought in advance, is sufficient. For children it is also useful for protecting the ears during play.

An incision is the opening of the skin with a scalpel through which the surgeon gains access to the tissues beneath. The length and placement of the incision determine what the resulting scar will look like — which is why surgeons place incisions in natural creases, in the hair-bearing scalp, behind the ear or in the crease beneath the breast.

Each operation has typical incision patterns; the surgeon chooses the one that matches the extent of the procedure and the client's anatomy. At the end of the operation the incision is closed with stitches. Exactly where the incision will run for your procedure is explained at the consultation, often with a drawing.

Packing is the filling of a cavity — after nose surgery, the nostrils — with soft material that stops bleeding and supports the tissues in their new shape. Gauze strips or soft tubes are used, the latter allowing at least partial breathing through the nose.

Packing is inserted at the end of a rhinoplasty and removed at the first check-up, usually the following day. Until then you breathe through your mouth, which is uncomfortable but brief; removal takes a moment, and breathing immediately feels noticeably freer. The nasal splint stays on longer.

A nasal splint is a rigid cover applied to the nose at the end of a rhinoplasty. It holds the nasal bones and cartilage in their new position, protects the nose from knocks and limits swelling. Alongside traditional plaster, thermoplastic splints that work the same way are also used.

The splint usually stays on for one to two weeks and is removed by the surgeon at a check-up. After removal the nose remains sensitive for many weeks — it is protected from the pressure of glasses, from sport and from direct sun. The final shape of the nose settles over many months after the splint comes off.

An analgesic is a drug that relieves pain. After aesthetic operations, ordinary over-the-counter painkillers — paracetamol or ibuprofen — are usually sufficient, taken as needed during the first days. After more extensive operations the doctor may prescribe stronger medication.

Pain after plastic surgery is generally mild to moderate and feels more like pressure or a bruise; it peaks in the first two to three days and then subsides. Before an operation, by contrast, it is important to stop medication that affects blood clotting, such as aspirin — always in agreement with your doctor.

A stitch, or suture, is the surgical closure of the edges of a wound with thread. It holds the tissues together until the wound heals on its own, and its precision strongly influences how the scar will look. Plastic surgery uses very fine threads and a delicate technique, often in several layers — deeper stitches take the tension off the skin.

Skin stitches made of non-absorbable material are removed at a check-up, usually after 5 to 14 days depending on the site; sooner on the face, later on the body. Dissolvable stitches disappear on their own. Besides thread, skin adhesives and adhesive strips are also used.

A support bra is a post-operative bra without underwiring that holds the breasts in the correct position after breast surgery, limits swelling and protects the healing scars. It fastens at the front so that it can be put on without raising the arms, and is made of soft, breathable material.

It is worn after breast augmentation, reduction and lift — continuously, including at night, for the first weeks, then during the day for several more weeks. The size is chosen according to the planned result, and you buy it in advance as recommended by your surgeon. Underwired bras are worn only after complete healing.

Altered sensation is a change in how touch is perceived in the operated area — numbness, tingling, burning or, conversely, oversensitivity. It arises because fine nerve fibres in the skin are divided during the operation; it is common after breast and abdominal surgery, liposuction and a facelift, and is not a sign of error.

Nerve fibres regrow slowly, so sensation returns gradually over weeks to months, occasionally up to a year; its return is often accompanied by tingling. After some procedures, such as the nipple after breast reduction, the change in sensation can be permanent — the surgeon explains this risk in advance.

Asymmetry is a difference between the two sides of the body — the breasts, ears, eyelids, labia or the two halves of the face. A degree of asymmetry is natural and everyone has it; plastic surgery can reduce it, but perfect symmetry is not achievable, because the two sides heal and change independently.

Before the operation the surgeon documents any existing asymmetry and allows for it in the plan — for example by choosing implants of different sizes. In the first weeks after the procedure asymmetry may be temporarily accentuated by uneven swelling. If it persists once the result has settled, it can be corrected in justified cases.

Bleeding is the escape of blood from vessels damaged during an operation. During the procedure the surgeon stops it as they go; slight oozing from the wound in the first hours after surgery is normal and stops on its own. Significant post-operative bleeding leading to a haematoma is a rare complication.

