Many of us in Nottingham have an area of the body that we’re not happy with and there is a wide range of surgical procedures aimed at reshaping the body.

Trunk Contouring, the Tummy Tuck and Liposuction

For anyone with an excess of skin on their tummy or an overhanging tummy, the idea of surgery can be very appealing. Much of the popular media, both magazines and TV shows, will show quick decisions, without any shadow of doubt and delighted patients coming out of the operating theatre talking about how easy it all was.

Always remember that no cosmetic surgery comes without risk. The magazines and TV shows do not have time or space to display the discussion and planning that takes place before these procedures. Remember that, in some cases, liposuction may be the best option, in others, an abdominoplasty (tummy tuck) would be better and sometimes, the best thing to do is nothing. Beware of any surgeon or agent who takes one look at you and says, “You need a tummy tuck.”

Liposuction

In this operation, fat is removed from a deep layer of tissue, just above the underlying muscles. In order to do this safely, I inject fluid into this tissue before the liposuction. This fluid contains local anaesthetic, which helps relieve post-operative pain, and adrenaline, to reduce bleeding in the tissues. The procedure can sometimes be done with local anaesthetic alone, with the patient awake. In most cases though, a general anaesthetic will be needed.

After liposuction, the skin in the treated area will be soft and floppy. This will tighten over six to twelve weeks and during this time, most people will benefit from using a pressure garment to compress the area.

Abdominoplasty – the Tummy Tuck

This operation is done under general anaesthetic and will possibly require a stay in hospital of two or three days. It involves the removal of all of the skin and fatty tissue layer below the belly button. The skin from the upper abdomen is brought down to the level of the hips and pubic area, within the “bikini line”. The belly button is placed in this skin at its normal position.

After surgery, you will have two plastic drains, which are removed after about two days, usually. You will also have a tight compression garment. This helps reduce any bleeding in the deep tissues and swelling that may occur from fluid in the tissues. It needs to be worn, night and day, for six weeks.

Thigh Lift

This procedure removes loose skin and excess fat from the thighs and is particularly good for patients who have undergone massive weight loss and find that the skin has been stretched and won’t snap back.

Arm Lift (Brachioplasty)

A surgical solution to the dreaded ‘bingo wings’, an arm lift removes excess fat and skin from the upper arms to produce a tighter and smoother look.

Labiaplasty

Usually aimed at reducing the shape and/or size of the labia, this procedure is growing in popularity. It can be done for purely aesthetic reasons, although some women find that overly large labia can cause pain and irritation.

Fat Transfer and Grafting

This is the process of taking fat from an area of the body where it is unwanted – such as the stomach, buttocks or thighs – and re-injecting it in other areas such as the breasts, hands and face. It can also be used to improve the appearance of scars on the face or body.

Please ensure you book a consultation with a fully accredited Consultant Plastic Surgeon

Problem Scars, Keloid and Hypertrophic Scars

No-one wants a scar. If scarring has to happen, we want the scar to be as fine and as near to invisible as possible. Unfortunately, for some people scarring can be a real problem. Abnormal scarring can produce visible lumps, which may be obvious. It can also cause pain or itching. In my experience, itching is often the worst aspect of these scars.

Scar treatments: the problems

Over the years, there have been a number of different scar treatments developed but problematic scars are challenging to treat in a predictable way and no treatment has been shown to cure all problematic scars.

Scar treatments: possible solutions

As an evidence basis for treating hypertrophic and keloid scars, I use the ‘International Clinical Recommendations on Scar Management’, which was written by the International Advisory Panel on Scar Management in 2002. Of course, this means that their guidelines, although important, are now more than ten years out of date and a few advances have been made since then. I will discuss all the possibilities for treatment of scars, both non-surgical and surgical, with you in the clinic.

Cryotherapy – CryoSafe Freezing Treatment

This is a relatively new type of treatment for problematic scarring that involves freezing the scar tissue from the core to the outside. The results are very encouraging and I am now certified to deliver this treatment. It can be given in the treatment room of the clinic, with a local anaesthetic injection. The scar will need dressings for about four to six weeks.

Steroid Injection

This is a well-established technique for treating scars. It can be done in the clinic room and tends to work well in most hypertrophic scars and some keloid scars. Its benefits are that it is quick and tends to reduce both the thickness of the scar and the associated itch. Drawbacks are that the treatment is a bit painful and may leave a little chalky residual whiteness within the scar. If it occurs, this usually disappears after a few weeks. Most scars will require about six injection treatments, spaced about a month apart.

Laser Treatment

This was the main focus of my doctorate. Lasers can offer improvement for many types of scars but work best in scars that are red. They are tremendously effective in reducing itching in scars and may also reduce the scar’s thickness. The treatment will sting a little and will leave a bruise-like mark in the scar, which disappears over about two weeks.

Surgery

Surgery can be used to change the line of scars and to help reduce the size of some large scars. In some extensive scars, the whole scar may be removed and a special skin substitute may be applied to improve the contour and texture of the skin. You must remember though, that no surgery can make scars completely disappear. Anyone who tells you they can make scars disappear (without using make-up) is lying to you. Occasionally, in keloid scars which have not responded to other forms of treatment, surgery may be carried out, sometimes in combination with radiotherapy.

Radiotherapy

Low dose radiotherapy is sometimes used following removal of a scar that has not responded to other treatments. If I think you would benefit from this, I would arrange for you to be seen by the consultant radiation oncologist, who would give the radiotherapy. They would counsel you regarding the expected benefits and risks of this treatment. If you decide to have radiotherapy, we would co-ordinate your treatment so that you would have the scar excised on one day and then receive the radiotherapy the following day. Usually, only one or two radiotherapy treatments are required.

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