Enlarged Male Breasts (Gynecomastia)
Plastic Surgery Dubai | 13 October 2020
Gynaecomastia is the benign (non-cancerous) growth of male breast tissue and can be due to a number of causes. It may be due to hormone imbalance or as a consequence of medication you are taking. It can also be due to alcohol excess or recreational drug abuse. Your doctor will discuss the cause of your gynaecomastia with you. Along with causing swelling of the breast and nipple, gynaecomastia can be uncomfortable and the nipple can become sensitive.
HOW CAN GYNAECOMASTIA BE TREATED?
Some cases of gynaecomastia will get better without any form of treatment. If one of your medications is thought to be causing the gynaecomastia, it may improve with changing or stopping a particular tablet. Your doctor will discuss this with you.
Whilst gynaecomastia itself can be uncomfortable and unsightly, it is not dangerous and no harm will come from having it. When cancer has been ruled out, many men are happy to have no treatment.
Another form of treatment is to have medication. These medications are often good at reducing discomfort and sensitivity but may not reduce the size of the breast.
The third form of treatment involves surgery to your breast.
SURGICAL TREATMENT OF GYNAECOMASTIA
There are three main surgical procedures which can be undertaken:
Liposuction
Liposuction is used to remove the fatty tissue under a general anaesthetic. Small incisions (cuts) are made on the chest wall. A small metal tube (cannula) is used to suck out the fatty tissue. The incisions are then sutured to give a flatter, firmer and better-contoured chest. Any stitches will be of the dissolving type and so do not need to be removed.
Excision of Gynaecomastia
In excisional surgery, I will make a cut around the nipple to remove the breast tissue. This may be combined with liposuction of the breast tissue at the same time.
Male Breast Reduction
If the breast is very large more tissue and skin may have to be removed. This will give more scars. The degree of scarring will depend on how much skin needs to be removed. I will advise you about this.
After Surgery
After surgery for gynaecomastia your breasts will look discoloured and feel firm and swollen. You may need to have a drain (a fine plastic tube) inserted into the breast during the operation. This will be removed seven days after your operation. You should be able to go home the same day. You may be advised to wear a corset for up to six weeks after the operation to help with the swelling. I will advise you where these can be bought. You will not be able to drive home after your operation and it may be two to three weeks before you can drive.
The dressings can be removed after 7-10 days and you should be able to return to work after two weeks. For the first three weeks after the operation, don’t lift anything heavy or do heavy manual work. Most men resume normal activities within two to three weeks.
Risks and Complications
All surgery carries with it some risk. Common side effects of a general anaesthetic include nausea and vomiting. As mentioned earlier, the chest can be swollen and bruised following the operation.
Specific Complications
Haematoma
This is bleeding into the tissues following surgery. It can occasionally lead to patients returning to theatre to stop the bleeding or remove the blood.
Wound infection
This can occur after any kind of surgery and may need treatment with antibiotics or a return to theatre. If your wound becomes red and inflamed you should contact your doctor.
Deep vein thrombosis
This can happen after any operation or general anaesthetic. The risks are reduced by wearing preventative stockings (TEDS) for two weeks.
Poor wound healing
With a male breast reduction problems may occur with the wound. The blood supply to the area around the vertical scar is at its poorest. This may delay healing and very occasionally the wound may break down and leave a small raw area. This gradually heals with time but may take several weeks.
Nipple complications
The operation by its nature partially disrupts some of the blood supply to the back of the nipple. There is a small risk therefore of the nipple dying resulting in its loss. There is a risk of loss or alteration in sensation to the nipple.
Asymmetry
There may be some lasting differences in the size and shape of your breasts following surgery. Most men are asymmetrical prior to the operation.
Scarring
Initially the scars will be bright red lines – in most cases the scars will heal satisfactorily and soften becoming much paler in time, usually within twelve months. Some patients have a tendency to form red and lumpy scars or keloid scars which are broad raised scars. Such scarring will be permanent.
FOLLOW UP
You will be given an appointment to return to the clinic in 7-10 days where the dressings and drain(s) will be removed and the wounds inspected. You will also be reviewed approximately six weeks after your surgery once the bruising and swelling has completely settled.
