Plastic Surgery

Types of Surgery



Face Lifts (Rhytidectomy)


Many people looking for a more youthful appearance will start to seek out procedures that will help improve, lines, wrinkles and sagging skin. While Botox, fillers or laser treatments can improve lines and wrinkles, there is little can be done about sagging skin, sometimes referred to as skin redundancy; It’s at this point people will look at having a Rhytidectomy or what’s commonly known as a facelift.

Several different types of facelifts are available, and your surgeon will advise you which type suits your particular case. Some facelifts will involve tightening of the neck the same time; others may include a brow lift.

 

Mini-Facelift


Mini facelifts are ideal for people who have a mild degree of sagging or jowls; the procedure can help address undesirable signs of ageing before they become too prominent. This less invasive technique permits the surgeon to tighten the deep facial tissues through shorter incisions along the hairline, in the natural creases above and below the surrounding the ear. The mini facelift corrects jowling by lifting and tightening structural tissues around the cheeks; the procedure can also refine the jawline and give a fresher, rejuvenated look.

If you think the mini-facelift may be right for you, speak to a surgeon who will recommend the best option for you. Depending on your individual case, the surgeon may choose to perform the procedure using local anaesthesia with sedation where you will be awake, or general anaesthesia where you will be entirely under. Opting for the mini facelift early-on may postpone the need for more extensive surgery later.

The Recovery period for the mini facelift is less than that of a traditional or full facelift. However, there will still be swelling and possibly bruising; for this reason, people usually take at least a week off work. Every surgeon will have their post-surgical recovery instructions, and some may ask the patient to wear a surgical neck or chin garment to help reduce swelling and allow your skin to adapt to the new face shape. As with most surgical procedures, the improvements will continue for several weeks or months after surgery.

 
 

Mid-facelift


A mid facelift tries to address the problems of sagging cheeks and loose or baggy eyelids. As the cheeks sag, a fold can develop between the nose and the corner of the mouth, referred to as the nasolabial fold, further adding to the ageing appearance. The mid-face procedure lifts the mid-portion of the face, restoring the youthful connection between the lower eyelid and cheek.

On some occasions, mid facelifts are done to correct the lower eyelid from pulling down, sometimes resulting from previous eyelid surgery. The mid-facelift procedure is often done using incisions in the lower eyelid similar to the incisions made in lower eyelid surgery or blepharoplasty. In other instances, incisions are made in the hair of the temple region, and less frequently longer incisions can go from just above each ear within the hairline. The front cheek muscles and tissues are lifted higher along the bone, restoring a more youthful shape face. Depending on the individual case, some surgeons may recommend a combination of mid-facelift and traditional facelift techniques, quite possibly combined with eyelid surgery and or fat grafting.

The recovery period after a mid-facelift will be more extended than that of the mini lift and the total recovery time will vary according to the amount of intervention. As a general rule, you will feel sleepy after coming around from the anaesthesia, and you will require the most pain medication during the first few days. Before leaving the hospital, usually, the following day, you can expect a visit from your surgeon who will evaluate your incisions. You can expect some bruising and significant swelling, which will increase over the coming days, starting to subside around day five. While the bruising will go through the usual colour changes until it’s gone, the swelling will slowly decrease over the following several weeks.

 

During your recovery period, you must attend all your postoperative follow-ups and adhere to the specific advice of your medical team. Sutures are usually removed in the first week or two depending on the extent of the surgery, and the healing process. Rest is particularly important during the first week but provided you are healing well you should be able to some light chores by around day’s four to six.

Going into week two, it’s normal to feel some numbness, tightness or tingling sensations, but by the end of this week, most people are feeling more like themselves and may think about returning to work. It’s essential to be patient during the recovery period and beyond. When the wounds have completely healed, you can start to use silicon gels or strips to allow the scar to lay flat and fade. Even though the swelling and bruising may have subsided, with the improved contours of the face more apparent, the final result will not be seen for several months. Results are expected to last around ten years, depending on the individual ageing process.

 

SMAS and Deep plane facelifts


The SMAS or superficial musculoaponeurotic system facelift gives a natural and long-lasting result, particularly effective in treating sagging of the mid-face, jaw and neck, in some cases the forehead may also be included in the procedure.

