Others:

Other body contouring procedures performed by Professor Malata include the following:

• Post-massive weight loss surgery

• Fat transfer surgery

• Beauty after baby

• Creation of waistlines

Post Massive Weight Loss Surgery

 After massive weight loss from dieting, exercise, gastric banding or gastric bypass the body is left with collections of loose tissues in different areas. These result in noticeable deformities which are not only distressing for the patient to look at but can also give rise to health problems such as rubbing, excessive sweating, infections, hernias, etc. Body lift surgery (see above) is designed to surgically remove and uplift the loose hanging skin which follows massive weight loss. Most frequently body lift surgery addresses excess skin on the breasts, arms, back, abdomen, thighs and buttocks through a series of 2 – 3 operations. Some patients also require face, neck and eyelid lifts to refine the facial appearance. Body lift surgery can make you feel better about yourself and boost your confidence following the considerable achievement of dramatic weight loss whether this is done by dieting and exercise or gastric bypass or gastric banding. Some people feel demoralised that despite great weight loss they remain unable to fit into smaller clothes due to excess skin. The cosmetic appearance after such weight loss is also upsetting to the patient and many feel unattractive and extremely self-conscious. Post-massive weight loss surgery will address these issues.

It is important that you have lost all the weight you intend to lose and your weight has been stable for at least 6 months. For your safety Professor Malata does not undertake other surgeries combined with a body lift (in order to reduce the risks during and after surgery).

The final results are not guaranteed and depend on your BMI, fat deposition pattern and the quality of the skin-fat envelope; and continue to improve for 1 – 2 years. The aim of the surgery is to return your body contour towards the normal range.

This is often a major life-changing operation which carries many significant risks.

Risks of post-massive weight loss surgery:

All operations carry risks as well as benefits. As in any cosmetic surgery, there are benefits, risks and the final results are not guaranteed. The chance of complications following a post-massive weight loss surgery depends on the type of operation and other factors such as your general health. Professor Malata will explain how the risks apply to you. Detailed postoperative instructions will be discussed during consultation and a procedure-specific handout given to you by Professor Malata.

Some risks of post-weight loss body contouring

Frequent

• Bruising and swelling of tissues: common

• Discomfort on movement

• Numbness: widespread, severe, can be long lasting

• Seromas (fluid collections) needing aspirations: 30-50%

• Small areas of wound breakdown: common

• Healing problems: breakdown/separation, skin loss, slowed

• Scars: stretched, wide, lumpy, raised/ red/ itchy

• Psychological distress - common: weeping, anxiety, relationship & body image problems

• Limited improvement of nearby areas: depending on sites treated

Infrequent

• Bleeding and hematoma: infrequent - 5-10%

• Infection (5%): infrequent: antibiotics ± drainage

• Tissue loss (5%): skin & umbilicus [smokers, extensive undermining; T-cuts, previous scars]

• Contour irregularities: depressions, ridges, wrinkling

• General complications: chest infection, blood clots [DVT & PE]

• Revision surgery: dog ears, asymmetry, dissatisfaction, mons pubis excess

• Persistent redundancy of buttocks

• Feminization of the lower trunk in men.

• Long term effects from: ageing, weight loss/ gain, pregnancy, etc, long scars

Alternatives to post-bariatric body contouring surgery

• Surgery in stages: tummy tuck, thigh or flank lifts, buttock lifts

• Isolated areas only

• No surgery at all: baggy clothes

Fat transfer surgery (Lipofilling)

Fat transfer surgery involves taking fat from one area of the body and transferring it to another to restore shape and definition. The technique employed by Professor Malata for a variety of indications in aesthetic and reconstructive surgery is the tried and tested “Coleman fat transfer”. The most common uses of lipofilling in Professor Malata’s practice are restoring facial volume which has diminished in the natural ageing process and enhancing breast surgery usually after breast reconstruction. Small amounts of fatty tissue harvested from the abdomen, buttocks or the thighs using a technique similar to liposuction. The fat is purified (by centrifuging and removal of water and oils) and then injected using a fine cannula in a controlled fashion to the areas to be treated. Uncommon indications include treatment of deep wrinkles and breast augmentation avoiding breast implants.

Risks of fat injections or lipofilling:

All operations carry risks as well as benefits and fat transfer is no exception. As in any cosmetic surgery, there are benefits, risks and the final results are not guaranteed. The chance of complications following a lower body lift depends on the type of operation and other factors such as your general health. Professor Malata will explain how the risks apply to you. Detailed postoperative instructions will be discussed during consultation and a procedure-specific handout given to you by Professor Malata.

Some risks of fat injections or lipofilling

• Bruising & swelling common at both the donor and injected sites

• numbness (temporary)

• incomplete improvement: very common

• residual asymmetry

• need for repeat surgery: universal, more than 2 treatments needed

• fat embolisation into vessels: very rare

• bleeding (haematoma): rare

• infection: rare

• delayed healing

• local nerve injury: facial, etc

• unsightly scarring – infrequent

• scar hypertrophy or keloid formation - rare

Beauty after Baby (“Mommy-Makeover”)

“Beauty after Baby” is the collective term for a number of cosmetic body contouring procedures that are used to counteract the physical effects of pregnancy and breast feeding. Although having a baby is one of the greatest joys in life pregnancy and breastfeeding have a wide variety of physicial effects on your body. These effects vary from woman to woman but they can occur as a result of a single pregnancy, repeated pregnancies, twin pregnancy, small or light birth-weight babies, normal or overdue pregnancies. The effects on the body are related not only to the hormonal changes but also to the considerable weight gain during, or loss after, the pregnancy. Although breast milk is the best food for the baby, breast feeding for more than a few weeks has a considerable effect on the breasts in addition to the breast changes accompanying pregnancy . The skin's elasticity, particularly of the breasts and abdomen, is "tested" by pregnancy, and the skin responds differently in every woman.

Often, the tummy is left with both laxity of the muscles (called a diastasis) as well as excess skin with or without stretch marks. The abdomen therefore bulges to a variable degree. The breasts often lose volume compared to your pre-pregnancy size, and they may droop or sag to varying degrees. Some women the breasts remain larger than they were before the pregnancy but lose their shape. Less common changes after pregnancy include dark patches or spots on the face (melisma), broken veins (telangiectasia and spider veins), varicose v eins, unwanted hair or increased fine lines and wrinkles.

There are a variety of treatments available to reverse or eliminate the effects of pregnancy and lactation., ranging from minimally invasive non-surgical procedures and treatments, to plastic surgery procedures for post-pregnancy changes. The ideal candidates are the mothers who have been with deflated breasts, tummy laxity, or skin changes after pregnancy The plastic surgery procedures following pregnancy include:

• Tummy tuck (abdominoplasty)

• Breast augmentation

• Breast lift

• Combined breast enlargement and breast lift (Augmentation-mastopexy)

The minimally invasive procedures which may be indicated include injections (botox, restylane or juvederm), hair removal technics (intense pulsed light or laser), injection sclerotherapy for spider naevi, chemical peels or microdermabrasion.

For specific details about each type of operation including the return to work and exercise following surgery please refer to the relevant parts of the website. In general terms the average times back to work and gentle exercise are

• Breast Plastic Surgery, about 7 – 10 days

• Tummy Tuck with or without breast surgery, about 10 to 14 days

• Nonsurgical Treatments: Immediate