LONG TERM OUTLOOK
If lipofilling is performed and only fat is removed, weight gain can make the gynaecomastia return. If the breast tissue itself is removed, as in the excision surgery or male breast reduction there is a chance the breast tissue can regrow. You will have medical photography before and after surgery of your chest. There will be nothing which will identify you to anyone else on these and they are used as a record of your treatment.
Liposuction: Uses & benefits
Cosmetic Surgery Dubai | 11 October 2020
Liposuction, Liposculpture, Suction Lipectomy, Body Reshaping is a Plastic Surgery operation to reshape areas of the face and body by removing excess fat that does not respond to diet and exercise in order to achieve a more aesthetic facial or body shape. Abnormal or excess fat deposition can arise from a familial trait or simply as a result of the changes of aging. Fat deposition in the lower body and legs (Lipodystrophy) commonly has a genetic link and can prove difficult for the patient to reduce with diet and exercise but is suitable for Liposuction, Liposculpture. Fat deposition in the male chest (Gynaecomastia) is relatively common and rarely responds to diet and exercise but is suitable for Liposuction, Liposculpture, or PAL Liposuction, VASER Liposuction.
What is Liposuction, Liposculpture?
Liposuction is a technique for fat removal using minimal incision and a thin cannula. Many methods have been developed to assist or improve the efficiency of fat removal. Traditional Liposuction uses manual movement of the cannula with suction, while Power Assisted Liposuction PAL, uses a rapidly vibrating cannula to remove fat. Ultrasound Assisted Liposuction UAL/ VASER, utilizes ultrasonic waves to disrupt fat cells before suction. LASER Assisted Liposuction achieves the similar effect as UAL but is less selective to the fat cells. BodyJet utilizes high flow water to disrupt fat while removing with suction. It is important to understand that all techniques require fat to be removed by suction. Many claim to be better than “Traditional Liposuction” but no scientific data has been published comparing these techniques. Like many surgical procedures (Liposuction is a surgical procedure) the results are determined by the skill and training of the operator more than the technique used.
What are the benefits of Liposuction, Liposculpture?
Liposuction – Liposculpture is performed to remove excess fat that does not reduce following exercise and diet. Liposculpture or Liposuction aims to improve body shape and self-image enabling you to wear the clothes you want. Liposuction – Liposculpture is carried out to correct abnormal fat deposits; under chin, neck, male chest (Gynaecomastia), and lower body (Lipodystrophy).
Am I the ideal patient for Liposuction, Liposculpture?
If you are on a good diet, are able to exercise and your weight is stable or reducing, but are concerned about stubborn fat around the abdomen, hips, thighs, knees, neck or arms then Liposuction can improve your body shape and self-image. Loose skin in the area of concern will reduce the benefit of Liposuction and some form of skin tightening treatment or procedure may be necessary in combination with Liposuction. Smoking must be avoided before and after Liposuction to avoid complications such as infection or poor healing. You should also avoid any blood thinning medication or supplements.
Do I need to lose weight before my Liposuction, Liposculpture?
We recommend that you should be as close to your ideal body weight as possible before you undergo Liposuction, Liposculpture. However, many patients find it very difficult to exercise effectively. It is important even in this circumstance that you eat a good diet and are losing weight before your surgery.
Dermal fillers – everything you need to know before a treatment
Fillers in Dubai | 9 October 2020
Dermal fillers are used to maintain volume in the face, and thus restore (or prolong) a youthful, rested, healthy appearance. Dermal filler injections take only minutes to perform and the cosmetic results are immediate. I inject the selected facial filler at sites where natural fat has depleted, the most common being the cheek bone area and the folds next to the nose (nasolabial), the lines running from the mouth toward the chin (marionette lines) and thinning lips. The new generation of facial fillers is more practical than the animal-based collagens they are descended from, as the newer products are biocompatible, more versatile in their weights and densities, and last longer. However, most facial fillers are still temporary, and depending on the staying power of the product as well as the reaction of the patient. Touch-ups will eventually be required.
