Beware of the Brazilian Bum Lift

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We get an increasing number of enquiries for buttock augmentation or the so-called Brazilian Bum Lift.
A few years ago it was pretty much unheard of but it is rising in popularity and when I speak to my colleagues overseas particularly in America, they are performing huge numbers of these operations.
We specialise in breast and body contouring here at the Staiano Clinic and you might have thought that this is something that I would be keen to embrace, but on the contrary, it is a technique that I would be wary of and I do not know anyone in the UK who is performing significant numbers of the procedure.
Buttock augmentation used to be done by using implants, but now fat injections are increasing in popularity and this is certainly something that we are very comfortable doing.

However, you have to be very careful when considering fat injections into the buttock and it is not something that should be performed by a general plastic surgeon who is doing them once in a while.
In fact the American Society of Plastic Surgeons have recently issued a warning to all plastic surgeons that there has been a rise in the number of complications most notably death, as a direct result of the procedure.
They stressed the need for the surgeon to be experienced in the technique, because if fat is injected into the wrong areas it can have catastrophic consequences.

It is obviously important to ensure your surgeon is a fully trained plastic surgeon and a specialist in their field whatever you are having done

but I would urge extra caution if you are considering buttock augmentation.
In fact that there is a recent article from the surgeons in the TV showed Botched.
They have seen terrible complications and adverse outcomes from buttock augmentations, leaving patients disfigured and unable to sit comfortably.

I am sorry that we cannot help you if you are thinking of having a Brazilian Bum Lift , and I do not even know who to recommend because I do not know of any UK plastic surgeon who specialises in this.

My advice would be to do your research,  make sure you have realistic expectations of the outcome, and you are aware of all the limitations and potential complications of the procedure.

 
If you have any questions, our director, Jonathan Staiano, does a LIVE Q&A on Facebook at 7 o’clock every Tuesday evening, so feel free to drop in.

Tummy Tuck or Liposuction?

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If you are thinking of a tummy tuck or liposuction, it might seem that they are poles apart in terms of downtime, scarring and price. 
It is very common for people to come to the clinic requesting liposuction to their tummy, because let’s face it, most of us carry a little bit of extra fat in this area and would be very happy to be rid of it.

Liposuction

Liposuction  is certainly a great technique for removing the fat and the beauty of it is that the scarring is very limited and once it fades can be very difficult to see.

Sometimes people think that with liposuction the fat can come back, but this is not true.

The fat is removed permanently and in fact we all have a certain number of fat cells in our bodies no matter whether we are fat or thin, and it is just that fat people have an enlargement of their fat cells compared to thinner people.
They do not actually have more fat cells, and so when liposuction is performed the fat cells are removed and this is a permanent effect.
Having said that, liposuction or any surgery for that matter, does not protect you from the future and so if you were to put on weight then the fat cells that remain would get larger and so you are not guaranteed a stable result.
You need to ensure that your weight is stable because weight fluctuations can have an unpredictable effect on the results of surgery.
It is very common for people to be unsure whether they need a tummy tuck or liposuction or maybe even a combination of the two –

the difference lies in the fact of whether they need to have skin removed or not.

Tummy Tuck

A tummy tuck is a bigger operation than liposuction and involves removing not only the fat but also the skin of the abdomen, and this causes a tightening of the skin and a significant improvement in the abdominal contour.
At the same time as the tummy tuck the rectus abdominis muscles (the six pack) can also be brought closer together, as these muscles are often splayed apart after childbirth or if you have put on weight and no amount of diet or exercise will bring them back together.
At the time of a tummy tuck this distance between the rectus muscles known as diastasis or divarification of the recti muscles can be repaired by suturing them back together.  You can read more about muscle repair with tummy tuck here.

The downside of a tummy tuck is that not only is it a bigger operation with more downtime, it leaves a scar in the lower abdomen and may also leave a scar around the belly button.

For this reason, a balance has to be made as to whether the downside of the scarring offsets the upside of the removal and tightening of the skin and improvement in abdominal contour.

As a rule, for patients who have a mild amount of excess fat in the abdomen that they just cannot shift through diet and exercise, it might be that liposuction will be sufficient.
However, you are relying on the skin to recoil once the fat is removed and so the best candidates will have good quality skin which has not been significantly stretched with previous weight fluctuations or pregnancies, so is more suited to younger patients who do not smoke.
All these factors will increase the ability of the skin to snap back once the fat has been removed.
The limitation of liposuction is that if that skin does not recoil and snap back, then it can leave redundant skin which can look unsightly and cause distress –

this is where a tummy tuck comes in.

