COSMETIC SURGERY ENHANCES AN ASPECT OF APPEARANCE OR REVERSES THE SIGNS OF AGEING CAUSED BY LOSS OF ELASTICITY IN THE SKIN.

People  request cosmetic surgery for a variety of personal reasons. Broadly speaking it is usually to enhance an aspect of their appearance that they have disliked for a number of years or to reverse the signs of ageing caused by loss of elasticity in the skin. Recently it has also become common for people to request surgery to remove skin from the tummy, breasts, thighs and arms, after rapid weight loss.

 

The techniques available include non-operative solutions for the face, such as BOTOX injections, injectable fillers and chemical peels/lasers. A range of operative solutions are also available for longer lasting results, including facial procedures and other body reshaping procedures.

 

Information on each of the available procedures can be found below. More detailed information is also made available during the initial consultation.

PROCEDURES

 

  • ABDOMINOPLASTY – TUMMY TUCK

    Pregnancy and rapid weight gain can cause the skin of the abdomen to become stretched and loose. In pregnant women the muscles of the abdomen can also be separated permanently in the midline (rectus divarification) this muscle separation interferes with your core strength and stability. All patients report improved posture and core strength following muscle reconstruction.

     

    Abdominoplasty (tummy tuck) involves the removal of excess skin and fat from the lower abdomen, with a hip to hip scar hidden in the 'knicker line'. This results in a slimmer waistline and an improved body contour. Tightening or repair of the abdominal wall muscles may also be performed at the same time, to enhance the abdominal contour and improve core stability.

     

    This technique often involves additional liposuction of the flank hip and abdominal wall to achieve optimum results. This surgery can be particularly risky for smokers who are instructed to give up before commencing surgery.

     

    My anaesthetist uses a local spinal anaesthetic block to improve post operative pain control.

    PROCEDURE STATS

    GENERAL ANAESTHETIC

    and Abdominal Block

     

    2-3 NIGHTS STAY

     

    RECOVERY 4-6 WEEKS

    muscle repair 6-8 weeks

     

    CORSET 6 WEEKS

  • BLEPHROPLASTY – EYE LIFT

    With advancing age the skin gradually loses elasticity. This is particularly noticeable in the delicate skin around the eye, producing excess skin, wrinkling and puffiness. In addition, large fat pads that lie beneath this skin can begin to protrude forward through the weakened muscles, creating 'eye-bags' and giving the eyes a tired appearance. In the upper eyelid, excess skin produces a hooded effect, which may partially obscure vision.

     

    I use a variety of techniques depending on the specific problem to be addressed, but most commonly a combination of skin tightening procedures together with a reshaping of the fatty eye bag. This safely produces a more alert, brighter and younger look, with scars easily hidden in the national creases of the eyelids. Eye drops are given for a few weeks to prevent dry eyes.

     

    Smokers are urged to quit for 6 weeks before surgery. Aspirin should be avoided 2 weeks before surgery.

    PROCEDURE STATS

    GENERAL ANAESTHETIC

     

    1 NIGHT STAY

     

    RECOVERY 1-2 WEEKS

  • BREAST AUGMENTATION – BREAST ENLARGEMENT

    A breast augmentation is a surgical procedure that enlarges the breasts by the insertion of a silicone implant underneath either the breast or muscle (in thinner women).

     

    Women undergo breast augmentation to enlarge the size of their breasts because they feel they are too small or they have dropped or become empty after pregnancy, with advancing age or weight loss. Implants can also be used to correct asymmetry or in post mastectomy breast cancer reconstruction. Excessive sagging of the breast may require removal of the excess skin giving uplift (mastopexy). This is sometimes combined with an implant to increase size.

     

    I use silicone implants. Some of the newer products on the market (such as Macrolane implants) have proven to be damaging to the breast. More recently fat transfer has been performed to augment the breast in my opinion the risk of this are unknown and may interfere with mammogram assessment.

     

    Silicone implants have been used for breast augmentation for more than 30 years and have the only reliable long term data. For an independent review on silicone implants visit:
    www.silicone-review.gov.uk.

     

    My Technique

    I use a small incision under the breast which normally heals very well and gives easy and accurate access to the breast. In approximately 90% of cases I use a novel partial muscle splitting approach (bi-planar pocket) which avoids the 'fake look' which often occurs following insertion of the implant directly under the breast. Evidence suggests that this technique also prevents the rapid drooping of the breast by keeping the supporting breast ligaments intact. The implant size is decided in the clinic using trial prosthesis in your bra. The risks and expected outcome will be discussed with you.

