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- WHAT ARE THE 5 MAIN PROCEDURES IN TOTAL BODY MAKEOVER SURGERY ? (and HOW MUCH THEY COST YOU)
Total Body Makeover Surgery can change up to 90% of your body appearance. Due to this fact, this particular procedure is becoming more popular all over the world where Plastic Surgery facilities are available. The indications are for removal of excess skin after massive weight loss or simply following multiple pregnancies, where the youthful skin firmness is loss and instead being replaced by unsightly flabby tissue. How much is the Cost of Total Makeover? Read till the end to find out. Procedures such as Liposuction alone may not be sufficient to overcome this. Total Makeover Surgery is also gaining popularity with the increasing number of Bariatric Procedures being performed lately. So what actually this surgery consists of? The 5 Main Procedures of Total Body Makeover are; 1) ABDOMINOPLASTY (2 TO 4 HOURS) Abdominoplasty or Tummy Tuck is a procedure to remove the excess skin in the abdomen and followed by recreation of a new umbilicus. It is suitable for those with excess flabby skin of the abdomen. The main objective is to remove the excess skin and recreate a shapely and taut abdomen, with a nicely-placed small umbilicus that is swimwear-ready. Abdominoplasty may or may not be combined with liposuction, depending on the Plastic Surgeon’s assessment. There are several type of Abdominoplasty such as the Total Abdominoplasty, High lateral-tension Abdominoplasty, Fleur-de-Lis Abdominoplasty and 360 Degree Abdominoplasty. A Plastic Surgeon with the track-record of performing high volume Abdominoplasty cases will be able to provide the best results that you wanted, as Abdominoplasty is a highly-demanding procedure that needs to be tailored exclusively to each individual patient. 2) ARM LIFT ( 1 TO 2 HOURS) Arm Lift or also known as Brachioplasty, is the procedure to remove the excess hanging skin of the arms. There are 2 typed of Arm Lift, namely the Long-scar Arm Lift and the Short-scar Arm Lift. The Long-scar technique involved incision from the elbow to the axilla and the scar will be hidden in the underside of the arm. On the other hand, the Short-scar technique will utilize the incision only within the axilla. The former is only feasible for patients will minimal skin excess. The resultant scar after Arm Lift Surgery can be minimized using specialized techniques such as scar massage, silicone gel, LASER treatment and RadioFrequency method. 3) THIGH LIFT (1 TO 2 HOURS) Similar to the previous 2 procedures, Thigh Lift is again indicated to remove the excess skin of the body, and in this case, the thigh. There are also two types of Thigh Lift, namely the Long-scar Thigh Lift and the Vertical Thigh Lift. The Long-scar Thigh Lift involved surgical incision along the length from the knee to the groin. The Short-scar thigh lift will only have scar within the groin region. Depending upon the assessment by the Plastic Surgeon, the short scar option is only appropriate for minimal to moderate skin excess. 4) BUTTOCK LIFT (2 TO 3 HOURS) To overcome the problem of sagging buttocks, we can do the Buttock Lift procedure. There are 3 options to achieve this objective, a. Gluteal turn-over Flap The adipose-cutaneous tissue of the lower back is rotated down to augment the buttock. b. Fat Grafting ( Brazilian Lift) In this procedure, fat grafts are used to fill up the space in the buttock to create firmness. c. Silicone Gluteal Implant Silicone Implants can be placed to elevate and create fullness of the buttocks. 5) BREAST LIFT ( 3 TO 4 HOURS) To complete the Body Makeover procedures, we can perform a breast lift procedure to overcome the sagging breasts tissue. Massive weight loss can result in loss of breast volume and sagging of the overlying skin and this can be very disturbing to the patient. In mastopexy, the breast tissue and nipple-areolar complex will be repositioned and the result will be a perky-looking breast. Sometimes, I may combine mastopexy with breast silicone implant insertion or breast fat grafting to add in additional volume. The price range for the combination of procedures are between rm25k to rm40k depending of which procedures are being performed together? WHEN IS SUITABLE TO UNDERGO TOTAL BODY MAKEOVER SURGERY? Most plastic surgeons will perform these procedures after the patients have obtained stable body weight of around 6 months. For post Bariatric Surgery patients, it is best to wait for at least 18 months after the surgery to allow for complete healing and stable weight. CONCLUSION By understanding what Total Body Makeover Surgery consists of, we can make an informed decision to determine which procedure is the best for us. Learn more about other Plastic Surgery procedures here Breast Augmentation, Liposuction, Abdominoplasty, Bhlepharoplasty, Otoplasty, Non-cosmetic Plastic Surgery, Hair Transplant, Buccal Fat Removal. Learn about the most popular Plastic Surgery for Man Learn about the price of Liposuction in Malaysia.