In fact the ideal candidate for a tummy tuck is someone who has been pregnant or lost weight because both of these cause a temporary fullness in the tummy which is then removed in the same way that liposuction can remove the fullness in the tummy.
The problem is when the skin does not recoil it leaves redundant overhanging skin which needs to be removed.
The difficulty always comes in borderline cases and it may be that a mini tummy tuck would be suitable to limit the scarring on the abdomen, but still remove skin.
However, this is limited to the area between the pubic bone and the belly button.
There are some techniques reported to cause some degree of skin retraction and some types of assisted liposuction like VASER or laser liposuction.
These treatments give energy to the fat before it is sucked out and this energy causes heat which reports to cause a degree of skin retraction which is so important in the abdomen.
Other forms of non-surgical liposuction such as CoolSculpting also report to give some degree of skin retraction and so these could be considered.
There are certain areas where liposuction works particularly well because the skin is thicker and so recoils better, and this is particularly in the hips and the flanks.

It is not uncommon to combine a tummy tuck with liposuction to the hips and flanks if the whole area needs to be contoured.

As with any body contouring surgery, you often find that it is not a case of one size fits all and whether you have a tummy tuck or liposuction, you really need to have a bespoke plan made according to your particular body shape, the quality of your skin, and also your plans for the future, as sometimes liposuction can be performed as a holding procedure if you are planning to have children in the future and so do want to go all out and have a tummy tuck now.

We are the only clinic in the UK that is owned and run by a plastic surgeon that specialises in breast and body contouring so if you would like to come along and have a chat with one of our surgeons, call us now or e-mail us to arrange a consultation.
You can download our guide with frequently asked questions about tummy tucks here.
If you have any questions our Director, Jonathan Staiano is on LIVE o Facebook at 7 o’clock every Tuesday evening, so feel free to drop in.
To see further examples of our work and reviews from patients check out our Tummy Tuck page.

Am I a good candidate for liposuction?

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Liposuction is an amazing procedure and can produce dramatic effects in terms of body contouring and leaves little, if any, visible scars.  However, there are limitations and not everybody is a good candidate for it.  The image is of the lottery winner who decides to have a new body, and so goes to the cosmetic clinic to have whole body liposuction, and unfortunately we still see some people who are overweight or have a certain distribution of fat and may not be a good candidate for liposuction but they feel they should be able to transform their bodies, because this is what they have been led to believe.
Whilst liposuction is an excellent way to remove fat while leaving very small scars, it does have its limitations.

Am I a good candidate for liposuction if I am overweight?

It is not really an operation that is suitable for people who are overweight.  In fact, cosmetic surgery and body contouring in general is not really for people who are overweight.  If you are overweight and are unhappy about it, then the best thing to do is to lose weight and cosmetic surgery is not a way of losing weight.  Cosmetic surgery is something that can be done to help shape and contour your body if you are unhappy with your shape once you have lost weight, or perhaps you have always had a certain distribution of fat on your body that you are unhappy with, rather than just having a global problem with your weight.  You really need to be happy and stable with your weight before having any body contouring, and this includes liposuction.  So first of all the ideal candidate for liposuction is someone who is happy with their weight, but unhappy with the shape of their body and is looking for some contouring or sculpturing.

Does liposuction tighten the skin?

One of the main limitations of liposuction is that it only removes fat and does not remove skin, and for this reason it is often used in combination with other types of body contouring surgery to help shape and fine tune the final result.  Probably the best example of this is a tummy tuck where the skin is removed by the tummy tuck surgery, and then liposuction can be used to the sides around the hips and flanks to help contour these areas.  There are certain areas of the body where the skin does recoil better than others, and the hips and flanks, outer thighs, and the male chest are well suited to liposuction and patients with excess fat in these areas are good candidates for liposuction alone.  Those areas where the skin does not recoil so well once the fat is removed, then liposuction alone is more limited, for instance, the central abdomen and the inner thighs.

Will the fat come back after being removed by liposuction?

Patients often ask me if the fat will come back following the procedure and the answer is no.  Once the fat has been removed by whatever means, whether it be cut out or removed by liposuction, it has gone forever.  However, there is always some fat left behind which is why it is so important that you are stable with your weight, because if you put on weight after having it, then the fat that remains will expand and so you can still put on weight in the same areas.  It is not the fat that has been removed coming back, but it is the fat that is left behind getting bigger because you are putting on weight.

Do I need to be put to sleep for liposuction?

