Xanthelasma Removal

Xanthelasma are white plaques or spots that develop around the eyes.

The treatment involves surgical removal which can be done here in the clinic on a walk-in, walk-out basis, and this is something we can do with our see and treat service when you can have your xanthelasma removed on the same day as your consultation.

Xanthelasma are cholesterol deposits and so it is important that you have your cholesterol checked as they could indicate high levels of cholesterol which may predispose to heart disease.

It is possible to have a xanthelasma with a normal cholesterol level, but it is worth getting this checked out with your GP.

Removal of any skin lesions will leave scars, but because of the position of xanthelasma which are normally around the eye, scars in this area heal so well that they can be difficult to see.

There are natural lines and creases around the eyelids which are formed by the eyelids opening and closing, and as plastic surgeons we aim to hide our scars in these natural lines, so that once they have settled they blend in with the facial features and are almost invisible even when you look closely.

 

Feel free to leave a comment below, give us a call on 0121-454 3680 or drop us an e-mail.

Three reasons to have your mole removed (and three reasons not to)

 There are two sides to every coin and when patients ask us, should I have this mole removed, it is sometimes difficult to give a straight answer and we will often come back with:

 ‘it depends’

 

Three reasons to have your mole removed:

  1. You think it might be cancer. This is the main one.  In these situations  then the decision is easy and you really should have your mole removed.  It is important to be vigilant and look out for the signs of cancer, (see our guide when to worry about a mole) and if there has been any recent change in your mole and any suspicion of cancer, then this trumps all the other reasons and the mole should be removed and sent away for histological analysis.

 

  1. Peace of mind. If the mole is not obviously cancerous, then we will often say that you can keep an eye on it and get in touch if there are any changes.  We offer free consultations so you can always come back to the clinic to get it checked out and I am sure your GP will be able to keep an eye on things for you.  However, some people are worried and when they start focusing on a particular mole, they are not sure whether it has changed of not ‘has it got bigger, has it just started itching, or is that me?‘.    Sometimes the moles can be in difficult areas like your back, and it is difficult to keep an eye on things and so it might be easier to have it removed and then the problem has gone once and for all.

 

  1. I do not like the look of it. This is one of the most common reasons that we see patients in the clinic and we hear things like ‘I hate my mole’, or ‘I have never liked it’, or it may be nuisance and can be raised and catch on things, which makes them bleed or they may have hairs growing from them and it is this reason that probably needs the most discussion, because as you will see from the reasons not to remove a mole, mole removal does leave a scar and so you need to be confident that the scar will be preferable to the mole.

 

Three reasons not to remove your mole:

  1. It will leave a scar. Now just because we are plastic surgeons, it still does not mean that we do not leave scars.  Of course a large part of our training is in tissue handling and wound closure, so we do take great care to leave neat scars and we have tricks of the trade that allow us to hide the scars or orientate them in such a way that makes them less obvious.  However, at the end of the day removing a mole will leave a scar of some sort.  It might be a thin line or a faint patch, depending on how it is removed (see shave or excision of mole) and scars do tend to fade particularly when they are on the face, and so it is often difficult to see where they were.  However, in the early stages they are often red and obvious and you need to look after them to ensure that you get the best result possible.

 

  1. Your mole has always been a part of you. We specialise in breast and body contouring here at the Staiano Clinic and you cannot underestimate the effects of changing your body in some way.  If you have had a mole for a long time, particularly if it is on a prominent area of your face, this is something that people will associate with you and you may look completely different without it.  It can sometimes be difficult to come to terms with your new look and we have seen lives transformed with a simple 20 minute procedure removing a prominent mole on the nose or the forehead and it can be tremendous to see the positive effect of what some might call a ‘minor’ operation.  Whilst the only person you need to convince is yourself, it can be helpful to talk to friends and family members to get their take on things, because at the end of the day a mole is a natural attribute whereas a scar is not.  This is particularly true for people who want multiple moles removed because multiple scars might look more obvious than the moles themselves.

 

  1. Once it has gone you cannot go back. Obviously if there is a worry about skin cancer your mole needs to be removed, but if it is more of a cosmetic issue it is always good to take time to consider things and weigh up the pros and cons, because if you are not sure you can always go away and come back another day.  Even if you come to one of our see and treat sessions, we will never pressurise you into having a mole removed, because we realise it can be a significant decision.  There is no harm in delaying things, having a think, and talking it over with your friends and family.  We will still be here a month, six months, or in a year’s time.  You will never regret delaying the decision to have it removed, although you may think I wish I had done that years ago.  However, once it is removed there is no turning back and the scar is permanent, although we would stress it is often more obvious in the early stages and so do not be too alarmed because it will fade.

