In the field of Plastic and Aesthetic Surgery, form, shape and appearance is improved to fulfil your desire to achieve natural and harmonious results in the safest way possible: At the Vitality Fountain Clinic, we offer the highest standards of quality and ethics for your full satisfaction.
Plastic surgery is much more than cosmetic surgery, or what people refer to as “beauty surgery”. The specialty of Plastic Surgery consists of four main components:
• Reconstructive plastic surgery which is all about restoring appearance and function to the human body after illness or accident, or if they are born with deformities like cleft lip and palate
• Aesthetic plastic surgery (also called “cosmetic surgery”) which is done to change the appearance by choice,
• Hand surgery which deals with all conditions affecting the soft tissues and bones on hand and fingers, and
• Burn surgery, where patients receive surgical help either during the acute stage of the injury, or later, when deformities caused by burn wounds need to be reconstructed.
All four fields form part of the surgical expertise a qualified and certified specialist in plastic surgery displays and uses during everyday practice – like Dr Tilman Stasch. Although you hear people mostly talking about cosmetic plastic surgery, the main work of the modern plastic surgeon is reconstructive: covering all aspects of wound healing and reconstruction after congenital, acquired and traumatic problems, for the restoration of function and appearance. Aesthetic surgery plays an important part in the working week, depending on the special interests, expertise and skills of the surgeon.
Etymologically, the adjective “plastic” in plastic surgery stands for “sculpting, modelling or moulding” and derives from the Greek word plasticos.
At the Vitality Fountain Clinic, our extensive experience of reconstructive plastic surgery techniques informs our practice when we engage in aesthetic surgery. In turn, our work on form, shape and appearance helps us when we are carrying out reconstructive procedures.
At the Vitality Fountain Clinic, we offer a variety of plastic surgery and cosmetic enhancement procedures. Below are just some of the many procedures that we perform to help you achieve the look of your dreams. If you have any questions about plastic surgery or wish to schedule an appointment for an initial consultation, please feel free to give us a call. We welcome the opportunity to talk with you.
Breast augmentation is the surgical placement of breast implants to increase fullness and projection of the breasts or to improve symmetry of the breasts. Breast augmentation is typically performed to enlarge small underdeveloped breasts, breasts that have decreased in size after a woman has had children or weight loss or simply because the woman wants to enhance the size and shape of their natural bust line. Breast augmentation is most commonly accomplished by surgically inserting an implant behind each breast, or by augmenting the breast volume with fat (lipofilling, fat grafting).
A feminine body image is important to many women and that includes the appearance of the breasts. In fact, breast implants come in a variety of sizes, shapes and profiles to achieve a natural-looking physique. Other important features include the texture of an implant’s shell and the substance that fills the shell, like silicone.
Summary
• General anaesthetic
• Operating time about 1-1.5 hours
• Hospital stay 1-2 nights
• Back to work after 1-2 weeks
• Compression garments for 6 weeks
• Full exercise after 4-6 weeks
Am I a good candidate for breast augmentation?
If exercise and weight loss efforts have not achieved your goals for a body that is firmer, more youthful-looking and more proportionate to your overall body image, or if this has resulted in loose, saggy skin, then a surgical breast augmentation may be right for you.
You are a good candidate for breast augmentation if:
• You have the sense that your breasts are too small
• Clothing that fit well around your hips is often too large at the bust line
• You feel self-conscious wearing form-fitting clothing or a swimsuit
• Your breasts have decreased in size and lost their firmness after having children
• Fluctuation in weight has changed the size and shape of your breasts
• Asymmetry exists where one of your breasts is noticeably smaller than the other
• You are healthy, do not have medical conditions that can impair healing or increase risk of surgery
• You have a positive outlook and realistic goals for what breast augmentation surgery can accomplish
What breast augmentation won’t do:
Breast augmentation alone does not correct severely drooping breasts. If you want your breasts to look fuller and to be lifted due to sagging, a breast lift may be required in conjunction with breast augmentation. Breast lifting can often be done at the same time as your augmentation or may require a separate operation. We will discuss the options and help you in making this decision.
During the consultation, you will be asked about the results you would like to achieve from your breast augmentation surgery. This will help us to understand your expectations and determine whether they realistically can be achieved.
Breast augmentation - the operation
There are a number of different techniques used to perform a breast augmentation, depending on the shape of the breast and the desired result. Implants can be placed either directly behind the breast (known as subglandular placement), or behind the breast and chest wall muscle (known as submuscular placement). The implants are usually inserted using an incision under the breast at the crease, which is the safest method, also used by Dr Stasch.
The implant placement - behind the breast
The insertion of implants behind the breast is considered to be the simplest of the available enlargement procedures and the least likely to cause discomfort. This route is also the most effective for patients with slightly drooping breasts, resulting in fuller volume and better uplift. One must consider, with this technique it is more difficult to create a natural shape in patients who are very thin.
The implant placement - behind the muscle
The insertion of implants behind the breast muscle provides more padding, which is a key consideration for slender patients and those with very little breast tissue where the edge of an implant may be detectable through the skin. The muscle provides extra cover and helps to hide the upper portion of the implant and so is strongly recommended for those whose ribs are visible.
A special technique - the dual plane operation
When slender women with slightly drooping breasts seek enlargement surgery, Dr Stasch often combine these two routes, placing the implants partly behind the breast and partly behind the muscle. Through this combined approach we give you the benefits of both techniques.
To enlarge the breast the implant is inserted either directly behind the breast itself or beneath the muscle behind the breast.
Implant shape
Implants can either be round or tear-shaped. Round implants provide a bigger volume at the top of the breast, along with a deeper cleavage. Tear-shaped implants meanwhile can look more natural. With either of these options, there are varying degrees of projection, depending on whether you want your augmented breasts to look subtle or more noticeably pert. Temporary implants, placed inside a bra, can help us to assess our options and make decisions about which implants will help you achieve the augmentation you desire.
Breast augmentation - the operation
Breast enlargement surgery takes between one and one-and-a-half hours, and is done under general anaesthetic. The operation itself involves accessing and creating the pocket into which the implant will be placed using the insertion route mentioned above: an approximately 6 cm incision will be placed on the lower outer edge of the breast-crease, making it almost invisible. Once the pocket has been created, the implant is inserted and the incision wound is stitched. The breast is then supported by adhesive tapes, which hold the breast in shape and allow a little compression.
After the breast augmentation - Your recovery
• You will be admitted on the day of surgery and your length of stay depends on your recovery. Usually, you will stay in the hospital for 1 – 2 nights.
• The first 2-5 days following your breast implant surgery you may feel stiff and sore in the chest region. Your breasts may feel tight and sensitive to the touch and your skin may feel warm or itchy.
• You will have tape dressings applied to stabilize your breasts. Drains (plastic tubes attached to a suction bottle) will have been placed to drain excess wound fluid and blood from each side. The drains will usually be removed after 3 – 4 days. Sometimes it is wise to keep them for longer if there is a lot of lymphatic drainage to prevent it from collecting in the wound. You will however be able to leave the hospital with the drains inside, if the wounds look fine.
• Most people do not find breast augmentation surgery to be that painful. Post-operative pain in these procedures is easily controlled. Some discoloration and swelling will occur initially but this will disappear quickly. Most residual swelling will resolve within a month.
• On the day following surgery, we will encourage you to mobilise in order to reduce the risk of deep venous thrombosis. You will also be fitted with a special breast garment that needs to be measured and ordered before the surgery to support your breast in the following weeks. You will be encouraged to wear this for about 8 weeks following the operation.
• You will be mobile immediately after you have recovered from your general anaesthetic on the day of surgery and should be back to full exercise within six weeks. Skin stitches will need to be removed after 2 weeks. Most people have approximately 1 – 2 weeks off work following a breast augmentation procedure depending on the type of work you do. It is important in the first 3 weeks to avoid any activities which can cause stretching of the incisions and too much upper body movement. You may experience difficulty raising your arms. You should not lift, push or pull anything or engage in any strenuous activity or twisting of the upper body.
