1- I am a single mother of two and recently finalized my divorce. The fact is after having children and getting older I know my body is not as youthful as when I met my ex husband. The idea of actually having a sexual relationship with someone other than him is still strange and a little frightening. I have been told that you provide a surgery that can make me feel more confident or like new again by actually reversing the effects of child birth, etc., Is this a relatively safe procedure and will it make a real difference if and when I do decide to be more sexually active?
I understand your concern. Many women have the same problem and more and more of them want to reverse the effects of child birth. This procedure is safe and makes a big difference. Women who went through it report, as in your case, a lack of confidence before, and a total confidence after. The healing time is 3 weeks during which you can not be sexually active.
2- My sister is currently undergoing treatment for breast cancer and the question has come up again about having a mastectomy. In fact as horrible as it sounds to have a breast removed, surely it has to be the safest thing to do when diagnosed with breast cancer for the second time? I looked into the risks and the advantages, but would like to know more about why it is easier to replace or reconstruct a breast the same time as removing it. Doesn’t your body need time to heal? My sister is in her late 40’s and is worried she could get an infection when her immunity is low. The other problem is having different parts added on at different times like the nipple. Can’t this be done all at once? How can I make this easier for her?
You are perfectly right; one can consider there are some risks in reconstructing a breast in the same time of a mastectomy. But every case is different and it is difficult for me to comment on the options offered to your sister by the team in charge of her, without any detailed information. In theory, re-constructive surgery is not recommended after radiotherapy because of a very low healing potential due to immune depression. Before radiotherapy, If the tumour is small and localised, if it has not invaded too much tissue, lymph knots, and has not send metastasis through the blood stream, it can be considered that a minimum invasive procedure can be performed. It is possible and sometimes necessary to reconstruct a breast after an extended mastectomy if the tumour resection has been quite wide. Most of the time the reconstruction is only partial. A flap is taken from the back for example, with muscle and skin, so the wound can be properly closed. The areola and the nipple are reconstructed. Later the actual shape can be improved with expanders and breast implants. Those operations are usually successful, dependant on the health of the patient. If there are any further concerns, after a few months, it is possible to operate again and focus on only the aesthetics.
3- Is there a surgery that can give eyebrow shape? My eyebrows are so low and they have no shape almost like a straight line across my forehead, it doesn’t matter what I do to change the shape with waxing or tweezing. Even make up tips don’t work for me. Do you have any suggestions that would not be radical like facial reconstruction?
It is possible to reshape your eyebrows without a major facial reconstruction. We still need a bit of surgery. In your case, we could combine an eyebrow lift, to pull up the central portion, and a temporal lift to lift the tail. Both procedures require only very little incisions (2 to 3 cms), and are not major. I don’t advise the thread lift, unfortunately the midterm results are not convincing. The threads are felt under the skin or even come out. I advise you to look at the eyebrow shapes of the women on the cover pages of the magazines. You will see they are always quite low and full, with the tail a little bit higher. I never advise to lift the central portion of the eyebrows too high as it would result in a surprised or scared expression.
4- I am 43, smoke, drink and spend too much time in the sun. I know it is not good for me but I am not a heavy smoker or drinker and I only go out in the sun after 3pm. But now I have deep facial lines around my mouth, especially feathering around the lips. I'm not the only one that does this because all my friends do it in the mirror, but, when I lift the skin just below my cheeks with my finger tips it removes the sagging skin around my jaw line and I look so much better. Would I be a good candidate for a mid face lift? And is there a way to get rid of these lip wrinkles?
Seems to me that you could benefit from a midface lift but it could just as well be not necessary. We must evaluate the elasticity of the skin at the first place. If it is good, you are a good candidate for surgery. If not, you should be a candidate for an Exomask (see marbellaclinic.com exomask chapter). The exomask achieves a soft fullface lift without surgery but mainly improves greatly the elasticity of your skin. It also eliminates the wrinkles without injecting them. After evaluating the elasticity of your skin, I would check your cheeks and your jowls. If your cheeks are dropped, you need a midface lift, if you are jowly, you should have a liposuction of the neck and jawlines. This simple procedure will aleviate your jowls and allows the skin around your mouth to go up. We can also fill your cheeks to lift them up without surgery.
5- Is there an alternative to liposuction? I have seen on various documentaries the actual surgery you undergo and to be honest it scares the life out of me. The problem is I am in my thirties and my thighs are at the point where the jiggle of the fat is scaring me even more, especially when I am walking! The idea of putting on a bikini is out of the question. I am not overweight, but I can’t seem to get rid of the fat on my thighs even after regular-ish exercise. I don’t want to diet because I don’t need to lose the weight but I have to do something. I don’t think I would mind the lipo-suction surgery if it also promised to get rid of the cellulite but I have a feeling that is asking too much or is it? If it is, then is there a slightly less traumatic surgery I can have?