The risk is increased by medication that affects clotting — aspirin, some painkillers, supplements containing ginkgo or omega-3 — and by high blood pressure, which is why everything the client takes is discussed with the surgeon before the operation. Heavy bleeding that does not stop with pressure is a reason to contact the clinic immediately.

A bruise is discolouration of the skin caused by blood that has leaked from small damaged vessels into the tissue beneath the skin after an operation. The colour changes as the body breaks the blood down — from blue-purple through green to yellow — and it usually disappears within one to three weeks.

Bruising is common after aesthetic operations, especially around the eyes after eyelid or nose surgery and on the trunk after liposuction. Its extent is reduced by a gentle operating technique, cooling, a compression garment and stopping blood-thinning medication before the procedure. A bruise is only colour; unlike a haematoma it does not form a lump.

Capsular contracture is the thickening and tightening of the fibrous capsule that the body naturally forms around every breast implant. A thin capsule is normal and harmless; in contracture it thickens and contracts, the breast becomes firm, may change shape, ride up, and in advanced stages become painful.

It is the most common implant-specific complication; the risk is reduced by a gentle operating technique, a high-quality implant and adherence to the post-operative regime. Milder degrees are monitored, more pronounced ones are treated surgically — by releasing or removing the capsule and exchanging the implant.

A haematoma is a collection of blood in the tissue or in the surgical wound that forms a palpable, often painful lump. It occurs when a small vessel bleeds into an enclosed space after an operation. Unlike a bruise, which is only discolouration of the skin, a haematoma has volume and tension.

A small haematoma is reabsorbed on its own; a larger one needs to be drained promptly so that it does not press on the surrounding tissue and impair healing — which is why rapidly increasing swelling, pain or tightness in the wound should be reported to the clinic immediately. The risk is reduced by a gentle operating technique, a drain, compression and stopping blood-thinning medication.

Healing is the natural process by which the body closes and rebuilds damaged tissue. It proceeds in phases: in the first days the wound reacts with inflammation and cleans itself, over the following weeks new tissue forms and the wound closes, and over months the scar remodels, softens and fades.

The speed of healing is influenced by age, blood supply, nutrition, smoking, diabetes and certain medications; the face heals faster than the trunk. You support healing with rest, by protecting the wound from tension, sun and infection, and by following your surgeon's instructions. It cannot be hurried, but it can be left unhindered.

A hypertrophic scar is one that heals with excessive formation of fibrous tissue — it is raised, firm, red and sometimes itchy. Unlike a keloid it does not extend beyond the boundaries of the original wound, and over time, usually within one to two years, it tends to flatten on its own.

It develops more often in areas of skin tension — on the chest, shoulders and in the crease beneath the breast — and in younger people. It is treated with pressure massage, silicone sheets and, if necessary, corticosteroid injections into the scar or laser. A tendency to hypertrophic healing is worth mentioning to your surgeon before the operation.

A wound infection is the multiplication of bacteria in the surgical wound, causing inflammation. It presents as increasing redness, warmth, swelling and pain, sometimes with discharge from the wound and fever — usually between the third and tenth day after the operation. It is rare in plastic surgery, because operations are carried out under strictly sterile conditions on healthy tissue.

The risk is increased by smoking, diabetes, a weakened immune system and neglect of wound care; before an operation you therefore need to be completely well, with no cold or cold sore. An infection is treated with antibiotics and wound care; starting treatment early is crucial, so the first signs should be reported to the clinic immediately.

A keloid is a scar that grows beyond the boundaries of the original wound into healthy skin and does not regress on its own. It is firm, shiny, raised and often itchy or painful. It is a disorder of healing with a hereditary tendency; it occurs more often in people with darker skin and on the chest, shoulders, earlobes and neck.

A keloid is harder to treat than a hypertrophic scar — with corticosteroid injections, pressure, silicone or laser; simple excision without further treatment often leads to recurrence. Anyone who has developed a keloid after a previous injury or piercing should tell the surgeon before any operation so that the risk can be weighed and healing monitored.

Necrosis is the death of part of a tissue that occurs when it loses its blood supply. In plastic surgery it can rarely affect the edge of the skin at an incision or fatty tissue after liposuction and lipofilling; it presents as darkening and hardening followed by separation of the affected part.

