Blepharoplasty – Eyelid Surgery

One of the most common procedures I perform in my Fourways rooms is Eyelid surgery, or Blepharoplasty.

 

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This is because, unfortunately, the eye area is one of the first areas to show the signs of aging.

Indeed, many men and women suffer from droopy or hooded eyelids, either due to aging, heredity factors, or both. And the same applies to the wrinkles, puffiness and fat bulges that can develop in the lower eyelids. These conditions can be particularly bothersome, since the eyes are such a critical part of our expressions and our interactions with others. Patients often complain of appearing tired or unhappy despite feeling otherwise.

Eyelid surgery always has a tremendous impact on the overall appearance of the face and gives my patients a younger, more awake and energetic look that boosts their confidence.

Contact my Fourways plastic surgery practice on 011 875 1631 to learn more about the eyelid surgery.

 

IS BLEPHAROPLASTY THE RIGHT SURGERY FOR YOU?

Eyelid surgery is a wonderful procedure for restoring youthfulness to eyes that are showing severe signs of ageing resulting from gravity, time and genetics. During this procedure, I remove fat pockets and tighten the muscles but I explain the procedure in more details further on in this article.

The best candidates for this plastic surgery procedure are healthy men and women who are in their 30s or older and who have realistic expectations.


Of course, as with all cosmetic procedures, it is especially important that I carefully assess your eyes and the surrounding areas and understand your goals and concerns before recommending eyelid surgery.

During your consultation, I will determine if you truly have excessive eyelid skin, or if your sagging eyelids are mainly caused by a drooping brow. If this is the case, you may actually need a brow lift, either with or without blepharoplasty. Find out more about brow lift on my website

I will also decide whether you require upper eyelid surgery, lower eyelid surgery, or both, and what approach would be best suited to your condition.

Since the eyes and the eye area are such an important part of our appearance, it is extremely important that eyelid surgery be performed only by a board-certified plastic surgeon specializing in this delicate procedure. I, myself am a member of the APRSSA.

 

WHAT IS THE DIFFERENCE BETWEEN UPPER AND LOWER EYELID SURGERY?

This is probably the number one question my eyelid surgery patients ask me.

 

→Upper Eyelid Surgery

When performing upper eyelid surgery, my goal is to remove excess skin and occasional fat bulges that are responsible for the tired, grumpy look. I make an incision that runs along the natural fold of the upper eyelid, and extends just beyond the outside corner into the existing creases.

Through this incision, a strip of excess skin is removed and fatty tissue is eliminated or repositioned to create a more refreshed, alert appearance. Because the incision follows the natural crease of the eyelid, it is usually very well-concealed and rarely noticeable.

 

→Lower Eyelid Surgery

While upper eyelid surgery primarily involves the removal of sagging skin, lower eyelid surgery mainly targets the fatty deposits, which are more predominant under the eye. Removing these deposits in conjunction with the sagging skin leaves a smooth, firm, younger-looking surface above the cheek.

Lower eyelid surgery may be done through the inside of the lower eyelid, using what is called transconjunctival or “scar-less” technique which requires no external incision, and is appropriate only for the removal or redistribution of fat. It is therefore not suitable if you are showing severe wrinkling in that area.

I usually complete upper and lower eyelid surgery within one to two hours, it is usually done as an outpatient procedure. Did you know that some of my patients choose to have blepharoplasty done in conjunction with a facelift?

Here is an article I wrote about Facelift surgery at my practice
 

RECOVERING FROM EYELID SURGERY

After surgery, you will have eyelid sutures in place. They provide support to the eyelid tissue to ensure that the incision lines heal beautifully, without excessive strain or tension. These sutures are removed 5 days after surgery.

My patients usually report mild levels of pain following blepharoplasty but I will prescribe oral medications to alleviate any discomfort you may feel. You should expect bruising and swelling too, at least for the first week after your surgery. After 10 to 14 days, most of my eyelid surgery patients feel comfortable in public and return to work and social activities.

We will schedule follow up appointments so that I can check up on your healing progress. I will remove your sutures within the first week of surgery.

The eyelid surgery results can last for years but remember to be patient with yourself during the healing process. While it is imperative to be active, eat well and get plenty of rest, it is true that people heal at different paces.