 

For more details on what to look out for with a mole download our free guide here.

If you want to come for a free no obligation consultation with one of our plastic surgeons, please call or email us or fill in the on-line contact form.
Or you can ask our director, Jonathan Staiano, a question LIVE on Facebook at 7 o’clock every Tuesday evening, so feel free to drop in.

How To Reduce Enlarged Earring Holes

How to reduce enlarged earring holes

There is very much a fashion for gauging (stretching) or tribal piercing, which involves having your ear pierced and then having the hole gradually increased in diameter so that you can put bigger and bigger earrings in.
The problem with the fashion is that as you increase the diameter of your earring hole there is only one way you can go.
You can either choose to keep it at the same diameter or increase the diameter.
If you decided that you no longer liked the look of it or if you need to get a job or start a career where having an enlarged earring hole is not welcome, then you might start to regret things.
If you start to put progressively smaller earrings in, they will just start to fall out and the skin of your ear lobe will not shrink back.

But don’t panic,

because it is relatively simple to fix the problem.
Earlobe Repair is something we can do here in the clinic under a local anaesthetic on a walk-in, walk-out basis, and in fact, we can see and treat you on the same day as your consultation in our fully equipped minor operating suite that we have here on site.
The procedure takes about 45 minutes and can transform the look of any ear lobe no matter how large the enlarged earring hole has been stretched to.
It will leave a scar which will be slightly red to start with, but this tends to fade quite nicely and so the hope is that it will be difficult to see in the future.

If you wanted to go and get your ear re-pierced then this is perfectly possible, although we advise that you pierce it slightly off the scar because the scar will be weaker than the normal ear lobe skin.
For more details or to book a free consultation please contact us by phone or e-mail and we would like to see if we can help you.

Ear lobe reduction for enlarged earring holes is one of the specialties here at the clinic

and it can be quite transformational the difference that can be made in just a short and relatively simply operation.
So drop us a line and we would be more than happy to see if we can help.
And you can read more about Earlobe Repair here

Scar Revision

Scar Revision At The STAIANO Clinic

You may think that scar revision is bread and butter for a plastic surgeon, but it is important to be aware of what is possible when it comes to considering revision of your scar.
It is not possible to remove scars completely, but plastic surgeons are trained in techniques to alter and improve scars so that they can be hidden or blend in with their surroundings.
If you think that you might be a suitable candidate for scar revision, then watch this video where our director, JJ Staiano, talks about what can be achieved with plastic surgery to help improve and reduce scarring.

What Scars Are Suitable For Scar Revision?

Not all scars are suitable for scar revision and you would be welcome to send us a photograph of your scar so that we can give you an assessment on whether we can help.
Scar revision is particularly suitable for scars that are stretched or indented or scars that are lying in an unfavourable orientation.  This is usually scars that are caused by some sort of trauma or injury rather than scars that have been made following surgery.
If you have a surgical scar, then it could be raised and lumpy and this is known as a keloid or hypertrophic scar.  Keloid scars are best managed by a qualified surgeon or dermatologist as they are difficult to treat and there is a risk of causing more keloid scarring if surgery is performed.
We have a wealth of options to treat problematic scars at The STAIANO Clinic ranging from non-surgical treatments such as silicone gel that can be applied to your scars to steroid injections that we can perform here at the clinic through to surgical revision to improve the look of your scar.

Before - Puckered Scar

Before Scar Revision – Puckered Scar

After Scar Revision - Puckered Scar

After Scar Revision – Puckered Scar

 

Before Scar Revision - Stretched Scar

Before Scar Revision – Stretched Scar

After Scar Revision - Stretched Scar

After Scar Revision – Stretched Scar

When plastic surgeons perform scar revision surgery, they are creating new scars and so the aim is to create a new scar that is better than the old scar.  It is very much a bespoke service that we offer and we will assess your scar and take a full history so that we can offer you the best treatment for your scar and give you the best result possible.

When Is The Best Time To Undertake Scar Revision Surgery?

All scars take 6 to 12 months to mature and so you should not consider scar revision until your scar has fully matured and is going to be as soft and supple as it is going to get.
It may sound counter-intuitive to wait until your scar has fully settled before undergoing revision, but it it is important for it to have softened and settled fully before undergoing further surgery.