Dermal fillers instantly plump up nasolabial folds, marionette lines, sunken cheeks, thinning lips and soft jaw lines. They can also be used to correct scars and deeper wrinkles.
No prep time is required with fillers, though you may request topical numbing cold ice packs prior to the procedure.
Cosmetic surgery top tips
Cosmetic Clinic Dubai | 7 October 2020
1 Make sure you have clear reasons for wanting cosmetic surgery and ensure these reasons have been made by you and you alone. Spend some time considering whether surgery is right for you.
2 Try to be certain it will improve your well being and quality of life and consider whether now is the right time
3 Ensure you receive a professional opinion to provide you with sound clinical advice. Your consultant plastic surgeon should be certified and highly experienced.
4 Find out about the surgeon’s clinical history. What are your surgeon’s results like? Do they publish corrective surgery statistics and collect patient satisfaction data?
5 Consultations are very helpful if you’re not sure of your options.
6 Ensure you feel at ease with your consultant. Are they courteous and professional? Do they understand your concerns and desired outcomes? Do they clearly explain your options? Do they take photographs with signed consent?
7 Research the procedure you intend to have thoroughly, ensuring you are aware of any possible complications. Your surgeon should not shy away from explaining the risks or complications of your procedure.
8 Be clear of your desired outcomes and ensure you understand what results you can expect.
9 If you are having implants, make sure you know how long they will last and if they will need to be replaced? Will there be any future costs?
10 It is important to have the support you need before surgery, but have you considered post-surgery? What aftercare will be provided and who should you contact if you are concerned?
11 Discuss prices beforehand.
12 Don’t feel pressurised to proceed after your first consultation, make sure you have a good think about whether surgery is right for you. It’s always advised to have a cooling off period to be 100% sure.
Hyperhidrosis: Diagnosis and treatment
Aesthetic Medicine Dubai | 5 October 2020
Excessive sweating is common and can affect the whole body or just certain areas. Sometimes it gets better with age but there are things you can do and treatments that can help.
What is excessive sweating?
It’s normal to sweat if you get hot or do exercise, but you may be sweating excessively if you’re sweating when your body doesn’t need to cool down. Excessive sweating can happen for no obvious reason, because of another condition you may have or as a side effect of medication you’re taking.
Things you can do to help with excessive sweating
Do
wear loose-fitting clothes to minimise signs of sweating
wear socks that absorb moisture and change your socks at least twice a day if possible
wear leather shoes and try to wear different shoes day to day
Don’t
wear tight clothes or man-made fabrics – for example, nylon
wear enclosed boots or sports shoes that may cause your feet to sweat more
do things that might make your sweating worse – for example, drinking alcohol or eating spicy food
Treatment with botulinum toxin temporarily blocks the nerves that cause sweating. Your skin will be iced or anesthetized first. Each affected area of your body will need several injections. The effects last six to 12 months, and then the treatment needs to be repeated. This treatment can be painful, and some people experience temporary muscle weakness in the treated area.
How to get natural-looking and kissable lips with a lip filler
Fillers in Dubai | 3 October 2020
Lip Fillers, also known as Lip Augmentation or Lip Injections, are a popular treatment which addresses many lip concerns.
Increases fullness of thin lips.
Enhances lip definition
Creates a more defined smile
Give the mouth area a youthful, rejuvenated appearance
Dermal fillers are also effective for smoothing out ‘Lipstick Lines’ or ‘Smokers Lines’ around the mouth, as well as other troublesome areas on the face.
There are many reasons why people are unhappy with the shape and size of their lips. For some their lips have started to appear thinner and less defined as a result of the natural ageing process. For others their lips have always been narrow with a less pronounced cupid’s bow. Make-up can create the illusion for fuller lips, however many lipsticks are prone to smudging, distorting and bleeding into the vertical lines known as ‘lipstick lines’ above the mouth.
My lip fillers have been specifically developed to enhance the natural pattern of your lips, helping you achieve more defined, beautifully shaped, bigger lips. My semi-permanent fillers are a manmade, non-animal gel that mimics the body’s natural hyaluronic acid, giving safe, long-lasting and natural looking results.
