10.5 Cosmetic Surgery & Medical Aesthetic Procedures
Key Takeaways
- The CIDESCO syllabus requires basic general knowledge of cosmetic surgery so therapists can recognise procedures, use correct terminology and refer appropriately, never so they can perform or advise on them.
- Surgical procedure names follow consistent suffixes: -plasty means surgical reshaping (rhinoplasty, blepharoplasty), -ectomy means removal (rhytidectomy) and -pexy means lifting or fixing (mastopexy).
- Botulinum toxin type A relaxes muscle by blocking presynaptic acetylcholine release; onset is 3-7 days, peak effect about 2 weeks, and duration typically 3-4 months.
- Hyaluronic acid dermal fillers restore volume rather than relaxing muscle and typically last 6-18 months depending on product cross-linking and injection site.
- Facial massage, electrotherapy and exfoliation are withheld for about 2 weeks after injectables and for a surgeon-defined interval after surgery, commonly 3-6 months following a face lift.
10.5 Cosmetic Surgery & Medical Aesthetic Procedures
CIDESCO Exam Tip: The CIDESCO syllabus lists cosmetic surgery as basic general knowledge under Cosmetic Products and Cosmetic Science. You are examined on terminology, mechanism and aftercare intervals so that you can hold an informed conversation and refer safely. You are never examined on how to perform these procedures, and performing them is outside the beauty therapist's scope of practice.
A large proportion of salon clients have had, or are considering, a medical aesthetic procedure. A therapist who cannot name a procedure, does not know how long it takes to settle, or applies a galvanic current over a two-day-old filler is a professional liability. This section supplies the vocabulary and the timing rules.
Terminology: Reading a Procedure Name
Surgical nomenclature is systematic. Learning three suffixes decodes most of the list:
| Suffix | Meaning | Example |
|---|---|---|
| -plasty | Surgical reshaping or repair | Rhinoplasty (nose), Blepharoplasty (eyelid), Abdominoplasty (abdomen), Otoplasty (ear) |
| -ectomy | Surgical removal of tissue | Rhytidectomy (removal of wrinkles, i.e. face lift), Lipectomy (fat removal) |
| -pexy | Lifting and fixing in a new position | Mastopexy (breast lift), Browpexy (brow lift) |
Common Surgical Procedures
| Procedure | Common name | What is done | Typical initial recovery |
|---|---|---|---|
| Rhytidectomy | Face lift | SMAS layer and skin are lifted and redraped; incisions run in front of and behind the ear | Bruising and oedema 2-4 weeks; scars mature over 12 months |
| Blepharoplasty | Eyelid surgery | Excess upper lid skin, or lower lid fat pads, are removed | Sutures out ~1 week; oedema settles 3-6 weeks |
| Rhinoplasty | Nose reshaping | Nasal bone and cartilage are reshaped | Splint ~1 week; final contour up to 12 months |
| Liposuction | Lipoplasty | Adipose tissue is aspirated through fine cannulae | Compression garment 4-6 weeks; contour settles 3-6 months |
| Abdominoplasty | Tummy tuck | Redundant skin excised and abdominal muscles plicated | 6 weeks before normal activity |
| Otoplasty | Ear pinning | Antihelical fold recreated to set the ear back | Headband ~2-6 weeks |
Surgery is a controlled wound. Everything covered in the wound-healing phases applies: the scar is immature and vulnerable for months, and its final appearance depends heavily on protection from sun and tension.
Non-Surgical Medical Aesthetic Procedures
Botulinum Toxin Type A
A purified neurotoxin injected into specific muscles of facial expression. It binds presynaptically and blocks the release of acetylcholine at the neuromuscular junction, so the muscle cannot contract and the dynamic line it creates softens.
- Onset: 3-7 days. Peak: about 2 weeks. Duration: typically 3-4 months as new nerve terminals sprout.
- Typical sites: glabellar complex (corrugator supercilii, procerus), frontalis, lateral orbicularis oculi.
- Therapist implication: it treats dynamic lines only. It does not add volume and does nothing for static creases or lost fat.
Dermal Fillers
Injectable gels that restore volume, most commonly cross-linked hyaluronic acid, which is hygroscopic and biodegradable and can be dissolved with hyaluronidase if placed poorly. Typical duration is 6-18 months, varying with cross-linking density, injection depth and site mobility. Other categories include calcium hydroxylapatite and poly-L-lactic acid, which act as collagen biostimulators over several months.
Energy- and Chemistry-Based Medical Procedures
- Medium and deep chemical peels: trichloroacetic acid (TCA) at medium depth, phenol at deep. These reach the papillary or reticular dermis and are medical procedures, unlike the superficial AHA and BHA peels within aesthetic scope.
- Ablative laser resurfacing: fractional CO2 (10,600 nm) and Er:YAG (2,940 nm) vaporise columns of tissue and trigger dermal remodelling. Significant downtime and a real risk of post-inflammatory hyperpigmentation in phototypes IV-VI.
- Non-ablative and IPL devices: heat the dermis or target chromophores while leaving the epidermis intact; used for vascular lesions, pigment and diffuse redness.
- Radiofrequency and HIFU: deliver controlled heat to the dermis or SMAS to contract collagen and stimulate neocollagenesis.
- Sclerotherapy: injection of a sclerosant into telangiectatic or varicose veins, causing them to fibrose and be reabsorbed.
- Hair transplantation: follicular unit extraction or strip harvesting relocates androgen-resistant occipital follicles.
Waiting Intervals Before Beauty Therapy Resumes
These intervals are the therapist's core professional knowledge. Where a client is under a surgeon's care, the surgeon's instruction always overrides a general guideline.
| Procedure | Withhold facial massage, electrotherapy, exfoliation and heat for |
|---|---|
| Botulinum toxin | About 2 weeks; avoid pressure or heat over the site so the toxin is not displaced |
| Dermal filler | About 2 weeks; avoid deep massage, vacuum suction and heat that could migrate or degrade the gel |
| Superficial chemical peel | Until flaking has fully stopped, usually 7-14 days |
| Medium or deep peel, ablative laser | Until fully re-epithelialised and cleared by the practitioner, commonly 6-12 weeks |
| Face lift, blepharoplasty | Commonly 3-6 months, and only with written surgeon clearance |
| Liposuction | Manual lymph drainage is often prescribed early, but only on the surgeon's instruction; other body work waits 6-12 weeks |
| Systemic isotretinoin | Waxing, abrasive exfoliation and peels are withheld during treatment and for 6-12 months afterwards |
Scope of Practice & Professional Language
A beauty therapist must not diagnose, recommend a specific surgeon or procedure, quote clinical outcomes, or perform any injectable or medical-depth treatment. When a client raises surgery, the correct professional response is to describe what aesthetic treatments can achieve, acknowledge the limits, and direct the client to a suitably qualified medical practitioner for anything beyond that. Recording the discussion neutrally on the consultation card protects both parties.
Consultation habit: Add a standing question to the record card - "Have you had any injectable, laser or surgical cosmetic procedure in the last 12 months?" A client who has had filler placed a week earlier will rarely volunteer it, and vacuum suction or galvanic current over that site is exactly the avoidable incident this question prevents.
By what mechanism does botulinum toxin type A soften a dynamic expression line?
A client books a deep-cleansing facial with galvanic desincrustation and mentions she had hyaluronic acid filler placed in her nasolabial folds five days ago. What is the correct action?
Which surgical term correctly denotes a face lift, and what does its suffix indicate?