Category: Blog

The eyes are one of our most striking facial features but as we age, our skin slowly loses its elasticity causing the tissue of the brow, lower and upper eyelids to sag. This can cause both functional and aesthetic concerns. 

 

In the upper lids excess skin can interfere with sight, impairs vision and an upper lid blepharoplasty may offer a functional improvement. Removal of excess skin and fat can reduce the heaviness, create a more aesthetic lid crease and also provide an aesthetic improvement. Upper blepharoplasty is a common procedure where the skin of the upper eye is removed, placing the scar in a natural crease line. It is one of the commonest aesthetic procedures and results in minimal downtime with minimal risks and complications. It is often performed under local anesthetic. Sometimes small amounts of fat need to removed and occasionally fat needs to be added in the form of autologous fat transfer. It can also be performed alongside a brow lift, lower lid blepharoplasty and face-lifting surgery.

In the lower lids the fat that sits next to the lining of the eyeball often moves forward as the muscle and the septum, a thin membrane that separates the fat and the muscle, weaken with age. This septum is fixed to the bone of the orbital rim and as the upper facial structures drop the orbital rim can become more visible and often leads to a groove that is often referred to as the tear trough. Lower lid surgery can be performed through an incision inside the eye or through an incision on the skin. Sometimes small amounts of fat need to removed and occasionally fat needs to be added in the form of autologous fat transfer. More commonly the fat that was moved forward can be repositioned to disguise the groove or tear trough.

For patients in whom the midface has dropped and there is excess skin around the lower lids a lower lid blepharoplasty through a skin incision can be combined with a mid face lift. The mid-facelift in combination with lower lid blepharoplasty can tighten the sagging lower eyelid and the mid-face through a lower blepharoplasty incision with a net effect that the existing tissues are simply repositioned into a higher position. This can be performed with a facelift and in Mr. Ross’s practice is performed under general anesthetic.

It is important for all patient undergoing blepharoplasty procedures that you are a suitable candidate and it is important to consult with an experienced clinician regarding your aims and expectations. It is important to discuss any previous eye, eyelid / facial surgery or non-surgical treatments, any eye problems, past medical and surgical history, allergies, medications and whether you smoke. 

There are risks and complications and although these are rare if they happen to you they can be devastating. Take your time to do your research and do not rush into surgery. Mr. Ross only operates on around 30-40% of patients he consults with and will be able to give an honest opinion regarding the pros and cons of eyelid rejuvenation surgery.

 

Who Is It Suitable For?

Those with excessive skin and/or noticeable fat deposits. Excessive skin can even interfere with vision and removing the excess skin and removing/repositioning the fat can improve the appearance.

Who Is It Not Suitable For?

Those with unrealistic expectations and those with a significant medical history. It is important to declare any history of thyroid disease, glaucoma or previous eye surgery.

 

How Much Does A Blepharoplasty Cost?

This depends on what is required. After a consultation if you are suitable for eyelid rejuvenation surgery you will be given a quote for surgery that will include the surgeons, hospitals and anaesthetic fee.

 

What To Expect During Your Consultation?

The success of the consultation depends on your openness and honesty in relation to what troubles you and your expectations of surgery. You will be asked questions about your health, desires and lifestyle. Different operations can be tailored to your needs and the potential outcomes and the risks and complications will be discussed with you. The operation often involves the removal skin and removal / reduction or repositioning of fat. The operation can be combined with other operations such as a mid-face-lift or a brow lift.

 

Preparing For Blepharoplasty Surgery

Blepharoplasty procedures may be performed under either general or local anaesthetic. Your health is of prime importance and any cosmetic surgery should be postponed if you are unwell for any reason. It is important that if anything changes with your health that you make contact with us. You should ideally stop smoking 6 weeks prior to surgery and stop taking aspirin, anti-inflammatory drugs and herbal supplements before surgery. You may need preoperative tests prior to surgery, which we will arrange if required. You will generally experience bruising, swelling and discomfort following the surgery and should aim to be off work for at least 1 week depending on the type of work you do.