    PROCEDURE STATS

    GENERAL ANAESTHETIC

     

    DAY CASE

     

    RECOVERY 4 WEEKS

  • BREAST REDUCTION

    Breast Reduction and Mastopexy.
    I have included these procedures together as they involve similar techniques and incisions:

     

      In breast reduction surgery the breast is uplifted and reduced

    in size

      Mastopexy lifts the breast but aims to keep the volume and

    size of the breast unchanged

      Augmentation mastopexy will lift the breast and increase

    volume and cup size by adding a silicone implant

     

    The scars in each case will be around the areola with an inverted T shape down to the fold of the breast. They can take up to 1 year to fade. The type of operation and your requirements will be balanced against possible risks. Smoking is particularly inadvisable with this type of surgery. All sutures are absorbable and do not need to be removed following procedure.

    PROCEDURE STATS

    GENERAL ANAESTHETIC

     

    1 NIGHT STAY

     

    RECOVERY 5-6 WEEKS

  • ENDOSCOPIC BROW LIFT

    The brow lift procedure raises the eye brow, and opens the eye creating a more youthful appearance. It is often combined with a facelift or eyelid surgery to address other areas involved in the ageing process.

     

    As we age the skin loses elasticity and the underlying muscle in the brow drops, leading to horizontal wrinkles lines and 'sagging' of the brow. This can create the impression of a tired, stern or sad face. The brow is raised by keyhole surgery techniques and re-suspended in a more youthful position. The scars are hidden in the hairline.

     

    The excess skin in the upper eyelid may be removed at the same time to achieve an enhancement of the rejuvenation.

    PROCEDURE STATS

    GENERAL ANAESTHETIC

     

    1 NIGHT STAY

     

    RECOVERY 3-6 WEEKS

  • FACE LIFT

    The Classic Face Lift

    Loss of elasticity in the facial muscles, combined with the effects of gravity, lead to the classic signs of ageing: eye bags; hollow cheeks; prominent wrinkles; jowl formation around the jaw line; and loose skin around the neck. I believe short scar techniques (MACS lift) have higher risk for minimal benefits compared to the classic face lift.

     

    The aim of face lift surgery is to rejuvenate the face, jaw line and neck by lifting and re-draping the skin and tightening the underlying muscles to improve the tone and contour of the skin. I normally use liposuction on the neck and jaw line and often recommend a chemical peel to refresh the skin quality and reduce fine wrinkles and blemishes. Scars are initially visible in front and behind the ears but can usually be concealed by make up and fade after a few weeks.

     

    The classic face lift is sometime combined with eye bag surgery (blephroplasty) and brow lift, depending on an individual's requirement. Smokers are required to give up prior to surgery

    PROCEDURE STATS

    GENERAL ANAESTHETIC

     

    1 NIGHT STAY

     

    RECOVERY 2-4 WEEKS

  • FAT INJECTION & FAT TRANSFER

    Fat injection is a technique that transfers fat from one area of the body to another. It is most commonly used to rejuvenate the face by filling hollows, restore shape and improve definition. Small amounts of fat are harvested from the abdomen, buttock or thigh with minimal access liposuction techniques, where the scars are hidden in natural crease lines. The fat is then washed and injected into areas requiring treatment. It can be used to augment or change the shape of the face. This procedure can also be used in combination with other cosmetic procedures such as a face lift to enhance the result.

    PROCEDURE STATS

    GENERAL ANAESTHETIC

     

    1 NIGHT STAY

     

    RECOVERY 2-3 WEEKS

  • GYNAECOMASTIA – MALE BREAST REDUCTION

    Some men develop unwanted breast tissue (gynaecomastia) that causes social embarrassment. This can happen at any age but is more common in the late teenage years and mid life. For most the cause is unknown, but hormonal imbalance, anabolic steroid, prescribed or recreational drug use can also associated with this condition.

     

    Reduction of the male breast should lead to a flatter and more defined masculine chest, which improves patient confidence. If liposuction only is used scars are small. If open surgery techniques are required, scars are more visible around the areola. Compression garment need to be worn for 4 weeks.

    PROCEDURE STATS

    GENERAL ANAESTHETIC

     

    DAY CASE

     

    RECOVERY 3-6 WEEKS

  • LIP AUGMENTATION

    Fillers can be used but the results can be unpredictable and cause lumpiness if used long term.

     

    A new soft removable silicone lip implant is now available in a variety of sizes. Inserted under local anaesthetic swelling subsides in a couple of weeks and the effect is reversible by removing the implant under local anaesthetic. The PermaLip implant is rapidly gaining popularity due to its predictable results and reversibility.