Want To Find Out More About Scar Revision?

Find out more about removing your scar on our scar removal page.
All of the surgeons at The Staiano Clinic are fully trained plastic surgeons and have extensive experience in managing scars and obtaining the best outcomes possible.
For more information, call us now on 0121-454 3680 to book a FREE consultation with a Consultant Plastic Surgeon or you can send us a photograph of your scar to info@staianoplasticsurgery.co.uk and we will get back to you with an idea of what can be achieved.

Tattoo Removal

Have you looked in to tattoo removal but don’t know where to turn?
Do  you have a tattoo that you no longer like? Or Regret? Have you tried laser but it just doesn’t seem to be working? Well we might be able to help.

If laser fails, we may be able to help

We perform tattoo removal by excision.  This is were a plastic surgeon  surgically removes your tattoo and it can be completely gone in as little as one session.
It involves removing the tattoo by cutting it out of the skin.
There is a couple of things that are important when considering whether your tattoo is appropriate for excision, the first is the size of the tattoo and the second is the location of the tattoo. If you want to find out more about this and whether your tattoo is suitable for excision watch Jonathan’s video:

To see further examples of our work and testimonials from patients check out our tattoo removal by excision page.
If you would like to know if your tattoo is suitable for removal by excision, then you can send us a photograph and we will let you know what would be involved and how much it would cost.
You can email us at info@staianoplasticsurgery.co.uk or you can call us on 0121 454 3680.

Shave Excision of Your Mole

Shave Excision Mole
Have you got a mole?
Did you want to get it removed?
Not sure of what the best way to remove it is?

Formal excision vs shave excision?

You can read more about mole removal at The STAIANO Clinic here.
In this video Jonathan discusses the different ways plastic surgeons can remove your mole. He talks about shave and formal excision as techniques of removing your mole and discusses the benefits and risks of having each of these.
He also talks about the criteria your mole must fulfil to have each of these procedures, for example a skin lesion will only be shaved if it is benign. If you are unsure if your mole is benign, we have information on when you should worry about a mole here.

If you would like to see how shave excision of a mole is performed, then you can watch LIVE surgery being performed in this video:

This is a before and after example of a shave excision of a mole on the forehead:

shave excision mole

Removal of 3 moles on the forehead by shave excision

This is a before and after example of a formal excision of a mole on the forehead:

Formal excision of mole on forehead

 

We hope you found this helpful and if you would like any more information, please email us or call us on 0121 454 3680.

Why Choose a Plastic Surgeon for your Mole Excision?

