Monday, 30 July 2007

Basic Tummy Tuck Information

We've created basic descriptions and explanations of the most popular procedures for you to help you figure it all out - this one's on tummy tucks...


The decision to have this procedure should only be made after an examination in consultation with your surgeon. If you have loose muscle and excess skin in both the upper and lower abdominal areas with only modest fat deposits you will most likely require a full Abdominoplasty/Tummy tuck. If however you have loose skin confined mainly to the lower abdominal area but have retained good skin and muscle tone above the umbilicus with little or no excess fat, then a "mini tuck" may suffice. Alternatively if this is accompanied by modest excess fat in the upper abdomen then liposuction may be used in conjunction with the "mini tuck" to improve the result. It would be fair to say that the term "mini tuck" is actually a misnomer as the scar is about 10 inches long and cannot be deemed very "mini" therefore most surgeons find that the most pleasing results can really only be achieved by performing a full Abdominoplasty/Tummy tuck.

Following surgery, be prepared for considerable swelling and bruising of the abdomen. This will be even more noticeable if the Abdominoplasty/Tummy tuck was accompanied by Liposuction. The bruising usually lasts app 3/4 weeks. While most of the swelling will have dissipated by this time, some subtle swelling will still be present for up to 3 months.

In addition you will notice that the abdomen will feel firm to touch, particularly along the edges of the incision site. This will be as a result of the normal healing process laying down elements of scar tissue to facilitate healing. When this occurs, massage as instructed by your surgeon will speed up the recovery. It gradually resolves in time but may take a few months to complete. You should expect the sensation to the skin over the lower abdomen to be reduced after surgery. This is as a result of surgical trauma to the nerves in the region. Although this usually recovers in a few months, permanent numbness in the region can ensue. Abdominoplasty/Tummy tuck is usually performed under general anaesthesia (completely asleep). You will require a minimum of one overnight stay at the hospital.

When an Abdominoplasty/Tummy tuck is performed by a qualified plastic surgeon the risks are small, nonetheless, specific complications with this procedure can and do occur. Providing one accepts you must not expect to see results immediately and be aware of the recovery period, the results are pleasing. The procedure will give confidence to the individual and allow you to wear clothes that you found were previously unsuitable. The effects are generally long lasting provided you follow a balanced diet and exercise regularly.

Basic Liposuction Information

We've created basic descriptions and explanations of the most popular procedures for you to help you figure it all out - this one's on liposuction...

Liposuction is the removal of localised unwanted lumps and bulges of fat by the use of fine straw like metal tubes, called cannulaes. In women and men, these localised fat deposits may be formed virtually anywhere on the body but are more commonly deposited on the abdomen, hips, flanks, inner and outer thighs, knees and chin. In men a condition called gynaecomastia (fatty breast enlargement) is very common.

The cannulaes are inserted into the body fat through tiny incisions. A vacuum is subsequently applied through a hose attached to the cannula and the fat is drawn out of the body. Liposuction is not an alternative to weight loss and exercise, but rather a means of resculpting the body into a slimmer profile by removing the fat that does not respond despite strenuous diet and exercise efforts.

In the some cases however, patients may have decreased skin elasticity as witnessed by loose, hanging, or crepey skin in the affected area. In these cases liposuction alone will not produce the desired result and you may therefore require some form of skin removal/reduction instead (i.e. tummy tuck) or perhaps in combination with liposuction.

Liposuction is the probably the most popular cosmetic surgery procedure in the UK. It is an effective technique for giving you a new body contour with minimal scarring. In most instances it will improve your body image by making you feel better and more comfortable about your body.

The results can be permanent, providing you eat sensibly, exercise regularly, and maintain your weight. As long as your expectations are realistic and understand that the final results may take from a few weeks to a few months before becoming apparent, you should be happy with your new shape.

Liposuction will not remove the orange peel skin condition known as cellulite.