I hope you enjoyed this article? It was great for me to share some key facts about blepharoplasty. If I have left out something that you would like to know more about, please leave a message right here on my blog or, alternatively, on my Facebook page or via Twitter and I will get back to you as soon as possible.

Lastly, if you wish to book a consultation with me, please phone my rooms on 011 875 1631.

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DR CHARLES SERRURIER’S JANUARY 2013 NEWSLETTER: LIPOSUCTION

Liposuction

Happy new year to you all and I wish you all a prosperous 2013. Coming back to work after a holiday is for some a nightmare, but for me it is an exciting affair. There will be new challenges and much interesting work to be done.

I am thrilled to talk about Liposuction in this January newsletter! Did you know that liposuction is surprisingly a popular month for cosmetic surgery?

“Liposuction is a great combination procedure”

Also, liposuction is a procedure that I find most people want to add as a combination procedure.
I.e. Have your facelift and include some liposuction or a breast augmentation with additional liposuction.

I hope you enjoy the topic, remember you can also stay in touch via my facebook page or website www.drserrurier.co.za

Enjoy!

Is liposuction right for you?

First things first! Liposuction is NOT a weight reducing procedure and ideally, patients should be within their healthy body weight for height range (BMI 19-25).

This cannot be stressed enough. Ideally we want to shape and remove stubborn, diet and exercise resistant fat with liposuction.

Any one or combination of the following conditions may indicate that you are a good candidate for liposuction surgery:

  • Areas of fat deposits that are out of proportion with the rest of your body and do not go away with diet and exercise
  • Diet Resistant fat
  • Areas with minimal amounts of excess skin (Liposuction removes fat not skin) and good skin elasticity.

We will discuss this in more detail during the consultation process, we will also talk about your aesthetic needs, if you want combination surgery and of course the surgical risks.

It is extremely important to be fully informed.

→ Basic Liposuction technique involves the removal of fat via a hollow metal tube (cannula) that is passed through the fatty tissue. A common liposuction approach is called Suction Assisted Liposuction (SAL). This technique involves the removal of fat by attaching a pump that generates a vacuum.

Before your liposuction surgery

During the initial consultation, you may be asked to look in a mirror and point out exactly what you would like to see improved.
Knowing and understanding your needs is part of achieving your desired result.

Pictures may be taken of you, especially if the areas that will be treated are on your posterior aspect (back, buttock, etc.). This will help me understand your expectations and determine whether they can realistically be achieved.

A determination of the elasticity of the skin will also occur during the consultation. I have to know I can achieve what you need.

A discussion concerning your ideal weight and realistic weight will most likely occur during the consultation. Plans such as future pregnancies, etc. may be also discussed. These simple but often overlooked questions can radically effect your long-term results.

The amount of fat removed at any one session is restricted to 2,5 – 3 litres; this is to minimise the chances of postoperative complications. This is another reason why we want you to be close to your ideal weight.

What is recovery like?

Liposuction surgery is usually performed as a day case. If this is the case, be sure to arrange for someone to drive you home after surgery and to stay with you for the next 24 hours as precaution.

You will be uncomfortable for the first few days. Pain medication will keep you pain free but having help around the house is highly recommended.

If you are undergoing large volume liposuction, I will recommend you be hospitalised for the night.

Physical activity should be restricted for the first 24 hours post operatively for all Liposuction cases. Just because the pain medication will have you feeling well doesn’t mean you should be up and about.

After the first 24 hours, light exercise is encouraged but strenuous exercise should not be resumed for at least 4 weeks.

Post operatively Liposuction patients are required to wear a support garment for approximately 6 weeks to help minimise swelling and bruising, and to maintain the aesthetic result.

I estimate that it will take 6 months for all the swelling to subside and the final result to become visible. That said Liposuction has superb results and an incredibly high patient satisfaction rate.

 Make an appointment now if you would like to discuss your Liposuction options.

Dr Charles Serrurier 

Plastic & Reconstructive Surgeon
MBBCH (Wits), FCS Plast. Surg (CMSA)
PR. N0. 0304131                                              

Suite A9,
Life Fourways Hospital

Cedar Road & Cedar Avenue West
Fourways
2055
TEL: 011 875 1630
FAX: 011 875 1631
FACEBOOK  Dr Charles Serrurier
drcharlesserrurier.wordpress.com

WEBSITE: http://www.drserrurier.co.za 

DR CHARLES SERRURIER’S DECEMBER 2012 NEWSLETTER -SKIN CANCER-

Skin Cancer

The holidays are coming up and even though it is rather unpleasant to talk about cancer, I always need to make sure that my patients take good care of themselves and stay safe, especially in South Africa where the levels of Ultra Violet light we get are the highest in the world. Do you always remember to apply sunscreen on yourself and the little ones around you? I cannot stress enough how crucial it is.