- FACELIFT IN MALAYSIA 5 MOST COMMON QUESTIONS
In 2022, Facelift is in the top 10 most popular Plastic Surgery procedures performed worldwide, amounting up to more than 400 000 cases. This upward-going trend is similar to other Cosmetic Surgeries procedures. This similar trend has been ongoing for the last decade and will continue so for the coming years, with the projected combined revenue in Asthetic Plastic Surgery industry alone of approximately 100 Billion USD by 2030.
- BREAST IMPLANTS SURGERY MALAYSIA - 7 COMMON QUESTIONS
There were 193,073 cases of Breast Implant surgeries performed in the US in 2020 alone, accounting for one of the top 5 most-requested procedures in Plastic Surgery. The price for Breast Augmentation surgery in Malaysia ranges from rm25k to rm35k, varying between different Cosmetic Surgery Clinic ran by Plastic Surgeons. This trend is similar to other procedures such as Liposuction, Abdominoplasty, Hair Transplantation, Otoplasty, Buccal Fat Removal and Facelift. The followings are 7 of the Most Commonly Asked Questions regarding Breast Augmentation Surgery : 1) WHAT ARE THE DIFFERENCES BETWEEN BREAST AUGMENTATION AND BREAST MASTOPEXY? This is of course the first thing that will go through your mind when getting a consult for a breast augmentation procedure. Most of the indications are loss of breast volume and/or projection, following multiple pregnancies, weight loss or tumor removal surgery. The first thing that a Plastic Surgeon will determine is whether the patient need a breast augmentation or breast mastopexy ( reshaping) or a combination of both procedures Breast augmentation is performed using either : 1) Implants ( saline or silicone) 2) Fat grafts 3) Flap procedure ( transfer or adjacent body tissue to augment the breast size) Breast Mastopexy on the other hand, is when we can reshape the breast by rearranging the tissue to recreate the projected appearance and reposition the nipple-areolar complex We may do a combination of these 2 procedures if there are significant drooping of the breast together with loss of volume. 2) HOW LONG DO THE IMPLANTS LAST? The common connotation is that breast implants need to be replaced every 10 years. However, the newer technology in implants manufacturing nowadays enable them to be inside the body for a much longer period. MENTOR for example, stated that they have a lifetime guarantee for their breast implants. 3) HOW TO KNOW WHICH SIZE IS BEST FOR ME? In my practice, the determination of breast implants size is done together with the patient. We will ask the patient to give an idea of what size that she wants, (based on photo-reference if possible). The patient lifestyle is also an important aspect that will be taken into consideration. A person who is an avid runner or swimmer will require the selection to be tailored accordingly. Following this, an exact measurement of the following parameters will be taken: 1) Breast base diameter 2) Nipple to Inframmary crease distance 3) Upper border of the breast level 4) Degree of breast skin laxity 5) Chest diameter The most suitable breast implants size will need to comply with these ideal calculations for each individual assessment. For example, if a small-chested patient want to have an extremely large implants, she may end up with a lot of post-procedure problems like neck pain and difficulty to do daily activities. 4) HOW IS A BREAST IMPLANT SURGERY PERFORMED? Basically the 2 important aspects of Breast Implant surgery is the skin incision type and plane of implant placement. Skin incision There are 4 ways to insert the silicone implant 1) Inframmary Incision · This is the most popular approach where the implant is inserted using an incision below the breast. 2) Periareolar incision · In this type of incision, the cut is around the lower half of the areolar. 3) Trans-axillary incision · The incision is done under the axilla. An endoscope can also be used for this type of procedure to assist in tissue dissection 4) Peri-umbilical incision · An implant in inserted from the abdomen. This is the least popular approach as the difficulty to dissect the tissue and risk of infection is significantly higher. ò Plane of placement There are 3 different plane to place the implant 1) Subpectoral · The implant is placed underneath the Pectoralis Major muscle of the chest. 2) Subglandular · The placement is underneath the breast tissue but above the muscle. 3) Subfacial · The implant is placed under the fascia of Pectoralis Major muscle. This plane may cause a lot bleeding during the dissection process. Most Plastic Surgeons will do a dual-plane insertion technique, there the lower portion of the implant is underneath the breast glands while the upper portion will be under the muscle. 5) WHAT TO EXPECT FOR POST-SURGERY PAIN AND RECOVERY? The post-operative pain is managed with analgesia given by the anaesthetist. The patient will be required to wear a special bra for 3 to 6 months. Swelling will gradually resolve within the next 1 to 3 months. The breasts will settle into the final shape and location after 6 months on average. 