Friday, 27 July 2007

Basic Eyelift Information

We've created basic descriptions and explanations of the most popular procedures for you to help you figure it all out - this one's on eyelifts...

Blepharoplasty (Eyebag / Eyelift Surgery)

The normal ageing process involves the stretching of the eyelid skin resulting in excess folds and wrinkles, sagging of the fat around the eye itself and appears as bulges in the upper and lower lids. Heredity is often an important factor when young or middle-aged patients exhibit changes that are usually associated with older age. These patients are used to comments from their friends that they constantly look tired, despite having had a good night's rest.

Although Eyelift/Eyebag removal surgery can correct drooping upper lids and puffy bags below your eyes, it cannot remove crow's feet lines, or eradicate all eyelid creases. Any attempt to do so would invariably require excessive tensioning of the skin, which would result in a downward pulled or staring appearance of the eyelid. Nor does it improve or lift sagging eyebrows. Procedures such as laser skin resurfacing (for lines and wrinkles) and the Brow lift (for sagging eyebrows) are designed for these purposes.

A properly performed Blepharoplasty procedure will brighten the face and restore a more youthful appearance. And while it is true that it can add an upper eyelid crease to Asian eyes, it will not erase evidence of your ethnic or racial heritage.

On the upper eyelids the incision is carried out in the natural crease line that occurs approximately 1 cm above the eyelashes. The incisions may extend into the crow's feet or laughter lines at the outer corners of your eyes. Surgery here is designed to correct both the excess skin and the excess fat. After making the incisions, the excess skin and muscle is trimmed from the upper eyelids together with any fat, which is usually present on the area adjacent to the sides of the nose. The incisions are then closed with very fine sutures.

On the lower eyelids, the technique very much depends on the patient's individual circumstance and requirements. Therefore if the problem is mainly prominent lower bags without excessively loose skin, you may have what is termed as a Transconjuctival Blepharoplasty. In this procedure the incision is made inside your lower eyelid, leaving no visible scar. Alternatively, when loose skin needs to be trimmed, the incision starts underneath the eyelashes and extends 1 cm or so outwards into the crow's feet area. The skin is then lifted upwards and outwards, gently tensioning the area and overlapping skin removed.

Eyelid surgery is performed using either local or general anaesthesia depending on the extent of surgery. In the former, the skin around your eyes will be numbed using an injection. This is usually accompanied by some intravenous sedation to make you feel relaxed and insensitive to pain. In the case of a general anaesthetic you will be completely asleep. The type of anaesthetic suitable for you will be discussed at the time of the consultation.

The Eyelift/Eyebag surgery together is normally carried out under a general anaesthetic, but in most single procedures (uppers or lowers) are commonly performed as a sedation day case procedure.

Basic Nosejob Information

We've created basic descriptions and explanations of the most popular procedures for you to help you figure it all out - this one's on nosejobs...


Rhinoplasty is carried out under general anaesthesia and in some cases through incisions inside the nostrils, In the majority of cases there are no external scars, unless you decide to have the size of the nostrils reduced (alar base reduction). In this case small scars around the sides of the nostrils are necessary which are placed in the natural crease lines between the nose and cheek.

In Rhinoplasty, firstly the hump is removed with a delicate chisel cut to give the new profile. If nothing else were to be done the bridge line would be too wide and so it is usually necessary to fracture the nasal bones in a carefully controlled way, to allow them to meet in the midline and narrow the bridge line again. A plaster cast is applied for app seven days to support and protect the bones while they set into their new position. The tip of the nose is shaped by cartilage underneath the skin. These are adjusted in size and shape to refine the nose so that it matches the new profile. When surgery is complete, small dissolvable stitches are used inside the nostrils and the plaster cast and nasal packs are applied.

Nasal packs may be necessary to prevent bleeding and ensure that the lining of the nose adheres correctly. If breathing passages have been operated upon, it may take longer for the nose to clear. This procedure can be done either as a day case or overnight stay in hospital.