There are many lip fillers on the market that are substandard in terms of ingredients and quality. I only use the most advanced temporary lip filler range available.
BENEFITS OF LIP FILLERS
Lip Fillers lend volume and definition to lips, producing a sensual, more pronounced pout.
Gives a more youthful, rejuvenated appearance
Can help turn the corners of the mouth upwards
The treatment is non-invasive with virtually no recovery time necessary; you can resume your normal activities immediately after treatment.
Non-permanent and will naturally break down.
Suitable for Vegans
The treatment can be tailored to your needs providing a natural look.
Your injectable filler treatment: What to Expect
Fillers in Dubai | 27 September 2020
Dermal filler injections are non-surgical and typically completed during an office visit. Your initial treatment will begin with a consultation, during which you will meet with your cosmetic surgeon to discuss your concerns and goals.
Pre-treatment consultation
During your consultation, your cosmetic surgeon will evaluate your area of concern and review your medical history. While the risks associated with dermal fillers are minimal, you need to fully disclose your medical history prior to treatment, as certain allergies, skin and neurological conditions, or medications can jeopardize your safety or results. For instance, you need to tell your cosmetic surgeon if you have been taking NSAIDs (e.g., aspirin, ibuprofen, naproxen) or blood thinners, as these increase the likelihood of bruising.
Your injectable filler treatment
Just before the actual treatment, the area will be cleaned, and you may be given a topical anesthetic to numb the area prior to injection. Many filler products also contain lidocaine, a mild anesthetic, which is intended to help minimize discomfort during and after your treatment. Your provider will then inject a precise amount of filler strategically beneath the skin. Depending on the product and the areas treated, you should be able to notice results immediately after receiving filler injections. Some patients experience mild bruising and swelling, but these are temporary and should subside over the days following treatment. You will be able to go back to your normal activities right after treatment, but your cosmetic surgeon may ask you to take the day off from exercise or other strenuous activity.
If you are having fat injections
Facial fat grafting is a surgical procedure and follows a different treatment protocol. Typically, fat grafting is performed as an outpatient procedure, using general anesthesia or local anesthesia with sedation. Up to 2 weeks of downtime may be required, depending on the extent of liposuction performed. Your cosmetic surgeon will go over what to expect with surgery and recovery during your consultation.
Tummy Tuck: Know you options…
Tummy Tuck Dubai | 24 September 2020
What are the alternatives to tummy tuck?
Although it’s not strictly an alternative, you might be able to have liposuction to reshape your abdomen. This is where your surgeon uses a special machine to suck out excess fat from under your skin. You can have it on its own instead of a tummy tuck, but it only removes fat, whereas a tummy tuck removes fat and skin. After liposuction, your skin will shrink back a little, if you’re younger and your skin is still quite elastic. But if you have loose skin or muscles before the operation, then liposuction alone won’t be effective. Liposuction might be helpful if you’re not generally overweight, but have localised areas of fat that you want to get rid of. If you have excess skin, liposuction alone won’t be effective. Liposuction may occasionally be an added part of a tummy tuck procedure. As with any medical procedure, liposuction can have side-effects and longer-term complications. Your surgeon will tell you about the potential risks and benefits of tummy tuck and any other treatment options available to you.
What happens during a tummy tuck?
Depending on how much fat and skin you’re having removed and the technique your surgeon is using, the operation can take between two and four hours. There are several types of tummy tuck. The one you have will depend on how much skin and fat you have removed. Your surgeon will discuss this with you and explain which type is most suitable for you and why. Occasionally, liposuction may also be done at the same time as your tummy tuck, but your surgeon will explain whether this is needed.
Standard tummy tuck
Your surgeon will make a cut in your abdomen from hip to hip along your pubic area (in women this is also called your bikini line). They’ll make another cut around your belly button to free it from the surrounding skin. Then the repair will tighten your abdominal muscles and remove excess fat and skin. The remaining skin is pulled down and a new hole is made for your belly button so that it is in the correct position. You’ll have a scar around your belly button and a long curved scar on your abdomen above your pubic area. Because of the normal pattern of pubic hair, the scar is generally higher in men than in women. You can usually hide these scars with your underwear or with swimwear such as a bikini or shorts, but this may not always be possible. This will differ from person to person and on the type of tummy tuck you have. Your surgeon will explain the scars you’re likely to have.
