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Post-operative compression garments

After body contouring surgery such as breast re-shaping, a tummy tuck, gynaecomastia correction and liposuction, we utilise post-operative compression garments to give support and help with swelling.

The reason for the garment is to aid your recovery and to make you feel more comfortable.

There is often swelling following body contouring and when the tissues swell it can be uncomfortable, not to mention looking unsightly.
This is particularly important to be aware of if you have just had liposuction to get rid of those persistent fat pads that you have always hated and then two weeks after surgery you look in the mirror to see that they are still there!

Do not be alarmed, the results of any sort of body contouring can take two to three months before they start to settle and full recovery in terms of sensation and maturation of scars can take a year or more.

We will size you up in the operating theatre and will usually put the post-operative garment on you as soon as we have finished surgery so you will wake up wearing it.

It should be comfortable and supportive, not tight and restrictive

…so if you find that when you take it off you breathe a sigh of relief, then let us know, because it might be that you will need a larger size, especially if it leaves red marks or irritates the skin because we do not want it to cause problems.

It is often a major life event having body contouring surgery and so patients will stick to our post-operative guidance religiously which is to be commended, but when we say you should wear the garment for six weeks day and night, this does not mean that you cannot take it off to give yourself a breather or to have a shower.
It is fine to take the garment off for short periods and if you find it is bulky and uncomfortable, you may choose to use an alternative in the form of a tight figure-hugging t-shirt or body contouring pants.

You will always have open access to Vicki our clinic nurse, if you have got any questions about your garments, so please do not hesitate to give her a ring.

After the six weeks has passed, most of the swelling will be starting to subside and so you can start to take the garment off at night and at certain times of day if you find it more comfortable.

However, patients often feel secure when wearing the garment, particularly if they are going out in crowded places or have a busy day ahead.

You can play things by ear and see how you feel and continue to wear the garment if you wish.

We will work closely with you in the first few months and advise you about how to optimise your healing.

The garment is one part of the post-operative regime that we offer to make sure you get the best result possible and feel fully supported.

As ever,  if you have any questions, you can always join me on Facebook where I do a live Q and A every Tuesday at 7 o’clock or call us on 0121 454 3680 if you would like to have a chat with us.

If you have any questions feel free to get in touch or leave a comment and I would be happy to get back to you.

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Does Fat Freezing work?

I’ve been looking at the non-surgical liposculpture market for about 5 years now and I have really been trying to answer the question ‘Does Fat freezing work?’.

The concept is great.
It is a way to remove fat without having surgery (or dieting).
I’ve spoken to the companies and studied the technologies.

The science behind it makes sense.
The machines deliver energy usually in the form of cold (cryolipolysis) or heat (radio frequency).

The principle is that fat cells are more susceptible to temperature damage than other cells such as skin or blood vessels and nerves.

This means that there is a point where the fat cells will die but the skin, blood vessels and nerves will be able to recover.
The machines all work by delivering the right amount of energy for the right amount of time to reach that point and be able to destroy localised areas of fat.

Sounds great, right?

…but does it work?

I’ve spoken to other doctors who have these machines and I have spoken to the companies who make them and they are all very positive about them.
Very positive about how they can be good for business.
About how you can get a return on your investment.

How you can reach a whole new group of patients who you would never normally see because they don’t want surgery.

…and how you will indirectly increase your surgical practice by offering a non-surgical option.

All compelling reasons.

But then I go back to my core values.

The focus of my practice is to do what is best for the patient.
We want every patient that comes to see us to be a raving fan.

That is why 5 star reviews are the norm rather than the exception for us.

…and I a very protective about that.

I want to make sure that we can deliver an exceptional service to every patient that we see.
…and this sometimes means that we won’t treat you – if we don’t think that we can get a fantastic result for you.

And this is why we haven’t embraced fat freezing.

We have tried a couple of machines and in answer to the question ‘does fat freezing work?’, I think the answer is ‘yes’.
It does work!

But…..

There are 2 problems:

  • First, the results are quite subtle and variable. 

Sometimes there is hardly any difference and even at best you have to look closely to notice an improvement.
It takes several weeks for the results to show and it is important to maintain a good diet and exercise during this period, so it is questionable as to how much of the result is due to the treatment and how much can be attributed to the lifestyle changes.

This would all be fine if it wasn’t for the second point:

  • It’s expensive!!

The machines themselves costs tens of thousands of pounds and there are often consumables to consider on an ongoing basis.
This means that the cost to you, the patient, is high.

The treatment often needs to be repeated and it ends up costing many thousands of pounds to get, what is at best, a modest improvement in your body contouring.

I know that many people don’t want surgery, but surgery can give much more impressive and predictable results for similar costs (and often cheaper).

So, while I do think that fat freezing does work, I am concerned about the value for money it offers.

It is not a question of whether our patients could afford it, I know that many could.
…but just because you can afford something, doesn’t mean that you will be happy to pay for it.

If we want to keep getting raving fans and 5 star reviews, we need to be sure that we are looking after our patients properly
I will keep looking and trying to find a device that I can get behind, but for now, I don’t think the balance is right.
They either need to improve the technology so that it can remove more fat and give better results…
or they need to make it cheaper.

I am a big fan of offering complimentary services to my patients.

Vicki, the clinic nurse, is now offering non-surgical treatments like Botox and has a range of scar management products and sun creams.