6) CAN THE IMPLANT RUPTURE? It is very unlikely to rupture, including when flying in a aircraft, as the implant materials are quite solid. In my practise, I have rarely seen cases of implant ruptures, except after severe blunt trauma to the Implants. This is similar to any type of Implant in the body, not limited to breast implants only. 7) WHAT ARE THE RISK OF THIS PROCEDURE? The risks of breast implants insertion are similar to other types of Surgery, namely infection, hematoma formation and device extrusion or malposition. The specific risks such as loss of nipple sensation or difficulty to breastfeeding are more dependant on the type of technique used. The Plastic Surgeons will discuss them in detail during their preoperative consults.. CONCLUSION Understanding How and Why certain steps are taken is vital to ensure complications can be avoided while obtaining the best results possible. Learn more about common Plastic Surgery procedures for men here and Plastic Surgery procedures that are covered by health insurance here Keep learning about other procedures here : Liposuction, Abdominoplasty, Hair Transplantation, Otoplasty, Buccal Fat Removal How much is the cost of Liposuction in Malaysia?
- BUCCAL FAT REMOVAL SURGERY MALAYSIA (7 TOP QUESTIONS)
500 years ago, Heister first discovered a collection of fat tissue at midfacial area, currently referred to as the Buccal Fat, little did we know that it can be removed to reshape the face! Currently, this area of fat is targeted for removal to achieve a chiseled look and reduce the chubby-face appearance. Buccal Fat Removal is one of the highest demanded procedure in Plastic Surgery of 2022, similar to other procedures such as Liposuction, Abdominoplasty, Hair Transplantation, Otoplasty and Breast Implants. WHAT ARE THE 7- KNOWN FACTS of this procedure? Knowing these FACTS is important to ensure you avoid the unnecessary complications, and to assist in faster recovery. 1) AM I SUITABLE FOR BUCCAL FAT REMOVAL? One of the complications of Buccal Fat Removal is the appearance of a gaunt expression. This happens when the procedure is performed without properly assessing the patient. Buccal Fat Removal is not recommended for patients with extremely thin face or extra prominent maxillary bones. A meticulous assessment by the Plastic Surgeon is important to ensure the correct indication for the surgery. 2) CAN BUCCAL FAT REMOVAL CAN BE DONE TOGETHER WITH OTHER PROCEDURES AT THE SAME TIME? Yes, Buccal Fat Removal can be either done alone or in combination with a Facelift procedure. When performing this procedure alone, I usually do it using the intra-oral approach, meaning the incision to reach the fat is from the oral mucosa. On the other hand, if I performed a simultaneous Facelift procedure, then the fat can be approached via the facelift incision from the lateral cheek without requiring the intra-oral approach. However, the extra-oral approach will carry a higher risk of nerve injury, as we need to dissect more through the facial muscles compared to the latter, hence it requires more care in doing so. 3) CAN FAT-MELTING PROCEDURES REMOVE BUCCAL FAT? Fat melting procedure is not effective to removed the buccal fat. This is due to the deep location of the fat, behind facial muscle layers. The energy delivered by these machine will not be able to reach the targeted cells, rendering it to be ineffective. 4) WHAT TYPE OF ANALGESIA IS SUITABLE Buccal fat removal can be done either under Local Anaesthesia or General Anaesthesia. For the intraoral approach, the procedure is performed via an incision on the buccal mucosa posterior to the Stensen Duct's opening, close to the bite line. The buccal fat is the identified, behind the Buccinator muscle. Care is taken during the dissection as to not injure the facial nerves. The amount of buccal fat that will be removed will be decided by the Plastic Surgeon on individual basis. 5) HOW IS THE RECOVERY PROCESS LIKE? The post-operative pain is usually minimal, however expect some degree of facial swelling for the first 3 to 5 days. The swelling will then gradually resolve by the end of first week. Usually I will prescribe medications such as analgesic, antibiotics and predinisolone to expedite the healing process. 6) HOW MUCH IS THIS PROCEDURE IN MALAYSIA? The cost of this procedure is between around RM6k to RM9k, depending on the type of anaesthesia and hospital stay. 7) IS THIS RESULT LONG LASTING? Yes, if done according to the correct indications, by a proper Specialist and at a certified centre, the result will last for a long time. This procedure is also commonly done for men. (Read here for other popular procedures for Male plastic surgery). CONCLUSION As, a conclusion, please consult a fully-trained Plastic Surgeon to ensure the procedure is safe and able to achieve the desired outcome.