The two-part technique of the SMAS facelift incorporates skin tightening along with the underlying structure, allowing the surgeon to customise the result better. The procedure also involves a neck lift, as the SMAS connects to the platysma muscle in the neck. An incision is made behind the hairline at the temple, allowing the surgeon to lift and reposition the SMAS, reducing laxity and permitting tightening of the facial structure.

The Deep plane facelifts are similar to the SMAS lift but rather than using the two-part technique; the surgeon will lift the SMAS and skin at the same time. Although this procedure allows for better blood circulation, it does not have the same flexibility to make tailored adjustments. Since the tightening process happens at a deeper musculature level than with other facelifts, some surgeons will choose this method for patients with deeper jowls or more skin laxity for a more dramatic effect.

The recovery period is similar to that of a mid-facelift but with possibly more bruising and swelling. The surgeon may ask you to wear a facial compression garment, and you may need drains during the first week, the drains help remove a collection of fluid that forms after the surgery. (Please see the postoperative care for mid-facelift as it will be very much the same). Results are expected to last around ten to fifteen years, depending on the individual ageing process.

 
 

Thread facelifts


Thread lifts have been around for quite some time, but they have had a bit of a bad rap in the past, these days the materials used in the dissolvable threads are much improved, allowing for more satisfactory results. The thread lift is a procedure that uses temporary sutures or threads to produce a subtle but evident elevation in the skin. In contrast to the surgical facelifts I’ve mentioned, the surgeon does not remove the patient’s loose facial skin; instead, he or she will suspend it, inserting barbed or cogged threads.

The specific thread technique has the effect of pulling the skin back slightly and therefore lifting and tightening the face. In addition to the lifting, the threads invoke collagen production as a healing response to the procedure. Over time, the threads will dissolve. However, the collagen produced plays an essential role in anti-ageing, and patients will notice a gradual improvement in their skin’s tone and firmness.

While the thread lift may be appealing, not everyone is the right candidate for this minor procedure. It’s essential to have realistic expectations about the outcome and not to expect significant changes. The final result will be a definite improvement, but the procedure is nowhere near the same as a full surgical facelift.
According to Plastic surgery.org, results of a thread lift normally last one to three years.

 
 

Eyelid surgery (Blepharoplasty)



Eyelid surgery, or blepharoplasty, is a surgical procedure to improve the appearance of the upper or lower eyelids or sometimes both. Blepharoplasty can significantly improve eye bags and fatty deposits under the eye. Droopy eyelids can be elevated, and excess skin and wrinkles removed to reveal a more youthful appearance. Although the procedure is often done as a cosmetic procedure, it can also be functional, as loose or sagging skin on the upper eyelid can cause problems with vision.

Surgery can be carried out under intravenous sedation or general anaesthesia; this is something your surgeon will discuss with you. The blepharoplasty procedure is usually performed through external surgical incisions made along the natural creases of the upper and the lower eyelids, which will hide the surgical scars from view, in the case of the lower eyelid the scars are hidden in the lash line. Another method commonly used is to make the incision in the interior surface of the eye (the conjunctiva) this technique is preferred for darker skin patients, avoiding the possibility of a slight white scar visible against a darker skin tone.

Depending on the extent of the surgery, the procedure can take anything from approximately one to three hours. Following the procedure, there will be noticeable swelling and bruising, and the eyes may appear to look strange. Sometimes a special suture is placed inside the skin tissue near the outer corner of the lower eyelid allowing the eyelid’s position to remain fixed during the healing process. The corner suture does not need to be removed as it will dissolve after four to six weeks. It’s essential to realise at this point; the eyes will take a few weeks to look more normal, taking several months to see the final result. Postoperative care usually entails ointment being put into the eyes for a few days; you will be required to keep the area clean, and away from make-up until the wounds have fully healed. Patients can return to work within three to ten days, depending on the extent of the procedure.

