Surgical

Face

• Face/neck lift
• Blepharoplasty/eyelid lift
• Brow lift
• Facial and neck liposuction
• Facial fat filling
• Mid-face lift
• Lip dermal grafts
• Upper lid lift

Rhinoplasty/nose job

Cosmetic rhinoplasty or a ‘nose job’ aims to alter the shape and size of the nose and improve nasal appearance in order to restore balance and harmony to one’s face.

Chin augmentation

A receding chin may be augmented by placing a small implant on the chin or by surgically advancing the jaw bone. A less invasive technique could involve injecting fat into the chin.

Otoplasty/ear corruption

Prominent ears may be corrected by an otoplasty operation to set the ears back against the head in a natural way.

Breast cosmetic procedures

Cosmetic surgical enhancement of breasts aims to restore and modify undesirable breast size and shape as required by an individual towards a perceived aesthetic ideal. Changes due to pregnancy, the effects of gravity and ageing can be reversed in most patients and more youthful breasts restored without altering natural appearance or function.

Breast cosmetic procedure options are as follows:

Breast reduction
Breast reduction is a surgical procedure performed in order to decrease the size of the breasts.

Breast augmentation
This procedure enlarges breasts that are small, underdeveloped or have lost size and shape after childbirth. Enlargement of the breast is aided by the insertion of prosthetic silicone implants behind each breast. An incision is made either under the breast, around the areola or in the axilla/armpit, and a pocket is created for the implant either behind the glandular tissue or muscle between the breast and chest wall.

Mastopexy or breast lift
This is a surgical procedure to lift up a sagging breasts – there should be little to no change in the size of the breast after the procedure, merely an improvement in breast position, projection and appearance.

Breast reconstruction after mastectomy

The extent of the breast reconstruction operation is determined by the extent of the cancer surgery, which varies from partial mastectomy/lumpectomy (removing part of a breast only), subcutaneous mastectomy (removing the internal breast tissue but leaving the skin envelope and nipple/areola) to complete mastectomy (removing all breast tissue with nipple/areola and a varying amount of skin). In some cases it is possible to do an immediate reconstruction at the time of mastectomy, but in other cases reconstruction is best delayed until all cancer treatment is complete.

Breast reconstruction options are as follows:

Immediate breast reconstruction

• Prosthetic placement with or without tissue expanders.
• Latissimus dorsi back flap with breast implant placement.
• Abdominal DIEP free flap.

Delayed breast reconstruction

• Prosthetic placement with or without tissue expander.
• Latissimus dorsi back flap with breast prosthesis placement.
• Abdominal TRAM flap.
• Abdominal DIEP free flap.

Breast cancer patients have to deal with the threat and implications of the cancer, potential mutilation of their breasts and a sense of loss of womanhood, all of which could result in a period of emotional upheaval after the cancer surgery. Breast reconstruction can help patients to work through some of these issues and restore a sense of self-esteem and confidence.

Body contouring procedures

Cosmetic surgical enhancement of one’s torso aims to restore youthful contours and modify a body shape that is undesirable for the particular individual. Changes due to ageing, weight loss and pregnancy may be reversed and youthful body contours restored.

• Abdominoplasty (tummy tuck)
• Liposuction/liposculpture
• Thigh lift
• Gluteoplasty (buttock lift)
• Brachyplasty (arm tuck)
• Structural fat grafting – face, body & hands
• Labioplasty/vulvoplasty – female genital surgery
• Post weight-loss surgery

Reconstructive

Plastic surgical reconstruction of deformities takes many forms, deals with problems in many different anatomical areas and involves a variety of tissue types. Plastic surgeons are trained to apply their skills and techniques in original ways to solve each particular reconstructive problem, taking into account the state of the tissues, general health of the patient, function of the various structures and organs involved. The ability to perceive and plan three-dimensional structures and a sense of aesthetic appreciation help plastic surgeons to restore patients’ deformities to the best possible outcome.