We will keep a close eye on you after your surgery and would normally see you for your follow-up appointments at regular dressing clinics every 2-3 days and then 6 weeks and 3 months following surgery at which point your post-operative photographs will be taken.
What complications can occur?
Whilst these operations are generally safe in the hands of a qualified and experienced plastic surgeon and regarded to be highly successful there are, as with any operation, risks involved and the possibility of complications that patients need to consider.
Smokers are advised to discontinue smoking several weeks prior to surgery, as smoking increases the risks of complications and delays wound healing by altering blood circulation in the skin. You can reduce your risks of complications by closely following our instructions before and after the surgery.
Postoperative pain will vary from person to person, but this is generally not considered as a painful procedure.
Most patients are delighted with the physical and cosmetic improvements that breast augmentation brings. There might be minor asymmetries between your breasts, which might have been there beforehand already. Dr Stasch will make a point to demonstrate this to you before the operation.
Occasionally patients will bleed immediately after the operation and need to go back to the operating room for this to be dealt with. Wound healing problems occur extremely rarely. There is also a small risk of infection. These risks are less than 1%, but if they do occur will result in reoperation. A degree of altered sensation in the breast area is very common after breast enlargement. This usually gradually gets better, but there is a slight risk of losing nipple sensation completely. Hardening or encapsulation, around the implant is also a potential risk and up to 10% of women over a ten year period will experience this problem (this is called capsular fibrosis). The breast shape is likely to gradually change as time goes by. In the case of most women this will not trouble them, but sometimes the shape is not as good as it was and further surgery might be considered.
Recent scientific evidence suggests that it may be recommended that you take prophylactic antibiotics when any dental work is done to protect the implant from infection and capsular fibrosis for a short period of time.
Some patients can feel or see the edges of their breast implants under the skin. Sometimes visible folds and ripples become evident. The implants that we use at Vitality Fountain Clinic are the most modern, 4th generation implants and have a high degree of reliability. Theoretically, the envelope can gradually fail and a microscopic leak can occur (silicone bleed). This is not usually a serious event, but once detected will necessitate removal and exchange of the implant.
There is no universally agreed replacement schedule for breast implants and it is rare for there to be a need to exchange breast implants before ten years. However, you may develop one of the problems described above and may need or choose to have revision surgery at some time in the future. For this reason anyone having breast enlargement should be prepared both personally and financially to have a further operation at some time.
All breast augmentations result in some scarring although the nature of the scars will depend on the patients' ability to form nice scars. Scars tend to be reddish / brown in the first six weeks but darkens over the next three months and then fades off. Most patients will form good quality scars over time, but occasionally and unpredictably some patients will get lumpy scars (keloids) that do not improve unless treated.
Breast cancer screening:
If you are at an age when mammographic examinations should be conducted on a periodic basis, it will be important for you to select a radiology technician who is experienced in taking x-rays of augmented breasts. Additional views of your breasts will be required. We might, in some instances, recommend other types of examinations such as ultrasound or magnetic resonance imaging (MRI). An implant may obscure some of the mammogram.
Results after breast augmentation
The breasts will be swollen and appear very large immediately following surgery. You will be required to wear a compression garment for several weeks following your procedure to minimize swelling and support the tissues as they heal. The swelling will gradually decrease and your breasts will develop a softer and more natural shape over time. It may take several months for the final result to fully develop.
The results of your breast augmentation surgery will be long-lasting. You will find it easier to wear certain styles of clothing and swim wear. Like many women who have had breast augmentation, you may also have a boost in self confidence.
It’s important to know that after receiving breast implants, results are not permanent as your body ages, weight fluctuations and gravity, it is natural to lose some firmness and projection. The implants may require replacement during your lifetime. If, after a period of years, you become dissatisfied with the appearance of your breasts, you may choose to undergo a breast lift or implant exchange to restore a more youthful contour.
A tummy tuck is also known as an abdominoplasty. This is an operation normally aimed to remove the excess skin and tissue from the lower part of the abdomen. There are a variety of abdominoplasty procedures available and operations are tailored to suit a patient's wishes and needs. Generally speaking, tummy tucks are most commonly carried out to remove excess skin after substantial weight loss, to remove unwanted scars, stretch marks or excess fat. Abdominoplasty is not an operation for people who are overweight or as a weight loss tool. However, patients who have already lost some weight, an abdominoplasty can have a very marked effect and is, in our experience, associated with high patient satisfaction, enabling a healthier lifestyle.
Summary
• General anaesthetic
• Operating time about 2-3 hours
• Hospital stay 3-4 days
• Back to work in 3 weeks
• Compression garment for 6 weeks
• Full exercise after 6 weeks
Am I a good candidate for abdominoplasty?
The abdominoplasty is best performed when a patient is fit and healthy. The ideal patient is someone whose weight is close to normal, particularly those who have been overweight and have lost the excess weight. You may be a good candidate for abdominoplasty if you have one or more of the following conditions:
• Excess or sagging abdominal skin
• An abdomen that protrudes and is out of proportion to the rest of your body
• Abdominal muscles that have been separated and weakened (rectus diastasis)
• Excess fatty tissue that is concentrated around your abdomen
During the consultation, you will be asked about the results you would like to achieve from abdominoplasty. This will help your surgeon understand your expectations and determine whether they can be realistically achieved. If you plan to become pregnant or lose weight in the future, you should discuss this with us. Scarring from previous abdominal surgery may limit the results of your abdominoplasty.
Abdominoplasty - the operation
The type of tummy tuck best suited to you depends on the appearance of your abdomen:
A mini tummy tuck is suitable if you have minimum excess of skin below the belly button.
A full tummy tuck is most often used if you have more excess skin and tissue between the belly button and your pubic skin region, but also if excess tissue exists above your belly button (umbilicus).
Mini abdominoplasty
For patients with only a small amount of excess skin a lesser abdominoplasty might be appropriate. During the operation, a wedge of skin and fat is excised from the lower tummy leaving a horizontal scar above the pubic hair. Sometimes the muscles will also be tightened. No scar is left around the umbilicus, which may be stretched slightly into a different shape.
Full abdominoplasty
For patients who have significant skin laxity, excess fat and separation of the muscles, a classic tummy tuck is the most common procedure. During the operation, an incision is made from hip to hip and around the umbilicus. The excess skin and fat is excised from above the umbilicus to just above the pubic hair. The muscles above and below the umbilicus are tightened. The skin is then brought down and the skin that was above your belly button is sawn to that above your pubic skin area.
This will give you a circular scar around the umbilicus and a long scar across the lower abdomen. Although this operation leaves a large scar, it does provide the greatest improvement in abdominal shape. If you do have a scar from a caesarean or hysterectomy, this can be removed at the same time.
Abdominal muscles:
In both mini and full tummy tucks, the muscles of the abdomen will usually be repaired. These are called rectus-abdominus muscles (the 6-pack muscles), which are stretched and may stay apart after pregnancy or weight loss (the opening is then called a rectus diastasis). During surgery, these muscles can be stitched back together into their correct position. At the same time, hernias can be repaired. This will improve the shape of your tummy, prevent future hernias and improve your posture.
After the procedure - Your recovery
• With a full abdominoplasty you will have tape dressings over your wounds, and tight tape dressings on your tummy. At least two drains (plastic tubes attached to suction bottles) will have been placed to drain excess wound fluid and blood. The drains will usually be removed before you go home and you will be given instructions about your dressings and stitches. On the day following surgery, we will encourage you to mobilise gently. You will also be fitted with a surgical compression garment to gently support your tummy. You will be encouraged to wear this for 6 weeks following the operation.
• Post-operative pain in these procedures is easily controlled.