 
 

Nose Job (Rhinoplasty)


Rhinoplasty is a surgical procedure that corrects or changes the shape of the nose; the procedure could be functional to correct a deformity or breathing defect, or cosmetic to change the shape or size of the nose. The surgery is often done as an outpatient procedure and is not usually necessary to stay in the hospital overnight. The surgeon may give you the option to be asleep during the procedure under general anaesthesia although, many people are quite comfortable with local anaesthesia and sedation.

The surgery requires incisions within the nostrils and sometimes across the base of the nose. The surgeon will then reshape the inner bone and cartilage to correct any deformity or produce a more pleasing appearance. Open Rhinoplasty is probably the most popular way of performing the procedure because it allows the surgeon full access to the whole nose and provides a well-hidden scar. For minor nose surgeries, your surgeon may opt for closed Rhinoplasty where incisions are made inside the nose. Tiplasty involves altering only the tip of the nose.

Immediately after the surgery, you can expect swelling and bruising; the surgeon often splints the nose to help retain its new shape. It is difficult to see the improvements directly after surgery as the nose is swollen and will remain so for quite a few days. Within a few weeks, you will start to see the outcome. However, the final result will be evident several months later.

 

Brow lift surgery


An ageing forehead can have a profound effect on our facial expressions, making us look angry, tired or worried. A brow lift can correct a sagging brow, eliminate deep creases, and restore a flatter, younger looking contour to the area above the eye.

Brow lifts are often done at the same time as eyelid surgery but in some cases can be done as a stand-alone procedure. Surgeons employ various techniques for lifting the brow depending on a person’s goals and suitability for the operation. Brow lift surgery may be performed under local or general anaesthesia and is often done as day case surgery. There are various types of brow lifts, and your surgeon will decide which is better for your individual needs.

An Endoscopic Brow Lift is minimally invasive with faster recovery time; a small incision is made in the hairline, the surgeon inserts a very tiny camera and fine surgical instruments to lift and reposition the forehead muscles, removing excess fat and skin. Temporal brow lifts require a slightly bigger incision in the hairline and will raise the outer brow area smoothing out frown lines. A full coronal brow lift is not done so often these days, but in some cases, surgeons may still opt for the procedure will require one long incision from ear to ear across the top of the head.

Following surgery, swelling and bruising will be evident, and the wound healing may take around ten to fourteen days. Your surgeon will decide when to remove the sutures or clips used to close the incisions. The surgical incisions must not be subjected to excessive force, swelling, abrasion or motion during the time of healing. When the wounds have completely healed, you can start to use silicon gels or strips to allow the scar to lay flat and fade. Although it may take several months for your complete recovery, most people are ready to return to work and regular activity after the wound healing.

 

Neck lift surgery


Many women find no matter how they look after their skin; the neck will inevitably indicate their real age, once the neck starts to sag there really isn’t much you can do about it in the long term, other than surgery. Short term results of HIFU, RF or temporary thread lifts may not satisfy your desire for a tighter jawline and neck. Neck contouring surgery creates a firmer, smoother appearance to the neck and chin and can dramatically improve wrinkled sagging skin, potentially taking years off your appearance.

There are various techniques used to tighten the neck or improve the jawline. Your surgeon may need to remove excess skin, a procedure referred to as cervicoplasty, more often than not this is accompanied by Platysmaplasty, as a technique that tightens loose neck muscles. Surgeons may perform one or both of these procedures to remove excess sagging skin and tighten loose neck muscles, restoring a more refined and tighter appearance to the neck. A neck lift procedure is typically performed as an outpatient procedure under general anaesthesia or intravenous sedation. Your cosmetic surgeon will make a small incision behind each ear, and depending on your needs may also make a third small incision underneath the chin. Through these incisions, he or she will tighten the neck muscles and underlying tissues and removing the excess sagging skin.

Immediately following the procedure, your surgeon will wrap the neck; this wrap may be changed for one that fits a little tighter. There will be swelling and bruising, and it’s essential to follow your medical team’s postoperative care instructions, including wearing your neck wrap or garment for as long as required. You will be required to sleep with your head elevated until instructed otherwise, and you must avoid twisting your head.