Mini tummy tuck
You can have a mini tummy tuck if you only need to have a small amount of skin or fat removed. Your surgeon will remove excess skin and fat from below your belly button and you usually have liposuction at the same time. Afterwards, you’ll have a curved scar on your abdomen above your pubic area. This may be slightly shorter than with a standard tummy tuck. Your belly button stays in the same place, but it may be a slightly different shape.
BREAST AUGMENTATION: UNDERSTANDING THE SURGICAL PROCEDURE
Breast Augmentation Dubai | 21 September 2020
Having fuller more voluptuous breasts is a very important part of feeling feminine and more confident for women. The breasts give the female body more proportion, curves and shape, which makes many women feel more sexy. There are a variety of factors that make women unhappy with their breasts. Such factors include the effects of aging, gravity which leads to sagging, post pregnancy changes and natural asymmetry. A breast augmentation helps women improve the overall appearance of the breasts and cleavage. This results in an improved self esteem, confidence and feeling sexier about your body.
Reasons why women seek breast augmentation include:
Improved body proportion
Correct loss of fullness or sagging due to aging, gravy, or pregnancy
Improve cleavage appearance
Increase breast shape and size
Correct asymmetry of the breasts (one breast is larger than another)
WHAT TECHNIQUES ARE INVOLVED?
Breast augmentation involves the placement of an implant under the patient’s breast tissue to enhance the size and shape of the breast. The breast implants are usually inserted using an incision placed under the breast at the crease, but can also be put in via an incision in the armpit or around the nipple. Breast augmentation surgery takes about one and a half hours, and is usually done under general anaesthetic. The operation itself involves accessing and creating the pocket into which the implant will be placed, using one of the insertion routes mentioned above: breast-crease, armpit or nipple.
Incision Options
There are three different types of incisions that can be performed when getting a breast augmentation surgery. These incisions are Inframammary (incision below the breast), Transaxillary (through the armpit), and Peri-Areolar (along the lower edge of the Areola). Dr Vigo will go over the different options available to you during your consultation, showing you the benefits of each option and explaining exactly how they are performed including the associated recovery time for each.
Inframammary
An inframammary incision is the most common incision when getting a breast augmentation. This incision is made in the fold below the breast and carries a very low risk of complications. Inframammary incisions are highly recommended for large pre-filled implants such as silicone. These incisions are usually discreet as it goes along the natural crease below the breast, however, on occasion the scar may be visible due to the size or shape of the implant. All patients heal at different rates. Your incisions will be monitored after surgery and tailor your scar managment to optimize healing and appearence. Proper care and maintenance of your incisions will be closely followed with you as you heal.
Peri-Areolar
A Peri-Areolar incision is done around the bottom edge of the areola and is typically four to five centimeters in length. This incision is very discreet after it is healed. Often times it is impossible to notice as it goes along the natural edge of the areola. The trade off risks and benefits of their incision approach will be disscused at the time of your consultation. Some women may experience difficulty with breast feeding after this incision approach. Nipple sensitivity is also jeopardized with this approach compared to other incision sites.
Transaxillary
A Transaxillary incision is the least visible of the different incision options as it is made in the armpit. This ensures there are no scars anywhere near the breasts. The breast augmentation procedure is performed using an endoscope during the surgery, which allows the surgeon to see the implant inside the pocket. Having the ability to see the implant inside the pocket allows for the best surgical decisions and precise placement of the implant. Implant type is limited by the incision, as only round smooth implants can be placed through this incision.
Once the pocket has been created, the surgeon may insert a trial implant to check that the size chosen is appropriate. The trial implant is removed, the definitive implant inserted and the incision wounds are stitched. You will be able to go home the same day. Postoperative pain in these procedures is easily controlled. Your chest will feel tight. Your breasts and ribs below your breasts will be tender. Patients will be mobile from day one and should be back to full exercise within six weeks. Patients are recommended to take around one to two weeks off work immediately after the operation in order to ensure you recuperate fully.