• You will be mobile from day one and should be back to full exercise within six weeks. Stitches will need to be removed after 2 weeks. Most people have approximately 3 weeks off work following a tummy tuck procedure, depending on the type of work you do. The recovery is slightly slower if you have had your muscles repaired as there will be more tenderness. Important to point out is the fact that some people recover quicker than others.
We will keep a close eye on you after your surgery and would normally see you for your follow-up appointments at regular dressing clinics every 2-3 days and then 6 weeks following surgery, at which point your post-operative photographs will be taken.
Results after an abdominoplasty
Abdominoplasty will enhance your body contour by making your abdomen firmer and flatter. You may find that you feel more comfortable in your clothing and are more confident about your appearance.
All abdominoplasties result in some scarring although the nature of the scars will depend on the technique that has been used. We will aim to locate the horizontal scar within the area covered by usual underwear or swimwear. Scars tend to be quite red and raised in the first six weeks, changing over six months or so and then should start to fade. Most patients will form good quality scars over time, but occasionally and unpredictably some patients will get lumpy scars that do not improve unless treated. Especially in black skin, hypertrophic or keloid scarring can occur, in which case appropriate treatment will be initiated.
How long will the results last?
When the excess skin and fat are removed from your tummy and your muscles repaired you are unlikely to develop excess skin or splitting of the muscles unless you have further pregnancies or you put on a significant amount of weight – your abdomen should remain firmer and flatter for many years. However, gravity and the effects of aging will eventually take their toll. If, after a period of years, you again become dissatisfied with the appearance of your abdomen, you may choose to undergo a second procedure to restore a more youthful body contour.
Generally we advise you that tummy tuck procedures should be performed after you have completed your family. It is possible to get pregnant and have children following your abdominoplasty but this will undo some of the corrective surgery that was involved in the procedure.
What complications can occur?
Whilst these operations are generally safe in the hands of a qualified and experienced plastic surgeon and regarded to be highly successful, there are, as with any operation, risks involved and the possibility of complications that patients need to consider.
A full abdominoplasty is a major operation and you must be prepared for the process and recovery period. Most patients are delighted with the physical and cosmetic improvements that abdominoplasty brings. However, it is impossible to guarantee that every patient will be completely satisfied with the result. There will be minor asymmetries with respect to the scars, and possible residual bulges (dog ears on the sides). Occasionally patients will bleed immediately after the operation and need to go back to the operating room for this to be dealt with. Wound healing problems may occur.
Most wound problems are minor and can be managed with simple dressings; however more major wound problems can arise such as infections, skin loss, wound separation and delayed healing. Wound problems, if they occur, can delay your recovery and result in worse scarring. In some patients fluid will collect in the abdomen in the region of the operation (seroma formation). If this occurs it needs to be removed using a needle, this is done in the outpatient clinic.
All patients can expect alteration in the feeling of the lower abdomen which is usually permanent. This operation carries a risk of blood clots in the legs and possibly the lungs. Various precautions are taken to limit this risk but if a blood clot occurs, treatment with blood thinning medication will be needed for several months. Blood clots in the lungs can be serious.
Patients who undergo breast reduction surgery frequently are seeking relief from physical symptoms caused by the excessive weight of large breasts. Breast reduction usually can solve these problems as well as improve the size and shape of your breasts. Following breast reduction, your breasts will be more proportional to the rest of your body, and clothes will fit you better.
Summary
• Local anesthesia with general anaesthetic
• Operating time about 2-3 hours
• Hospital stay 2-3 days
• Back to work within 2 weeks
• Compression support bra for 12 weeks
• Full exercise after 6 weeks
Am I A Good Candidate For Breast Reduction?
You may be a good candidate for breast reduction if you have one or more of the following conditions:
• Your breasts that are too large in proportion to your body frame
• Large hanging breasts with nipples and areolas pointing downward
• Breast asymmetry: one breast is much larger than the other
• Backpain, neck or shoulder discomfort due to the weight of your breasts
• Skin irritation underneath your breasts
• Tight bra straps that cause indentations in your shoulders
• Restriction of physical activity and exercise due to the size and weight of your breasts
• Dissatisfaction or self-consciousness about the largeness of your breasts
Breast reduction can be performed at any age. Commonly you will have experienced a lifelong struggle with all the problems associated with oversized breasts, and now you feel it is time to do something about it. Ideally, you should have stabilized your weight.
Sometime large breasts cause problems from an early age, but we usually recommend waiting with surgery until breast development has been completed. Pregnancy and breastfeeding may have significant and unpredictable effects on the size and shape of your breasts, which might decrease in size again over time. Sometimes the size stays too large to be comfortable, at which stage breast reduction surgery can be performed. Nevertheless, many women decide to undergo breast reduction before having children.
During the consultation, you will be asked about the results you would like to achieve from your breast reduction surgery. This will help us to understand your expectations and determine whether they realistically can be achieved.
Breast Reduction - The Operation
There are a number of different techniques used to perform a breast reduction, depending on the size, amount of ptosis and your expectations of the results. In almost all cases of breast reduction, a method is be used to reduce the amount of scarring.
The Incision For Breast Reduction; Vertical Scar Reduction
Using the safest and aesthetically most pleasing method of the vertical reduction with superomedial pedicle, the incisions and subsequent scars will run around your areola, and from there downwards, curving slightly outwards towards the under-breast fold. Using this type of incision, complications such as wound breakdown are reduced greatly. In very larger breasts, it is sometimes necessary to extend the incision into the fold underneath your breast (anchor- or inverted T- incision).
The Superomedial Pedicle In Breast Reduction; Elevation Of The Areola
In all reductions, the nipple-areola complex (NAC) is repositioned upwards to the original position and the breast skin is drawn around the areola to define your new breast contour. By excision of the excess breast tissue, the breast is not only reduced in size, but also tightened and moulded into a natural shape. The areola, which in large breasts usually has been stretched, is also reduced in size. The amount of fat, tissue and skin removed will depend on the final breast size that you have agreed with us. We usually recommend a size that will fit the proportions of your body.
Sometimes it might be necessary to shape the lateral sides of you chest using liposuction, in order to improve the contour. Usually, the nipples and areolas remain attached to underlying mounds of tissue, and this allows for the preservation of sensation. The ability to breast-feed may also be preserved by this method, although this cannot be guaranteed.
Circumareolar Reduction For Smaller Reductions
If you only need a mild or modest breast reduction, or there is an asymmetry between the breasts, the incision needed might just be around the areola, which is sutured again after excision of the excess skin and tissue. This technique is suitable when only a small amount of tissue needs to be removed.
After The Breast Reduction - Your Recovery
• You will be admitted on the day of surgery, and your length of stay depends on your recovery. Usually, you will stay in the hospital for 2 – 3 nights.
• You will have tape dressings applied to stabilize your breasts. A small drain (plastic tube attached to a suction bottle) will have been placed to drain excess wound fluid and blood from each side. The drains will usually be removed after 2-3 days. Most people do not find breast reduction surgery to be that painful.
• On the day following surgery, we will encourage you to mobilise gently. You will also be fitted with a special support bra to gently support your breasts. You will be encouraged to wear this for 12 weeks following the operation.
• You will be mobile from day one and should be back to full exercise within six weeks. Stitches will need to be removed after 2 weeks, the circumareolar sutures after 3 weeks. Most people have approximately 2 weeks off work following a breast reduction procedure, depending on the type of work you do. It is important in the first 4 weeks to avoid any strenuous activities which can cause stretching to the incisions and disturbance of the new shape.
We will keep a close eye on you after your surgery and would normally see you for your follow-up appointments at regular dressing clinics every 2-3 days and then 6 weeks following surgery, at which point your post-operative photographs will be taken.