The initial swelling will increase over the first few days and gradually decrease over the coming several weeks and months; final results will be evident after the six-month postoperative period. When the wounds have completely healed, you can start to use silicon gels or strips to allow the scar to lay flat and fade. Results of a neck lift usually last around ten years or more, depending on your health and weight stability.

 
 

Body Surgeries: Breast


There are various reasons for a woman to want breast surgery, but usually, it will be to change the shape of size. Sometimes the breasts can sag, especially after childbirth or with ageing, sagging can also happen with naturally heavy breasts or after weight loss. In some instances, a woman may feel her breasts are too small and would like to increase the size with implants, or is seeking a breast reduction. In addition to these common breast surgeries, other problems such as nipple deformity, the concavity of the chest wall or tuberous breasts can be evident. Men can also have issues, including abnormal breast tissue (gynocomastia).

Before considering breast surgery, it’s essential to be healthy and maintain a stable weight, many surgeons will advise against breast augmentation close to a planned pregnancy. Please inform your surgical team if you have a family history of breast cancer so appropriate screening can take place before surgery.

 

Breast Augmentation


Breast Augmentation is the process of altering the breast size and shape by the insertion of breast implants. These days most surgeons use very safe cohesive gel silicone implants which don’t leak or rupture, although some still opt for saline ( sterile water ), your surgeon will advise what the best option is. Depending on your situation, the surgeon may do a breast lift at the same time.

Following your consultation with your surgical team, and having decided on your procedure and implants, you will be advised on your pre-operative requirements and booked for the surgery. The surgery will be performed under general anaesthesia in the operating room and is usually a day case, however, depending on the extent of the surgery the surgeon may require you stay overnight in the hospital or medical facility. The placement of the implant will depend on your anatomy, and if the surgeon thinks it should come under the pectoral muscle or sub-pectoral. There are various techniques for inserting the implants; sometimes an incision is made around the areola edge or in the armpit, other times an incision is made in the fold under the breast. If the surgeon decides on a breast lift at the same time, the surgery will take longer and be more complicated; you can read more about the breast lift under mastopexy.

Following the procedure, you will wake up with your breasts bandaged or with a pressure garment which must be worn for several weeks after surgery. Aching, swelling and bruising will subside over the coming weeks. You will leave the hospital with medication and postoperative care instructions. Don’t do any lifting or exercise until cleared by your surgical team. You will need to sleep on your back during the recovery period and change your dressings regularly making sure your incisions are kept clean and dry, sutures will be removed when during one of your postoperative checkups and you will be advised on when you should start applying silicone scar healing gel.
Although it can take several months to see the final result, most people are happy to go back to work after about a week, some sooner.

 
 

Mastopexy procedure (breast lift)


Mastopexy is a procedure that lifts and firms a woman’s breasts to create a more youthful and aesthetically pleasing appearance. During the process, redundant or sagging skin is removed, and the surrounding tissue is tightened to support the new uplifted and contoured breast. In some instances, the areola surrounding the nipple is resized or repositioned at the same time

When done as an independent surgery, mastopexy does not increase the size of the breast; however, the new shape can create a better profile. To add the volume, you can opt for breast implants (breast augmentation as above). In some cases, a patient may opt for breast reduction with an uplift. The postoperative care and recovery is more or less the same as breast augmentation (As above)

Fat transfer breast augmentation


Some women prefer to use their own fat to increase their breast size, but the procedure may not be suitable for everyone. To achieve the fullness required to the breast, the patient needs a significant amount of fat which will be taken from other parts of the body by liposuction. Very slim women may not have enough fat to harvest.

According to the American Society of Plastic Surgeons, (2011), new pre-expansion techniques in fat transfer breast augmentation can achieve volumes of up to 300cc. The pre-expansion process requires the patient to wear a device not dissimilar to a bra for several weeks before surgery. The device creates negative pressure to expand the breast, creating a space in the breast that is later backfilled with the harvested fat.

 
 

All surgeons may not use the pre-expansion technique, and you will need to ask the professional advice of your chosen surgeon to ascertain your suitability for breast fat grafting. In the event, a patient undergoes this procedure the results are permanent, providing you maintain your weight. As with all fat cells in the body, if you lose weight, the fat cells shrink in size, and if you gain weight, they expand. In some instances, a patient may need a second procedure to increase the size further. Surgery is usually done under general anaesthesia due to the liposuction procedure, although some surgeons may offer local anaesthesia with sedation depending on the volume of fat being removed.

