Cosmetic Surgery Clinic

In men who have a receding hair line in the forehead either in the center or on the sides, it becomes a great psychological problem especially in the young!

There are a few methods available to treat this problem. Most of them are procedures to camouflage the baldness. To mention a few:

Rotation flaps are performed wherein the hair bearing skin flap from the sides of the head are rotated to the front.

In pinch graft technique, small pinches of hair-bearing tissue is planted in the non-hair bearing forehead area and await the hair growth which may be a few months.

The same can also be done with the help of Co2 laser. Hair roots are placed under magnification in the grooves created by the laser beam and this procedure is known to give better results.

There may sometimes be some irregularity of face on one side due to congenital cause or as a result of some infection in childhood.

This asymmetry can be corrected by either bone grafting on the deficient side or soft tissues (like de- epithelialised skin or fat) or both together.

Fat injection is another procedure that can be done to treat such problems.

Wrinkles of the face and forehead; hanging folds of the cheeks and chin are the usual complaints for which face lift is performed. Usually this can be performed as an out-patient procedure and occasionally may need 24 hour hospitalisation. Local or general anaesthesia is suggested depending on the extent of problem. Tightening of the skin after removal of the excess and loose skin is the principle of this procedure. Suture line is almost invisible in the hair line on the sides.

Mini facelift is a more recent procedure wherein nylon like material is used to pull the drooped skin of face through small needle holes on the sides of face in temple region.

Filler injection and mesotherapy are also performed to reduce the wrinkles depending on the need and individual choice.

Initial darkening of the skin due to blood may be noticed which may take 3 to 5 days to subside. This can also be done in the neck for the double chin and skin folds. The scar is hidden in the natural skin creases.

Laser dermabrasion is another alternative to face in which Laser is used to remove the wrinkles of face.

In individuals in whom the chin is less prominent or drawn in, an augmentation of the chin is performed either by adding a piece of bone aken from the hip or an artificial material called silicone prosthesis. This can be performed under local anaesthesia but general anaesthesia is preferred if bone is to be removed from the hip.

The suture line is under the chin and is invisible.

Correction of Bat ears, Dome ears and also absent / deformed ears by birth is called otoplasty. It may be on one or both sides. This can be performed under local anaesthesia as an out-patient procedure.

Excessive skin and cartilage tissue is removed and the ears are folded and fixed to correct the deformity. Dressing is maintained for about a week to retain the shape

This is the correction of lips; in young or older persons; both males and females, but mostly girls opt for this procedure. Thick lips are reduced in size and white patches on the lips are also removed in this procedure.

Removing the excess tissue and suturing with fine material will result in invisible scar.

Only fluid diet is allowed for 48 to 72 hours. Initially there may be swelling of the lips which may take a week to two to come down to required size. Actual reduction of the lip size can be perceived after a 2-3 weeks.

Occasionally skin graft might be needed in those who require removal of large white patches.

Middle aged and older individuals - either male or female are the usual patients for this procedure.

Hanging eyelids, baggy eyelids and discoloured eyelids are treated by this procedure. This can be performed comfortably under local anaesthesia as an out-patient procedure. Excessive skin and tissues causing bagginess are removed. Suture line is almost invisible. Occasionally there may be post operative black eye which will recover within 2 to 5 days.

This can also be repeated after a few years if necessary.

Sucking of excessive fat accumulated in various parts viz., abdomen, loins, buttocks, thighs, calves, arms, chin and chest in males. This is not to be considered as a procedure for weight reduction; as this reduces the girth rather than the weight.

There is a limitation of the amount of fat that can be removed in one stage! However this can be repeated after a few weeks if further suction is needed. This procedure is done under general or spinal anesthesia. Hospitalisation is for 24 to 48 hours. Tight bandages and garments may be necessary for some time after surgery. Occasional collection of fluid may necessitate aspiration. Regular fitness exercises are essential and motivation is mandatory. Diet should be followed as prescribed.

Recurrence of obesity is usually in some other parts as a result of improper motivation or diet and lack of exercises.

Middle aged or younger women with multiple pregnancies, multiple cesarean scars, obese individuals with gross abdominal obesity are the ones who need this tummy tuck operation.

Preoperative motivation, exercises, diet and weight reduction are mandatory.

Excess of fat, hanging fatty apron in front of abdomen, fatty loins, multiple lower abdominal scars, previous pregnancy marks called stria gravidarum, general laxity of abdominal wall are the usual indications for this surgery.

This is performed under spinal or general anesthesia. Excess of fat and the extra skin is removed Belly-button may have to be replaced. Scar is below the waist line.

Two to four days of hospitalisation is required.

General exercises like walking, jogging, skipping, aerobics, swimming and specified exercises for abdomen and loin are advised and motivation of the individual is essential. Diet is to be controlled as per the calorie requirement. Obesity may recur if improper diet and sedentary habits are continued.

Occasional collection of fluid and some skin necrosis or gaping of the wound may be minor problems which may need dressing for a few days or an occasional second time suturing. Abdominal corset should be used for about 2-3 months. Bed rest is for a week followed by usual activity and resumption of exercises after 6 to 8 weeks

Young adults or middle aged people opt for it entirely for cosmetic reasons.

Performed under general anaesthesia, but can be done under local anaesthesia also.

The aim of surgery is to make the breast look bigger in size by mammary prosthesis (artificial material made of silicone) Alternatively natural and own body tissues are used. In the later the tissues have to be obtained form other sites like chest wall, back or abdomen.

Scars are either in the darker area of areola or below the breast fold and almost invisible.

Hospitalization generally is for a day. Mammoplasty does not interfere with milk secretion as the material is placed under the breast tissue.

Pain is minimal after surgery.
Heaviness is expected till the patient gets used to the same. Occasionally fluid discharge may be noticed and one should not get alarmed about it. The silicone might become slightly hard over a period of years in some but usually mimics the feel of normal breast. Among the silicone prosthesis there are two varieties -one gel filled and the other saline filled- the later being slightly superior!
Fever or discharge or gaping of the wound, if any, should be immediately brought to the notice of the surgeon. Antibiotics or an occasional suture to the gape may be rarely required. Complete extrusion or removal is rare in a case of gross infection.

There is mention of increase incidence of carcinoma in the media and it is usually an apprehension rather than of any statistical significance.

REDUCTION MAMMOPLASTY

Generally the patients are young adults or middle aged. This is due to abnormal growth of breast tissue. This causes not only physical embarrassment and discomfort, but can also cause difficulty in breathing due to heaviness. Cosmetic unacceptability is the usual presentation. This can either be on one side or both. Surgery is done under general anaesthesia. Excess breast tissue is removed leaving only the desired amount. Scars are in the lower part of breast in the breast folds and become almost invisible over a period of time. Hospitalisation is for two to three days. There will be a suction drain for a day. There may be occasional fluid collection which needs aspiration with a syringe or it might get absorbed on its own. Pain is minimal to moderate after surgery. Small sized bras are to be kept ready to wear immediately after surgery. Sensations might appear to be diminished for a few weeks.

Breast feeding is possible even after surgery.

MASTOPEXY

Most patients are middle aged group. Sagging of breast due to loss of elasticity is the usual cause.
This is done under general anaesthesia.
Hospitalisation is usually for two days.
Scars will be in the lower part of breast and the surgical principle is to fix the breast tissue, nipple and areola at a higher level for the breast to appear pointing forwards and upwards.

May be performed more than once after a few years if the individual so desires

GYNACOMASTIA

Large looking breasts among males that cause embarrassment are removed by tiny incisions. Moderate gynacomastia can also be treated by liposuction.