A-Z SURGICAL PROCEDURE GUIDE
(Smoothing Fine Lines)
Double Chins, Jowels, Weak Chins
Upper Eyelid Bags / Blepharoplasty
Lower Eyelid Bags / Shadows & Hollows
Turkey - Gobbler Neck Deformities
Thin Lips - Lip
Facial Spider Veins / Thread Veins / Liver Spots / Birth Marks
Breast Enlargment / Augmentation / Implants
Breast Reduction (Female)
Breast Reduction (Male)
Facial Spider Veins / Thread Veins / Liver Spots / Birth Marks / Freckles
Massive Weight Loss
Chest (Pec) Implants
three components for reconstruction are:
1) Skin envelope.
2) Breast mound.
to be reconstructed after:
i) Removal for disease.(cancer)
ii) Failure to develop.
iii) Unequal development
during adolescence resulting in asymmetry.
Reconstruction of a breast may require multiple, staged procedures.
a) Additional skin iscreated by stretching (expansion)of the existing skin or
b) Transfer of
skin from another area of the body to the chest.
2) Breast Mound:
a) A breast mound is created by
insertion of a breast implant or:
b) By transfer of tissue from another area of the body.
3) Nipple Reconstruction:
Reconstruction of a nipple areolar complex may require multiple, staged
Medical Insurance would
usually cover the costs of breast reconstructive surgery.
BREAST ENLARGEMENT/ AUGMENTATAION/ IMPLANTS
implants are inserted to:
i) Enlarge small breasts.(augmentation)
ii) Lift sagging breasts.(ptosis correction/mastopexy)
iii) Refill breast skin envelopes. - Weight loss/ breast feeding/ pregnancy and aging often results in loss of breast tissue.
iv) Reconstruct absent breasts.(breast reconstruction)
v) Correct unequal sized breasts.(symmetry correction)
Breast implants are one of the most commonly performed Plastic Surgery operations. Breast implants have a low complication
rate and very high patient satisfaction rate.
BREAST REDUCTION: (FEMALE)
Woman with large breasts
often complain of backache and related problems. They often get rashes under their breasts in summer, difficulty in buying
"off the peg" clothes, will not participate in sport and can be socially withdrawn.
Breast reduction is an
operation, which removes skin and breast tissue or occasionally breast tissue only.
Young women with good skin
tone and moderately enlarged breasts can be reduced by liposuction.
Very large, glandular (non- fatty) breasts or
breasts that have excess skin are reduced by an excisional surgical procedure.
The choice of the surgical procedure
will depend on the patient's particular problem.
Breast reduction surgery usually results in significant scars.
Woman that have undergone breast reduction surgery are usually very accepting of these scars, as they are happy to have been
relieved of their "load".
BREAST REDUCTION: (MALE)
All men have some breast tissue.
Breast development occurs in most teenage boys, but usually regresses. Breast tissue in men is embarrassing and is corrected
by liposuction or excisional surgery with pleasing results.
Medical Insurance would usually cover the cost of male
Ptosis correction or mastopexy is the correction of drooping breasts
The causes of breast ptosis are: age, reduced female hormones, gravity, weight loss, pregnancy and breast-feeding.
Their combined effect is stretching of the skin and loss of breast tissue.
The method of treatment of ptosis is
determined by the underlying problem and the patient's expectations.
Treatment may involve:
tightening - excision of skin.
ii) Skin tightening and removal of breast tissue - excision of skin and breast tissue.
iii) Replacement of lost breast tissue via an implant - augmentation.
iv) Replacement of lost breast tissue via an
implant plus tightening of the skin - excision of skin plus augmentation.
is a major surgical procedure that takes two-three hours. A face-lift tightens the skin of the face and neck and mainly removes
deep, heavy lines. The excess facial and neck skin is excised and discarded.
Modern face-lifts often involve adjustment
of the deeper foundation layers of the facial structures.
Tightening the deeper layers of the facial structure allows
a better face-lift with less tension on the skin. (SMAS face-lift)
Patients seeking facial rejuvenation surgery
that are over 55 years of age derive the maximum improvement from a face-lift procedure.
Patients less than 50 years
of age benefit more from other Facial Rejuvenation procedures, the facelift being a complimentary procedure. The heavy lines
that a face-lift improves have resulted from many years of gravity and the action of the muscles of facial expression. Aging
also causes a reduction in the layer of fat beneath the skin. This sagging and thinning takes years to develop and is not
fully established under the age of 50.
SKIN RESURFACING (smoothing fine lines)
is a procedure that causes shrinkage and tightening of the skin envelope of the face. The imporvement is most noticable on
the fine (crepe) lines of the eyelids and the lipstick bleed-lines of the lips. After a skin resurfacing procedure the skin
is tighter, has a more uniform colour (pigmentary blothchyness is improved) and the skin texture is softened.
of skin resurfacing are:
1) Laser resurfacing.
2) Chemical peels.
Exposure to sunlight,
wind, smoking and aging all contribute to fine wrinkling of the facial skin.