Tanning can be dangerous and we often underestimate the terrible consequences of relaxing in the sun for long hours, unprotected. This is why this month; I chose to give you some insights about skin cancer. The South African statistics when it comes to this skin disease are alarming to say the least so I hope you enjoy this newsletter and remember to enjoy the sun in moderation!

Skin cancer in a nutshell…

Skin cancer is the uncontrolled growth of abnormal skin cells. It occurs when unrepaired DNA damage to skin cells (most often caused by ultraviolet radiation from sunshine or tanning beds) triggers mutations, or genetic defects, that lead the skin cells to multiply rapidly and form malignant tumours.

Who is at risk?

Those most at risk for skin cancers are people with a family history of skin cancer, past personal history of skin cancers, a past history of excessive sun exposure or sunburns, blondes and red-heads, and those who use tanning beds.

Fair-skinned people are at higher risk of getting skin cancer than the general population, but people with dark complexions can also develop skin cancers. These growths may appear suddenly or develop over time, just as with fair skinned people.

→ Skin cancers often appear on areas of the skin that are exposed to the sun. But they can also develop in other areas, including on the palms, under the fingernails, between or under the toes and in the genital region.

The different kinds of skin cancer

→Basal cell carcinoma is the most common type of skin cancer, accounting for 8 out of 10 cases in the United States, according to the American Cancer Society, with similar statistics here in South Africa.

This type of skin cancer is found most often in areas of the skin that are exposed to the sun such as the face, neck, arms, and legs.

Basal cell carcinoma is usually a very slow growing cancer, and very rarely spreads to other areas in the body.

→A second type of skin cancer originates from the flat and thin squamous cells of the skin: the Squamous Cell cancer. This type of skin cancer often appears on parts of the body exposed to the sun.

Squamous cell carcinoma sometimes spreads to the fatty tissue underneath the epidermis, and from there can spread to other sites in the body.

→Melanomas are a type of skin cancer that begins in the darkly coloured melanocytes that make up moles on the skin.

Like the other two types of skin cancer, sun exposure increases the risk that melanocytes will transform into uncontrollably growing cells of melanoma.

What I can do about it.

In treating skin cancer, Dr Serrurier’s main goal is to remove or destroy the cancer completely, with as small a scar as possible.

After the local anesthetic is given, the tumour is excised, the cancer is the wound is sutured together meticulously to make the scar as small and neat as possible.

What you can do about it.

You can improve your chances of finding skin cancer promptly by regularly performing a simple skin self-exam. The best time to do this self-exam is after a shower or bath.

Simply make yourself aware of any new growths or moles that are changing color and shape. If something is bothering you, then please make an appointment. It is better to be safe than sorry.

You should check your skin in a well-lighted room using a full-length mirror and a hand-held mirror. It’s best to begin by learning where your birthmarks, moles and blemishes are and what they usually look like. Check for anything new–a change in the size, texture or color of a mole, or a sore that does not heal.

Dr Charles Serrurier

Plastic & Reconstructive Surgeon 

MBBCH (Wits), FCS Plast. Surg (CMSA)
PR. N0. 0304131                                             

Suite A9,
Life Fourways Hospital

Cedar Road & Cedar Avenue West
Fourways
2055
TEL: 011 875 1630
FAX: 011 875 1631
FACEBOOK – Dr Charles Serrurier
BLOG – drcharlesserrurier.wordpress.com

DR CHARLES SERRURIER SEPTEMBER NEWSLETTER: Breast Augmentation

In my practice, breast augmentation surgery is hugely popular and I always try my best to give my patients great results and utmost satisfaction.

With spring coming, plastic surgeons do see an increase of breast surgery requests but there are many things you need to know and ask before making the final decision.

Before getting on with this month’s newsletter, I need you to know that my patient’s health and safety are my priorities and I always guaranty that silicone, and all the implants I use for all the breasts surgeries, are extremely safe and have undergone extensive research and testing.

I hope you enjoy what follows!

