FACE-LIFT SURGERY - RHYTIDECTOMY

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BEFORE  AFTER 
BEFORE  AFTER

‘patient post-operative 10 days hence cream around ears'


Now that cosmetic surgery is no longer the domain of the 'super rich' there is no need to look older than one feels. This procedure is relatively painless and one that heals extremely quickly. Done correctly, as First Appearance surgeons do, there is never the risk of the dreaded 'mask-like' appearance so feared by people who are contemplating this surgery.

The ultimate result is a softer, rejuvenated patient who looks and feels fresh.  A face lift does not alter the shape of the face except where jowls are removed.  Facial features remain the same but achieve a youthful appearance.  Only face-lifts that are performed under the muscles of the face actually change the shape and this procedure is not done unless specifically requested.

The choice of anaesthesia will be made in consultation with the surgeon and can be either a general anaesthetic or conscious sedation.

Jowls and sagging skin are extremely ageing and make an incredible difference when they are removed. By tightening the facial muscles, eliminating excess skin and tightening the chin area, the results achieved are excellent.

This procedure is often done in conjunction with a  lipoplasty of the neck/chin area, blepharoplasty (eyelid surgery) and / or a forehead lift.

Prior to being discharged from hospital, the small drainage tube inserted during surgery will be removed and patients are collected and transported to recuperate. After surgery, stitches both in front of and behind the ears will be present. On the second day the face swells but this will slowly subside within the next few days.

The hair must be washed in an anti-bacterial shampoo daily and the wounds cleaned twice per day and treated with anti bacterial cream. This will all be done by the caregiver.

After approximately four days patients are able to go out for short trips. The caregiver will constantly monitor progress  until the follow-up consultation with the surgeon. This care is 24 hours per day.

For this procedure it is considered necessary to stay one day and night in hospital. The majority of the swelling will be gone in approximately 10 days & most bruising after two weeks. Do not take arnica or aspirin two weeks prior to surgery.
Smoking is contra indicted for this procedure.

EYELID SURGERY - BLEPHAROPLASTY

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BEFORE AFTER

The loose skin or a fat deposit above and below the lids can be the result of a genetic pre disposition to the condition or as a result of the natural ageing process. It can ultimately result in a hooded effect on the eyes and may eventually impair vision. In either case the successful removal of the excess skin and fat deposit results in opening the eye and achieving a much more youthful appearance.

An incision is made in the upper eye in the fold of the lid, the fat and skin are removed and the area is stitched. The lower eyelid is cut just below the eyelashes, the excess fat and skin is removed and the area under eyes stitched. Minimal eyelid movement will prevent a great deal of bruising. Your caregiver will also administer chilled compresses to assist healing.

The choice of anaesthesia will be made in consultation with your surgeon but is normally conscious sedation for this procedure. The caregiver will constantly monitor progress until the follow up consultation with the surgeon. This care is 24 hours per day. The recovery period is approximately five days and all bruising should have subsided within 10 days to two weeks.

It is not necessary to stay over night in hospital for this procedure. Do not take arnica or aspirin two weeks prior to surgery.

FOREHEAD LIFT

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BEFORE AFTER

A forehead lift results in lifting the skin on the forehead and impacts the brows and the area under the brow. It is quite surprising what beneficial impact this procedure can have.

There are several surgical methods utilised and the surgeon will discuss each particular case with patients and determine the optimum methodology to use in each particular case. Patients will be kept fully informed of the procedure and likely outcome and will be encouraged to ask as many questions as needed.

The choice of anaesthesia will be made in consultation with the surgeon and can be either a general anaesthetic or conscious sedation for this procedure.

The caregiver will constantly monitor until the follow-up consultation with the surgeon.

This care is 24 hours per day. It is not necessary to stay overnight in hospital for the procedure and as soon as surgeon has conducted his post-operative examination, the patient is collected by the caregiver and driven to the recuperation centre.

The bruising will last approximately 10 days.
Do not take arnica or aspirin two weeks prior to surgery.

LIPOSUCTION - LIPOPLASTY - neck and chin area

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BEFORE AFTER

Liposuction or liposculpture on the chin and neck is a procedure to remove excess fat from these areas. A very thin tube is inserted and the excess fat is vacuumed away. The area is bandaged and this dressing must remain in situ for 48 hours. The results are immediate and there will be a little bruising which can be covered with makeup.

If  a smoker, it is recommended to stop smoking well in advance of surgery since smoking can impair the healing process. Liposuction surgery is usually performed on an outpatient basis.

Medications are administered for comfort during the surgical procedure. Frequently, local anesthesia and intravenous sedation are used for patients undergoing liposuction surgery, although general anesthesia may be desirable in some instances. For your safety during the operation, various monitors are used to check your heart, blood pressure, pulse and the amount of oxygen circulating in your blood.