 

The Surgery

Blepharoplasty usually takes between 1 and 2 hours. For upper blepharoplasty an incision is made in the crease of the upper lid. For lower blepharoplasty an incision may be made on the skin below your lashes or within the eye. Skin is usually removed as required and the fat deposits may be reduced, removed or repositioned. The skin is sutured and some steristrips are often applied.

 

After Surgery

You will usually return to the ward within an hour following surgery. You will be able to drink and eat and mobilize. You will feel swollen and have bruising and discomfort that may require analgesia. You may be able to go home on the same day and should keep the wounds dry for the next week. You should keep your head upright and avoid hot baths. You will be given an ice pack to place over your eyes and you should keep this in place for the first 24-48 hours. You should arrange for someone to pick you up following surgery and have some support at home when you are discharged. You may experience either dry or watery eye and occasionally you will feel a sensation of grittiness for a few days/weeks afterwards. You should avoid wearing contact lenses for 2 weeks although for lower lid blepharoplasty this should be extended to 4 weeks. You will be reviewed in clinic and the eyes checked after a week and any stitches removed. The final results of blepharoplasty can take a few months to become apparent. The scars can be red initially but usually fade over time and usually fade to become a white line.

 

If you are interested in undergoing eye surgery, be sure to book in for a consultation to speak with Mr Ross about your available options and the best course of action.

Breast hypertrophy is a condition in which there is an increase in the size of the breasts out of proportion with the rest of the female body.  

Women with increased breast size experience symptoms such as neck / back / shoulder pain, headache, intertrigo in the inframammary fold, difficulty exercising and performing daily activities alongside, low self-esteem and body dissatisfaction. 

A breast reduction or reduction mammoplasty can provide women symptomatic relief while also improving quality of life. 

Recently a study from Brazil has looked at how breast reductive surgery can have a positive impact on productivity and health in the workplace.

The authors used a similar technique to Mr Ross utilizing a superior / superomedial pedicle with inverted T scar without the need for drains. Mr Ross believes that this technique allows a better long term result by maximizing the tissue higher up the chest wall while preserving as much tissue in the upper pole of the breast as possible. This method can produce an aesthetic result while removing sufficient volume to give a functional improvement.

The authors evaluated 60 patients with breast reduction resection weights median, 617.5 g and mean, 465g which is similar to Mr Ross’s practice. They subsequently showed that breast reduction surgery led to a decrease in working hours lost, impairment at work, overall productivity loss and also in daily activity impairment outside of work. 

The authors concluded that reduction mammaplasty improved the work capacity and productivity of women with breast hypertrophy. Thus, its implementation, in addition to providing physical and psychological benefits for women can result in direct quality of life gains for patients and indirect economic gains for the production sector. 

 

Reference

Cabral IV, Garcia ED, Sobrinho RN, Pinto NL, Juliano Y, Veiga-Filho J, Ferreira LM, Veiga DF. Increased Capacity for Work and Productivity After Breast Reduction. Aesthet Surg J. 2017 Jan;37(1):57-62.

Arnica montana, is a European flowering plant in the sunflower family which is noted for its large yellow flower head. The main constituents of are essential oils, fatty acids, thymol, pseudoguaianolide sesquiterpene lactones and flavanone glycosides.

Arnica montana has a history of medicinal use dating back to the 1500s and patients have been using Arnica to help reduce post-surgical swelling and bruising. It is postulated that Arnica’s actions may be due to two chemicals called helenalin and dihyrdohelenalin.

In plastic surgery where bruising and swelling can be more apparent the widespread use of arnica has often been recommended even though the evidence has been somewhat contradictory.  

A recent randomized, placebo-controlled trial study from Holland has evaluated arnica and its effect on patients undergoing blepharoplasty surgery. The authors evaluated patients who had undergone bilateral upper blepharoplasty patients into two study arms: One received arnica ointment 10% and the other a placebo ointment. The periorbital area of the treated side received either arnica or placebo ointment, whereas the opposite periorbital area received no ointment and served as an internal control. The overall periorbital appearance was assessed by a medical and nonmedical panel using light photography at 3 days, 7 days and 6 weeks. Swelling, pain, ecchymosis (bruising), erythema and patient satisfaction with recovery/outcome were also assessed.