About the implants…

You will see, upon consultation for your breast augmentation surgery that breast implants vary greatly in shape and size.
Silicone implants are the most popular as they feel more natural than saline implants. I am not saying that saline implants are hazardous but there have been complaints linked to deflation.

Textured vs. Smooth

Breast implants can be textured or smooth.Most implants used in my practice are textured because research suggests that this is what gives the best rates of long term complications. It is thought that by choosing textured implants, we lower the chance of scar tissue forming around the implant.

In the past the shell of the smooth implants has been slightly softer; you will feel it less through the skin and tissue but this is no longer the case.

Please don’t be overwhelmed, I will take the time to discuss this with you in details so that you fully understand the procedure and its outcome.

Is silicone safe?

It has been scientifically proven as one of the biggest clinical studies that silicone gel implants carry no increased risk of breast cancer, autoimmune diseases and risks when breast feeding.

Placement Options

During a breast augmentation surgery, there are two placement options: behind or in front of the muscle. But because each patient is unique and wishes for different results, I will decide what’s best for you upon our one on one consultation.

If I decide to place the implant in front of the muscle, it will result in a more mobile breast with more fullness in its upper pole.

But if we go for behind the muscle, it will create a smoother transition from the chest onto the upper pole of the breast and thus a more natural overall profile.

Incision Options

With regard to the incisions (and thus, implant insertion sites), there are 3 different options:

  • Under the fold of the breast (the infra mammary fold)
  • Around the nipple
  • Through the armpit

Each has their advantages and disadvantages:  I personally prefer the infra-mammary fold or the periareolar but of course I will explain the pros and cons of each incision and answer all your questions before we make the final decision.

What is the recovery like?

The breast augmentation recovery does vary from one patient to another, but I usually advise my patients to take one week off work in order to get a good quality break and allow the breasts to heal nicely.

Expect your breasts to be swollen and tender and to experience some discomfort for a few days after the op.

After 5 or 6 days, the mild bruising will have disappeared but the swelling may remain for 3 to 5 weeks after the surgery.

Full recovery should normally be complete 6 weeks after the breast augmentation surgery.

Light activities can be resumed 2 days after the breast augmentation surgery but you must wait one whole week before resuming regular activities. I always insist that strenuous activities have to be avoided for 4 weeks in order not to impair the healthy recovery.

When it comes to exercise after a breast augmentation, I cannot stress enough how important it is to take it easy as certain movements can damage the operation’s results if done too soon after the surgery.

Remember you can get more information by visiting my facebook page or website. And of course this newsletter will be loaded on my blog.

Dr CHARLES SERRURIER’S AUGUST 2012 NEWSLETTER: CHEMICAL PEELS

Heading now into the warmer months, my cosmetic patients are starting to make plans to undergo elective surgery.
My advice to them is always to prepare their skin and start getting close to an ideal body weight.

These two preparations can go a long way to a satisfied result and their importance cannot be stressed enough.

Slowly mimicking the facelift results

Being physically fit is something I cannot control, but skin quality is something I can – that is why I want to teach you a few things about Chemical Peels.

I hope you enjoy

Charles

Light peels

Light chemical peels are the most superficial and common peels with mild primary ingredients. This are most commonly alpha hydroxy acids (AHA), such as glycolic, lactic or fruit acid. Light peels remove the top layer of the skin in order to reveal the new layer of healthy skin underneath.

These peels are best for people who are encountering superficial skin problems only.

Lunchtime Chemical Peels

These peels are so quick and easy and you can get back to your normal activities straight after the procedure. This is why they are commonly known as “lunch time” peels.

The procedure goes like this:

  • Your skin will be cleansed before gently applying the peel.
  • The duration is 10 to 15 min during which you may feel some mild tingling or stinging feeling.
  • After the allotted time the peel will be washed off, revealing a pink colored but renewed skin.

The slight redness (and some possible blotches) is totally normal and should fade soon after. These are the only after effects to be expected.

In order to obtain optimum results, different AHA concentrations can be applied weekly or monthly but Yana will typically recommend you repeat it every 4 to 6 weeks, then monthly after that for a glowing a radiant skin.

Alternatives to Surgery

Chemical Peels are one of a very popular series of tools used by Plastic Surgeons to either enhance surgical result or employ as anti-ageing alternatives to surgery. Other options include Botox and Dermal Fillers.