- TOP NON-COSMETIC PLASTIC SURGERY PROCEDURE ?
Do you know that 80% of Plastic Surgery procedures are actually for non-cometic purposes? Despite of what we usually seen on television shows such as Nip and Tuck and Extreme Makeover. A HUGE PORTION of a Plastic Surgeon workload consists of this and some of them can be covered by Health Insurance Policies. Aesthetic procedures such as Liposuction, on the other hand, are usually not covered. Yes, this is true. This, by looking into the fact that there are 5 Subspecialties in Plastic Surgery, namely : BURN SURGERY In this subspecialty, the Plastic Surgeon will manage conditions such as Acute Burn Injury and Complications of Burn Injury. Domestic burn injuries account for up to 75% of all burn cases and oftentimes involve children at home. Burn injury can be due to scald from hot water or oil, chemical burn from acid or alkali, thermal burn, electrical burn and rarely, radiation burn. Management during the acute phase consists of detailed assessment by the Plastic Surgeon in order to lead the burn care team to stabilize the patient, followed by dressings and. Instituting analgesia, fluid resuscitation and antibiotics if indicated, specialized surgery procedures may be required such escharotomy, skin grafting or usage of skin substitutes and cultured-keratinocytes (skin cells). Other than this, the Plastic Surgeon can also provide treatment for chronic sequela of burn injuries. This is known as Burn Contracture, where the severe scarring arising from the initial injuries give rise to debilitating deformities. In these situation, procedures such LASER treatment, compression garments and contracture-release surgery can be utilized to treat the patients. HAND AND MICROSURGERY The second subspecialty in Plastic Surgery, but is equally important, is known as Hand and Microsurgery. In this highly-specialised field, the Plastic Surgeon will perform complex procedures such as connecting the blood vessels of nerves. This is referred to as microvascular anastomosis. This technique is useful when we want to cover large bodily defects after surgical excisions, soft-tissue injuries or burn injuries. Similarly in Hand Surgery, the microsurgery procedure will be used to reattach amputated hands or fingers. This surgery will take an average of 8 to 10 hours, followed by close monitoring of the patient in Intensive Care Units after completion. PAEDIATRIC PLASTIC SURGERY All of us must have came across children with cleft lip or palate. The repair of this condition falls under the scope of paediatric plastic surgery. Cleft Lip and Palate is a portion of a more complex deformity known as Facial Cleft. The best treatment can be delivered by a multi-disciplinary teams consisting of Plastic Surgeons, Anaesthetists, Dentists, ENT Surgeons, Speech Therapists and Paediatricians. Certain hospitals government and private hospitals, like Avisena Women and Children Hospital, will have a dedicated team to manage this type of cases. Other than this, paediatric plastic surgery cases also involve other areas such hands, ears or feet. For ears, conditions known as Microtia or Anotia occur when there is underdevelopment of the ears during the growing phase. Surgery techniques for the ear, like in Otoplasty, requires meticulous planning and execution. CRANIOFACIAL SURGERY Another subspecialty that is non-cosmetic Plastic Surgery is Craniofacial Surgery. This is another interesting area where conditions involving congenital deformity of the skull bones can be corrected. Do you know that a cone-shaped skull is known as Trigonocephaly, a flat-shaped skull Brachycephaly and a boat-shaped skull Scaphocephaly. Craniofacial Plastic Surgeons will rearrange the skull in a timely manner after careful assesment. COSMETIC SURGERY This is the most-popular subspecialty of Plastic Surgery, where procedures such as Abdominoplasty, Liposuction, Breast Augmentation, Bhlepharoplasty, Otoplasty, Hair Transplant and other aesthetic procedures are done. Lately, the trend for plastic surgery for men is also on the rise. CONCLUSION This is a very interesting look at Plastic Surgery that not many people are aware. By understanding this, you can plan your visit to the Plastic Surgeon and get the health insurance to cover the right procedures.
