Abdominoplasty / Tummy-Tuck
Body Lift
Liposculpture / Liposuction
Microfat Injections
Buttock Augmentation
Calf Augmentation

Abdominoplasty/ Tummy-Tuck

Through the hormonal changes of pregnancy or weight gain, the rectus abdominus muscles move apart (diastasis) and the lower abdomen distends with external and internal fat. Abdominoplasty is not a good operation for the obese. Like liposuction, abdominoplasty is indicated in those who have lost weight through diet and exercise have attained their ideal body weight but have a remaining “apron” of fat and lax skin. Similarly, it will not tackle the problem of intra-abdominal obesity.

A mini-abdominoplasty involves removing skin and fat excess from the lower abdomen without scars around the umbilicus. It does not address upper abdominal excess significantly. It is the only type of abdominoplasty that I am prepared to consider in smokers. This is due to a significant increase in the incidence of skin slough in these patients.

A full abdominoplasty involves plicating the rectus muscles in the midline and narrowing the waist. The umbilicus is repositioned. The skin is redraped and excess tissue is selectively removed. Liposuction is possible in limited or adjacent areas.

Occasionally abdominoplasty and hernia repair can be combined.

The ideal candidate for a full abdominoplasty has completed their family (no further pregnancies planned), is a non-smoker, has attained near to their ideal weight, is motivated in keeping with lifestyle changes (healthy eating and exercising), has no major medical conditions (heart disease, a history of thrombosis, diabetes) and is willing to accept a lower abdominal scar.

Body Lift

This is an all-encompassing term that refers to the surgery that I do following massive weight loss.

Bariatric Surgery has revolutionized weight loss and is one of the fastest growing procedures in the world. It is not without complication. When considering cosmetic surgery, a patient who has undergone bariatric surgery must consider the following. Depending on the weight-loss procedure that was performed you may have:

• Vitamin and trace element deficiencies
• Electrolyte imbalances
• An increased risk of anaesthetic complications
• Other malabsorption problems
• Wound healing problems

I require a 1 year period of ideal weight and lifestyle stability before considering you for cosmetic surgery post bariatric surgery.

Massive weight loss is indiscriminate on the normal “fatty anatomy”. The most desirable bodies do not look like sticks. We need curves in the right places for the ultimate sexy figure. I believe that purely resecting the skin excess after massive weight loss results in an unshapely, elderly look to the body. I frequently, therefore, recommend that Augmentation of the buttocks and breast be combined with the body lift procedures (buttock and thigh lifts, abdominoplasty and brachioplasty).

Scars are noticeable in body lift procedures, particularly brachioplasty, abdominoplasty and buttock/ thigh lifts.

Liposculpture / Liposuction

Liposuction is not a weight loss treatment. I will perform liposuction in patients who have committed to healthy living. It is only indicated for disproportionate fat deposits that will not disappear with diet and exercise. For example, “love-handles”, buttock deposits, “saddle-bags”, inner thighs and selective abdominal deposits.

Liposuction in excess can lead to serious complications. I limit myself to 5 litres per procedure. I follow strict guidelines as laid down in “The Practice Advisory on Liposuction” by The American Society of Plastic Surgeons.

Microfat Injections

Fat loss in the face is one of the most telling signs of facial ageing. Microfat injection is a way of permanently returning volume and reshaping certain areas. The microfat grafts survive better than the traditional fat grafts. This results in less chance of overcorrection and fewer procedures. I will frequently combine face lift and blepharoplasty procedures with microfat grafting.

Latest research shows that the stem cells found in fat grafts promote revascularisation and neovascularisation. This is especially useful in the treatment of scars. Repeated fat injections into tissue that has been damaged by radiotherapy can markedly improve the overlying skin and even heal ulcers. Fat is therefore not only regenerative and reconstructive, it is actually therapeutic. This is why we see the skin take on a rejuvenated look after we have treated patients with fat injections

Fat can also be used for mild to moderate breast augmentations.

Buttock Augmentation

Buttock Augmentation is fast gaining popularity as the shapely figure is recognised as desirable. The female (and male) buttock, like the breast, is a symbol of fertility and sexuality. However, far less is written about the intricacies of buttock augmentation. The anatomy of the buttock area is also more complex than the breast.

Augmenting the buttock involves the use of silicone implants often combined with fat grafting and liposuction to adjacent areas. I prefer placing my implants intramuscularly, this decreases the potential complications of nerve damage and implant extrusion. I place a single scar in the natal crease so that it remains fairly well hidden.

I occasionally augment the buttock with tissue flaps as part of body lift procedures.

The biggest post operative hassle is that you may not sit for three weeks; please bear this in mind when making travel arrangements.

Calf Augmentation

There are 2 distinct groups of patients who request calf augmentation, body builders and women with very thin calves. I approach each group differently and use different implants.

Up to 4 implants are needed, depending on the muscle deficiency and desired result.

Three days of leg elevation is required before gradual return to normal ambulation. The scar is placed in the popliteal crease (behind the knee).