The recovery time for the procedure depends on the extent of the initial liposuction, the amount of fat inserted into the breast and individual healing ability. There will most certainly be swelling and some bruising for the first week or two, and the breasts may feel a little heavy or achy this is perfectly normal. Your surgeon may ask you to wear a sports bra day and night for the first three months, supporting the newly shaped breasts and helping to control swelling. As with other types of surgery, you should avoid any exercise or strenuous activity until given the go-ahead by your surgical team. Most people will go back to work within the first few weeks of surgery. Final results can be seen after a few months when all the swelling has subsided.

 

Liposuction


Liposuction is a surgical procedure to remove stubborn and unwanted fat from the body. Many people are unhappy about lumps, bumps and bulges of fat that may not go as a result of diet and exercise alone. Liposuction can help contour and improve the shape of your abdomen, hips, thighs, buttocks, back, arms and other areas of your body, including the face and under the chin areas. The fat removal procedure can also accompany other surgical procedures at the same time, especially Abdominoplasty (tummy tucks).

If you are considering liposuction you must be in good health; most surgeons will not operate unless you are within 30% of your ideal body weight, and you should not smoke or have any underlying health problems. Unless you have firm elastic skin, you are likely to have sagging after so this must be taken into consideration; also, it is essential to know that liposuction will not improve cellulite. Liposuction can be done as a day case but while small areas can be done under local anaesthesia, larger areas which take more time are usually done under general. There are various types of liposuction techniques and machines; however, they all have one thing in common, and that’s the cannula or instrument used to suck out the fat.

Liposuction is done through small, discreet incisions placed strategically throughout the areas being treated. Diluted anaesthesia is then placed in the areas that require treatment; next, a long thin hollow instrument or cannula is inserted through the incisions to loosen and break down the fat. The cannula is attached to a surgical vacuum machine which will now aspirate or suck out broken down fat. On some occasions where only a small amount of fat is removed, such as that required for minor fat transfer, a smaller cannula may be attached to a syringe and manually aspirated (sucked out).

 
 

Depending on the area treated the whole procedure can take from half to two or three hours. Once the process is done, the doctor may fit drains ( small plastic tubes with a fluid collection vessel) the drains help remove the remaining fluid left in the body. Surgical drains are removed after a few days, and the incision closed with sutures. Some surgeons do not use drains, but merely leave the small incisions open and bandage the area, in this case, the liquid will drain naturally and be absorbed by your dressings.

After the surgery, you will be considerably bruised and swollen, bruising will fade during the coming weeks, but swelling may continue for several weeks, the more fat removed, the longer this will go on. You will be required to wear a compression garment 24 hours a day for several weeks; you will only remove the garment to shower or change to a clean one. It’s always advisable to have two garments, so one is always clean to change into. The pressure garment is an essential element to the final result and must not be neglected. Moreover, the garment keeps the swelling down and helps manage any pain.

Although you may feel sore for a few days after liposuction, so should be able to move around freely and return to work within a week, for minimal areas people often return to work in a day or two. You can take pain medication if and when you need it, but after three of four days, many patients report no significant discomfort. A week or two after the procedure, you may be instructed to have a course of manual lymphatic drainage followed by endomology or LPG to reduce fluid and help smooth out any irregularities. Providing you maintain your weight, the fat will not return. However, if you do gain a significant amount of weight, you may notice the fat accumulating more on non lipo-suctioned areas. Some patients will combine liposuction with fat transfer to other areas of the body.

 

Fat transfer


Surgical fat transfer sometimes referred to as a fat graft or lipo sculpting, is a cosmetic surgery procedure that moves fat from one part of the body to another. Fat can augment many other areas of the body such as the breasts, buttocks, face or hands; it can also be used to smooth out depressions or irregularities in the body shape. Since the procedure requires liposuction to remove the fat first, some liposuction patients take advantage of having their fat available for further cosmetic enhancements.