Results After Breast Reduction
Breast reduction often makes a dramatic change in your appearance. Most women feel very pleased with the results of surgery, they often start to exercise again and enjoy new hobbies. Of all plastic surgical procedures, the level of patient satisfaction resulting from breast reduction is among the highest. However, your breasts may require some time to assume a more natural shape – this might take as long as 3 months for the final result to become apparent.
A breast reduction operation is considered a permanent solution to reduce large heavy breasts. Unless you gain or lose a significant amount of weight or become pregnant, your breast size should remain fairly constant. However, gravity and the effects of aging will eventually alter the size and shape of virtually every woman’s breasts over the years. You may choose to undergo a breast “lifting” procedure to restore their more youthful contour at that stage.
The incisions from your breast reduction surgery will heal and fade over time. It is important to realize, however, that the incision lines will be permanently visible, more so in some individuals than others. Ideally, the scars will heal well over time and will then be well concealed. Any scar goes through a maturation process, which takes a year to complete.
What Complications Can Occur?
Whilst these operations are generally safe in the hands of a qualified and experienced plastic surgeon and regarded to be highly successful, there are, as with any operation, risks involved and the possibility of complications that patients need to consider.
Postoperative pain will vary from person to person, but this is generally not considered as a painful procedure.
Most patients are delighted with the physical and cosmetic improvements that breast reduction brings. It is impossible to guarantee that a particular cup size will result. There will be minor asymmetries between your breasts and the scars. Occasionally patients will bleed immediately after the operation and need to go back to the operating room for this to be dealt with. Wound healing problems can occur, particularly in the anchor scar procedure where the horizontal and vertical scars meet. All breast reductions result in some scarring although the nature of the scars will depend on the technique that has been used. Most patients will form good quality scars over time, but occasionally and unpredictably some patients will get lumpy scars that do not improve unless treated. Especially in black skin, hypertrophic or keloid scarring can occur, in which case appropriate treatment will be initiated.
Most wound problems are minor and can be managed with simple dressings. However, more major wound problems can arise such as infections, skin loss, wound separation and delayed healing. Wound problems, if they occur, can delay your recovery and result in worse scarring. You may notice that you feel less sensation in the nipple and areola areas. This usually is temporary. It may, however, take weeks, months or even more than a year before sensation returns to normal. After many breast reduction techniques it will still be possible to breast-feed, but this ability might be lost.
If you are considering losing weight and shaping up, and have been doing your best to lose those kilos, but cannot get rid of the last pockets of fat, then liposuction is a procedure which can give you the shape that you envision. It is important to remember that this treatment is not a cure, but can help to correct and improve bodily contours in areas that are resistant to weight loss. As a surgical technique, liposuction works by removing pockets of fat in areas that are beyond the reach of diet and exercise. It should not be thought of as a substitute for losing weight. Liposuction procedures can be performed on their own or in combination with other procedures, such as breast reduction, tummy tuckorfat grafting (using the suctioned fat to enlarge breast or buttocks).
The Areas That Are Most Commonly Treated By Liposuction Are:
• The tummy and flanks (“love handles”)
• The thighs (“sattlebags”)
• The buttocks
• The knee and lower leg areas
• Upper arm area
• The neck
• Excess tissue in men and women in the breast and chest area
Am I A Good Candidate For Liposuction?
Any one or combination of the following conditions may indicate that you are a good candidate for liposuction:
• Areas of fat deposits that are out of proportion with the rest of your body and do not go away with diet and exercise – so called “diet resistant fat”.
• Areas with minimal amounts of excess skin (Liposuction removes fat not skin) and good skin elasticity.
Liposuction is equally effective in both men and women.
Liposuction – The Procedure
Liposuction is carried out using a thin (3 – 4 mm wide), hollow tube called a cannula that is inserted under the skin through tiny incisions. The cannula is then used to loosen the fat and create a nicer shape within the body part being treated. A special vacuum or suction device is attached to the cannula, and the fat is getting sucked from thebody after being loosened using the accurately directed water spray from the tip of the cannula (water assisted liposuction).
There are various liposuction techniques available, the best being the one your surgeon is most familiar with. Each liposuction procedure will be tailored to a patient’s needs and physical condition. Using the Water assisted liposuction technique (BodyJet®) fluid is infiltrated into the area to be suctioned. This fluid will contain local anaesthetic to numb the area and adrenaline to shrink the blood vessels. It will thereby help to reduce bruising and swelling after your surgery.
Water-assisted liposuction employs pulsating jets of water to dislodge and remove the fat cells. One advantage of this procedure is that the harvested fat cells are removed intact, allowing for reinjection into other areas of the body where more fat is needed (Fat grafting).
After The Procedure - Your Recovery
• You will be admitted on the day of surgery, and your length of stay depends on which procedure is done.
• Usually the procedure is performed under sedation with local anaesthetic. In most cases, patients will only need to be in hospital for a few hours, but an overnight stay may be recommended if a large amount of fat is to be removed.
• The procedure takes between 1 - 3 hours to perform, depending on the size and number of treatment areas.
• At the end of the operation, tight bandages or elasticated clothing (compression garments) will be applied to the area to minimize swelling and help the body conform to its new shape. With the exception of showering, this garment should be worn both day and night for at least two weeks and thereafter for another four to six weeks. The tighter the garment and the more regularly they are worn the better your results and shape afterwards.
• Post-operative pain after liposuction is usually controlled with oral medication.
• You will be mobile from day one and should be back to full exercise within 4-6 weeks.There will be no stitches at all.Most people have a few days off work following liposuction, depending on the type of work they do.
We will keep a close eye on you after your surgery and would normally see you for your follow-up appointments at regular dressing clinics every 2-3 days, 3 weeks and then 6 weeks following surgery, at which point your post-operative photographs will be taken.
Results After Liposuction
Liposuction surgery usually improves the contour of your body greatly. Results are visible immediately but you will find some irregularities, firm areas and softer areas for a few weeks. As healing progresses these areas will smoothen out and soften. Sometimes Dr. Stasch will recommend lymphdrainage to improve post op swelling and since the healing process is gradual, you should expect to wait at least several months to get an accurate picture of the results of your surgery. The small incisions used for access of the liposuction cannula, will heal after a few days and the small scar will fade over a number of months usually becoming barely visible
How Long Will The Results Last?
The results of liposuction surgery are usually long-lasting, but they may be affected by weight gain, aging, pregnancy and lifestyle factors. We are born with a certain amount of fat cells in each region: when you put weight on, these fat cells swell - you do not increase the number of fat cells when you put on weight. By removing a number of these fat cells using liposuction, you are likely to have a permanent reduction in an area. It is important to remember that, if you do put on weight again, the remaining fat cells can once again swell. It is therefore best to maintain a steady and healthy weight after liposuction in order to prevent the areas of excess fat recurring.
What Complications Can Occur?
Whilst these operations are generally safe in the hands of a qualified and experienced plastic surgeon and regarded to be highly successful, there are, as with any operation, risks involved and the possibility of complications that patients need to consider.
Fortunately, significant complications from liposuction surgery are infrequent. Some of the potential complications that may be occur include haematoma (an accumulation of blood under the skin that may or may not require removal), infection, changes in sensation, scarring, allergic reactions, damage to underlying structures, need for revisions, unsatisfactory results possibly necessitating additional procedures. Other risks more specific to liposuction may include indentations and irregularities. Swelling & bruising is common and will usually resolve after the cause of a few weeks.
Smokers
Smokers are strongly advised to discontinue smoking several weeks prior to surgery and after the operation, as smoking increases the risks of complications and delays wound healing by altering blood circulation in the skin. You can reduce your risks of complications by closely following our instructions before and after the surgery.
Arm lift surgery is also known as brachioplasty. The operation can remove excess skin and fat, leaving the upper arms with a slimmer, more pleasing and youthful contour. As a person ages, upper arm skin often becomes loose and flabby. brachioplasty, or upper arm reduction surgery, involves reducing this skin through an incision that runs on the inner part of the upper arm all the way from the elbow to the axilla, often crossing into the arm pit.