The risk is markedly increased by smoking, which constricts blood vessels and impairs the skin's blood supply — which is why not smoking is required before and after an operation. Other factors are diabetes, pressure from a dressing or haematoma, and extensive lifting of skin. Small areas of necrosis heal on their own with a scar; larger ones require treatment by the surgeon.

Ptosis means drooping — under the influence of ageing, gravity, weight changes or pregnancy, tissue shifts lower than where it belongs. In plastic surgery the term is used most often for breast ptosis, where the nipple drops below the level of the crease beneath the breast, and for drooping of the upper eyelid, which partly covers the pupil.

The degree of drooping is graded and determines the choice of procedure: breast ptosis is treated with a breast lift (mastopexy), excess eyelid skin with blepharoplasty. True eyelid ptosis caused by a weakened lifting muscle requires a different kind of operation from a simple overhang of skin — the surgeon distinguishes between them at the consultation.

Recovery is the period after a procedure during which the body heals and the client gradually returns to normal activities. Its length depends on the extent of the operation: after non-surgical treatments it is practically nil, after smaller operations under local anaesthesia about a week, and after major operations several weeks.

Recovery usually has several milestones — returning to work, driving, sport, and high-impact sport — and the surgeon advises on each individually. It involves rest, wearing a compression garment and protecting the scars. The final result, however, takes longer to settle than the recovery period itself.

A scar is the fibrous tissue with which the body replaces skin divided by an incision or injury. One forms after every surgical incision; plastic surgery cannot avoid it, but it can place and treat it so that it is as inconspicuous as possible — in natural creases, in the hairline or in areas covered by underwear.

A fresh scar is red, firm and sensitive for the first weeks to months; it gradually fades and softens, reaching its final appearance after six to twelve months. Maturation is helped by moisturising, pressure massage, silicone gels or sheets, and strict sun protection for at least six months. How a scar looks also depends on skin type and age.

Scar pigmentation is darkening of a scar caused by excess production of the skin pigment melanin in the healing skin. A fresh scar reacts to ultraviolet light far more sensitively than the surrounding skin — sun exposure in the first months can permanently brown the scar and make it more visible.

Scars are therefore protected from the sun for at least six months, ideally a year, with clothing or a high-factor sunscreen, even in the shade or in winter. The tendency to pigmentation is higher in darker skin. Pigmentation that has developed fades partly over time; more pronounced cases can be treated with dermatological methods.

A seroma is a collection of clear tissue fluid in the space created in a wound by the removal or separation of tissues. It presents as a soft, fluctuant swelling, usually painless. It occurs most often after operations in which a large area of skin is lifted from the underlying tissue: abdominoplasty, liposuction or breast reduction.

A small seroma is reabsorbed on its own; a larger one is drained by the surgeon with a needle at a check-up, sometimes more than once. The risk is reduced by a drain, a compression garment and rest in the first weeks. A seroma is not an infection, but left untreated it can prolong healing.

Swelling, medically oedema, is an accumulation of fluid in the tissue as a natural reaction to surgery. It occurs because fluid leaks from small blood vessels into the surrounding tissue and the lymphatic system drains it more slowly than it collects. It appears after every operation and is not a sign of a complication.

It is usually greatest on the second or third day after the procedure and then subsides — most of it within two to four weeks, while residual swelling of the nose or breasts can persist for several months. Cooling in the first days, keeping the area elevated, rest, a compression garment and limiting salt all help. The final result of the operation is visible only once the swelling has gone.

The areola is the darker-coloured circle of skin around the nipple; the nipple is the raised centre through which the milk ducts open. The size of the areola and the position of the nipple are among the main features of breast shape — as the breasts sag, the nipple moves downwards and the areola often widens.

In a breast lift and reduction the surgeon moves the areola and nipple higher and usually reduces the areola's diameter as well; the incision around the areola heals at the border between dark and light skin, where it is barely noticeable. The nipple remains connected to the gland and its blood supply, but its sensitivity may be temporarily or permanently altered after the operation.