The study found no significant differences between arnica and placebo justifying the conclusion:-

“Our study demonstrates that the use of topical arnica after upper blepharoplasty does not reduce postoperative ecchymosis, erythema, swelling, or pain of the eyelids, nor does it increase patient satisfaction with postoperative recovery or outcome.”

As the authors suggest this study should provide guidance to patients and clinicians about the role of arnica in postoperative recovery.

Mr Ross believes that patients should be empowered to make their own decisions regarding the use of Arnica Montana and does not routinely recommend its use within his plastic surgery practice.

 

Reference:

 

Van exsel DC, Pool SM, Van uchelen JH, Edens MA, Van der lei B, Melenhorst WB. Arnica Ointment 10% Does Not Improve Upper Blepharoplasty Outcome: A Randomized, Placebo-Controlled Trial. Plast Reconstr Surg. 2016;138(1):66-73.

Recent research from The British Association of Aesthetic Plastic Surgeons (BAAPS) found that ‘tweaked, not tucked’ has become the new ideal for many. Research has shown that there has been an increase in the number of people over the age of 60 undergoing plastic surgery treatments.  Additionally, research from The Independent Pensions Advisory Service (TPAS) found pensioners have been informing their advisers they would like to spend the money on cosmetic surgery such as breast enlargement, face lifts, and dental implants.

The reason suggested behind this increase in the over 60s undergoing cosmetic treatments is that many people are looking for a little extra help to match how they feel with how they look.  People are living longer and are in better health, many older adults are exercising on a regular basis and tying to stay fit. All of us want to look as good as we feel, and this may mean a nip and tuck here and there. 

Another factor affecting the increase in patients over the age of 60 has to do with people working longer these days. Many older adults are not fully retired and want to spend their pensions and extra cash on themselves to make them feel happier in their body. An article on Real Self interviewed an elderly lady who was shocked by her aged appearance and wanted to change her exterior to match the age she felt inside.  This notion of wanting to look as good as we feel seems to be the driving factor behind older adults undergoing plastic surgery, and many are feeling much better having done so. 

There have been questions raised surrounding older adults undergoing elective surgery at their age, but many professionals have addressed these questions. As with any surgery, it is important for the patient to be in good health before undergoing an operation, and just because a person is older, doesn’t mean they’re in poor health.  How healthy a person is doesn’t always depend on physical age, as long as the person leads a healthy lifestyle then being over 60 does not mean that they are at an increased risk during surgery. 

 

Vitamin D is a vital part of a healthy lifestyle due to its many health benefits. Vitamin D is important for growth and development of healthy bones and teeth, and is suggested to protect us against diseases such as cancer and diabetes. 

New research into the sources of vitamin D has found that the winters of Britain do not expose us to enough sunlight in order for our bodies to synthesise this and produce the vitamin D that we need. 

This research means that in the UK, we can’t rely on sunshine to meet our vitamin D requirements. The likely effect of this will be an increase in vitamin D supplements across Britain as we can’t get our entire vitamin D requirement solely from food. 

It is important that we lead a healthy lifestyle and as this new research has shown that many of us are likely to suffer a vitamin D deficiency in the winter months, we must look to other ways of meeting our vitamin D requirements. Taking Vitamin supplements and consuming food rich in vitamin D can help to increase a person’s daily intake of vitamin D and aid them in living a healthy lifestyle. For example, Marks and Spencer recently became the first retailer to fortify their complete range of bread products with vitamin D, increasing a person’s vitamin D intake from consuming these products. 

 

These lifestyle choices are important in the winter months when we may not be synthesising enough vitamin D from sunlight in order to meet our daily requirements.

With summer starting to show its presence, we will be swapping our winter boots for those summer time heels, but does wearing high heels damage your feet and cause any long-term damage? 

According to research, wearing high heels all day and having to walk around in them for long periods of time can cause and even worsen common conditions such as bunions and neuromas. 

We have listed a few warning signs to be aware of if you do wear heels often and for long periods of time:

 

• Pain in the ball of your foot or toe joints
• Shooting pains or numbness in the balls of your feet
• Bleeding underneath your toenails

 

According to research, it is safe to wear high heels for a few hours a day, like at work for example, or for a night out. It is advised that a broader heel is better than a thin, pencil type heel as a broader heel is more stable and reduces the pressure to your feet. 