- LIPOSUCTION PRICE IN MALAYSIA
There are 1,525,197 cases of Liposuction performed in the US alone on 2021 with an increase of 70% of cases compared to 5 years ago. WHY IS THIS SO? Liposuction is getting more popular in Malaysia as well as other countries due to the the increase in self-awareness to stay healthy and looks good, especially with the advent of social media. This trend is similar to other procedures such as Bhlepharoplasty, Otoplasty, Breast Augmentation, Abdominoplasty, Hair Transplantation and many other cosmetic Plastic Surgery operations. Nowadays we have a lot of different methods to do liposuction such VASER Liposuction, LASER Lipolysis and Waterjet Liposuction. Truly, this plastic surgery procedure has evolved much since it was first introduced nearly a century ago. Liposuction can be performed alone or in combination with other Cosmetic Surgery procedures such as Abdominoplasty, Rhinoplasty, Bhlepharoplasty, Buccal Fat Removal or Silicone Breast Augmentation. The cost of Liposuction Surgery Malaysia is dependant on a few factors such as 1) Whether it is done in a hospital or a small clinic setup? 2) Whether the procedure is under general anaesthesia or local anesthesia? 3) Will there be a few days of hospital stay or just as a daycare procedure? 4) Which areas of the body that is going to be treated? 5) Will it be combined with another procedure? With this is mind, we can look into the price range for Liposuction in Malaysia, according to body area; LIPOSUCTION OF THE ABDOMEN RM 9000 TO RM 18000 Abdominal liposuction can be for the upper and lower abdomen. Usually this type of liposuction needs to be done under general anaesthesia due to the huge area of abdomen. Abdominal liposuction can also be performed to create the six-pack in men and women. LIPOSUCTION OF ARM RM 7500 TO RM 12500 Arm liposuction is another frequently-requested procedures. Liposuction of the arm will result in a nicely-shaped arms. However, if there is too much excess skin of the arms, liposuction is not suitable but the patient may benefit more from skin removal or also known as Brachioplasty. LIPOSUCTION OF SADDLE BAGS RM 7500 TO RM 12500 Liposuction of the saddle bags can be done to reshape this area of the body. Saddle bags or fat collection in the flanks is notorious as one of the areas with stubborn fat resistant to diet and exercise alone. LIPOSUCTION THIGH RM 7500 TO RM 12500 Similar to the saddle bags, thighs are another popular areas of liposuction. Thigh liposuction needs to be done carefully as it may cause irregularity of the skin surface if not perfomed properly. As for the other areas, the patient will be required to wear compressive garments for 6 to 9 months after liposuction to help recontour the treated areas. LIPOSUCTION OF CHIN RM4500 TO RM 9500 Double Chin Liposuction technique is slightly different due to the anatomical arrangement of tissue at this area. The chin is compartmentalized into. several zones by the delicate fascia and contains a lot of vital structures such a. blood vessels, lymphatic channels, salivary glands and nerves. The fatty tissue at this area too is different from those in other parts of the body such as the abdomen, as they are finer and less dense. Sometimes, to get the best treatment outcomes for double chin liposuction, additional procedures such as mesotherapy, radiofrequency, threadlift, microbotox and lymphatic massage. LIPOSUCTION OF THE CHEST (GYNAECOMASTIA) RM6000 TO RM 15000 Chest Liposuction for gynaecomastia is done either alone or in combination with surgical removal of breast tissue also known as Webster procedure. This procedure will take around 2 to 4 hours depending on the amount of tissue to be removed. The patient will be required to wear compressive garment and can revert to normal activity around 1 week after this operation. CONCLUSION As a conclusion, Liposuction is widely-performed in Malaysia. The most important thing is to get it done by a qualified at a certified centre to ensure safety while obtaining the best results as desired.