The breast gland is the glandular tissue of the breast that produces milk in women. It rests on the large chest muscle, surrounded by fat and supported by fibrous bands; the ratio of gland to fat is individual and changes with age, weight and hormones. Breast size is determined mainly by fat, shape and firmness by the gland and its connective tissue.

In breast augmentation the implant is placed under the gland or under the muscle; in reduction and lift part of the gland is removed and the rest reshaped. The operation does not interfere with the gland in a way that prevents breastfeeding, although after some procedures the ability to breastfeed may be reduced. An up-to-date ultrasound or mammogram is recommended before breast surgery.

The columella is the narrow strip of skin and cartilage between the nostrils that connects the tip of the nose to the upper lip. Its length, width and angle influence how the nose looks in profile and from below — a columella that "hangs" too low or is retracted is a common reason for correction.

In the open rhinoplasty technique the surgeon makes a small inverted-V incision across the columella, which allows the skin of the nose to be lifted and the tip cartilages to be shaped precisely. After some months the healed scar is practically invisible. The closed technique does not cut the columella.

Diastasis recti is the separation of the two rectus abdominis muscles, which normally run side by side down the middle of the abdomen and are joined by a firm band of connective tissue. When this band is stretched — most often by pregnancy or major weight gain — the muscles move apart, and the abdomen bulges even after weight loss.

Exercise can reduce a diastasis, but the stretched tissue does not tighten on its own. During an abdominoplasty the surgeon stitches the separated muscles back together at the midline, firming and flattening the abdominal wall. A diastasis is not a hernia, although the two may occur together; the surgeon assesses both at the consultation.

Dynamic wrinkles are created by the movement of the facial muscles and disappear or soften at rest — typically the lines on the forehead, between the brows and the "crow's feet" around the eyes. Static wrinkles are visible even at rest; they result from loss of skin elasticity, loss of volume and sun exposure, for example the folds running from the nose to the corners of the mouth.

The distinction determines the treatment: dynamic wrinkles respond to botulinum toxin, which relaxes the muscle, static ones to a hyaluronic acid filler, which fills the crease from within. Deep dynamic wrinkles become static over time, and the two methods are then combined.

The auricle is the visible outer part of the ear, formed of flexible cartilage covered by thin skin. The shape of the ear is determined by the folds of the cartilage; protruding ears are most often caused by an underdeveloped outer fold (antihelix) or an overly deep central bowl (concha), or both.

The ear cartilage reaches its final size around the age of six — which is why prominent ears can be operated on in children. Otoplasty thins and reshapes the cartilage and fixes it in its new position with stitches through an incision behind the ear. The cartilage gradually "remembers" the new shape; in the first weeks it is protected by a bandage and a headband.

The earlobe is the soft lower part of the ear and the only part that contains no cartilage — it is made up of skin and fat alone. That is why it is easy to pierce for earrings, but also why it tears easily under heavy earrings or lengthens and sags with age.

Earlobe corrections are minor procedures under local anaesthesia: repairing a torn lobe, reducing an overly large one or restoring volume to a deflated lobe with a filler. In otoplasty the lobe is generally not altered, although a protruding lobe can be corrected during the operation; in a facelift the incision runs closely around it.

The eyelids are mobile folds of skin that protect the eye; their skin is the thinnest on the whole body. Beneath it lies the muscle that closes the eye, and behind that a thin fibrous septum that holds in place the fat pads surrounding the eyeball.

With age the eyelid skin loses elasticity and overhangs, the septum weakens and the fat bulges forward — creating bags under the eyes and heavy upper lids that give a tired appearance. Blepharoplasty removes the excess skin and reduces or repositions the fat pads. Dark circles under the eyes have other causes and are generally not treated by surgery.

The facial expression muscles are small muscles of the face that attach directly to the skin and create expressions — a smile, a frown, raised eyebrows. Through repeated contraction over the years they press creases into the skin, which gradually turn into permanent expression lines: on the forehead, between the brows and around the eyes.

Botulinum toxin treatment relaxes a selected expression muscle in a targeted way, and the wrinkle above it smooths out; the surrounding muscles keep working, so the natural expression is preserved. Knowledge of the anatomy of these muscles is essential for the doctor — it determines where and how much product to inject.