Whereas cosmetic surgery is principally concerned with appearance and function an essential secondary consideration, reconstructive surgery aims to restore function with appearance an essential, but secondary concern.

The reconstructive operations offered are extremely varied and the following list contains some of the deformities and diseases dealt with:

• Skin cancer surgery
• General soft tissue reconstruction
• Reconstruction of facial fractures and deformities
• Cleft lip and palate/craniofacial surgery
• Breast reconstruction following mastectomy/deformity
• Scar revision

Introducing liposculpture

Sometimes, despite our best efforts with diet and exercise, we just cannot get a particular body part to obtain the shape we most desire. There are so many negative terms used to describe ladies’ legs that do not ascribe to the Steffi Graph ideal of shapeliness.

‘Saddlebags’ describes the stubborn fat pouches that are diet resistant on the sides of the thighs. Then there is the genetic curse of ‘cankles’ (a mash of the words calves and ankles) – where there is no tapering from the knee down to the ankle. This condition is also completely resistant to diet and exercise. Fortunately there is a surgical solution to these problems: liposculpture.

Liposculputure is a technique whereby fat is sucked out with a liposuction cannula. The remaining fat is shaped to mirror the underlying muscles. This creates a more toned and athletic look.

The technique is particularly effective for the problems described above, but can also be used to remove ‘muffin tops’ and/or to sculpt the anatomy of the abdomen to uncover a six-pack that has been hiding under a thin layer of fat. In the hands of a skilled plastic surgeon, liposuction can be used to reshape your body and set you free to bare your legs or tummy with confidence.

We are the proud owners of a SlimLipo machine – the only one available in the Western Cape. This technology merges the known effectiveness of conventional liposuction with the addition of skin tightening laser technology. The common problem areas of the upper arms and double chin can benefit from localised fat removal and skin tightening at the same time for a more rejuvenated appearance.

Slimlipo treatment

What is the SlimLipo procedure?
This procedure is a combination of liposuction and laser treatment. It removes fatty tissue and tightens the skin, creating a more toned and athletic look.

What areas can be treated?
The abdomen, love handles, hips, inner and outer thighs, upper/lower back, neck/chin and upper arms.

When will I see results?
Once the swelling subsides, you will notice an improvement of the skin and contour of your body. You will continue to see improvements over the following six months.

Fat Filling

Plastic surgeons have identified that, along with the sagging and descent of the skin and underlying structures of the face, the normally occurring fat deposits in the face also atrophy (thin) over time. A traditional facelift will reposition the architecture of the face and deal with excess skin, but it does not always restore a youthful plumpness to the face.

Fat filling takes fat from one part of the body (knees, thighs, hips, back rolls) with liposuction techniques and then re-injects it into areas that need volume restoration. It can be used to fill tear troughs under the eyes, hollow cheeks, nasolabial lines, hollow temples, thinning lips and asymmetrical breasts. The procedure is also excellent for scar revisions and correcting indented scarring.

The benefits of fat filling are more than just the direct improvement in volume in the area treated. Liposuctioned fat is filled with stem cells. Patients have reported improvement in skin condition and complexion due to the rejuvenating effects of the stem cells deposited with the fat re-injection. The repairing and rejuvenating effects of stem cells are especially advantages to tissue damaged by radiation after cancer surgery.

Another benefit of fat filling is that the procedure is permanent, unlike hyaluronic fillers that need to be repeated every nine moths or yearly, resulting in increased cost over time. It is sometimes necessary to repeat the fat filling procedure a second time as some of the fat can be resorbed, but what remains is permanent.

Are you a good candidate for fat filling? If you feel you need volume restoration to your face or body, you can test the area by having hyaluronic acid filler. If you like the result, you can ask your surgeon for a permanent solution and have the same area filled with your own fat. The nursing team involved in a fat filling procedure must be specially trained and experienced in processing the extracted fat in preparation for re-injection. At Somerset Surgery, our nurses have extensive experience in this highly specialised rejuvenation/reconstructive aspect of plastic surgery.