- 5 MOST POPULAR PLASTIC SURGERY PROCEDURES FOR MAN
Cosmetic Surgery Plastic Surgery for male is getting more popular nowadays especially with the advent of social media. Traditionally, Plastic Surgery has been more popular for the female population, and the procedures of choice are Liposuction, Abdominoplasty, Breast Augmentation, Rhinoplasty and Facelift. As for the opposite sex, the preferred procedures are slightly different as follows: LIPOSUCTION In man, the anatomy of abdominal adipose tissue is slightly different compared to woman. In female, most of the fatty tissue is located underneath the skin (subcutaneous) whereas for male, it is located inside the periteoneal cavity (visceral fat). This is a very important anatomical variation that will determine how the final outcome after this surgery will turn out. Abdominal six-pack creation liposuction is a unique type of technique that is used to sculpt the abdomen which is popular in man. To perform this procedure, the suction will be concentrated along the rectus sheath that demarcates the border of the six-pack. The most-suitable type of machine for these procedures are energy-based cannulas such as the VASER (Ultrasonic Liposuction) or LASER Lipolysis. The heat energy used to melt the fat by these machines will not only allow fat removal but also contraction of the overlying skin resulting in a nicely-shaped abdomen. RHINOPLASTY Rhinoplasty is also popular in the male population. Rhinoplasty can be divided into open and closed technique. Open rhinoplasty is when there is a transcolumellar incision to expose the cartilage. On the other hand, closed rhinoplasty involved just an incision around the alar rim. 3 most popular rhinoplasty technique for men are a) Dorsal Hump Reduction b) Augmentation Rhinoplasty c) Alar Reduction HAIR TRANSPLANTATION This is one of the highest-demanded procedure for man as male-pattern baldness growing in incidence. The two types of Hair Transplantation technique are FUE (Follicular Unit Extraction) or FUT(Follicular Unit Transplantation). Other than scalp, other areas of transplantation are beard, mouthache and eyebrow. In cases of early-phase hair loss, other options are hair serum application, PRP (Platelet-Rich-Plasma) injection, oral medications such as Finasteride or Dutasteride, Minoxidil and Diode-light therapy. BTa INJECTION There are 2 types of BTa injection technique, namely the intramuscular injection and microBotox Injection. Botulinum toxin injection can be used to reduce wrinkles at the forehead, Crow’s feet, nasal bunny lines and angle of mouth. One of the commonly-asked questions regarding BTa injection is how long does the effect last. To answer this question, we need to relook at the pharmacology of this treatment. The toxin acts by causing a non-reversible blocking to the neuromuscular junctions. However, there will be a formation of new neural pathways after 4 to 6 months resulting in the injectded muscles to regain their activity. Therefore, for optimal results this treatment may need to be repeated every 4 to 6 months. OTOPLASTY The is another procedure which has equal-demand between both sex. Otoplasty can be divided into incisional and non-incisional type. I have explained this procedure in depth in another Blog posting here.