Fat tissue is tissue made up of fat cells (adipocytes) that stores energy, insulates against cold and shapes the figure. Its distribution across the body is largely determined by heredity and hormones — which is why some fat deposits resist both exercise and diet.

The number of fat cells is more or less constant in adulthood; with weight gain the cells increase in volume rather than in number. Liposuction permanently removes some of the cells, so fat is less readily stored in the treated area — with significant weight gain, however, the remaining cells enlarge. Fat is also a valuable material for lipofilling.

Hyperhidrosis is excessive sweating beyond what the body needs to cool itself. It most often affects the armpits, palms and soles and can significantly interfere with daily life and work. The cause is overactivity of the nerves that control the sweat glands; it is not a disorder of the glands themselves, nor a sign of poor hygiene.

An effective treatment is the injection of botulinum toxin into the skin of the affected area: the product blocks the nerve signals to the sweat glands and sweating is markedly reduced for several months — after which the treatment is repeated. Botulinum toxin is used here just as in aesthetic medicine, only in a higher number of units.

The labia minora are the two thin folds of skin inside the labia majora that protect the entrance to the vagina and the opening of the urethra. Their size, shape and colour vary greatly between women, and the two sides are often unequal — neither is a sign of abnormality.

If the inner labia extend well beyond the outer labia, they may cause chafing during sport, irritation from clothing or discomfort during intercourse; labiaplasty reduces them. The procedure does not involve the clitoris or the internal reproductive organs and has no effect on sensation or fertility.

The nasal bridge is the line from the root of the nose between the eyes to the tip; its upper part is formed by the nasal bones, its lower part by cartilage. A nasal hump — a bump on the bridge — is the most common reason for rhinoplasty. The tip of the nose is formed by a pair of cartilages whose shape and position determine whether the tip is narrow, round, upturned or drooping.

During the operation the surgeon reduces the hump, narrows the bones and reshapes the tip cartilages with stitches or grafts. The bridge heals faster than the tip: swelling over the bones disappears within weeks, while subtle swelling of the tip can take up to a year. The final profile therefore shows only after some time.

The nasal septum is the vertical wall of cartilage and bone that divides the nasal cavity into two halves and supports the bridge and tip of the nose. A deviated septum is common — it may be congenital or the result of an injury — and narrows one nostril, making breathing more difficult.

Correction of the septum (septoplasty) is often performed together with a rhinoplasty: the surgeon straightens the septum and may harvest cartilage from it to shape the tip of the nose. The external shape of the nose and the patency of the septum are related, which is why they are assessed together.

The navel is the scar left by the umbilical cord and is firmly attached to the abdominal wall — unlike the skin around it, which is pulled downwards during an abdominoplasty. To keep the navel in its natural place, in a full abdominoplasty the surgeon cuts it free from the skin, draws the skin down over it and brings the navel out through a new opening at the correct height.

This step is called umbilical transposition, and it leaves a small circular scar around the navel that is usually barely noticeable once healed. In a mini-abdominoplasty, where only lower abdominal skin is removed, the navel is not moved. The shape of the new navel can be refined during the operation.

The skin is the body's largest organ and consists of three layers: the thin outer epidermis, the firm dermis containing the collagen and elastin that give skin its elasticity, and the subcutaneous tissue (subcutis) made up of fat and connective tissue. The subcutaneous layer links the skin to the muscles and shapes the body's contours.

Plastic surgery works with all the layers: liposuction removes subcutaneous fat, a facelift tightens the skin and subcutaneous connective tissue, fillers add volume in the dermis and subcutis. Skin quality — its elasticity and ability to retract — influences which procedure is suitable and how the result will look.

A round implant is shaped like a symmetrical dome and adds fullness to the whole breast, including the upper part; the result is usually more pronounced, and the implant can rotate freely within the breast without changing its shape. An anatomical implant is teardrop-shaped, with more volume at the bottom — it follows the natural slope of the breast, so the result looks more subtle.

The choice depends on the figure, the amount of natural tissue and the desired result; an anatomical implant requires precise placement, because rotation would alter the shape of the breast. Which type suits a client better is recommended by the surgeon at the consultation. Estela uses both shapes from the manufacturer Mentor.