Acne scarring is also treated by skin
resurfacing procedures. Medical insurance may pay for treatment of acne scarring.
persistent surly look can result from the deep furrows between the eyebrows in people with active muscles of facial expression.
are many methods of treating frown lines. Temporary paralysis of the muscles of facial expression results from Botox injections.
Botox needs to be repeated every 4 months.
A method of obtaining a permanent improvement of frown lines is achieved
by serial (2-4) fat injections. Fat is removed from an area of excess (eg.tummy) and injected into the hollow of the frown.
The fat injections often have to be repeated until the grooves are filled up.
DOUBLE CHINS;JOWELS;WEAK CHINS
2) People of normal weight who carry excess fat in their necks.
3) Under development of the
4) Age and gravity - gravity causes a continual sagging and descent of facial fat.
People of normal weight
can develop jowels and fat deposits under their chin as a result of the slow settling of facial fat into the areas of dependency
under the chin - gravity and time.
Treatment depends on the underlying problem:
1) Liposuction of this area
is an excellent way of restoring the angle between the chin and the neck. Jowels can be removed at the same time.
The projection of the chin can be increased by placement of a chin implant.
Restoring the angle between the chin
and neck with liposuction and occasionally also a chin implant, is a very satisfactory method of restoring a strong chin,
good bone structure and facial profile.
UPPER EYELID BAGS / BLEPHAROPLASTY
People develop upper
eyelid bags due to age, gravity and especially the overactivity of the facial muscles caused by the glare of bright light.
The excess upper eyelid skin can overhang the eyelashes and reduce the person's ability to see.
Treatment is by
surgical removal of excess skin and underlying tissues. The remaining skin with its fine crepe-like wrinkles can be tightened
via laser resurfacing as a secondary procedure.
Acne scarring results from nodular
cystic acne. Different types of scars can result.
Treatment of acne scarring depends on the type of scarring.
of acne scarring might entail:
1) Skin resurfacing with laser.
2) Skin resurfacing with dermabrasion.
Medical insurance may pay for treatment of acne scarring.
EYELID BAGS / SHADOWS AND HOLLOWS
The tear-trough is the hollow shadow below the "bag" of the lower eyelid.
The above are caused by:
1) Many people have abnormal fat deposits in their lower eyelids. These "bags"
are often noticed from childhood.
2) Cheek fat descends with time due to gravity. The fat just below the eyelids is contained
in a pocket and does not descend with the cheek fat. This results in a hollow below the lower eyelid. Many people request
removal of the "bag" below the lower eyelid. The problem is not the bag but the descent of the cheek fat and the
resultant shadow caused by the hollow that has formed. Removing the bag of the lower eyelid may result in gauntness in time.
3) Bags around the eyes can result in excess skin. This is often as a result of an outdoor lifestyle associated with overactivity
of facial muscles, occupational - welders etc.
Treatment of the above depends on the underlying problem:
People with eyelid bags from an early age - removal of the abnormal fat deposit.
2) Shadows below the eyes as a result
of the descent of facial fat and thinning of cheek fat - treatment by lifting cheek fat and / or injecting fat into the hollows.
3) Excess skin and tissues around the eyes - surgical excision.
4) Laser resurfacing is often needed later to improve
the fine crepe-like texture of the remaining eyelid skin.
EYEBROW LIFT / BROWLIFT
The forehead skin
and eyebrows descend with time due to the action of gravity and the muscles of facial expression, resulting in a sombre "hang-dog"
A brow lift is a surgical procedure that elevates the level of the eyebrow. The surgical technique employed to
elevate the eyebrow is determined by the underlying problem.
TURKEY-GOBBLER NECK DEFORMITY
describes the deformity of the neck resulting from excess skin.
A turkey-gobbler neck deformity usually occurs in thin
people or after weight loss.
Treatment is by surgical excision.
Different techniques are employed to
correct the problem.
THIN LIPS- LIP AUGMENTATION
Thin lips can be "plumped out" by injections.
There are various injectable preparations available. Permanent augmentation of the lips is obtained with fat injections. Usually
about three fat injections sessions are required to obtain lip fullness.
Fat is removed from an area of excess (eg.tummy)
and injected in thin columns, thereby increasing the volume of the lip in a serial fashion.
VEINS/ THREAD VEINS/ LIVER SPOTS/ BIRTH MARKS/ FRECKLES
The cause of spider veins on the face is not known. There is
an association between:
1) Exposure to the elements.(sunlight and wind)
A vascular laser is a very effective treatment of all of the above in people with a fair
The projection and contour of the chin can be improved by placement of
a chin implant.
A "strong chin" is associated with masculinity and good looks in men.
hide their weak chin behind a beard.
Facial beauty - the chin in women enhances a good bone structure.
often believe that their facial proportions would be improved by surgery to reduce the size of the nose. Their problem is
often one of underdevelopment of the chin. Placement of a chin implant restores normal facial proportions.
CORRECTION / OTOPLASTY
Ears need operative correction when:
1) Too prominent.
2) Abnormally shaped.
of ear abnormalities can be done at any age, but is usually done before a child begins school.
will often pay for ear corrective surgery in children.