There are plenty of options available to reduce stress levels and leave us looking good and feeling great, from wrinkle treatments to meditation. Below we look at some of the key factors that cause us to age and the ways you can combat these and start to feel more relaxed and rejuvenated inside and out.

 

Alcohol

– Alcohol dries out the skin, so reducing your alcohol intake is the simplest way to minimise the impact this has on the appearance of your skin. Make sure your keep your skin hydrated by drinking plenty of water.

 

Water Intake

– Increasing your water intake can drastically improve your skins appearance by increasing its radiance and healthy glow. Hydrated skin looks fresh and healthy and will drastically improve the effects of ageing.

 

Smoking

– Lines caused by smoking can be tackled with dermal fillers which plump out and fill lines. This is a particularly effective treatment for lines around the mouth.

– For deeper lines Botox can be used to ease deeper wrinkles around the mouth and eyes.

 

Lack of sleep

– Sleep tracking apps and devices will help you define your sleeping habits. These devices can recommend personalised sleep schedules, give you reminders of when it’s time to go to bed and tips for improving your night time routine.

– Meditation is a well-known way to reduce stress and anxiety, but did you know it can also improve sleep? One study showed that 58% of insomniacs showed significant improvements in sleep by practising meditation. The easiest way to drift off to a better night’s sleep is with a guided meditation app with features designed to ease you into sleep.

Increasing your hours of sleep will help your skin to appear less tired and will rejuvenate your facial appearance.

What Is An Abdominoplasty?

An abdominoplasty is also called a ‘tummy tuck’ and is an operation designed to rejuvenate the abdominal area and remove excess fat and skin. It is often performed on patients who have either lost a lot of weight or to remove the excess loose tissue following childbirth. In most cases it restores weakened or separated muscles creating an improved abdominal contour.

 

Who Is It Suitable For?

For those of normal stable body weight who have developed excess skin and / or fat. The common causes are pregnancy, weight loss, aging, genetic or due to prior surgery.

 

Who Is It Not Suitable For?

A patient who has been encouraged to improve their contour by others is not a good candidate for surgery as they may not actually be comfortable going ahead with surgery. Patients with unrealistic expectations are also not good candidates for surgery as they will never be happy with the results they achieve if they expect perfection or unrealistic outcomes. Patients who smoke or have a significant past medical history are also not ideal candidates for surgery. Those who plan to have more children should consider the pros and cons of an operation.

 

How Much Does A Tummy Tuck Cost?

This depends on what is required. After a consultation with Mr Ross you will be given a quote for surgery. This will include the surgeon’s fee, hospital fee and anaesthetic fee and will include all the benefits of the BMI’s options package.

 

What To Expect During Your Consultation?

The success of the consultation depends on your openness and honesty in relation to what troubles you and your expectations of surgery. You will be asked questions about your health, desires and lifestyle. Different operations can be tailored to your needs and the potential outcomes and the risks and complications will be discussed with you. The operation removes excess tissue from the abdominal area and the type of abdominoplasty needs to be tailored to the individual. Various types of abdominoplasty procedures are available and may be combined with liposuction. It may involve lifting the whole abdominal skin, repositioning of the belly button and tightening of the abdominal muscles. For patients following significant weight loss other adjunctive procedures may be required. A consultation regarding the risks and limitations of surgery will help you to choose a procedure that will meet with your expectations.

 

Preparing For Tummy Tuck Surgery

The majority of abdominal rejuvenation procedures on the abdomen require general anaesthetic. Your health is of prime importance and any cosmetic surgery should be postponed if you are unwell for any reason. It is important that if anything changes with your health that you make contact with us. You should ideally stop smoking 6 weeks prior to surgery and stop taking aspirin, anti-inflammatory drugs and herbal supplements before surgery, you may need preoperative tests prior to surgery, which we will arrange if required. You will generally experience abdominal discomfort following the surgery and should aim to be off work for at least 2 weeks depending on the type of work you have done.