One of the areas we have had a lot of growth in here at The Staiano Clinic is in mole excision. I think one of the reasons is that we are able to offer a ‘See and Treat’ service which not many clinics are able to. We have our own state of the art operating suite here on site and so should you decide to have your mole excised on the same day as your consultation, then we can go straight to the operating suite and remove it for you.
The other reason that I think we are so popular when it comes to mole excision is that all of the Surgeons here at The Staiano Clinic are fully trained Plastic Surgeons. When it comes to mole excision there is a very wide range of Doctors who offer this procedure right from General Surgeons or ENT Surgeons through to GPs or Dermatologists who may not have any surgical training at all. So why choose a Plastic Surgeon for your mole excision?
When it comes to getting a good scar, there are several factors to consider. Plastic Surgeons are trained to respect the tissues and are known for their delicate instruments and meticulous techniques. If ever there is a complex wound to close in sensitive areas such as the face, around the eyes or lips, in situations where tissues are fragile or friable such as in the elderly or young children, and in cases where there has been extensive tissue loss or damage such as in explosive injuries or major trauma, the Plastic Surgeon is called in to put things together again.
We spend time thinking about what sort of sutures we are going to use to close the wound and what techniques would give the best cosmetic result with the maximum strength. Priorities are different for other surgeons and you may have seen a classical laparotomy scar which is classically a straight line on the abdomen with dots on either side. This is because General Surgeons, when they are performing a laparotomy, have a priority to treat some intra-abdominal pathology in the quickest, most efficient and safest way. They are not focusing on the cosmetic outcome of the skin scar, and if I was having a laparotomy I would not want them to be too concerned about the cosmetic outcome because it is usually performed for a serious condition. Most Surgeons when they are performing operations open and close the skin as a means to an end which is to perform their core surgical procedure, but in plastic surgery often the core surgical procedure is the opening and closing of the skin. We only operate on soft tissues and are trained to contour the body or remove tumours and therefore the training revolves around excision and closure. Because we are all trained as reconstructive surgeons we are very aware of the need to completely remove the tumour in the most effective way to allow us to close and reconstruct the defect with a minimum amount of morbidity. We will often be called in to reconstruct a defect after another surgeon has removed a cancer; and in these circumstances, the surgeon who is performing the excision is solely focused on getting a clear margin for tumour clearance and they do not have to think about the reconstruction because they know the Plastic Surgeon will come in and be able to handle any defect that they find.
We are in a unique position as Plastic Surgeons of being able to remove tumours and reconstruct them afterwards and so we can find that balance between making sure we get the lesion out completely, but at the same time minimising the damage to neighbouring structures and giving the best cosmetic outcome.
Plastic Surgeons are able to deal with skin lesions of any size and any type. We treat benign skin lesions, warts, skin tags, xanthelasma’s (cholesterol deposits around the eyes), we treat skin cancers (BCC, SCC and melanoma) of all shapes and sizes and in all locations. For this reason, when it comes to simple moles and cysts there is nothing that can phase us and if something was to crop up it is very unlikely that we will not have seen it before and know how to handle it. It is perfectly reasonable for GPs and Dermatologists and other Doctors to be removing moles and cysts and they can get good outcomes too, especially if they have spent some time with Plastic Surgeons learning some of our techniques. So, if you do have a lesion that you would like to have removed, whether it is because you are worried about it, or whether because it is unsightly, or it might be that it catches on your clothes, or bleeds, or is a nuisance; you can come for a free consultation with one of our Plastic Surgeons and if you did want to have it removed on the day then we could take you straight to the minor operating suite so that you could be rid of it forever within the hour.
For more information of what to look out for in a mole, you can download our guide here, and if you want to arrange a free, no obligation consultation then please call or email us.
If you are not sure whether your mole or lesion is suitable for excision then you can always send us a photograph and you will get an opinion from one of our Surgeons as well as a detailed quote of what it would cost to have it removed. All surgery is performed under a fixed price package which means there is an all-inclusive fee which covers the after-care and all dressings as well as any follow-up appointments.
Furthermore, our Director Jonathan Staiano does a live Q&A every Tuesday evening at 7pm so feel free to join in by going to our Facebook page and asking questions live, or email Laura your questions beforehand.
We would love to hear from you.

Same Day Mole Removal

In this video Jonathan discusses mole removal here at the Staiano Clinic and the option to have a see and treat service for this procedure. This means your consultation is the same day as your procedure.

If you would like any more information on our see and treat service you can call us on 0121 454 3680 or email on info@staianoplasticsurgery.co.uk. You can also download our mole guide here to get more information on mole removal itself.

Do I Need To Send My Mole For Histology?

A question I get asked a lot is: What is histology?

Histology is when we analyse parts of the body by putting them under the microscope.
It is performed by a specialist type of doctor called a histopathologist and is often done in a laboratory which may not be located in the hospital. Samples are often sent away for analysis and usually take days or weeks to be processed.
Histology allows an accurate diagnosis to be made of the type of tissue and perhaps most importantly, whether it is cancerous or not and if it is cancerous, whether the cancer has been completely removed.
You see, when we are doing surgery and we remove parts of the body, there is always the question as to whether we send it away for histology or not.
For instance, if I am doing a tummy tuck there is no need to send the skin and fat away for histology because there is very little chance of there being anything abnormal about it.
However, when doing a breast reduction we routinely send the tissue away for histology because the risk of breast cancer in the general population is very high.
For minor procedures such as removal of moles, cysts or skin tags, we need to decide whether we send the lesion away for histology or not.
Obviously if there are any concerns about the mole such as a change in size, shape or, colour or any bleeding or itching, then there is no question that it should be sent away for histology.
Often patients have moles, cysts or skin tags which are simply a nuisance and have always been present and they are not concerned they might be cancerous but they just want them removed for cosmetic or functional reasons.
In these situations, they may not always need to be sent away for histology.
Certainly, if it is a brown mole it is usually good practice to send these for histology, even if they look totally fine because it is always good to have a record of this.
However, if it is a simple skin tag or an cyst then histology is not necessarily essential.
There are some types of moles which you can tell by looking at are nothing to worry about.
These are things like seborrheic keratoses which are brown flat warty lesions which have a stuck-on appearance and appear later in life.