Medium Chemical Peels

When it comes to medium peels, more potent acids are used, such as trichloroaetic acids (TCA). These peels are more intense in the sense that they penetrate further into the skin and can reduce deep acne scars, smaller wrinkles and help even skin tone.

TCA peels have been known to be especially successful in treating patients with darker skin tones.

These peels may require pre-treatment with AHA or Retin-A creams but we will guide you through the whole process.

Because its concentration is closer to that of a deep peel, medium peels can, to a certain extent and depending on the concentration and manner of application, achieve the results of a phenol (deep) peel.

During a medium peel:

Yana will cleanse the skin before applying the peel. The area will then turn a whitish-grey color and we will apply a saline compress to neutralize the acid in the peel. It is normal for your face to swell and burn while the peel is applied. Patients usually report a stinging feeling for around an hour after the treatment.

It roughly takes one week for most patients to recover after a medium peel. Your skin will be itchy and will then start to peel, first turning to a dark brown color and then becoming red.

In order to get the best results out of your medium peel, you should repeat the procedure monthly until you reach the desired effect and thereafter maintain the result with regular treatments every six to 12 months.

The final outcome will show a major improvement once your skin has fully healed.

Deep Chemical Peels

As its name suggests, the third peel category is the strongest: meet the Deep Peel (also called phenol peel). It is a great option if your face is showing deep wrinkles from unprotected sun exposure. It is also ideal for wrinkles around the lips and chin area but its high potency means you need to chat about it in detail with Dr Serrurier.

A full-face phenol peel usually takes Dr Serrurier 1 to 2 hours to perform and only a specialist should perform these peels.

After this procedure, your face will feel burny, itchy and swollen and you must be warned that you could feel unwell and experience moderate to severe pain for a few days.

It will be around two weeks before you can socialize again after a deep peel. But on the plus side, phenol peels give the most dramatic results by far and the effects can last up to ten years!

Dr Charles Serrurier

Plastic & Reconstructive Surgeon
MBBCH (Wits), FCS Plast. Surg (CMSA)
PR. N0. 0304131                                              

Suite A9, Life Fourways Hospital

Cedar Road & Cedar Avenue West
Fourways
2055
TEL: 011 875 1630
FAX: 011 875 163 Dr Charles Serrurier
BLOG – drcharlesserrurier.wordpress.com

WEBSITE: http://www.drserrurier.co.za/

Mid Month May 2012 Newsletter: Aesthetics

I know I briefly touched on this in my last newsletter but I decided to write a midmonth newsletter to let you all know a little more about Yana and the aesthetic procedures she is offering at my practice.

Yana is a qualified beauty therapist and now that she has settled into her role as practice manger she is getting started on booking patients who would like to undergo Chemical Peels and Facial treatments.

“Non-Surgical Anti-Ageing Options”

Aesthetic Medicine and Cosmetic surgery go hand in hand, and I am happy to be able to offer these treatments in my practice to enhance your aesthetic outcome.

Yana is qualified to treat patients using dermaceutic Chemical Peels, offer advice on MD Lash Factor and also importantly give direction for suitable homecare products too.

I hope you enjoy the following.

Dr Charles Serrurier

The DermaCeutic Range

Dermaceutic is a full range of cosmeceuticals imported from France, used to prepare, optimize and maintain the results of all aesthetic procedures. This collection focuses on the three essential areas of skin rejuvenation: Protection, Stimulation and Repair.

Yana also makes extensive use of the Chemical Peels range. Feel free to ask her for skin advice about pigmentation and problematic skin conditions as well as rejuvenation.

UNIQUE
What makes Dermaceutic so unique is that they contain an original combination of active ingredients at unequalled concentrations and this is why Yana knows she is working with some of the best Cosmeceutical on the market. She uses the products herself and knows that these products will give your skin improved firmness as well as a smooth texture and improve all pigmentation problems as well as acne scarring and acne prone skins.

COSMO PEEL
Amongst Yana’s most trusted treatments, we find Cosmo Peel. This Chemical Peel she uses to improve a variety of skin disorders caused by ageing such as dark pigmentation, smoker’s skin complexion or fine lines. Most patients need 4 or 5 sessions for best results but Yana will give you all the information you need during your consultation. 

SPOT PEEL
Yana also loves to use Spot Peel; a highly efficient depigmentation peel specialized in treating pigmentation spots, pregnancy dark spots, melasma, or post-inflammatory pigmentation.