A Rhinoplasty is a
procedure performed to change the shape of the nose.
A Rhinoplasty is often necessary following trauma, to straighten
the nose or to correct breathing problems.
A nose can be corrected by:
4) Changing the profile or hump.
5) Altering the shape of the tip.
6) Altering the shape of
A Rhinoplasty is a major surgical procedure that can take up to three hours. Patients are required
to wear a plaster cast on the nose for approximately ten days.
Following nose corrective surgery the final result
will not be apparent for up to one year.
Medical insurance may pay for nose reconstruction following trauma or if
there are concomitant nasal airway problems.
Hair growth can be restored to areas
of the scalp following loss due to balding and injuries.
Small groups of hairs with their roots are transplanted
from an area of the scalp, where there is good hair growth and where balding will not occur to the areas of hair loss.
newly transplanted hair takes a few months before it starts growing. Hair transplantation is done in multiple stages. The
size of the bald area and the thickness of the hair will determine the number of stages.
Contracture is a condition affecting the hands of mainly people of European origin.
The process affects the palms
of the hands and results in contraction of the skin of the hand that results in permanent "curling up" of the fingers.
little and ring fingers are the most commonly affected fingers.
Correction of the deformity involves excising the
affected tissue in the palm of the hands.
Medical insurance would usually pay for correction of Dupuytrens Contracture.
Abdominoplasty removes excess skin and tissue of the lower abdomen.
Abdominoplasty is performed
1) Excess stretched lower abdominal skin following massive weight loss or childbirth.
2) Lower abdominal excess
following separation of the abdominal muscles.
3) Removal of stretch marks and scars of the abdomen.
of excessive skin of the abdomen caused by hernias.
Abdominoplasty is a major surgical procedure that takes two
hours. One or two nights hospitalization is required.
Abdominoplasty is a very effective method of correcting the
lower abdominal excess that dieting, weight loss and exercise will not correct.
Liposuction or Liposculpture is the removal of fat through a small (3-5mm) incision.
Liposuction is most effective
in removing diet-resistant fatty deposits in people with good skin tone.
Liposuction is not a treatment for excess
fat / obesity.
The following areas are successfully re-contoured with liposuction:
1) Love handles on hips.
2) Jodhpurs on thighs.
3) Fat pads above knees.
4) Double chins and facial jowels.
5) Fatty breast tissue
under the armpits.
Absent or under-developed calf muscles are enlarged by placement of
Under-developed or unequal cheekbones are enhanced with placement
of cheek implants.
MASSIVE WEIGHT LOSS
The skin is often over-stretched as a result of gross obesity.
Massive weight loss reults in redundant skin.
Various surgical procedures remove redundant skin:
1) Arm reduction.
2) Abdomen reduction.
3) Thigh reduction.
4) Breast skin reduction.
CHEST (PEC) IMPLANTS
One side of the chest may be underdeveloped due to the absence or underdevelopment of the pectoralis muscle from birth.
can be obtained by placement of a pectoral implant. Bilateral underdevelopment of the pectoral muscles can occur - this is
corrected by placement of bilateral pectoral implants.
tags are harmless growths of the skin. Skin tags are easily removed with minimal scarring. Indications for removal:
Snag on clothing and jewelry.
3) Irritated by friction.
4) Cut while shaving.
Birthmarks can often be successfully treated with modern laser. Successful
treatment depends on:
3) Colour of birthmark.
5) Colour of skin.
Moles are a normal part
of the skin. Moles can occasionally change and become cancerous.
Reasons for removal of moles:
2) Snag on clothing and jewelry.
3) Cut while shaving.
4) Analysis for cancer.
are unsightly growths on the skin caused by a virus. There are many treatments to remove warts. The treatment of warts is
associated with a high rate of recurrence. The treatment of warts with a vascular laser reduces the rate of recurrence. Warts
on the soles of feet are called plantar warts. Plantar warts are associated with an especially high rate of recurrence. The
recurrence rate of plantar warts is significantly reduced if the defect on the sole of the foot, following removal, is surgically
reconstructed and not merely left to heal.
Sunspots are rough patches on
the skin often red or white in colour. Sunspots are caused by accumulated ultraviolet light exposure.
various treatments for sunspots.
Scars are more noticeable if they
2) Differ in colour from the surrounding skin.
3) Unyielding and raised.
4) Not in
the same direction as natural skin creases.
Large ugly scars can result following burns and deep abrasive injuries.
correction usually involves multiple surgical procedures.
The skin can be left with
ugly impregnation tattoos following abrasive injuries. Most tattoos are acquired voluntarily!
The removal of tattoos
4) Colour of tattoo.
5) Colour of skin.
are various techniques for removing tattoos, including surgery and laser.
are cancerous growths of the skin associated with exposure to ultraviolet light.
Rodent ulcers need to be surgically
Medical insurance would usually pay for treatment of rodent ulcers.
loss of a uniform skin colour is due to aging and sunlight.
Fine wrinkles, texture and colour variations are improved
by a resurfacing procedure.