Breast
Augmentation & Lifting
Breast Reduction
Breast
Reconstruction
Male Breast
Enlargement (Gynecomastia)
Hair
Transplantation
Face & Neck
Lift, Forehead (Brow) Lift
Face Fillers & Botox
Rhinoplasty (Nose
Surgery)
Blepharoplasty (Lid Surgery)
Otoplasty (Bat Ears)
Liposuction &
Body Contouring
Face Resurfacing (LASER, Dermabrasion,
Chemical Peel)
Cleft "Hare"
Lip & Palate
Reconstructive Surgery for Congenital
Anomlaies, Burn Scars and Trauma
Breast
Reduction Breast reductive surgery is done for
large breasts to ensure better shnape as well as to relieve sometimes back
problems that can arise from huge breasts.
The procedure is done under general
anesthesia
There are several techniques for
breast reduction, the most used of which are the inverted T scar with different
nipple-aroela transfer patterns, and the single longitudinal scar techniques
(Lejour Method)
The first technique is done through
an incision around the areola, avertical scar from the areola down to meet
a transverse scar under the breast forming a T-shaped final scar.
The latter method is suitable for
small to moderate sized reduction and is done wthout the transverse incision
component.
Surgical drains are usually placed
for 48 hours and the patient usually stay overnight in hospital.
The scars usually heal well, the
scars are usually inconspicuous, the transverse scar is not visible being
hidden under the breast.
future lactation can not be guaranteed
after surgery despite the fact that lactiferous ducts are preserved in
many techniques used.
Breast
Augmentation & Lift
Breast Augmentation
Breast augmentation is done using a
prosthetic implant that does not react with the body tissues. It is implanted
through a very small incision in the infra-mammary crease which will not
be apparent as it is in the under surface of the newly sized breast.
The procedure has not been found
to cause any harmful side effects, nor to cause cancer. There are two types
of implants: the saline filled implants and the silicone gel implants.
Both types can be implanted under the breast or under the chest muscles
below the breast. The latter way is used more as the implant can not interfere
in the future with breast examination, mammograms or any breast procedure.
The main concern in breast augmentation
is the development of breast capsule (fibrous tissue reaction around the
implant) which may cause alteration of the shape of the breast if what
is known as capsular contraction occurs.
Ways to avoid breast capsular contraction:
Many methods to prevent capsular
contractions are used
1- Selection of implant type: Saline
filled implant have very little incidence of capsular contraction compared
with Silicone gel implants
2- Selection of implant surface:
Textured implants have very little incidence of capsular contraction compared
with smooth ones
3- Place of implantation: Submuscular
implantation have very little incidence of capsular contraction compared
with subglandular ones
4- Postoperative breast excercises:
During postoperative period, the patient is instructed to do certain breast
excercises in all directions which markedly reduces the possibility of
developing capsular contraction
The procedure is done under general
anesthesia as a day case surgery, the patient can leave hospital at the
same day.
Postoperatively there is no significant
pain, just slight discomfort from the muscle being stretched over the implant,
which will fade over the following weeks, meanwhile the patient is instructed
not to lift heavy objects.
The patient will wear restrictive
garments or hard bras for the first week after surgery in order to keep
the desired position of the implant and to help moulding the shape of the
augmented breast.
It is a safe and simple surgery with
almost no side effects and a great aesthetic benefit.
Breast lifting (Mastopexy)
Different procedures are done to treat
breast sagging (ptosis) which usually occur after multiple pregnancies
and lactation, or may occur in young individuals before marriage.
According to the degree of breast
ptosis, different modalities of treatment are used:
1-In mild
ptosis: use of breast implant alone can achieve the desired lifting with
minimal enlargement of the breast through a very small incision on the
under surface of the breasts.