Summary
• Local anaesthesia with sedation or general anaesthetic
• Operating time about 1.5 hours
• Overnight hospital stay
• Back to work within 1-2 weeks
• Compression garment for 4 weeks
• Full exercise after 6 weeks
Am I a good candidate for arm lift surgery?
Many people can develop excess skin in the inner aspect of their upper arms, as part of a normal aging process, but particularly if they lose significant amounts of weight.
Arm Lift surgery can be performed on a large variety of patients including normal weight patients who simply need a little tightening. As time goes on and gravity takes its toll, the extra skin might become bothersome. This creates difficulties wearing clothing that reveals the arms – you then tend to conceal this area by wearing long sleeved garments.
If you have lost a significant amount of weight and have stabilized your weight and do not have any serious medical problems, the excess skin and fat in the upper arms (also called “bat wings”) may worry you. An upper arm lift procedure can then add considerably to your daily comfort and improve your appearance.
During the consultation, you will be asked about the results you would like to achieve from your arm lift surgery. This will help us to understand your expectations and determine whether they realistically can be achieved.
Arm lift or brachioplasty - the operation
There are a number of different techniques used to treat the excess skin area, depending on the distribution of the fatty tissue and skin in your case.
Liposuction
For patients who have minimal upper arm fat excess, with no skin excess, liposuction alone can be effective. It is extremely good at removing the fatty tissue on the arms but does have the disadvantage that it will only tighten up moderate amounts of skin in the area.
Skin tightening around armpit
For patients with minimal or moderate skin excess located near the arm pit, an improvement can be attained through a scar limited to the arm pit. This is often combined with liposuction. The advantage of leaving the scar purely hidden within the armpit is that it is well concealed. However, if you do have excess skin tissue extending down the arm towards your elbow, this form of excision may not fully treat the whole arm.
Full arm lift reduction
For patients who present with a lot of upper arm excess, as in the case of most weight loss patients, tissue must be removed through a scar that runs from the elbow, to, and sometimes into, the arm pit. The advantage of this procedure is that it is very effective at reducing the amount of skin all the way down to your elbow. The disadvantage is that you will be left with scarring extending down the inner aspect of your arm. We will aim to conceal this scar in the inner aspect of your arm as it lies against your body so that it is not overtly visible from either the front or back, however, it will be visible if you raise your arm. Generally, the scar in your inner arm area tends to settle well with time but may remain red and slightly painful for up to a year following surgery (this does vary between individuals).
After the arm lift operation - Your recovery
• You will be admitted on the day of surgery, and your length of stay depends on your recovery. Usually, you will stay in the hospital for one or two nights.
• You will have tape dressings over your wound, and bandages along the whole length of your arms for compression. Preferably, the arms should rest on pillows above the level of your heart. This will reduce the swelling, which in turn will speed up recovery and prevent bruising. A small drain (plastic tube attached to a suction bottle) will have been placed to drain excess wound fluid and blood. The drains will usually be removed a day later.
• On the day following surgery, we will encourage you to mobilise gently. You will also be fitted with a surgical compression garment to gently support your arms. You will be encouraged to wear this for 4 weeks following the operation. It is important to keep your hands and elbows moving in the weeks following surgery.
• You will be mobile from day one and should be back to full exercise within six weeks. Stitches will need to be removed after 2 weeks. Most people have approximately 1 week off work following an upper arm lift procedure, depending on the type of work you do. It is important in the first 2 weeks to avoid any strenuous activities which can cause stretching to the incisions.
We will keep a close eye on you after your surgery and would normally see you for your follow-up appointments at regular dressing clinics every 2-3 days and then 6 weeks following surgery, at which point your post-operative photographs will be taken.
Results after arm lift surgery or brachioplasty
After an upper arm lift, the excess skin in the area is unlikely to return unless you do gain then lose a significant amount of weight. Once the excess skin has been removed, the appearance of your upper arms will be tighter and more harmonious, allowing you to wear closer-fitting clothes and making you less self-conscious about the appearance of this region. Most scars are conspicuous, at least initially, when raising the arms. Ideally, the scars will heal well over time and will then be well-concealed. Any scar goes through a maturation process, which takes a year to complete.
What complications can occur?
Whilst these operations are generally safe in the hands of a qualified and experienced plastic surgeon and regarded to be highly successful, there are, as with any operation, risks involved and the possibility of complications that patients need to consider. Postoperative pain will vary considerably from person to person, but this is not considered a very painful procedure. The average patient undergoing an upper arm reduction procedure will usually require a few days of oral pain medication to treat discomfort and a feeling of tightness.
• Bleeding
• Infection
• Unattractive scarring
• Swelling of the hands
• Seroma formation (seromas are fluid collections that can arise after surgery along the incision line)
Smokers are strongly advised to discontinue smoking several weeks prior to surgery and after the operation, as smoking increases the risks of complications and delays wound healing by altering blood circulation in the skin. You can reduce your risks of complications by closely following our instructions before and after the surgery.
Thigh lift reshapes the thighs by reducing excess skin, and in some cases fat, resulting in smoother skin and better-proportioned contours of the thighs and lower body.
In thigh lift surgery, the tissue of your inner and outer thigh regions are pulled upwards and inwards. The potential results can be simulated by pulling up the skin of your inner and outer thigh with your hands (rather like pulling on a pair of stockings). You can see the wrinkles and excess tissue disappear.
Summary
• General anaesthetic
• Operating time about 2.5 hours
• Hospital stay 2-3 nights
• Back to work after 2-3 weeks
• Compression garments for 12 weeks
• Full exercise after 6 weeks
Am I a good candidate for thigh lift?
If exercise and weight loss efforts have not achieved your goals for a body that is firmer, more youthful-looking and more proportionate to your overall body image, or if this has resulted in loose, saggy skin, then a surgical thigh lift may be right for you.
This surgery reshapes the thighs by reducing excess skin, and in some cases fat, resulting in smoother skin and better-proportioned contours of the thighs and lower body.
You are a good candidate for thigh lift if:
• there is excess soft tissue along the inner or medial thigh region and/or the outer thigh.
• you are healthy, do not have medical conditions that can impair healing or increase risk of surgery.
• your weight is stable.
• you don’t smoke.
• you have a positive outlook and realistic goals for what thigh lift surgery can accomplish.
What a thigh lift won’t do: Thigh lifts are not intended strictly for the removal of excess fat. Liposuction alone can remove excess fat deposits where skin has good elasticity and is able to naturally conform to new body contours. In cases where skin elasticity is poor, a combination of liposuction and thigh lift techniques may be recommended.
During the consultation, you will be asked about the results you would like to achieve from your thigh lift surgery. This will help us to understand your expectations and determine whether they realistically can be achieved.
Thigh lift - the operation
There are a number of different techniques used to perform a thigh lift, depending on the shape of the thigh and lower body, amount and quality of skin and fat and your expectations of the results. In almost all cases of thigh lift, a method is used to minimize the amount of scarring.
The Incision - medial thigh lift
Incision patterns vary based on the area or areas to be treated, degree of correction and patient and surgeon preference. Most commonly, a thigh lift incision is placed in the groin anteriorly, extending down and backwards towards the fold of your buttocks and top of the thigh. The tissue of the inner thighs will be pulled upwards and reshaped, and the skin will be reduced and redraped resulting in a more proportionate and smoother shape.
This groin incision for a medial thigh lift might have to be extended in the midline of the thigh down towards your knee if there is a lot of loose skin and tissue. We will discuss the exact position of the incisions together in order to get the best results. However, one must always note that scars will be visible, although they will be hidden in the groin and down the inner thighs.
The Incision - outer thigh lift
Improving the contours of the outer thighs, often as part of a body lift after weight loss, may require an incision extending from the groin around the hip.