    PROCEDURE STATS

    LOCAL ANAESTHETIC

    or

    GENERAL ANAESTHETIC

     

    DAY CASE

     

    RECOVERY 1-2 WEEKS

  • LIPOSCULPTURE – FAT REMOVAL

    Liposculpture or liposuction involves removal of fat through small incisions. It is particularly useful for removing stubborn areas of fat that persist after weight loss, for example in the thigh and hip regions. It can be used to contour the body into a more feminine or more masculine shape. Liposuction is also used to treat men with excessive breast tissue (gynaecomastia).

     

    The benefits of liposuction will be maintained as long there is not general weight gain following the operation. Compression garments need to be worn for 4 weeks.

    PROCEDURE STATS

    GENERAL ANAESTHETIC

     

    1 NIGHT STAY

     

    RECOVERY 2-3 WEEKS

  • PINNAPLASTY – EAR CORRECTION

    Adults can be self-conscious about the size and shape of their ears and children may be teased or bullied at school. Normally this is because the ears are asymmetrical, or protruding. Occasionally they may have an abnormal pixie or cup shape.

     

    Ear correction surgery (pinnaplasty) can be performed to set the ears back against the head or to create a proportionate and symmetrical appearance by reshaping the cartilage framework of the ear. Scars are hidden behind the ear.

    PROCEDURE STATS

    LOCAL ANAESTHETIC

    or

    GENERAL ANAESTHETIC

     

    DAY CASE

     

    RECOVERY 2-4 WEEKS

  • RHINOPLASTY – NOSE JOB

    Adults can become self-conscious about their noses and children may be teased or bullied at school. Normally this is because the nose is not straight, is large, protruding, or has an abnormal hook or piggy shape.

     

    Nose correction surgery (rhinoplasty) is performed to correct nose shape and size. The aim is to change the nose by reshaping the bone and cartilage framework to create a proportionate and symmetrical appearance balancing the facial appearance. The surgery can be performed from within the nose for simple cases and via an open tip approach for more complex tip surgery, leaving a tiny hidden scar on the nose. Swelling can last a few weeks.

    PROCEDURE STATS

    GENERAL ANAESTHETIC

     

    ONE NIGHT STAY

     

    RECOVERY 3-4 WEEKS

MR JAMES' ADVICE

Before embarking on cosmetic surgery always do your research and find a reliable surgeon with a local reputation. Developing a rapport with you surgeon is essential. You need to be able to trust your surgeon and be able to ask as many questions as you need to without feeling pressured. I would urge those considering cosmetic surgery to insist on a
pre-operative consultation with the surgeon (not a nurse or company representative) some weeks before considering surgery to discuss all your options and concerns. At least half an hour is usually necessary to get through all the important topics, including the risks involved. Also ensure that your surgeon will be available to look after you following the procedure.

MEDICAL INSURANCE

Most cosmetic surgery comes as a package price which includes hospital fees, the initial surgical consultation and follow up fees. It should also include any treatment of complications that may occur within 6 months. For added peace of mind there are cosmetic surgery insurance packages to cover you for up to 5 years if you have any associated problems. See surgeryshield.com for more details.

ARRANGE YOUR CONSULTATION

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THANK YOU, WE WILL BE IN CONTACT SHORTLY TO ARRANGE YOUR CONSULTATION.

GENERAL AFTER CARE

Analgesia (pain relief) - Ibuprofen and paracetamol can be taken

Complete rest will be necessary for 48 hours

Daily tepid showers will be possible after 48hours

Surgical skin tapes should be left in place for 2 weeks

The hospital or surgeon should be contacted if you develop a temperature

The hospital or surgeon should also be contacted immediately in rare cases of bleeding or

rapid swelling

Patients should take care not to over exert themselves in the first few weeks and to keep

pressure off the wounds

Wounds will be checked and sutures removed normally at 1 week

I will see you routinely at 1, 2 and 6 weeks after surgery

Dressing care nurses may see you more often

Swelling reduces after a few weeks

COSMETIC SURGERY

Mr Matthew James

MB ChB, FRCS(eng), FRCS (plastics) BAAPS BSSH

CLINIC LOCATIONS

 

LONDON BRIDGE

 

BMI HOSPITAL BLACKHEATH

Independents Road, London SE3 9LG

 

ST THOMAS' HOSPITAL NHS

Westminster Bridge Road, London SE1 7EH

 

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BLACKHEATH

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