The fat grafting procedure is a three-step process. Step one is the liposuction (See liposuction above) the second step is the preparation of the fat, which involves separating the fat cells from collected blood and other fluids. The third step is injecting the fat back into the required site of the body.

After the procedure, you can expect to been bruised and swollen; the recovery period will depend on the extent of the surgery and the initial liposuction procedure. It’s not uncommon for patients to lose some of the fat that they have had relocated as some of the fat cells may not take, and further treatment may be necessary. To compensate for some volume loss, surgeons often overfill the area, so it’s essential to wait to see the final results some weeks or even months later.

 
 

Brazillian butt lift (BBL)


The Brazilian butt lift with fat transfer (see above) has become popular in the last few years, but it is not without its risks. According to NHS Choices, (2020), the procedure carries significant risks and should not be taken lightly.

Many patients want to enhance the size or shape of their buttocks and use their own fat to create volume, the technique used is the same as regular fat transfer to other parts of the body; however, the aftercare is far more complicated. Patients must be committed to carefully follow their surgeon’s instructions and not sit directly on their butt for several weeks following surgery.

The recovery period after surgery is similar to liposuction, with some modifications to your sitting and sleeping positions. Most people will resume light duties and return to work after about two weeks by which time your surgeon may allow you to sit on a doughnut ring to take the pressure of your butt; special ergonomic kneeling stools can be used shift the weight of your behind.

 
 

Abdominoplasty (tummy tuck )


A tummy tuck is a surgical procedure that can tighten and reshape the abdomen. Having a firmer and flatter midsection can achieve a more streamlined slimmer appearance. People often feel more comfortable in the way their clothes fit, providing them with newfound confidence.

The tummy tuck is one of the most popular surgeries for women after pregnancy. Many women struggle with getting their flat belly back after pregnancy despite diet and exercise. Sometimes the muscles that hold the stomach in are stretched beyond natural return (Diastasis recti). In the case of Diastasis recti, surgical intervention is required to suture the muscles back together in the midline. During the procedure, the abdominal muscles are not only tightened but excess or sagging skin can be eliminated.

Aside from post-pregnancy, other reasons why men and women want abdominoplasty is to remove fat and excess skin or just to remove excess skin after weight loss—whatever the reason, a tummy tuck can make a significant change to the appearance. There are various types of tummy tucks, including mini, standard, extended and sometimes the Fleur-de-lis tummy tuck. Your surgeon will explain which technique best suits your condition.

 
 

Mini tummy tuck


The mini tummy tuck, although sometimes less invasive, is not a suitable choice for most patients. The less extensive surgery mainly focuses on the lower abdomen below the belly button and is designed for a patient with limited skin laxity. The procedure can also incorporate liposuction and muscle tightening where required. It is possible to remove small amounts of skin above the belly button with a procedure that repositions the belly button to a slightly lower place. The mini tummy tuck may suit someone who has a small pooch or protrusion of the lower abdomen.

The surgical procedure will usually be done under general anaesthesia or in some cases local and sedation, depending on the doctor and patient preference. The surgery takes between one and three hours, done as a day case or with an overnight stay in hospital. Advantages of a mini tummy tuck over standard or extended tucks include a shorter scar, flatter tummy and a faster recovery time.

The recovery from a mini tummy tuck is about 10 to 14 days. The first 48 to 72 hours you will probably be a bit sore, bruised and swollen. Wearing your compression garment as instructed will help reduce swelling and discomfort and must not be removed except to shower, follow your surgeon’s advice on how long you must wear it. You will need to get plenty of rest, eat healthily and refrain from any exercise and strenuous activity for at least six weeks. You must be vigilant in keeping your incision sites clean and dry and attend all your postoperative follow-ups Most people will return to after about two weeks with limited activities. Results from abdominoplasty can be maintained as long as the patient keeps their weight stable.

 
 

Standard or Full tummy tucks


Whereas the mini tummy tuck can treat the lower abdomen or below the belly button, patients with loose skin above and below, or those needing extensive muscle repair are more suited to a full tummy tuck. The main difference between the full and the mini tuck is the length and location of the incision and the extent of intervention needed. The procedure is done under full general anaesthesia where the surgeon will tighten the abdominal muscles, and remove excess fat and redundant skin.