Through these incisions the tissues of the outer thigh and hip will be lifted and thightened, for a smoother, better-toned lower body contour.
Advanced techniques usually allow incisions to be placed in strategic locations where they can be hidden by most types of clothing and swimsuits. However, incisions may be extensive.
We will use buried, deep support sutures that will resolve over a few months time, in order to help support the underlying tissues heal in their new position and to take the tension off the skin to allow for better scaring.
After the thigh lift - Your recovery
• You will be admitted on the day of surgery, and your length of stay depends on your recovery. Usually, you will stay in the hospital for 2 – 4 nights.
• You will have tape dressings applied to stabilize your thighs. Drains (plastic tubes attached to a suction bottle) will have been placed to drain excess wound fluid and blood from each side. The drains will usually be removed after 3 – 4 days. Sometimes it is wise to keep them for longer if there is a lot of lymphatic drainage, to prevent it from collecting in the wound. You will however be able to leave the hospital with the drains inside, if the wounds look fine.
• Most people do not find thigh lift surgery to be that painful.
• On the second day following surgery, we will encourage you to mobilise gently, in order to reduce the risk of deep venous thrombosis. You will also be fitted with a special compression garment which need to be measured and ordered before the surgery, to support your thighs. You will be encouraged to wear this for 12 weeks following the operation.
• You will be mobile from day two and should be back to full exercise within six weeks. Skin stitches will need to be removed after 2 weeks. Most people have approximately 2 – 3 weeks off work following a thigh lift procedure, depending on the type of work you do. It is important in the first 4 weeks to avoid any activities which can cause stretching of the incisions and disturbance of the new shape.
We will keep a close eye on you after your surgery and would normally see you for your follow-up appointments at regular dressing clinics every 2-3 days and then 6 weeks and 3 months following surgery, at which point your post-operative photographs will be taken.
Results after thigh lift
The contour of your upper thighs will be smoother and tighter and excess, hanging skin will have been removed. These results will be apparent almost immediately, although initially obscured by swelling and bruising. You will be required to wear a compression garment for several weeks following your procedure to minimize swelling and support the tissues as they heal. Following a thigh lift, skin quality can improve both in appearance and feel, although one needs to be realistic as to what can be achieved. It may take several months for the final result to fully develop.
The incisions from your thigh lift surgery will heal and fade over time. It is important to realize, however, that the incision lines will be permanently visible, more so in some individuals than others. Ideally, the scars will heal well over time and will then be well concealed. Any scar goes through a maturation process, which takes a year to complete. In dark skin, the risk of hypertrophic or keloid scarring must be kept in mind.
As your body ages, it is natural to lose some firmness. However, most of your initial improvement should be permanent.
What complications can occur?
Whilst these operations are generally safe in the hands of a qualified and experienced plastic surgeon and regarded to be highly successful, there are, as with any operation, risks involved and the possibility of complications that patients need to consider.
Smokers are advised to discontinue smoking several weeks prior to surgery, as smoking increases the risks of complications and delays wound healing by altering blood circulation in the skin. You can reduce your risks of complications by closely following our instructions before and after the surgery.
Postoperative pain will vary from person to person, but this is generally not considered as a painful procedure.
Most patients are delighted with the physical and cosmetic improvements that thigh lift brings. There might be minor asymmetries between your thighs and the scars. Occasionally patients will bleed immediately after the operation and need to go back to the operating room for this to be dealt with. Wound healing problems can occur, particularly in the groin area, where the horizontal and vertical scars meet. All thigh lifts result in some scarring although the nature of the scars will depend on the technique that has been used. Most patients will form good quality scars over time, but occasionally and unpredictably some patients will get lumpy scars that do not improve unless treated.
Another possible complication is prolonged drainage of wound fluid. In these cases, the drains have to be taken out at some stage, and if the fluid continues to collect, one might simply have to drain it though the skin during follow-up visits.
Most wound problems are minor and can be managed with simple dressings. However, more major wound problems can arise such as infections, skin loss, wound separation and delayed healing. Wound problems, if they occur, can delay your recovery and result in worse scarring. You may notice that you feel less sensation in the groin and inner thigh areas. This usually is temporary. It may, however, take weeks, months or even more than a year before sensation returns to normal.
Body lifts are a plastic surgery procedure that’s purpose is to tighten, tone, and lift the abdomen, buttocks, breasts, and thighs. Excess sagging fat and skin are removed to treat conditions caused in part by poor tissue elasticity. A well-toned body with smooth contours often is a sign of fitness achieved by healthy diet and exercise.
But exercise cannot always achieve desired results for people who have loose, sagging skin and uneven contours. Aging, sun damage, pregnancy and significant fluctuations in weight as well as genetic factors may contribute to poor tissue elasticity and can result in sagging of the abdomen, buttocks, thighs and upper arms.
Excess sagging fat and skin are removed to treat conditions caused in part by poor tissue elasticity. In addition, the procedure(s) can improve a dimpled, irregular skin surface, commonly known as cellulite.
A body lift may include these areas:
• Abdominal area, locally or extending around the sides and into the lower back area.
• Buttocks, that may be low, flat or shaped unevenly.
• Groin that may sag into the inner thigh.
• Thigh, including the inner, outer, or posterior thigh, or circumferentially.
What it won't do
• Body lifts are not intended strictly for the removal of excess fat.
• Liposuction alone can remove excess fat deposits where skin has good elasticity and is able to naturally conform to new body contours.
• In cases where skin elasticity is poor, a combination of liposuction and body lift techniques may be recommended.
Labia minora reduction surgery or labiaplasty is a surgical procedure meant to reduce the size or change the shape of a woman’s labia minora (the inner vaginal lips). It is often performed on women who feel that their labia minora are uneven or too large. Enlarged labia minora is a medical condition known as labial hypertrophy, and can cause discomfort while performing certain activities or wearing tight clothing as well as embarrassment with a sexual partner.
This can be caused by childbirth, age, and hormonal changes, or it may simply be present from birth.
Labia minora reduction surgery does not mean that the enlarged labia is removed altogether. Instead, the labia minora are contoured, reshaped, and reduced in size with as little cutting as possible.
Fat grafting, also known as fat injections or fat transfer, can provide long-lasting facial rejuvenation without relying on manufactured substances. Fat grafting involves taking excess fat cells from a donor area of your body and injecting them into facial areas targeted for rejuvenation, or other areas of your body that need to be enhanced. The procedure can be very useful for smoothing out wrinkles and fine lines, as well as adding volume to facial features such as the lips and cheeks. Fat grafting can sometimes be combined with a liposuction procedure, which can provide the fat for the facial rejuvenation procedure. The harvested fat is purified after removal, and then injected into the target areas. Although results vary with each patient, the effects of fat grafting can last for years.
A face-lift (also sometimes known as a rhytidectomy) is a rejuvenation procedure that is performed to restore a patient’s face and neck to a more youthful – but still natural looking – version of themselves. A face-lift is used to address age-related problems with the lower half of the face, from the eyes and ears downwards. Anything above the eyes is treated with a brow-lift or non-invasive procedures.
Summary
• Sedation and local anaesthetic or general anaesthetic
• Operating time about 3-4,5 hours
• Daycase or 1-2 nights inpatient stay
• Back to work after 2 weeks
Am I a good candidate for Facelift surgery?
Any one or combination of the following conditions may indicate that you may be considered a good candidate for facelift surgery:
• Excess skin starting to sag on cheeks, jawline, around chin and neck.
• Good bony support and skin elasticity.
• Non-smoker.