First you should not give full credit to what you see on television. It has to be impressive to catch people’s attention. It looks much more invasive that it actually can be. There is a way to perform a soft liposuction or liposclupture with small probes (from 3 to 5 mm diameter) instead of an agressive one with big probes (up to 8 mm diameter). When the surgeon uses small probes, the whole procedure is much softer, there is hardly any bleeding, and the recovery is easier and shorter. The procedure is just longer then with a big probe. So it depends on the surgeon to work softly or more agressively. Diet and exercise don’t have an interesting impact on localised fat; you might have to loose 10 kilos to loose the 1 or 2 kilos of localised fat that bother you on your thighs. So surgery is the only answer for you. I am also afraid you are asking too much. The liposculpture or liposcution have no effect on cellulite, which is a superficial condition due to vascular disorders. You can successfully treat cellulite with external treatments like good creams and Endermology- LPG technique
6- I have been thinking about nose surgery for the last two years and I recently read about a surgeon who uses microscopic sutures instead of removing tissue, is this something that is easily performed here in Marbella and could you explain to me what the difference this type of surgery will make over time.
The nose surgery includes different areas. The nose tip reshaping is performed through the excision and/or the sutures of the cartilage the bone re-shaping is done through surgical fractures and elimination of excess bone. The width of the nostrils can be reduced by cutting the excess of skin at the base. The length of the nose can be changed by cutting of a bit of skin and cartilage of the tip and/or the septum (the central wall of the nose).
In the surgical field, sutures are usually used to join the edges of two identical structures (fat to fat, muscle to muscle, and skin to skin) or to plicate them in order to reduce their length. Microscopic sutures, or rather micro sutures, are used to repair nerves and blood vessels. Micro sutures can not have an effect on the bone nor on the cartilage of the nose. I can only consider it would be used to reduce the size and change the shape of the skin. In this case, the microscopic threads used in microsurgery would not be strong enough. I would rather say that the surgeon you have been reading about uses “little” sutures and not microscopic ones, and can definitely only work (in a limited pattern) on the soft tissues. Some doctors also claim they change the nose shape only with injections. It is true, but they can only make it straighter by making it bigger. They inject a permanent filler before and/or after a lump for example. I am afraid it is not possible to reduce the size of a nose without incisions and sutures.
7- Do you have any options for neck surgery? I have this horrible turkey thing going on that is like a load of loose skin attached from my chin to my clavicle. I don’t want to go through a serious surgery that will leave me with noticeable scars do I have any other options?
The turkey neck is usually a congenital condition. An excess of fat under the skin and a more important excess of fat under the muscle are responsible for a greater weight on the skin that becomes loose over time. If this is similar to your case, beautiful results can be achieved with minimum incisions. If your skin is just loose without fat, then you need a neck lift with scars (they are usually almost invisible) in front and behind your ears. Neck surgery, together with eye surgery is really one of my specialities. I have designed my own strategy for face rejuvenation for people who don’t want noticeable scars. I use a 3 cm incision in the hair of the temples for the upper face, and a 3 cm incision in the natural line under the chin. It is possible to achieve a very good result for the neck by using lipo sculpture to harvest the fat under the skin, and a small incision to harvest the fat under the muscle. Usually, the skin sticks back with a bandage with minimal skin removal because you need the skin to follow the new curved shape of the neck. Remember that the straight line between your chin and your clavicle is shorter than the curved line of a normal neck. So you see quite a straight line of loose skin not because there is too much of it, but because it has fallen from its ideal position. If you still have an excess of skin after that, it is possible to do a mini neck lift. It isalways very important to harvest the fat that weighs on the skin first, to avoid excessive tension and unnatural results.
8- If I undergo breast augmentation and find that I am not happy and don’t like it, how would you go about removing them and would my breasts then look deflated and worse than they were to begin with. I want better shaped fuller breasts but I am really worried that I won’t like them and it’s not like I can take them back or is it?
If you undergo a breast augmentation, you will be able to see the result very soon after the surgery. It will usually take a few weeks, if the implants are positioned under the gland and 2 to 3 months if they are under the muscle, by this time you will have a clear idea of the aesthetic outcome of the operation. If you don’t like it; you can have them removed with almost no consequences to your skin. It isonly if you had no breast at all, that the skin may have expanded a little. I can only tell you that I have never known any patient being unhappy with the fact of having breast implants. Occasionally, a woman might find her breast too big or too small with the implants. I always advise my patients to wait a few months to check if they get used to the size. If not, we can easily correct it. But this is extremely unusual.
9- I have been waiting to have surgery or breast enhancement surgery for a long time now in hopes that something new will come along that is not an implant. I have looked at all sorts of things from gum to bras, but I just heard that now fat grafting has been used to enlarge breasts. I remember hearing a while ago that you can take fat from one place and inject it somewhere else, but I think this is a lot more than just injection of fat, for instance; they talk of totally reshaping and reconstructing areas on the body with your own harvested body fat. Can this really be done?
Fat transfer is a common procedure, in the face or in the body. I have been practising it since 1997, and have conducted thousands of procedures. The techniques have improved and the harvested fat, once re-implanted, survives better and better. It is still not a 100% successful technique and more than one session is often necessary. Even when the experience and the technique of the surgeon are good, the survival of grafted fat cells depends on many criteria’s, like the quantity of grafted fat (too much fat on a specific point cannot survive), the areas which are corrected (the face reacts better than the body), the blood supply (to irrigate properly the grafted fat cells), the compression (if the grafted fat is compressed like in the buttocks when one sits, it will not survive), the diet (one can not try to loose wait after a session of fat transfer for obvious reasons), the exercise (too much sweating and fat burning exercise will destroy the grafted fat) etc.. This procedure is called autologous fat grafting. It is an option to increase the volume of an area of the face or the body, but one should be prepared to undergo more than one procedure to achieve perfect results.