Implant Placement Options
There are two choices when it comes to the placement of the breast implants you select. They are subglandular (above the muscle) or submuscular (below the muscle). The benefits of each of the different placement options will be discussed with you at your consultation with a recommendation of a specific placement option depending on the natural shape of your breasts or your overall goals for getting a breast augmentation.
Subglandular
Subglandular placement is when the implant is placed above the muscle. During this placement, the implants are placed below the natural breast tissue and the surgery is usually quicker but the recovery time is about the same as below the muscle. One of the benefits of subglandular placement is that if future surgery may be required due to rupture or leakage, it allows for easier access to the implant. However, subglandular placement does also have its downsides, such as an increased risk of capsular contracture, concerns about breast views on mammography, and the implant may be able to be felt through the skin.
Submuscular
Submuscular placement is when the breast implant is put under the pectoral muscle. The benefit with submuscular placement is that the final result of the breast augmentation will look and feel more natural. Any breast imaging will be easier including mammographies, because it is easier to differentiate the implant from real breast tissue. Most patients are able to drive in a few days and you may shower the next day. Most surgeons agree that implants under the muscle are in the best position for the long term health of the patient.
Dual plane augmentation
When slender women with slightly drooping breasts seek breast augmentation surgery, surgeons often combine these two routes, placing the implants partly behind the breast and partly behind the muscle. Through this combined approach surgeons try to give patients the benefits of both techniques. This is called a dual plane augmentation.
BEFORE BREAST AUGMENTATION SURGERY
Before going into breast augmentation surgery, it is very important to get a good nights rest. You must follow the instructions given such as limitations to food or medications the day before surgery. All of this is important to get the best results and have the quickest recovery possible when getting surgery.
On the day of surgery make sure you have a friend or family member drive you to the surgical facility. You may be very sleepy from anesthesia after the surgery. Before surgery, your surgeon will review the choices you selected and answer any final questions or concerns you may have.
Your body will then be marked and you will be guided through exactly what will happen during the surgery.
Tummy Tuck – consider the reasons that you want to have the surgery
Tummy Tuck Dubai | 15 September 2020
If you have spent endless hours in the gym and followed a healthy and well-balanced diet but still struggle to achieve a flat tummy, you may be thinking about a tummy tuck. There may be times that excess fat and skin simply don’t respond to diet and exercise, especially in the abdominal area. The reason for that lingering fat and skin may be weight loss, pregnancy, or the simple result of aging. Some new moms even get tummy tucks as part of a “Mommy Makeover” that allows for a whole body overhaul. A new mom can get a breast lift, a tummy tuck, and a breast augmentation to become virtually a whole new woman. No matter what the reason that you are thinking about a tummy tuck, I can help. A tummy tuck can help restore your self-confidence and allow you to feel good about yourself again.
To decide whether tummy tuck surgery is right for you, you should first consider the reasons that you want to have the surgery.
The best reason to get a tummy tuck: You want one! This is something that you should do for yourself, not because someone else tells you that you need it or should have it. Although you can always consider the thoughts of your partner, your own thoughts on the tummy tuck are the most important thing by far. In short, tummy tucks are only right for people who truly want them or truly feel they need them.
While every person may have different reasons for wanting a tummy tuck, here are some of the most common.
• Have you struggled to get your flat tummy back following the birth of your children? Do the stretch marks in your abdominal area make you feel miserable when you look at them?
• Have you found that the older you get, the harder it is to keep the stomach area toned?
• Have you experienced a significant weight loss after weight loss surgery and now find that you’ve got excess skin that makes your abdominal area look awful?
• Do you exercise and put considerable effort into toning your tummy, but never get the results you’re looking for?
• Do you diet and eat right, but find that your abdominal area just doesn’t respond like the rest of your body does?
Any of these reasons can be excellent reasons for choosing a tummy tuck. However, it is important to know that a tummy tuck can’t replace weight loss. It is not a magic bullet that will instantly take a person from being very overweight to being super svelte. However, people who are of healthy weight – or who are as close as possible to their ideal weight range – can often benefit enormously from a tummy tuck.