Cosmetic facelift surgery can usually correct these problems, though a combination of treatments may need to be considered. If the upper eyelids are sagging, then an upper eyelid lift (blepharoplasty) may be recommended. If the tear troughs are very deep, a facelift can very well be combined with a lower blepharoplasty. Smoothing of crow's feet around the eyes may be accomplished with botulinumtoxin, microneedlingor laser resurfacing procedures. Circles beneath the eyes caused by dark pigmentation may be treated with cosmeceutical skin products, microneedling, PRP or corrected with lipofilling (nanofatgrafting). Lipofilling is especially useful if the face has lost some volume, where injection of the patient’s own fat will be used in combination with the facelift, or at a later stage, to smoothen the contour, increase the fullness of the face and improve the complexion of the skin.
Most patients are between 40 and 60 years of age, but facelifts can be done successfully on people in their 70s or 80s. It should not be obvious that you have had a facelift, but instead you should look younger, more vital and refreshed. It is a procedure that can give great results and thus increases morale and your self-confidence.
During the consultation, you will be asked about the results you would like to achieve from your facelift surgery. This will help us to understand your expectations and determine whether they realistically can be achieved.
Facelift surgery in Kenya – the operation
A face-lift involves elevating and repositioning the skin and soft tissue of the face. During the procedure an incision is made from the temple (most commonly in your hairline), then in front of the ear and then passing behind the ear.
The fascia (SMAS) and soft tissues of the lower face and neck are tightened and lifted, redundant skin is then removed, and the remaining skin is re-draped over its new foundations and gently sewn into position. The skin is sutured so that it is lifted upwards and backwards, just as when one lifts the skin when looking in the mirror.
Occasionally it may be necessary to make a small incision under the chin. More usually however the platysma muscle and its fibrous attachments (SMAS) is dissected free and sutured tightly to the solid structures in front and behind the ear to achieve a smooth, lifted neck.
Fat along the jaw line and under the chin may be removed by liposuction or on occasion through an incision under the chin. Fat is sometimes added to the face, using lipofilling: the nasolabial folds or lips can be augmented to give the face a more wholesome appearance.
Face-lifts are usually performed under sedation with local anaesthetic or general anesthetic. The operation takes between 3 and 4,5 hours, and patients are likely to need to stay in hospital overnight.
After the facelift operation - Your recovery
We will keep a close eye on you after your surgery. The wounds will be covered with Steristrip-tapes; you will have small silicon drains coming out of the wounds behind your ears to drain the excess fluid and some blood. The whole head will be wrapped with gauze dressings and a comfortable bandage.You will be allowed to gently cool the skin to reduce possible bruising and swelling.
Oral medications will help with discomfort during your recovery. Dr. Stasch will see you regularly after the surgery, and for your follow-up appointments at regular dressing clinics every 2-3 days.
Stitches are removed about a week to ten days after surgery, at which point your post-operative photographs will be taken. Bruising and swelling will continue to decrease after stitches are removed. Sunglasses and protective sun block are recommended. After ten to fourteen days patients can think about returning to work or going out in public. Within 2-3 weeks, you will begin feeling more like yourself albeit a younger looking version.
Results after facelift surgery
The recovery from surgery will be marked by swelling and bruising initially, which will slowly decrease over the course of 1-2 weeks, at which time most of the bruising will have disappeared. We recommend the use of Arnica or Heparin-cream to speed up the recovery. It is better to keep the head elevated for a couple of days to reduce swelling. Drainage tubes will be removed a day or two after surgery. Avoid strenuous activity, saunas and massage for at least two weeks. Swelling will slowly subside, and can last for up to 3 months. After this time, the final result will become more apparent. However, patients are advised not to judge the final result of a face-lift for about six months post-op.
Face-lifts are generally successful procedures and can have beautiful results, often setting the clock back about ten years. However, patients need to be aware that no face-lift will ever make them look 18 again, and you should be aware of the limitations before you agree to undertake surgery.
What complications can occur?
Whilst these operations are generally safe in the hands of a qualified and experienced plastic surgeon and regarded to be highly successful, there are, as with any operation, risks involved and the possibility of complications that patients need to consider.
As with any surgical procedure, complications such as infection, bleeding, wound separation, or asymmetry can occur. More specific for this operation are: Feelings of tightness when opening mouth, swelling and bruising, feeling low and depressed in the first week, discomfort at night (sleeping upright with cooling packs applied to cheeks is recommended). We will discuss these issues in detail during the consultation.
Pain is not a major problem with facial surgery. It is normal for there to be some numbness of the skin ,of the cheeks and ears. This will usually disappear in a few weeks or months. However, all patients need to be aware that there is the chance of sustaining damage to the facial nerves. This can cause weakened movement of the eyebrow and lip, although such repercussions are not common and generally improve over several weeks. The scars in the hair do not usually show except when the hair is cut shorter immediately around the wound. There may be some slight reduction in hair growth in the temples, but this is not usually a problem unless the hair is very thin and repeated facelifts are being carried out.
Smokers are strongly advised to discontinue smoking several weeks prior to surgery and after the operation, as smoking increases the risks of complications and delays wound healing by altering blood circulation in the skin. You can reduce your risks of complications by closely following our instructions before and after the surgery.
Also known as a forehead lift, a brow lift minimizes the creases that develop across the forehead, or those that occur high on the bridge of the nose; it improves what are commonly referred to as frown lines; and repositions a low or sagging brow.
Upper or lower eyelid surgery in Kenya
Upper blepharoplasty is an eyelid surgery procedure used to remove excess skin and puffiness from the upper eyelid – the area that makes you look tired and worn out. Lower blepharoplasty involves reducing the depth of your teartrough area, reducing puffiness (“baggy eyes”) and wrinkling from below your eyes. After blepharoplasty, your eyelids will look fresher and more youthful.
Summary
• Local anaesthesia with sedation or general anaesthetic
• Operating time about 1.5 hours
• Day case surgery or 1 night stay
• Back to work within 1-2 weeks
Am I a good candidate for upper or lower eyelid surgery?
Any one or combination of the following conditions may indicate that you may be considered a good candidate for eyelid surgery:
• Excess skin obscuring the natural fold of the upper eyelids
• Loose skin hanging down from the upper eyelids, perhaps impairing vision
• A puffy appearance to the upper eyelids, making the eyes look tired
• Excess skin and fine wrinkles of the lower eyelids
• Bags and dark circles under the eyes (“teartroughs”)
• Lower eyelid baggyness or droopiness
Cosmetic eyelid surgery can usually correct these problems, though other treatments may also need to be considered. If the upper eyelid condition is accompanied by sagging of the eyebrows, then a forehead lift may be recommended. Smoothing of crow’s feet may be accomplished with botulinum toxin, radiofrequency or laser resurfacing procedures. Circles beneath the eyes caused by dark pigmentation may be treated with cosmeceutical skin products (like Lamelle) or irregularities corrected with lipofilling (fat grafting).
During the consultation, you will be asked about the results you would like to achieve from your blepharoplasty surgery. This will help us to understand your expectations and determine whether they realistically can be achieved.
Eyelid surgery - the operation
The particular technique that we use will depend on many factors such as the amount of excess fat and skin in the eyelid areas, the position of your eyebrows, and the condition of muscles around your eyelids. Because of individual factors, not everyone will achieve the same results from eyelid surgery. We will select the surgical technique that we feel will obtain the best outcome for you.
Upper Eyelids (upper blepharoplasty):
For upper eyelid surgery, generally an incision is hidden within the natural fold of the upper eyelid and extends slightly beyond the outside corner into the laugh lines or other existing creases. Through this incision, excess skin, a strip of muscle and fatty tissue are removed. Because the incision follows the natural contour of the upper eyelid, it usually is inconspicuous.
Lower Eyelids (lower blepharoplasty):
Through this incision, excess skin, muscle and sometimes a little fat are removed. Commonly, fat may be redistributed to eliminate puffiness or bulges, or fill in tear troughs. Other adjustments to correct special problems such as muscle laxity may be performed, where the lower eyelid is tightened to avoid it from being pulled downwards. As in upper eyelid surgery, placement of the incision in natural crease lines allows for the scar to usually heal in an inconspicuous fashion.