It is essential that you understand you must be patient. The nose takes between 6/9 months for the final shape to be fully achieved.

Basic Facelift Information

We've created basic descriptions and explanations of the most popular procedures for you to help you figure it all out - the first is on facelifts...

Facelift (Rhytidoplasty)

The best candidate for a facelift is a man or woman whose face and neck have begun to sag, but whose skin still has some elasticity. There is no need to wait until hanging folds or almost irreversible changes have taken place. While the facelift procedure is probably the most sought after within the over 40's group, increasingly these are being carried out on younger patients. In fact these days, many patients prefer earlier corrections to maintain youthful appearances, and therefore avoid living through a period of looking "old and tired".

The incisions used for both men and women are the same, although there is a slight difference, as result of the hair bearing nature of the male facial skin. Generally speaking the incision starts high in the temple area (hidden by the hair at this point) then courses down in front of the ear round the earlobe and up behind the ear before curving gently back into the hairline of the neck. It may on occasion, be necessary to add an incision in under the chin. A facelift can be performed either with local anaesthesia or a full general anaesthetic. This may also depend on whether you will be having extra work done to the eyes or brow area. Surgery for a facelift can take between 2-3 hours, although this takes longer when combined with additional surgery i.e. eyelid surgery.

Facial Fillers

Restylane and Outline effectively improve the most common initial signs of ageing, between the eyes (Glabbelar) nose to mouth depressions lines (Naso labial) and fine line around the lips. These products do not need allergy tests and the results can be seen immediately. Fillers involves injecting a substance into the skin to correct wrinkle, depressions, and scarring. When injected beneath the skin, fillers plump up the line depressions and fill out sunken areas of the face. They can also add fullness to the lips and cheeks.

Laser Skin Resurfacing

Lasers in medicine have been around for a number of years and have always been synonymous with "state of the art". Through constant development and research, laser technology eventually linked with computer technology, and the skin- resurfacing laser was created. Although many lasers now exist for different purposes, the carbon dioxide laser has emerged as the mainstay of treatment of wrinkles and scarring. It is thus very effective in rejuvenating ageing skin particularly around the mouth and eyes. Often the procedure is done in conjunction with another cosmetic operation such as a facelift or eyelid surgery. Certain skin blemishes, moles and warts can also be addressed with the carbon dioxide laser, It should be noted however that laser resurfacing is basically confined to treatment of the face and its suitability for treatment of the neck, hands and other areas has not been fully established.

It is important to understand that only finer lines can be completely eradicated with this procedure. Deeper wrinkles or smile lines etc. can only be reduced in depth and not removed altogether. In these cases, the improvements are in the order of about 50%. Additionally laser skin resurfacing will not remove dynamic lines where the skin is attached to the muscle, such as the nasolabial (nose to mouth) lines.

Laser resurfacing is a clinically induced burn; the software within the machine allows the surgeon to regulate the depth of penetration to safe levels, in order to allow even delicate areas of the face to be treated. The technique works by passing a beam of laser light of high power but very short duration (seven millionths of a second) onto the skin surface. It is in fact this phenomenal speed, which limits the spread of the generated beat to deeper tissues, thereby limiting any risk of scarring. Patients with darker skin such as those of Asian or Mediterranean background are at a higher risk of colour changes developing after the treatment and therefore will be advised accordingly.

Thursday, 26 July 2007

Our Mission

Surgery Lowdown is here to offer practical and safe advice on all questions and concerns related to cosmetic surgery. Any statistics, medical findings and industry recommendations we hear about will be listed here.

With so many practices offering a number of different cosmetic surgery procedures it's important that you're armed with the right information. As doctors and surgeons ourselves, we know that getting good advice can often be difficult and sometimes costly just for a consultation.

So whether you're considering rhinoplasty, liposuction or laser eye surgery we'll provide regular industry updates recommending the safest procedures and warning about those that are dangerous or risky. Thanks for reading,

Justin Stanton MD MMed(Plast) FRCS(Plast)