the skin is separated from the abdominal wall, from the pelvis to the bottom of the rib cage. A large skin flap is lifted. Excess fat is removed and the vertical muscles of the abdomen are pulled closer together and stitched to maintain the new position. Extra skin is then removed from the skin flap and a new hole is cut to fit around the navel. The incisions are then stitched. A tube might be inserted to drain excess fluid. The result is that the abdominal wall is narrowed and firmed, and the skin is tightened.

A partial abdominoplasty involves separating the skin between the pelvis and the navel The skin flap is steretched down and exess skin and fat are removed. The flap is then stitched into place.

Rhytidectomy

A rhytidectomy is a face-lift. It might be performed under twilight or general anesthesia ( completely unconscious) and can involve a brief stay as an inpatient, although many are performed on an outpatient basis.

The rhytidectomy is performed on one side of the face at a time. The incision begins inside the hairline in the temple area, and continues in front of the ear and around the ear lobe, then behind the ear into the hairline. The skin is lifted. Excess skin is redraped, and the incision is finely stitched. Results last five to ten years

Blepharoplasty

A blepharoplasty is a surgical produre to correct drooping upper eyelids and puffy bags below the eyes. It is frequently carried out under a twilight anesthetic, and patients are usually discharged the same day. this procedure is often carried out in conjunction with a rhytidectomy.

An incision is made in the natural skin crease of the upper eyelid. Excess skin, muscle, and fat are removed, and the upper lid is sculpted and finely stitched.

For the lower eyelid, excess fat can usually, skin wrinkling is increased and might be treated with laser exfoliation to stimulate the growth of new collagen and shrink the skin. If the lower lid is excessively baggy and saggy, an incision might be made to remove fat and excess skin. The lid is then finely stitched. Results last for years, and might be permanent.

Effect of Aging on the Integumentary system

As people age, the body's collagen starts to break down. Because cellular division also slows with aging, collagen production in the fibroblasts slows. The result is that lost collagen is not fully replaced, and thus the skin becomes loose and wrinkles start to appear in what was once smooth, tight skin

The number of keratinocytes and melanocytes also decreases, thus, the skin gradually loses its tough outer, keratinized surface. it becomes thinner and more transparent.

The sebaceous glands decrease their production of oils, resulting in dry, itchy skin. Irregular production of melanin by melanin by melanocytes gives rise to brown colored freckles called age spots or liver spots.

The result of all these processes is that aged skin is marked with wrinkles and age spots, and becomes dry and thin. coupled with damage due to smoking and sun exposure, the overall result is decreased skin vitality.

Hair is also affected by the aging process. Hair follicles are less active, and the hair becomes thinner. Some folicles cease hair production altogether, resulting in permanent hair loss.

Common Injuries and Diseases

BURNS 

Destruction of the skin by heant, chemicals, electricity, or radiation is called a burn. Burns can be classified as first degree, second degree, third degree, or fourth degree, depending on the extent of damage to the epidermis, dermis and deep tissue.

fist-degree burn (superficial burn) involves the epidermis. there is erythema but no blisters. An example is a sunburn.

Second-degree burn (partial-thickness burn) involve the epidermis and upper portion of the dermis. The skin is erythematous. there may or may not be blisters.

Third-degree burn (full-thickness burn) involves the epidermis and all of the dermis.

Fourth-degree burn involves the epidermis, dermis, subcutaneous tissue, and muscle.

In severe burns, where over two-thirds of the body surface has been destroyed, complications can cause death. The three major complications are shock, infection, and toxins.

Shock results from water loss. Ordinarily, the skin prevents water from entering and leaving the body. However, when large amounts of skin are destroyed, water loss can be singnificant. Loss of fluid leads to a drop in blood pressure, resulting in reduced blood flow to vital organs, or shock.

Infection is also a significant concern in burn patients. The skin is the first line of defense against microbes. When the skin is burned, this defense is lost. Bacteria readily enter the body and can become life-threatening.

Toxins released from burned skin are also a concern because they are poisonous to the body. Debridement, the removal of burned skin, prevents these poisonous reactions. In extensive burns, the patient is submerged in a large tank of water called a Hubbard tank, which loosens the skin and makes debridement easier.

Treatment for burns ranges from the application of ointment for minor burns to skin grafting for major burns.

SKIN CACER

Cancers are malignant tumors (neoplasms) within body tissues. Just as different tissues are named according to their origin( muscle tissue, osseous tissue, nervous tissue), cancers are broadly named according to their tissue of origin. Melanoma is a tumor arising from the melanocytes. Carcinomas arise from epithelial cells. Sarcomas arise from connective tissue. One example is Kaposi's sarcoma, a type of skin cancer that is a typical complication og AIDS. Adenocarcinomas arise from epithelial tissue in glands.

Carcinomas can be further classified by the type of epithelial tissue from which the canscer originated. Squamous cell carcinoma originates from epithelial tissue found in the outer layer of the epidermis. Basal cell carcinoma originates from epithelial tissue in the bottom layer of the epidermis.