- PLASTIC SURGERY REPAIR OF PROMINENT EAR ( OTOPLASTY)
The repair of prominent ears or otoplasty is one of the most frequently performed procedures in any cosmetic surgery clinic. The popularity is almost similar to other aesthetic surgery procedures such as liposuction, abdominoplasty, facelift, breast augmentation or rhinoplasty. This procedure is equally popular in both male and female population, and the main age group of my clients requesting for this procedure is between 20 to 35 years old. This is different from the demographic of patients coming for ear reconstruction in cases of under-developed (Microtia) or Absent (Anotia) Ears. For this type of procedure, the age group is usually younger, between 5 to 20 years old. Anatomy of Protruding Ears To understand how this procedure is performed, first we need to relook into the anatomy of the ear itself and what changes that happened causing the appearance of a prominent ear. Our ears, consist of structures known as the helix or the outer ear fold (refer to the diagram below). This is the outermost portion of the ear that gives it shape. Inside, we have the inner ear folds known as the antihelix and in between these 2 structures we have the conchas or the ear bowl.Behind these structures, at the portion where our ear is attach to the head, this is where the mastoid bone is located, and this area is referred to as the mastoid area. This particular area is worth mentioning as I will explained later the different suture-placement technique of otoplasty that involve the different areas, and this is one of them. The appearance of a protruding ear is due to the changes in the proportion of these structures to one another. For example, when one may has a prominent helical rim, but a relatively small antihelix or another example is when the concha bowl is too shallow. These changes will give the illusion of a protruding ear. Surgical Repair Techniques The repair technique of this condition is referred to as Otoplasty. There are 2 types of otoplasty, known as Open Otoplasty and Closed Otoplasty respectively. Open Otoplasty In Open Otoplasty, a surgical incision is done at the posterior portion of the ear, and the cartillages forming the helix, antihelix and concha are exposed. Subsequently, sutures will be placed to reshape these structures to reduce the appearance of a protruding ear. The suture placement can be between the Helix to Antihelix or AntiHelic to Concha or Concha to the Mastoid area. I will determine which type of suturing step to use based on my pre-operative and intra-operative assessment of the deformity. Otoplasty is one of my favourite Plastic Surgery procedures to do, as it involves a lot of artistic workmanship as does the surgeon's skills to get the most beautiful outcome possible. Closed Otoplasty On the other hand, in Closed Otoplasty, no surgical incision will made on the ear, but rather the sutures are placed percutaneously to reshape the cartillages. Both techniques can be performed either under local anaesthesia or general anaesthesia. The average surgical time to complete this surgery is approximately 30 minutes for each ear. Cartillage Scoring Some surgeons will also do scoring of the cartillages on the opposite surface to weaken them in order to reduce the incidence of recurrence a few months after surgery. This follows the Gibson Principle which states that all cartillages have memories, meaning that they will return to their opposite shape after being moulded to the opposite side. Therefore, the act of scoring will reduce this tendency and make the newly-shaped ear remains that way forever. What are the risk of this procedure? The surgical risk of this procedure is similar to other cosmetic plastic surgery procedures such as infection, hematoma and recurrence of the deformity. However, by getting this treatment done at a reputable centre by a trained Plastic Surgeon, these risks can be minimized while obtaining your desirable results.
- HOW DO WE TREAT EYEBAGS?
Eyebags are a very common problem that we see everyday in our Cosmetic Surgery Clinic. Usually the patients will say that they make them look tired whereas they don’t really feel so. Even in certain occupations, such as airline cabin crews, the presence of eyebags is not what their employers are keen of. To understand how eyebags are formed, we need to relook into the anatomy of the lower eyelid. The lower eyelid consists of a few structures that are closely inter-related to each other. We have the orbital septum, that separates the retro-septal fat from the skin anteriorly. The retroseptal fat is divided further into three separate components, namely the medial, middle and lateral. The medial and middle fatty tissue are separated by the inferior oblique muscle that controls the eyeball movement. Apart from this very delicate anatomical arrangement, we also have what is known at the tear trough portion of the lower eyelid. This segment is located next to the nasal bridge and the hollowness of tear trough varies between individuals. As you can see by now, this complex structures make the treatment of any condition here not as straightforward as it may seem. When tackling the issue of lower eyebags, first I will assess the integrity of the orbital septum, amount of fat protrusion, quality of the overlying skin and depth of the tear trough. The treatment plan will then be designed specifically based on which deformity that needs to be ironed out, either alone or in combination with one another. For example, if the the problem is due to very deep tear trough, the best option is fillers injection such as hyaluronic acid or fat grafts. On the other hand, if it is due to laxity of the orbital septum, then procedures such as microneedling or Carbon Dioxide LASERs can be utilized. Ultimately, if the issue is due to excessive protrusion of the retroseptal fat, then surgery may be the modality of choice.
- WHAT ARE THE TYPE OF HAIR TRANSPLANT?