In young patients the skin will normally have retained its elasticity and the liposuction should result in no loose skin. With older patients the skin may have to be removed to ensure a smoother result.

The choice of anaesthesia will be made in consultation with the surgeon and can be either a general anaesthetic or conscious sedation for this procedure. The caregiver will constantly monitor until the follow-up consultation with the surgeon. This care is 24 hours per day. It is not necessary to stay overnight for this procedure- as soon as patients are able to travel, the caregiver will drive you to the recuperation accommodation.

Do not take arnica or aspirin two weeks prior to surgery.

RHINOPLASTY - "nose job"

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BEFORE AFTER
BEFORE AFTER

Whether born with a nose shape that is not liked or perhaps a patient has had an accident that changed the original shape of the nose, there is no need to 'live with it'. Corrections to the length, shape, width of the nose are done after due consultation with the surgeon, whilst giving the optimum opportunity to determine the best shape to achieve. Once there is agreement on what is to be done, the surgeon will discuss the particular methodology he will adopt for the procedure.

The choice of anaesthesia will be made in consultation with the surgeon and can be either a general anaesthetic or conscious sedation.

The caregiver will constantly monitor until the follow-up consultation with the surgeon. This care is 24 hours per day.

It is not considered necessary to stay overnight in hospital. The bruising will last between 7 and 14 days.

Do not take arnica or aspirin two weeks prior to surgery.

Cheek & chin implants

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BEFORE AFTER
'patient also had a rhinoplasty'

A chin and or cheek augmentation is a simple procedure that achieves excellent results. After discussions with the surgeon at the consultation, the choice of prosthesis will be made based on the results desired.

The choice of anaesthesia will be made in consultation with the surgeon and can be either a general anaesthetic or conscious sedation.

There are varying techniques used to correct perceived chin / cheek imperfections. The first is an inconspicuous incision either under the chin or in the mouth. The prosthesis (the implant that will form the new chin) is inserted under the Periosteum and into the Mandible. For the cheeks, the implant is inserted above the gum inside the mouth, into the cheek area. The incision, although invisible externally, will be closed with dissolving stitches.

The caregiver will constantly monitor until the follow-up consultation with the surgeon. This care is 24 hours per day. Patients should fully recover after five days and will be checked thoroughly by the surgeon prior to being allowed to resume normal activities. For this procedure it is sometimes considered necessary to stay one day and night in hospital and the surgeon will decide this after a post operative consultation.

Do not take arnica or aspirin two weeks prior to surgery.

Ear surgery (otoplasty)

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BEFORE AFTER

This procedure can be done under local or conscious sedation anaesthesia.

Protrusion of the ears is a common problem and one that is simple to remedy. It is often a hereditary condition and involves either a malformed helical fold or the misalignment of the concha or perhaps both. The surgery allows the ears to be positioned more closely to the head.

The choice of anaesthesia will be made in consultation with the surgeon and can be either a general anaesthetic or conscious sedation.

The caregiver will constantly monitor  until the follow-up consultation with the surgeon. This care is 24 hours per day.

The surgeon will decide on the methodology of the operation after consultation with the patient. This is the ideal opportunity to ask the questions that inevitably arise.

The recover period is approximately 5 days, is uncomfortable for a few days but the results excellent

Do not take arnica or aspirin two weeks prior to surgery.

Breast enlargement - augmentation

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BEFORE AFTER

BEFORE AFTER

A Breast Augmentation is achieved by the insertion of either silicone or saline filled prosthesis into the breast area. The insertion may be made under the arm or under the breast and the decision on which method to utilise will be made in consultation with the surgeon.

The drainage tubes that are inserted during the procedure are removed in the morning after the surgeon has examined the patient before leaving the hospital

The choice of anaesthesia will be made in consultation with the surgeon and can be either a general anaesthetic or conscious sedation.

The personal caregiver will constantly monitor the patient until the next follow-up consultation with the surgeon. This care is 24 hours per day.

There will be some bruising and moderate pain will last for approximately 4 days but is easily controlled by analgesics. It is extremely important not to move the arms for the first few days after surgery. After the sutures are removed, the small surgical site must be kept covered by thin tape for 4-6 weeks to ensure the scar remains  thin and neat.

The recovery period is approximately 7-10 days

An overnight stay in hospital is at the discretion of the surgeon after a post operative evaluation.

Sometimes, particularly when an augmentation was received many years ago, the implant can encapsulate, go hard and need replacing.  In most instances, this is not a difficult matter to resolve and as with a first time augmentation, the surgeon would do his utmost to ensure a superbly shaped finished result.