Purchase any 2 Dermaceutic or Skin Medica product and receive a Milk Chemical Peel ABSOLUTELY FREE!

MD LASH FACTOR


Long and healthy eyelashes can give your eyes a dramatic and fabulous expression. And this is why the MD Lash Factor range is another one of Yana’s favourite products.

MD lash factor is suitable for lens wearers, protects your lashes from U.V rays and contains DNA protection as well as anti-aging properties.

Your lashes will never be the same: after only 2 weeks of conditioning treatment they will be noticeably fuller, thicker and longer.

Dr Charles Serrurier

Plastic & Reconstructive Surgeon

Suite A9, Life Fourways Hospital

Cedar Road & Cedar Avenue West
Fourways
2055

TEL: 011 875 1630 FAX: 011 875 163 Dr Charles Serrurier
BLOG – drcharlesserrurier.wordpress.com

WEBSITE: www.drserrurier.co.za

MAY 2012 NEWSLETTER: Blepharoplasty

It’s already May 2012 and things are moving forward in my practice. Yana has joined and settled in well taking the role as practice manger to heart and we love having her with us. Yana is also a fully qualified skin care therapist with experience and training in chemical peels and skin medica facials. If you are looking for this kind of treatment then please book directly with Yana.

Introductions aside I want to focus this month on Blepharoplasty or “corrective Eyelid Surgery”. Blepharoplasty surgery, although having a quick recovery time does require some down time for the first few days.

“The gleam back in your eye”

I hope you enjoy what follows.

What is Blepharoplasty?

Blepharoplasty or cosmetic eyelid surgery, is a plastic surgery procedure aimed at improving the upper and lower eyelids. Aesthetically this means opening the eyes and removing that tired and grumpy look associated with droopy eyelids.

if you have full and heavy eyelids, with or without prominent bags under the lower lids, then you are the ideal candidate for this surgery.

However, if you are encountering substantial eye issues such as glaucoma, or dry eyes, you might unfortunately not be eligible for Blepharoplasty but it is always best to make an appointment to visit Charles for clarification.

How is Eyelid Surgery performed?

The upper blepharoplasty specifically targets and rectifies the drooping skin that overhangs the upper lid. During Upper eyelids surgery Charles will remove skin and a small amount of fat from the inner corner of your eye.

The lower blepharoplasty, on the other hand, is a superb option to improve the “bags” that form beneath the eye. This surgery usually entails an incision underneath the eyelashes (subciliary approach) or through one inside the eye (transconjunctival).

What surgeries can you combine with Blepharoplasty?

A number of other cosmetic procedures such as facelift, neck lift, brow or forehead lift, neck and cheek liposuction may be safely performed at the same time as Blepharoplasty.

It usually takes Dr Serrurier between one and two hours to perform a Blepharoplasty, and in some cases he can perform the procedure in his rooms to minimize patient cost.

What about scarring?

Scarring from Eyelid surgery should not be of much concern. Of course this will all be explained in detail during the consultation process. But if lower lid incisions are made through the conjunctiva there will be no visible scars. If the incision is made below the lashes (subciliary) the scarring is well concealed.

Similarly, the upper lid incisions are made above the lashes and then the scar is well concealed in the tarsal crease.

Post Op Recovery

In most cases you will be discharged without spending the night in hospital.  On the fifth post-operative day, Dr Serrurier will remove the stitches. This can be slightly painful.

The results of blepharoplasty will not last forever. Revision surgery is uncommon since the fat pads do not regrow after they’ve been removed. The skin, however, may need to be removed again as one ages.

Going Home?

 You will be able to return to work a few days after your Blepharoplasty. However, you should avoid exercising for about three weeks after surgery.

You will be able to wear contact lenses one week after upper eyelid blepharoplasty and two weeks after lower eyelid blepharoplasty. Glasses and makeup can be worn a few days after the surgery.

 It is unlikely that your vision will be affected by the surgery. You might find it a bit blurry for a few days and it may take you 7-10 days before you feel comfortable out and about on the town.