It is not essential that you are put to sleep for this procedure and certainly small areas can be performed under local anaesthetic.  However, the constant moving can be a little bit uncomfortable and larger areas can be difficult to adequately anaesthetise with local anaesthetic, and so we often prefer to put patients to sleep for comfort during most liposuction surgery, although this is something we can discuss with you to decide what is best.
If you have questions please contact us or join Jonathan for a live Q&A every Tuesday evening at 7pm on Facebook.

Ideal Weight For A Tummy Tuck

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What is the ideal weight for a tummy tuck?
Well like most things in medicine there is not an absolute answer to this question however there are a couple of things you can take into account when deciding when might be the right time to have a tummy tuck. First of all there is the absolute value of your BMI and then almost more importantly is that your weight is stable and that you are happy with the weight you are at.
If you want to find out more about this, watch Jonathan’s vlog.

If you would like to read testimonials and see examples of Jonathan’s work, visit our tummy tuck page. Or if you have any questions after watching this video you can download our tummy tuck guide here or you can give us a call on 0121 454 3680 or email us at info@staianoplasticsurgery.co.uk.

The Pros and Cons of Fat Grafting

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The Pros and Cons of Fat Grafting

 I have recently seen a patient of mine in the clinic on whom I performed fat grafting to the calf.  She is a young lady who was born with a congenital defect of her ankle which meant that her left leg did not grow in the same way as her right leg and her calf and ankle were much thinner on the left side. We spoke about her options which were either to perform fat grafting or use an implant.  There can be particular problems with implants in the calf, particularly in terms of infection or being able to feel the edges of them and sometimes they can erode through the skin.
Of course, there are potential complications with any operation and there are complications with fat grafting too, but the main thing was that she was so young that the long-term durability of fat grafting is superior to implants and so we chose to go down this route.  She needed two operations spread over several months, but she has really got a fantastic result.  Her calf feels soft and supple just like the other side which is not surprising because once the fat is grafted it is normal fat.  The beauty of it is that it will change with you, so that if you put on or lose weight fat cells will get bigger or smaller just as they would have done if they had stayed in their donor site, (in this case her thighs).
I love the technique of fat grafting and you can produce really exceptional results, particularly when there is a 3-dimensional defect, because the fat can be laid down in a very careful and precise pattern.

Fat Grafting for cosmetic breast surgery

Clearly most of the work we do here at the clinic is in the breast and fat grafting for the breast is not as popular as you might think.Moving fat from one area and injecting it into the breast to enhance the volume without the need for silicone implants and all the potential long-term effects they can have is surely appealing.
But the main problem for cosmetic breast augmentation is that fat grafting only produces subtle results, and by definition most people who require breast augmentation are slim and so there is usually a limitation on the amount of fat that can be removed and this then has to be split between the two breasts.
I was privileged to be invited on the Faculty for the BAAPS 2017 Plastic Surgery Conference last week and was delighted to meet Foued Hamza who practices in Paris and London and presented his results of fat grafting in the breast.  He showed some really impressive results and also talked about the limitations that he has found during his extensive experience.  Like any surgical procedure the pros and cons need to be discussed with the patient so that we can make an informed decision together.
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The secret to getting a happy patient…

Is to have one whose expectations are aligned with what is feasible with the surgical technique being considered.  Certainly, there is no way that fat grafting can compete with implants when it comes to adding a predictable and significant volume to the breast.
The volume achievable is usually a cup size or less, and so the procedure often needs to be repeated and whilst it can sound appealing, the fact that it is harvested from the abdomen, buttocks or thighs, there is usually not a significant body contouring effect because fat harvesting is much gentler than traditional liposuction and so smaller volumes of fat are removed.
It can also be a bit uncomfortable where the fat is taken from, and there are risks of infection and fat necrosis or oil cysts, so this all needs to be put into the mix as to whether you think fat grafting to your breast might be right for you.
Because we are all specialists here at The Staiano Clinic we can talk to you about the pros and cons of each procedure and will not expect to have a ‘one size fits all’ approach.
If you would like to know more or have any questions please contact us at the Clinic, you can call us on 0121 454 3680 or email info@staianoplasticsurgery.co.uk.

Drains Or Glue For Tummy Tuck?

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Drains or glue for tummy tuck?
Are you interested in having a tummy tuck?
Do you want to know more about what is involved in one?
Do you want to know what technique is best?
Look no further! Jonathan Staiano, the clinic director here at the Staiano Clinic has done a video about tummy tucks and the pros and cons of using drains or glue.
He discusses what is involved in the procedure and the two different ways of closing the wound; drains and glue.
He explains the differences between these techniques and expresses which he prefers and why.
Throughout the video he shows examples of his work.