2- In moderateptosis:
the desired lifting is usually done through incisions around the areola
and a longitudinal incision below the areola . Both incisions usually heal
very well with the least conspicuous scars
3- In severe
ptosis: A formal lifting procedure should be employed entailing a circumareolar
incision, a longitudinal incision as well as a transverse incision under
the breast (The formal T-incision)
In all conditions the patient can
leave hospital the same day. The use of drains may be needed which are
usually removed after 48 hours. The patient will wear non-soft bras immediately
after surgery.
Breast
Reconstruction
Breast reconstruction after radical
mastectomy operation for breast cancer is of tremendous value for the patient's
moral adn self-esteem.
It can be done at the same time of
mastectomy operation provided proper staging shows early cancer (Stage
1-2), or can be done later on after operation.
There are different ways for reconstructing
the breast:
1-The use of implants
2- The use of muscle flaps from
the back (Latissmus dorsi flap) and from the apron area below the umbilicus
(TRAM flap)
The best results and least interference
with postoperative cancer theraphy is the use of the TRAM flap with transfers,
muscle, fat and skin from the abdomen below the umbilicus to fill in place
of removed breast, entailing the performance of an abdominplasty as well
The transfered tissues have the advantages
of feeling similar to that of the breast, adequate size and the tolerance
to post-mastectomy radiotherapy.
The abdominal wall defect following
muscle transfer is uasually closed directly, and in some cases closed with
the aid of a prolene mesh.
Drains are usually removed after
5 days, after which patient is discharged from hospital.
The stitches are removed after 10
days, after which radiotherapy can be started.
Nipple and aerola reconstruction
can be done thrre months following breast reconstruction as a day case
surgery
Gynecomastia
Breast elargement (Gynecomastia) in
men is a very distressing and embaressing condition.
This condition can be caused by a
variety of conditions, most common being idiopathic, it can be caused by
obesity, some hormonal disturbances, testicular or liver problems
The breast enlargement can be purely
fat, purely hypertrophied breast gland or more commonly a combination of
both.
Treatment starts with search for
a cause through physical examination, hormonal assays , and sometimes xrays
& sonography.
If a conditiion is revealed it should
be addressed first then gynecomastia can be dealt with.
The ways to remove the enalrged breast
liposuction for fatty breasts.
It there is a small glandular element
, it can be removed at the end of liposuction procedure through a small
incision around areola.
In cases of purely glandular enlargement
and/or huge enlargement, a formal surgical excision is mandatory.
After liposuction, the patient
wears a restrictive breast garment for atleast two weeks and stitches are
removed after 10 days
In cases of small and moderate cases,
patient can leave at the same day, but in cases of huge enlargement, drains
are placed fo 24 hours after which patient can be discharged.
Hair Transplantation
Hair follicle transplantation is the
most up-to-date method to manage androgenic baldness in males as well as
deficient hair density in females.
The procedure consists of the use
of a small 8-mm wide strip of the back of the scalp removed surgically
and closed primarily leaving a fine scar inbetween hairs which is completely
hidden with no areas of alopecia.
This strip in dissected under magnification
into hair follicles which are then implantation into the desired ares thourgh
small slits in order to leave no scars.
The procedure in performed under
local anesthesia in 2 stages, the first is about 25-30 minutes long in
which the scal strip is harvested after which the patient is transferred
back to his room.
Follicule dissection takes around
3 hours after which the patient in invited back to the operating roon,
where local aneshesia to recipient area is administered and follicles are
implanted.
The area is covered by bandage for
2 days after which bandage is removed and the area is washed gently and
left exposed. The scabs covering transplanted grafts should be left undisturbed
till they fall spontaneously.
The transplanted follicles remain
dormant for 3-6 months after which hair starts to grow naturally.
The number of cessions needed vary
according to the extent of baldness and the size of the area to be covered.
Rhinoplasty (Nose
Jobs)
Face & Neck
Lifts
Prominent Ear (Otoplasty)
Liposuction &
Body Contouring
Hair
Replacement
Cleft Lip