During surgery, the surgeon will make a horizontal incision between the hip bones and around the belly button which will be repositioned once the new shape is achieved. Quite often the muscles need extensive repair, meaning they will be sutured back together in the midline, the skin is then pulled down tightly over the muscle, removing the excess before reattaching the belly button.

The recovery period for the full tummy tuck is about two weeks. During this time, the patient needs to take extra care not to lift anything remotely heavy or participate in any strenuous activities. Swelling and bruising will be apparent for quite a few weeks before you see the final result of the procedure. The postoperative care includes that of the mini-tummy tuck (see above) with some additional precautions advised by your surgical team.

 
 

The extended tummy tuck


Beyond the mini and extended tummy tucks is the extended tuck which also addresses the hips and sides of the lower back, this is often the preferred tummy tuck post-delivery as part of a mommy makeover or after extensive weight loss.

The procedure is done under general anaesthesia where the surgeon will make an extended incision along the entire length of the abdomen extending around to the back of the hips. Once the muscle is exposed, it will be brought together in the midline and sutured to tighten it. Excess fat and skin is removed, and the belly button repositioned.

Due to the nature of the more extensive surgery, recovery is generally a little longer than that of the standard tummy tuck. Although you may be able to return home shortly after surgery, you will need help, especially in the first few days. Bruising and swelling may take longer to subside, and you may feel quite uncomfortable in the early days, wearing your pressure garment or surgical corset will most certainly help. Providing you are feeling well enough you should be able to return to work within two weeks, with limited activities.

The Fleur-De-Lis tummy tuck


Massive weight loss can be achieved through dieting and lifestyle change, but some people undergo bariatric surgery to lose weight. In this procedure, the stomach is significantly reduced, limiting the ability to overeat. Bariatric surgery entails having a gastric band, gastric balloon or gastric sleeve, which makes the capacity for food minimal; as a result, people who were previously obese often lose massive amounts of weight. The weight loss leaves extremely redundant abdominal skin, which cannot be entirely removed by traditional tummy tucks.

In the Fleur-de-lis tummy tuck, two incisions are made, one horizontal and the other vertical. The extra incision allows the surgeon to tighten the skin from the sides as well top to bottom. As with the standard tummy tuck excess fat and skin is removed and the muscle repaired, drastically improving the look of the abdomen. Recovery for this procedure is more or less the same as for the extended tummy tuck(above).

 

Thigh lift surgery


Thighs are a problematic area to trim down, even after weight loss and exercise many women are not satisfied with their legs. While liposuction can reduce the fat and the size, unfortunately, it doesn’t help with loose skin, this is where the thigh lift comes in.

There are many techniques to perform a thigh lift; your surgeon will discuss your goals with you and decide on the best solution for your particular thigh lift procedure.

The mini thigh lift


A mini thigh lift is most suitable to treat sagging in the upper part of the inner thigh. The procedure can be done with liposuction to remove minimal amounts of fat before pulling up and removing the excess skin. The incision is made in the natural crease of the groin area, helping reduce visible scars. The procedure can be done under local anaesthesia with sedation or under full general and usually takes less than a couple of hours. Recovery after a mini thigh lift is not very long; many patients can return to work within a few days and start light exercise within two weeks.

Medial thigh lift


A medial thigh lift is performed on the inner part of the upper thigh. Similar, but more extensive than the mini thigh lift, the procedure requires a longer incision in the groin starting at the top of the pubic area, close to the hip bone. After the incision is made,fat and excess skin are removed and the thigh lifted by suturing it higher and tighter in the natural crease of the groin. This procedure can be done with or without liposuction. Next to the mini thigh lift, it has the least amount of visible scarring, while achieving a significant difference in appearance.

 
 

Vertical thigh lift


For people who have all around large thighs or excessive skin, the vertical thigh lift offers the best solution. The procedure not only treats the inner thigh, but the lower and middle areas of the thigh are addressed at the same time providing the best solution for predominantly large thighs.