For lower eyelid surgery, often an incision is hidden just below the lower lashes.If both the upper and lower eyelids are involved then surgery will be carried out under a general anaesthetic. This will also include an overnight stay in hospital. If the upper eyelids only are operated on then this procedure can be performed as a day case. This surgery takes around 1 to 2 hours to complete.
After the blepharoplasty operation - Your recovery
We will keep a close eye on you after your surgery. The small wounds will be covered with Steristrip-tapes, your eyes will be lubricated with an ointment, which might initially cause blurry vision when you open your eyes, and you will receive a cooling-mask to cover your eyes.
During the post-operative period, cooling the area around your eyes is most important in order to reduce swelling and bruising. Oral medications will help with pain and discomfort during your recovery if necessary. Dr. Stasch will normally see you within 48 hours after the surgery, and then for your follow-up appointments at regular dressing clinics every 2-3 days.
Stitches are removed 5-7 days after surgery, at which point your post-operative photographs will be taken. Bruising and swelling will continue to decrease after stitches are removed. Sunglasses and protective sun block are recommended.
Results after blepharoplasty
The recovery from surgery will be marked by swelling and bruising initially, which will slowly decrease over the course of 2 weeks, at which time most of the bruising will have disappeared. We recommend the use of Arnica or Heparin-cream to speed up the recovery. Swelling will slowly subside, and can last for up to 3 months. After this time, the final result will be apparent.
What complications can occur?
Whilst these operations are generally safe in the hands of a qualified and experienced plastic surgeon and regarded to be highly successful, there are, as with any operation, risks involved and the possibility of complications that patients need to consider.
As with any surgical procedure, complications such as infection, bleeding, wound separation, or asymmetry can occur. More specific for this operation are suture cysts (milia), insufficient or excess skin removal, hollowing of eyes, scarring, damage to the eyeball surface, or double vision. We will discuss these issues in detail during the consultation.
If protruding or disfigured ears bother you or your child, you may consider plastic surgery. Ear surgery — also known as otoplasty — can improve the shape, position or proportion of the ear. It can correct a defect in the ear structure that is present at birth that becomes apparent with development or it can treat misshapen ears caused by injury.
The goal of corrective ear surgery is to restore balance and proportion to the face and shift unwanted attention away from prominent or misshapen ears. Correction of even minor deformities can have profound benefits to appearance and self-esteem.
Summary
• General anaesthetic or Sedation with local anaesthesia
• Operating time about 1,5 hours
• Daycase
• Back to school/work in 1-2 weeks
• Headband for 6 weeks
Who is a good candidate for otopexy?
Within the first few weeks of life: When an ear is noted to be prominent, it is possible to reshape it by applying a small splint to the rim (e.g. ear buddy). The cartilage of a new-born’s ear is very floppy and easily remodeled and after several weeks of splintage a permanent correction can be achieved. By the age of six months the cartilage is too hard to be remodeled and a surgical solution may be required. The best age for doing an otoplasty would be before entering school. This is a safe age for the anaesthetic, and will ease the social burden on potentially being teased at school.
Children who are good candidates for ear surgery are:
• Healthy, without a life-threatening illness or untreated chronic ear infections.
• Generally 5 years old, or when a child’s ear cartilage is stable enough for correction.
• Cooperative and follow instructions well.
• Able to communicate their feelings and do not voice objections when surgery is discussed.
Teenagers and adults who are good candidates for ear surgery are:
• Healthy individuals who do not have a life-threatening illness or medical conditions that can impair healing.
• Non-smokers.
• Individuals with a positive outlook and specific goals in mind for ear surgery.
During the consultation, you will be asked what results should be achieved from otopexy. This will help your surgeon understand your expectations and determine whether they can be realistically achieved.
Otopexy - the Operation for Prominent ear correction
Pinnaplasty or Otoplasty is an operation which adjusts the shape of the cartilage within the ear to create the missing folds and to allow the ear to lie closer to the side of the head. Because the operation is carried out from behind the ears, a small scar is left close to the groove between the ear and the side of the head. The procedure can be carried out under local anaesthetic in adults, but in young children a general anaesthetic is usually required. Where the lobe of the ear or bowl (concha) is especially large, a small procedure to reduce its size may also be required.
After the procedure - Your recovery
• The procedure will be a day case procedure allowing the patient to go home the same day.
• The head will be wrapped in a bandage to protect the newly formed ears and keep them warm.
• A small protective dressing is usually worn after a few days until the stitches are removed at between 7-10 days after surgery. Sometimes absorbable sutures are used for the skin.
• Once the dressing has been discarded, it is wise to wear a protective head-band or bandage at school or when sleeping to avoid the ears being bent forward against the pillow. This should be worn for at least 6 weeks.
• The ears are often sore and tender for several weeks and painkilling medication such as Paracetamol may be required.
• We will keep a close eye on you after your surgery and would normally see you for your followup appointments at regular dressing clinics every 2-3 days and then 6 weeks following surgery, at which point your post-operative photographs will be taken.
• The hair can be washed after the dressing and the stitches have been removed.
Results after an otopexy
The scar behind the ear usually settles well, but on rare occasions it can become red and lumpy. A small number of patients, particularly those who are very sensitive about the precise shape of their ears, may require a minor adjustment procedure. The vast majority of patients, however, are well pleased by the result, and the procedure has a high satisfaction rate.
It is recommended that although parents may feel that their child’s ears should be corrected to avoid teasing and stigmatization it is best to wait until the child recognizes the problem and wants the ears corrected. Children are generally more co-operative and happy with the outcome when they fully understand why the surgery is taking place. Pinnaplasty is also performed during the teenage years and in adult life with equally good results.
How long will the results last?
Ear surgery offers almost immediate results in cases of protruding ears, visible when the dressings that support the new shape of the ear during initial phases of healing are removed. With the ear permanently positioned closer to the head, surgical scars are either hidden behind the ear or well hidden within the natural creases of the ear. The results of the otoplasty surgery are permanent. In later years, it is almost never apparent that the surgery has taken place. There is a small risk that the repair may not hold properly, and further adjustment surgery is occasionally required. This would usually become apparent within a year of the surgery.
What complications can occur?
Whilst these operations are generally safe in the hands of a qualified and experienced plastic surgeon and regarded to be highly successful, there are, as with any operation, risks involved and the possibility of complications that patients need to consider. In children the operation is carried out under general anaesthetic, and this carries with it a very small risk. In a small number of patients (approximately 3%) the scars can become thick and red, and may require further treatment. Bruising and swelling is very common and will settle within two weeks. Infection is not common, but should this occur it would require treatment with antibiotics and regular dressing changes. The ears are often a little numb after the procedure, and this usually takes several weeks to settle.
Smokers are strongly advised to discontinue smoking several weeks prior to surgery and after the operation, as smoking increases the risks of complications and delays wound healing by altering blood circulation in the skin. You can reduce your risks of complications by closely following our instructions before and after the surgery.
Sometimes a necklift forms part of a face lift, where sagging skin and soft tissues of your face are redraped in order to restore volume and smooth out the features of your face. The same can be done with the neck individually. If you are concerned about wrinkling, sagging or unnatural vertical lines on your neck and below your jaw line, a neck lift procedure can restore the contours and tighten the skin.
Surgery for harmless moles or skin cancer
The incidence of most skin cancers increases as we get older. They tend to occur on sun-exposed parts of the body. Often sun exposure early in life will result in a skin cancer many years later. Plastic surgeons commonly treat skin cancer because they have the techniques to close wounds sometimes by skin grafts or flaps, but often by simpler means. This means that we can confidently remove the tumor knowing that the wound can be repaired. The priorities for treatment are complete removal of the cancer, achieving rapid healing, getting you back to normal and getting the best possible appearance.
The same can certainly be done for harmless lesions on your body, that are aesthetically unpleasing and which you want removed with minimal scarring.
