What plastic surgery is, and who it is for
Plastic surgery has two halves that everyday language blurs together. Aesthetic surgery starts with a healthy person and rebalances a proportion that bothers them. Reconstructive surgery restores form and function after skin cancer, a burn, an accident or a birth defect. They are the same discipline: the surgeon who rebuilds an eyelid after removing a tumour understands best how it behaves in a blepharoplasty.
This area is for someone arriving with a specific reason —a nose that does not match the face, a scar that keeps growing— and fit for planned surgery. It is not for someone looking for a change of life: that distinction is drawn at the assessment.
How a case is assessed here: judgement before technique
The assessment does not begin by choosing a procedure but by understanding what bothers you and whether it has a surgical correction. First the reason, in the patient's own words; then examination —fat, skin elasticity, muscle tone, bony projection—; then history and laboratory work. Technique is decided last.
Four criteria matter more than the rest:
- Anatomy outranks the fashionable technique. Two people with the same goal may need different procedures, and sometimes the one in highest demand does not fit.
- Marking is done standing and awake. Tissue falls differently lying down, and marking on the table leads to a disproportionate resection.
- A staged plan before a heroic operation. Every added hour in theatre adds risk; if total operating time is the problem, the plan is split in two.
- Surgery proceeds on expectations that were reviewed. If patient and surgeon do not describe the same result in the same words, it waits.
What is not operated on here
A surgeon is known by what he declines. These are not operated on, or wait until the condition changes:
Saying no has a cost too, and it gets said anyway: the patient carries a poorly indicated result for years. Results may vary from one person to another, and a wrong indication pushes that variation in the wrong direction.
- Expectations the anatomy cannot deliver. The honest move is to explain the real ceiling beforehand, not after.
- Uncontrolled disease —hypertension, diabetes, clotting disorders— and active smoking in operations that depend on the blood supply of the skin: abdominoplasty, facelift, flaps.
- Unstable weight. Body contouring is not a weight-loss method, and operating on a moving weight is aiming at a moving target.
- Surgery as an answer to grief, a separation, or pressure from a partner. If the reason does not belong to the patient, the result will not either.
- Distress out of proportion to the physical finding, and minors without a functional indication or complete development.
The face: choosing between a lift, an eyelid and a nose
On the face the question is what is happening: is there excess skin, is volume missing, or does the bone structure not add up? Confusing them explains nearly every result that disappoints.
Where there is descent and excess skin: facelift, extended with a face and neck lift if the neck is the real reason, or a brow and forehead lift for the upper third, endoscopically in selected cases. If the tired look comes from the eyelid, the procedure is blepharoplasty: repositioning the cheek does not raise an eyelid. A canthopexy is added if the eye corner has dropped.
If it is a matter of proportion, the work is structural: rhinoplasty —or revision rhinoplasty after previous surgery—, chin surgery, cheek augmentation or facial implants for a flat mid-face, otoplasty, lip lift, earlobe repair. Where volume is missing, facial fat grafting replaces what descent does not explain. For localised fat, submental liposuction and buccal fat removal, — a narrower indication than believed: in a thin face, removing the buccal fat pad brings the aged look forward. Thread lifts and facial endolift serve early laxity; they do not replace a lift.
The body: fat and skin are two different problems
The confusion around body contouring fits in one sentence: liposuction removes fat, not skin. If it still has elasticity the tissue retracts on its own; if it is stretched, taking fat out without excising the surplus leaves a worse contour.
With that rule: liposuction and HD liposculpture where the problem is fat over skin that responds, with laser lipolysis and body endolift as adjuncts. If skin is also in surplus: abdominoplasty, or a mini tummy tuck if the excess sits below the navel without diastasis; arm lift, thigh lift, 360° body lift or upper body lift if circumferential. Post-bariatric contouring is the extreme case: much skin, little fat, several stages.
For the buttock, buttock implants and the Brazilian butt lift (BBL) with the patient's own fat reach the same goal by different routes; the BBL demands a strict injection plane — safety rests on technique, not on promised volume. Fat transfer and body implants follow that logic. Gynaecomastia is almost never fat alone: a glandular component remains that liposuction cannot remove. A Mommy Makeover is a combined plan. In intimate surgery, labiaplasty and penoplasty are assessed conservatively: removed tissue does not come back.
Breast and reconstruction: the other half of the specialty
In the breast: is volume missing (breast augmentation), support missing with the breast descended (breast lift), or tissue in surplus with a cervical load (breast reduction). Two often coexist, and the plan is explained by what each step adds and costs in scar. Asymmetry correction and inverted nipple correction are frequent focused repairs. Implant exchange or removal is worth raising before operating: an implant is not a lifetime device.
The reconstructive side arrives with a diagnosis in hand: breast reconstruction after mastectomy, skin cancer surgery with repair by grafts and flaps, burn sequelae surgery, facial and body trauma reconstruction, eyelid, ear and nose reconstruction, complex wound closure, congenital defect correction and scar and keloid surgery. The goal is not an aesthetic ideal but recovering function, and it usually needs more than one stage.
Recovery: the realistic commitment
Plan the recovery before booking: it is the part most often underestimated. For most body surgery: one to two weeks off work, four to six without impact exercise, a compression garment, and swelling that comes down unevenly over months. Someone is needed at home for the first days, and smoking is stopped before and after.
Scars mature over twelve to eighteen months, and their appearance depends on tension, genetics and care, not on technique alone. Follow-up and recovery treatments are included; the post-surgical recovery and care guide sets out what to expect week by week.
What it costs, and why the figure is approximate
As a reference: rhinoplasty from approximately $45,000 MXN, breast augmentation from $55,000 MXN, liposuction from $70,000 MXN, abdominoplasty from $80,000 MXN and a facelift from $80,000 MXN, all approximate.
The gap against a cheaper estimate is in what the number contains. Here the price is all-inclusive: it covers theatre and facilities, the pre-operative laboratory work and the post-surgical recovery treatments. It is not the surgeon's fee alone; a fee-only estimate grows once hospital, anaesthetist and laboratory are added.
The final cost depends on the extent of the case, the technique, and whether the plan runs in one stage or several. Every figure here is approximate and is not a quote: any procedure first requires a private assessment consultation with Dr. Arístides Arellano —$800 MXN, charged separately— and there the cost of your case is set. The reference price list is available beforehand.
Who operates, and which credentials can be checked
Surgery is performed by Dr. Arístides Arellano Huacuja, plastic, aesthetic and reconstructive surgeon in Puebla, Mexico. Qualified in medicine at Universidad Autónoma Metropolitana Xochimilco (1986), he practises under professional licence D.G.P. 1125959 and specialty licence 0002008, both from Mexico's Directorate General of Professions and open to anyone to look up in the National Registry of Professionals. Specialty training: Hospital General de Agudos Dr. Abel Zubizarreta, Buenos Aires, 1987–1989; Fellow of the International College of Surgeons (F.I.C.S.) since 1994; US patent 5,928,158 (USPTO, 1999).
There is an uncommon continuity: the Clínica Dermatológica y Cirugía Estética de Puebla was founded in 1971 by his father, the dermatologist Dr. Francisco Arellano Ocampo; today it is directed by Dr. Arístides Arellano, plastic surgeon. What is verifiable are the licences; the continuity only means everything happens under one roof. If you are comparing surgeons, the guide to choosing a plastic surgeon in Puebla and the credential archive say what to ask for and how to check it. The clinic is at Calle 20 Sur 2539, Col. Bellavista, 72500 Puebla, Mexico. All surgery carries risk, and results may vary from one person to another.