Seborrhoeic keratosis on shoulder

Seborrhoeic Keratosis on shoulder shown at 1 week post removal at The Staiano Clinic

Or intradermal naevi which are raised, sometimes brown, sometimes fleshy moles which can have dark hairs growing from them. They appear in areas of friction such as at the back of the neck and they can also appear on the face and they can be troublesome in men as they catch when they shave.

Intradermal Naevus On Cheek

This is an Intradermal Naevus beside the nose shown at 6 weeks after removal at The Staiano Clinic

If it is possible to say with certainty that a mole is nothing to worry about, then it does not need to be sent for histology but this is only something we can do after discussion, which is why we offer free consultations for mole assessments.
Sometimes patients send us photographs of their lesions (you can email them to us here) and we can give them an idea prior to attending the clinic what will be involved in removing it.

If you come in for a see and treat procedure then it is always worthwhile to send us a photo or have a discussion with us beforehand to avoid any surprises when you arrive.

If you have any moles or lesions that are troublesome, I would always encourage you to get them checked out.

We offer a free consultation with one of our surgeons if you are simply looking for assurance and if you want the lesion removed on the day of consultation then we can accommodate this too in our state of the art minor operating theatre.
Contact us on: 0121 454 3680, email us or like our Facebook page as our director, Jonathan Staiano has a Q&A every Tuesday night at 7pm where he can answer your questions live.
If you are worried about your mole, then you can download our guide with what to look out for below:

The Secret of A Good Scar

All surgery will leave a mark or scar of some sorts whether it be having a mole cut out or shaved or having a lesion scraped or having something removed by laser.  All of these things will damage the skin and cause some form of scarring.  The scarring is usually quite red and obvious to start off with and it is how the scarring is managed that can often make the difference between a good scar and a bad scar.

Qualities of a good scar

The first step in obtaining a good scar is to plan where the scar is going to lie and this is something we as plastic surgeons spend a lot of time studying in order to hide scars as much as possible.  There are natural lines, skin creases and shadows all over the body and plastic surgeons will exploit these in order to leave as little a trace as possibly that anything has been done.  The next step is to use meticulous surgical technique and we are trained to minimise the handling of the tissues and to use fine instruments so that this normal skin is damaged as little as possible to improve the healing.  The technique of suturing a wound is an art in itself and it takes many years to learn the techniques to bring the edges together to maximise the contact and the quality of the resulting scar.  It is important that the wound is not closed under any tension and so we use techniques to support the wound using deep sutures or occasionally by moving tissue around to move the tension from one area to another in order to maximise the chances of good wound healing and resulting scars.

Postoperative management of scars

It is important that scars are supported in the initial phases which is why we often use deeper layers of sutures to reinforce the wound.  Tapes and dressings can help although these can often be kept light and the wound is to be kept clean.  Scars on the face are often left exposed and we will often dress these simply with antibiotic ointment.  We try to use waterproof dressings when possible, which means that you can wash and shower immediately.

Timing of suture removal

The classic hatched appearance of a scar with a straight line and dots on the other side as seen in Popeye is something we try and avoid and the dots are caused by sutures being left in long enough to cause a scar of their own.  For this reason we will avoid leaving sutures in too long and so on the trunk will often use dissolvable sutures which are buried and you cannot see and on the face we will remove sutures early, around five to seven days.  In some cases the wound healing is more important than the quality of the resulting scar and so there may be incidences where it will be reasonable to leave the stitches in for longer to make sure the wound stays together.  It is important to avoid too much activity around the scar to allow the wound to heal and to avoid stretching of the scar.

Long term management of scars

All scars will be red and quite obvious to start off with and can take some months before they start to fade.  Moisturise and massage of the scar will help them to fade and there are lots of products available such as Bio Oil, Vitamin E and Aloe Vera which can be used to massage the scars once they have had a chance to heal.  The scar will be red and obvious for the first three to six months and while it is red and obvious it is important to avoid the sun because if you get a suntan on a red scar while it is still active then when you lose the suntan the scar will stay pigmented and you will end up with a brown scar.  This does not mean that you cannot go into sunny climates but it does mean that you should keep your scar covered while you are out in the sun and this can mean high protection sun block, tape or simply wearing a wide-brimmed hat or clothes over the scar to avoid getting a tan on that area.  Most scars will settle by a year although it can take longer.
For more advice feel free to get in touch.  You can call us on 0121-454 3680 or contact us through the website.  I do a live Q&A on Facebook every Tuesday at 7pm.  It would be great to see you there and I would be happy to answer any queries.

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