Because the surgery is quite extensive, a more invasive incision has to be made going from the top of the inside thigh down to the knee (Crescent lift). While the scars from the vertical thigh lift will fade over time, they will always appear when the inner thighs are exposed; for that reason, the vertical thigh lift is only recommended for people who need to remove large amounts of excess fat or skin.

Posterior Thigh Lift


For people who have large amounts of dimpled skin or cellulite and saggy skin on the buttocks and the back of thighs, the posterior thigh lift is recommended. The technique and incision for a posterior thigh lift will vary according to each individual case.

 
 

Spiral Thigh/360 Lift


Popular with patients achieving massive weight loss or wanting a complete lower body transformation, the spiral thigh lift is the most invasive, but most dramatically changing procedure for thighs, buttock and waist. This 360 lift targets the entire thigh from every angle, slimming, shaping and tightening the upper legs and improving the contours of the waist and butt.

Although this procedure delivers dramatic results the surgical procedure is lengthy and requires longer more apparent incisions. Following liposuction in most cases, long incisions are made from groin to the inner knees, and from the groin to the hip bones, stretching around the waist to the incision from 36 the opposite leg at the top of the buttock area. Significant tissue is removed during the procedure giving the body a much smaller, tighter and shapelier appearance.

The recovery period is longer than other thigh lifts due to the extent of the surgery. Due to some common post op complications of the 360 lift, patients will usually need to stay in hospital for a few days. Drains will collect fluid from the surgery sites and the patient will need to be exceptionally careful as to not break the sutures, which can sometimes happen after such extensive surgery. You will leave the hospital with your mediation and instructions on how to aid your recovery.

The recovery period is longer than other thigh lifts due to the extent of the surgery. Due to some common post op complications of the 360 lift, patients will usually need to stay in hospital for a few days. Drains will collect fluid from the surgery sites and the patient will need to be exceptionally careful as to not break the sutures, which can sometimes happen after such extensive surgery. You will leave the hospital with your mediation and instructions on how to aid your recovery.

 

Arm Lift: Brachioplasty


If you have those dreaded “bat wings” that most women hate you will definitely be interested to know about brachioplasty or an arm lift. Even thin women may suffer from saggy upper arms as they get older, and the skin loses its elasticity. Spot fat reduction is very difficult and quite often weight loss and exercise will not give a person the trim arms they are aiming for. On the other hand people who have achieved massive weight loss are often left with significant amounts of redundant or hanging skin which can only be removed by surgery.

Depending on the individual case, the surgeon will decide where and how to make the incision. Some people only require a minimal incision lift where the surgeon will the incisions in the inner, upper arm joins and armpit, this procedure is only suitable for those who have only a small amount of extra skin near the underarm. However, for people who have a lot of fat, and or redundant skin a more invasive technique will be used. The surgeon will make the incisions in the inside of the arms from the armpit to the elbow. Liposuction may be used to remove excess fat and then the redundant skin is trimmed and tightened before being closed with absorbable sutures or stitches.

You will be prescribed some mild pain killers and you can keep your arms elevated with pillows while you are laying down. You must attend al your post- op follows ups to check your wounds and change the dressings. It’s very likely the sutures will be dissolvable, but if not they will be removed about a week after surgery.

Most people can return to work approximately one to two weeks after surgery, but must refrain from lifting and strenuous exercise for at least six weeks. Final results of an arm lift can be seen after a few months. Patients are advised to use silicon scar healing products once the wounds are completely healed.

 

Non-surgical treatments


These are usually advanced aesthetic procedures you will find at your Doctor’s office, Dermatology clinics and plastic surgery centres. I’ve listed some of the most popular treatments at the time of production of this e-book.

Skin tightening by Machines


There have been several machines over the past decade or so all offering skin tightening by inducing heat which creates collagen remodeling, lifting and tightening the skin. The technology includes Lasers, radiofrequency; high intensity focused ultrasound or a mixture of technologies and techniques.

HIFU – RF Micro-Needling


This amazing technology can be used to treat scars on the body, reduce pore size, treat fine lines and wrinkles and tighten the skin. A combination of HIFU and micro-needling gives spectacular results every time. An average of three treatments is required throughout a nine-month period.