Dr Charles Serrurier

Plastic & Reconstructive Surgeon
MBBCH (Wits), FCS Plast. Surg (CMSA)
PR. N0. 0304131                                             

Suite A9, Life Fourways Hospital

Cedar Road & Cedar Avenue West
Fourways
2055
TEL: 011 875 1630
FAX: 011 875 163 Dr Charles Serrurier
BLOG – drcharlesserrurier.wordpress.com

WEBSITE: http://www.drserrurier.co.za/

APRIL 2012 NEWSLETTER – Autologous Breast Reconstruction

Breast Reconstruction

For the month of April I want to revisit Breast Reconstruction but with a focus on Autologous Tissue Reconstruction.
Avoiding using an implant in breast reconstruction eliminates many possible extra complications associated with foreign bodies. Autologous reconstruction suits specific patients and is used specifically in certain circumstances e.g: radiation

“To undergo Breast Reconstruction is entirely your choice”

This newsletter will hopefully give you some insight into your options, what you can expect and also how to hasten your recovery.

 I hope you enjoy.

Dr Charles Serrurier

What is the process when undergoing breast reconstruction surgery?

If you choose to undergo Breast Reconstruction, we will discuss your individual case in detail to decide what is the best option for you.

In some cases autologous breast reconstruction is recommended. This allows further treatment post reconstruction and reduces risks associated with implants. The surgery is unfortunately long and can last anyting between 3 and 5 hours under general anaestethic.

The recovery time is also long due to the donor site sensitivity and breast sensitivity. Once recovered at approximately 6 months we will bring you back into theatre to reconstruct the nipple area too.

What donor sites can be used for autologous breast reconstruction?

There are traditionally three donor site options:

Each has it pro’s and con’s but each will have specific reference to your case and reconstruction.

  1. DIEP Flap – abdominal tissue is used in the reconstruction. This process is however complicated due to the necessity to perform a free tissue transplant (free flap). This means microsurgery is involved and there is risk that the flap will not survive.
  2. TRAM Flap – this is similar to the DIEP Flap but this time a small portion of the abdominal muscle is also used. There are free flap options but surgeons using this technique will nearly always attempt to use a pedicle (maintain permanent blood flow to the tissue) This method allows a very natural looking and feeling breast but again there is a significant risk of flap morbidity.
  3. LATISSIMUS Flap – probably the most popular autologous reconstruction option. This method uses your Latisimus muscle in your back for reconstruction. This is quick surgery with good cosmetic outcome. The additional benefit is that there is permanent blood flow and flap survival rates are extremely high. The Latissimus is considered world choice of breast reconstruction.

Definition of Autologous Breast Reconstruction:

Autologous reconstruction refers to plastic surgery that uses your own tissue to replace tissue that was lost to an injury or surgery. You are both the donor and the recipient of relocated tissue during autologous reconstruction. In breast reconstruction this means using your own tissue to reconstruct your breasts following mastectomy.

Post reconstruction recovery

Hospital stay

You will be required to remain in hospital for a number of days post surgery. You will have drains inserted and the fluid drainage will need to be monitored closely. Pain can also be dealt with immediately during your hospital stay.

At home

You will be required to take it easy for 3 or 4 weeks – this means no work, and no heavy lifting. Someone should also help you with your driving during this time.

Remember that no bathing is allowed until the drains are removed. Showering is ok, but bathing can lead to infection complications.

It is also very important to keep your follow up appointments – these are to change dressings, remove drains and generally follow up on your recovery.

Plastic & Reconstructive Surgeon
MBBCH (Wits), FCS Plast. Surg (CMSA)
PR. N0. 0304131                                             

Suite A9,
Life Fourways Hospital

Cedar Road & Cedar Avenue West
Fourways
2055
TEL: 011 875 1630
FAX: 011 875 1631

MARCH 2012 NEWSLETTER Education of the patient

I am proud to be representing both Health Intelligence Magazine and Everything Aesthetic as a member of their respective Advisory Boards – the reason for this is because of a passion of mine to educate patients about what surgeries are right for them and why some procedures are nothing more than money making scams.

In my middle of the month blog I spoke about patients knowing their implants and this month I want to give you a heads up on my article for Health Intelligence Magazine on the latest advancements on Tummy Tuck Surgery.

“A safe and happy patient is a safe and happy doctor”

I always want to be making a positive difference to your cosmetic and reconstructive options, so any feedback is always greatly appreciated.

I hope you enjoy.

Dr Charles Serrurier

What is Tummy Tuck surgery or Abdominoplasty?