Botulinum toxin is a purified protein which, when injected into a muscle, temporarily blocks the signal from the nerve so that the muscle relaxes. In aesthetic medicine it is used in very small doses to smooth dynamic wrinkles — on the forehead, between the brows and around the eyes — and to treat excessive sweating. "Botox" is the trade name of one such product that has become a household word.

The effect sets in within a few days and usually lasts two to six months, after which the treatment is repeated; the amount is measured in units. Botulinum toxin has been used in medicine for decades, in neurology and ophthalmology as well. It should always be administered by a doctor and is not recommended for pregnant or breastfeeding women.

A breast implant is a cushion-shaped medical device that is surgically placed in the breast to give it volume and shape. It consists of a flexible silicone shell filled with cohesive silicone gel; saline-filled implants are now used only exceptionally in Europe.

Implants differ in shape (round and anatomical), surface (smooth and textured), profile and volume, which is stated in millilitres. Modern implants have no fixed lifespan and are not replaced automatically — an exchange is indicated only if problems arise. Estela uses implants made by Mentor.

Dermal fillers are injectable gels placed in the skin or beneath it to fill wrinkles and folds or to add volume — to the lips, cheekbones, chin or temples. Today's standard is fillers based on cross-linked hyaluronic acid; cross-linking slows its breakdown, so the effect lasts for months.

Fillers vary in density: thinner ones for fine lines and lips, firmer ones for deep folds and contours. They are injected with a fine needle or a blunt cannula after numbing with a cream or local anaesthetic; the effect is visible immediately and lasts up to twelve months. A hyaluronic acid filler can be dissolved with hyaluronidase if necessary. Fillers should always be administered by a doctor.

Hyaluronic acid is a substance naturally present in human skin, joints and eyes that binds water — a single molecule holds many times its own weight — and gives the skin hydration, volume and elasticity. With age its amount in the skin decreases, the skin loses fullness and wrinkles form.

Aesthetic medicine uses hyaluronic acid produced biotechnologically, that is without animal origin, and therefore with almost no risk of allergy. As a gel it serves as a dermal filler to smooth wrinkles and add volume to the lips, cheekbones or chin; in a more fluid form it hydrates the skin in mesotherapy. The body gradually breaks it down; the effect lasts up to twelve months.

Hyaluronidase is an enzyme that breaks down hyaluronic acid and can therefore dissolve an injected dermal filler within hours to days. It is used when the result of a filler does not match expectations, for lumps or irregularities, or — rarely — as an emergency treatment if filler enters a blood vessel.

The ability to dissolve a filler is the main safety advantage of hyaluronic acid over permanent fillers. Hyaluronidase is injected into the site of the filler, if necessary more than once; it may also break down some of the skin's own hyaluronic acid, which is restored within days. A correction is decided by the doctor who administered the filler.

Implant placement refers to the layer into which the surgeon inserts the implant. Subglandular placement is under the breast gland and above the large chest muscle — the operation is shorter and healing quicker, but in slim women with little natural tissue the edge of the implant may be noticeable. Submuscular placement is under the chest muscle, which covers the implant.

A compromise is the dual-plane technique, in which the upper part of the implant is covered by the muscle and the lower part lies under the gland. The choice depends on the thickness of the breast tissue, the shape of the chest, any sagging and the client's sporting activity; the surgeon proposes it at the consultation.

Silicone gel is the filling of modern breast implants — a soft but cohesive substance that holds its shape and does not leak into the surrounding tissue if the shell is damaged. To the touch and in movement it resembles natural breast tissue more closely than earlier, more liquid fillings or saline.

Silicone is a medical material with a long history; current implants undergo strict approval and their safety is monitored. The degree of cohesiveness varies by implant type — a firmer gel maintains the shape of anatomical implants, a softer one gives round implants a natural movement.

The surface of a breast implant is either smooth or textured — with a finely roughened shell. A textured surface bonds more firmly with the surrounding tissue, so the implant stays in place and does not rotate; this is why it is used for anatomical implants. A smooth implant moves freely within the breast and feels naturally soft.

Both types have their place; the choice relates to the implant's shape and the surgical technique. The safety of the various surface types is monitored long-term by manufacturers and regulatory authorities, and the surgeon therefore selects from implants with an approved, proven surface. The specific type is decided at the consultation.