If you want to see more examples of this procedure performed by surgeons at the Staiano Clinic you can see them here. If you would like any further information you can download our frequently asked questions guide here or call us on 0121 454 3680 or email us.

Cosmetic surgery can be truly life-changing

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We need more positive news stories.

You may have seen our patient featured in The Sun, The Mirror, The Daily Star and The Mail last week.
She lost a significant amount of weight (8 stone) and had lost shape and volume in her breasts.  It is a great story as she is due to be married and has worked so hard to regain her body shape.  It is heartening to see stories like this in the media, as in this day and age, plastic surgery will often get negative press.  I specialise in breast and body contouring and the vast majority of patients that I see want a natural result that is in proportion with their frame.

Cosmetic surgery is about making people look and feel better

Plastic surgery is about restoring form and function and cosmetic surgery is about enhancing and improving on this.  It is not about overdoing it, whether it be breast implants or lip fillers.  The media is full of stories of strange looking people who have overdone plastic surgery, but this is a very small minority and something that I hardly ever see.

My waiting room is full of normal people like you

The waiting room in my clinics in Edgbaston and Harley Street are full of mums who have lost volume in their breasts following breast feeding or have redundant skin on their tummy which will not tighten, no matter how much exercise they do.  Or people like Chantelle, who have lost weight and they feel deflated and want their shape restored.

Thank you Chantelle, we need more positive role models

Cosmetic surgery can be truly life-changing, yet so many people carry guilt and feel that they are putting themselves through unnecessary surgery.  We need more positive role models like Chantelle to show the world that plastic surgery is for normal people who want to restore their self-esteem and their confidence and that there is absolutely nothing wrong with that!

Thank you, Chantelle, for sharing your story and good luck with the wedding!  I look forward to seeing you soon for your follow up appointment.

Jonathan
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There Will Always be a Need for Tummy Tucks

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Tummy Tucks Are Not for Overweight People

Some people have got the wrong idea about tummy tucks “ they think that it is a procedure that is for overweight people to help them to lose weight.  This is not the case.  If you are overweight, then you should avoid surgery because your risk of complications is higher.  In fact, if you have a tummy tuck when you are overweight, then you will not get as good a result as if you were at your ideal weight, because if you lose weight after your tummy tuck, then you may have some laxity in your abdomen and it will not be as tight as it could have been.

The Ideal Candidate for a Tummy Tuck

The ideal patient for a tummy tuck is one who is slim, ideally with a BMI below 30, with good quality skin.  Patients with good quality skin are young, non-smokers, who have not had significant sun damage from excessive sun exposure.  This means that their skin will still have some of its elasticity and so will respond well when tightened and not look slack.

Will my Stretch Marks be Removed?

The skin from the belly button to just above the pubic hair will be removed and so ideally any stretch marks will be  limited to this area.  If there are stretch marks above the belly button, or on the sides of the abdomen, then these may not be removed following a tummy tuck.

The Problem is Skin, Not Fat

The reason that people need a tummy tuck is the excess skin, not fat.  There are two main reasons why people have excess skin “ pregnancy and weight loss.  The mechanism is that the skin is initially stretched, either by the baby or by putting on weight, and then the stretching force is removed, either by giving birth or losing weight.  There is a natural ability for the skin to recoil to a certain extent, but if it is stretched too much, either by a large or multiple babies, or losing a lot of weight, then it will not be able to go back to its original state and you may be left with a redundant apron of skin on your lower abdomen.

No Amount of Exercise can Remove the Excess Skin

It is the excess skin that  is the root of the problem.  Exercise and keeping fit, can reduce the amount of fat that you have, but it will not improve the elasticity of your skin.  If there is fullness on your flanks or your thighs, then exercise and weight loss may well help these areas.  But it will not help if you have excess skin on your abdomen “ in fact weight loss can actually make it look worse!

Surgery is the Only Way

Surgery is the only way to remove the excess skin and tighten the abdomen.   A tummy tuck will restore your abdomen to a flat contour and remove the excess unwanted skin.  It will not protect you from what may happen in the future, so if you were to have more children (it is perfectly safe to have more children after a tummy tuck) or to put on and lose weight again, following your tummy tuck, then you may get problems with excess skin again.

Prevention is Better than Cure

Prevention is always better than cure, so you should take good care of your skin by avoiding smoking and excess sun exposure, drinking plenty of water and avoiding weight fluctuations to maximise your chances of keeping a tight and taught abdomen.

For More Information:

Download my guide

‘Tummy Tuck – Your Questions Answered’

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Jonathan is on a one man crusade to revolutionise the image of cosmetic surgery and is passionate about spreading his message about cosmetic surgery training.
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