A very popular procedure in Cosmetic Surgery and Plastic Surgery clinics nowadays is Hair Transplant. It is as popular as Abdominoplasty, Liposuction or Breast Augmentation. Two types of technique used in hair transplant is the FUT or FUE tecnniques. FUT or Follicular Unit Transplantation is performed by removing a strip of the scalp tissue in a longitudinal manner. Following this, the strip of tissue will be sliced to single hair follicles unit. FUE or Follicular Unit Extraction on the other hand, is performed by extracting each hair follicle one by one from the root. This is done using a special device that consist of a rotating cylindrical blade. Interestingly, currently there is a robotic system known as ARTAS than can do a wonderful job of extracting the hair follicles at tremendous speed. In terms of recovery, FUE are better in the context of less donor site pain and scarring as it does not need the long excision line used in FUT. However, the FUT technique is still being utilized in certain cases, for example when the donor site hairs are limited or low-lying. When comparing the operative time, FUT can done more quickly compared to FUE. The reason being that, excision the strip of follicles-containing skin, the step of slicing can be performed by many assitants at the same time even though this will incur additional cost of hiring them. The next step of implanting the hair follicles is the same for both technique. What is important though, to ensure high survival rate of the transplanted hairs, meticulous techniques during hair extraction and implantation is mandatoruy. In our centre, we used both FUT and FUE depending on the Plastic Surgeon assessment that fits the best for our clients.
- WHAT ARE THE TYPE DOUBLE EYELID SURGERY?
There are two types of Double Eyelid surgeries or also known as Upper Bhlepharoplasty. One is basically referred to as the Oriental Bhlepharoplasty. This is the surgery to create the upper eyelid folds, in Oriental population. In actuality, everyone has two eyelid folds, but the appearance of a single fold happens when the folds are located very close to eyelid margin. The other type of Upper Bhlepharoplasty is to remove the drooping upper eyelid skin that makes you look tired. This procedure will create a fresh-looking upper eyelid appearance. The steps for both procedures are almost the same, except for some minor difference. For example, in the Oriental Bhlepharoplasty, we need to create a newly located crease at a higher level than the existing one. To do this, the attachment of the levator aponeurosis will be relocate to the dermis. The standard measurement is approximately 3 to 4mm from the tarsal plate. For both procedures, the sutures will be removed after 1 week. Initially the eyelids will be swollen and we will advice to apply cold-compression using ice packs for the first 24 to 48hours to reduce it. Subsequently, once the sutured are removed, scar gels will be applied. The final results will be an inconspicuous looking scar that is well hidden in the new crease.
- WHAT IS THE DIFFERENCE BETWEEN AN ABDOMINOPLASTY AND A LIPOSUCTION?
Abdominoplasty or also more popularly known as tummy tuck is a procedure where we remove the excess abdominal skin. Sometimes we combine this procedure with rectus sheath plication, when we reduce the laxity of the abdominal muscle after multiple pregnancies by suturing the rectus sheath layer together. The effect will be like wearing a permanent corset where you will get a shapely abdomen. Liposuction, on the other hand, is a procedure when we use cannulas to suck out unwanted adipose (fatty) tissues. Both of these procedures can either be performed separately or in combination during a surgery, based on the Plastic Surgeon assessment. This beg the question, how do we decide on which procedure is more suitable then? Abdominoplasty is generally indicated when you have excess skin. This usually happens after multiple pregnancies or massive weight loss. If the abdomen has too much excess skin, doing a liposuction on these areas will only aggravate the skin laxity, instead of improving them. On the contrary, if you have not much skin laxity, but a localized collection of unwanted fat in certain areas such as the saddle bag, arms or thighs, then liposuction will be more suitable. It also very important to note that, if both of these procedures are not a short-cut to losing weight. If let say, a patient with a BMI of 35 or above wants to reduce it to less than 30, other treatment modalities such as sleeve gastrectomy or intra-gastric balloon insertion are more appropriate. There are several different types of Abdominoplasty cosmetic surgery techniques than we can do such as the Mini-Abdominoplasty, Total Abdominoplasty with New Umbilicus creation, Circumferential Abdominoplasty or Fleur-de-lis Abdominoplasty. Sometimes we can combine it with aesthetic procedures such as Breast Augmentation, Rhinoplasty, Facelift or Arm lift during then same anaesthesia time. Similarly, for liposuction in our aesthetic clinic, we use a variety equpments from LASER Liposuction, to VASER, power-assisted or water-jet liposuction.