The Tummy tuck is a surgical intervention to correct poor skin quality, excess fat and/or lax muscles in the stomach area. What we want to achieve during Tummy Tuck surgery is a flatter and smoother profile in the stomach by removing excess fat and skin and repairing stretched abdominal muscles.

Sounds simple? How is the surgery performed?

Well, first things first Tummy Tuck surgery is anything but simple. The case is done under general anaesthetic and will require significant time in theater. That said we get extremely good results and even more satisfied patients.

The incisions are similar to that of a cesarean section incision and well hidden below the underwear line.

Depending on your personal surgical specification the skin and fat will be lifted from the abdominal muscle wall. The excess skin and fat will be removed, the muscles will be tightened with sutures and the remaining skin will be stretched to the incision and you will have a new flat stomach.

Of course, each patient is different and in some cases there will be different approaches, but these will all be discussed with you during the consultation

Predictable results

As the Tummy Tuck surgery is so popular the surgery has undergone much advancement to improve the predictability of your result.

Technique

Today there are many different techniques to accommodate your body classification. We can use:

  • Traditional Abdominoplasty
  • Mini Abdominoplasty

(a smaller procedure where less skin and fat is removed via a smaller incision)

  • Sliding Umbilical surgery

(this is where we do not need to resite the belly button)

  • Resiting the Umbilicus

(used for significant surgeries where the belly button needs to be repositioned

Your surgical approach will depend largely on your classification and of course your desired expectations.

Classification

Over time we have developed a surgical classification for body types to help with surgical procedure:

  • Abdominal shape
  • Fat deposit location
  • Muscle laxity
  • Skin quality

All these elements play a significant role in the aesthetic result of your surgery. These criteria dictate a safe, effective and predictable surgery.

Realistic Expectations

Discussing your expectations will play a key role in your satisfaction post procedure. Dr Serrurier will discuss with you all the possibilities and limitations for his surgical approach based on your classifications.

An open honest approach to successful surgery and an ongoing relationship is what you will find at Dr Serrurier’s Fourways rooms – be sure to make an appointment should you have any questions.

Liposuction and Abdominoplasty: Recent research suggests that combining Abdominoplasty with Liposuction will give a far more satisfactory result than just Abdominoplasty alone. The two procedures in one improve aesthetic result and significantly reduce cost on undergoing both procedures. The one drawback is a longer recovery period.

Plastic & Reconstructive Surgeon
MBBCH (Wits), FCS Plast. Surg (CMSA) PR. N0. 0304131                                             

Suite A9, Life Fourways Hospital
Cedar Road & Cedar Avenue West
Fourways
2055
TEL: 011 875 1630
FAX: 011 875 1631

FACEBOOK – Dr Charles Serrurier
BLOG – drcharlesserrurier.wordpress.com

Know your Breast Implants – Dr Charles Serrurier

There has been so much said about PIP breast Implants in the media, and it has caused a stir amongst doctors and patients alike. I will give my two cents worth on the whole escapade, but this quick blog is more about secondary issues that I have noticed evolving – that being patients are not aware of what implants they have inserted, or even what size they are.

To start, let me give some local information regarding PIP implants. In South Africa we have been lucky – yes, PIP implants were represented here but not many were used – yes, some were used but the problem is not as extensive as in Europe. The PIP manufacturing facility has been closed for a few years now and this matter has been dealt with within the local fraternity.

That said many patients have been phoning their doctors asking what implants they have had inserted. It is imperative to remember what implant you have had inserted and what size your implants are, there are many reasons for this:

  • You may want to increase your implant size at a later date
  • You may not visit the same surgeon should there be a complication
  • There might be a complication that requires explanation and new implants to be inserted
  • You may leave the country or your surgeon may leave the country

In all the instances above your breast implant information is important, especially as most implant manufacturers offer warranties on their products and you could get the implants replaced for free. In the event of needing to reinsert implants, knowing what size implants you currently have is critical to making the best surgical decisions.

Your plastic surgeon will always have a record of your implants, and you should always be given some form of warranty card including your implant stickers. These stickers show manufacturer, implant type, implant size and in many cases a unique bar-coded serial numbers for unique identification.

It is you responsibility to keep those stickers and records safe – you never know when you might need them?

Sometimes issues like the PIP debacle can bring some good. I hope that this issue brings more patient understanding into their implant choice and the warranties that go along with them.

I hope this helps your thinking?

Dr Charles Serrurier