This is all stuff that we know works and we are happy to get behind.

We also hold events at the clinic covering topics like mindfulness, diet and holistic treatments because I think that these things have a lot to offer.
…but for now, we won’t be offering fat freezing at the clinic.

Not because it doesn’t work, but because it doesn’t work well enough.

Watch this space, if I can find one that can tip the balance and predictably produce raving fans, I’ll be right on it!

If there is anything I haven’t covered, then join me on Facebook Live at 7 p.m. every Tuesday night when you can pitch your questions directly to me, or you can e-mail here if you would prefer a more direct reply.

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Liposuction for Man Boobs

Liposuction for man boobs (or gynaecomastia, which is the medical term) is the mainstay of treatment.
However, it is often not enough to perform liposuction on its own.

Man Boobs are caused by an excess of breast tissue in a male, and males have breast tissue as well as females.

Breast tissue is made up of a combination of fatty tissue and glandular tissue and patients with man boobs often have dense glandular tissue behind the nipple.
Liposuction is very good at removing the fatty tissue and contouring the chest, but it cannot remove the dense glandular tissue.

Liposuction is good, but it may not be enough

If there is glandular tissue beneath the nipple and you just have liposuction, this dense tissue is left behind and you might still have a hard lump leaving the nipple looking puffy.

No one wants a scar, but we can hide them pretty well

This is why liposuction often needs to be combined with excision using a U-shaped excision at the lower border of the areola which can be difficult to see when it is healed as shown below:

It is often by combing liposuction with excision, the dense glandular tissue can be removed and the whole chest can be contoured to give a balanced and athletic look to the male chest whilst hiding the scars, so that once they have faded they are difficult to see.

A combination of liposuction and excision allows us to directly address both the fatty tissue and the glandular tissue and effectively remove the excess breast tissue.

If you want to know more about liposuction for man boobs and other frequently asked questions, you can download my guide here.

If there is anything I haven’t covered, then join me on Facebook Live at 7 p.m. every Tuesday night when you can pitch your questions directly to me, or you can e-mail here if you would prefer a more direct reply.

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When can I go back to work after surgery?

 The major surgery which we do at the Staiano Clinic, such as breast augmentation, breast reduction, breast lifts, gynaecomastia and tummy tucks have a dramatic effect on your body both physically and mentally and you should allow enough time to recover from them.

Surgery often involves tightening or stretching the skin, so it can feel tense and swollen for some time and you should avoid exerting yourself.
Not only does this run the risk of putting tension on the wound and the possibility of the wound not healing up as well as we would like, but it will also increase the swelling and the swelling can take some time to subside.

If you overdo it in the early stages then it can be a false economy in the long run and you would have been better off giving yourself more time to let things settle to start off with, and although cosmetic surgery has an image of a lunchtime procedure with no downtime, if you are seeking a dramatic change in the shape of your body then you should expect and plan for a period of rest and recuperation.

The First Week

The first week after surgery is always uncomfortable.

Everything feels tight and tender and you will not feel like doing much.

You will be able to potter around the house and look after yourself, but you should plan for little more.

After the first week you will come back to have the dressings removed and you usually do not need any dressings after this time.

However, everything will still be quite fragile and you should continue to take things easy in the second week, although you may be able to work from home for short periods.

Depending on the procedure you have had done and how you are feeling, you should be able to drive after two to three weeks although occasionally you are able to drive after one week.

You should always check with your car insurance company to make sure you are insured and talk to us as we will be able to guide you.

Every individual is different and you should listen to your body, so that if things are uncomfortable or start to swell, then you should ease off and rest.

It is important not to be too immobile and we always encourage you to keep your legs and arms moving, either by walking around or gently exercising while sitting, as well as taking deep breaths to expand up your lungs.

We encourage you to cough if you feel like you have anything on your chest.

After Two Weeks

After two weeks you may be able to resume gentle activities and you may be able to go back to work as long as it is not too strenuous.
If you have had surgery to your upper body, now is the time you can start exercising your lower body on the exercise bike or the stepper at the gym, but you should avoid too much activity with your arms.

Two To Four Weeks

Between two and four weeks you will start to feel better, although the scars will still be quite fragile and the tissues will still be quite swollen.
We normally advise people to wait at least four weeks before starting to massage their scars with cream, as they might be quite red and firm at this stage.

Four To Six Weeks

After around four to six weeks you can start engaging in more strenuous activities including heavy lifting or upper body exercises at the gym.  I would stress that this is the time to start these activities which does not mean that you should go straight in, doing the same level that you were pre-operatively.  It is merely that you can start to gently see how you feel and gradually build up.  If it is uncomfortable or the tissues swell then you should stop and give yourself more time to rest.

Three Months

It takes about three months before the shape and the scars really start to settle and there can be numbness or altered sensation, which can take many months to subside.

Twelve Months

At around twelve to eighteen months, you will be getting an idea of what the final results should be like, but it is not uncommon to still have some degree of settling after this.

We keep a close eye on you in the clinic and encourage you to get in touch if you have any concerns about how you are healing.  We realise that everyone is an individual and this is just guidance.
If you have any questions or concerns then we’d love to hear from you.  You can e-mail us or call us.
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.

Tummy Tuck or Liposuction?

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?

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.