Do not take arnica or aspirin 2 weeks prior to surgery.

Breast reduction - mammoplasty

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BEFORE AFTER
'marks on photographs are surgeons marking for procedure'

BEFORE AFTER
'marks on photographs are surgeons marking for procedure'

Breast reduction, technically known as a mammoplasty, is designed for women whose breasts are heavy and or pendulous. The procedure removes fat, glandular tissue and skin from the breasts, making them smaller, lighter, and firmer. The size of the areola can also be reduced i.e. the darker skin surrounding the nipple. The goal is to give the woman smaller, better-shaped breasts in proportion with the rest of her body.

The choice of anaesthesia will be made in consultation with your surgeon and can be either a general anaesthetic or conscious sedation.

The caregiver will constantly monitor until the follow-up consultation with the surgeon. This care is 24 hours a day.

Techniques for breast reduction vary but the most common procedure involves an anchor-shaped incision that circles the areola, extends downward and follows the natural curve of the crease beneath the breast. Often a lift is achieved at the same time as a breast reduction resulting in superb pert breasts

The surgeon removes excess glandular tissue, fat, and skin, and moves the nipple and areola into their new position. The skin from both sides of the breast is brought down and around the areola, shaping the new contour of the breast. The drainage tubes inserted during surgery will be removed prior to leaving hospital after the post operative consultation with the surgeon

For this procedure it is considered necessary to stay one day and night in hospital. Do not take arnica or any aspirin containing medication two weeks prior to surgery.

Many women do not undertake this surgery as they fear the resultant scars but, with the suturing done by an expert who takes great care in this area, the scars fade over a period of time and it is not uncommon for them to be hardly visible eventually.

The recovery period is approximately 10-14 days.

Breast lift - mastopexy

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BEFORE AFTER

'patient 7 days post operative - bruised and not completely healed'

Ageing and weight loss, child birth  or a combination of all three can result in the breast losing firmness and generally sagging. At the consultation the procedure will be described fully and the decision made on the methodology. This is the ideal opportunity to fully discuss the eventual results you can anticipate.

The choice of ideal size and expectations as well as likely scarring etc will be discussed fully at the initial consultation. After surgery, the incision site must be covered with plasters for approximately 6 weeks in order to keep the scars neat and unobtrusive. The decision regarding anaesthesia will be made in consultation with your surgeon and can be either a general anaesthetic or conscious sedation.

The caregiver will constantly monitor until the follow-up consultation with the surgeon. This care is 24 hours per day.

For this procedure it is considered necessary to stay one day and night in hospital. Recovery takes between 10-14 days.

Do not take arnica or any aspirin containing medication two weeks prior to surgery. Many women do not undertake this surgery as they fear the resultant scars but, with the suturing done by an expert who takes great care in this area, the scars fade over a period of time and it is not uncommon for them to be hardly visible eventually.

Tummy tuck - Abdominoplasty

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BEFORE AFTER

An abdominoplasty is undertaken to removed excess fat and skin and to tighten muscles in the abdominal area. If muscles are not involved, then a mini tummy tuck with perhaps some liposuction may produce the desired result.

Whilst an initial diagnosis may be made from photographs, the final decision of exactly what the surgeon recommends will only be made after your personal consultation. At this consultation patients are encouraged to ask questions relating to this procedure.

The procedure will be fully discussed at the consultation as will explanations concerning the anaesthesia.

Your caregiver will constantly monitor you until your follow-up consultation with the surgeon. This care is 24 hours per day.

Recovery takes between 12-14 days and the care giver will be with patients 24 hours a day but care must be taken for six weeks after surgery. i.e. no lifting etc. For this procedure it is considered necessary to stay one day and night in hospital.

Do not take arnica or aspirin two weeks prior to surgery.

Patients must have aftercare following this procedure.

Liposuction

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BEFORE AFTER

Liposuction is the surgical removal of fat deposits uitilising a canula affixed to a vacuum thereby creating improved body contours in the treated areas. The extent and areas to be treated must be fully discussed with the surgeon and a clear understanding of the anticipated outcome be established. An initial treatment plan can be made from photographs and final decisions will be made at the consultation. Firm undergarments must be worn immediately after the procedure and must be worn for approximately 4 weeks.

The majority of the bruising and swelling will dissipate after approximately two weeks but the final result is achieved only after about 4-6 months. Patience is necessary whilst the body readjusts to the new shape. Gentle massaging of the areas after seven days assists in reduction of swelling.

The choice of anaesthesia will be made in consultation with the surgeon and can be either a general anaesthetic or conscious sedation.

The caregiver will constantly monitor until the follow-up consultation with the surgeon. This care is 24 hours per day.

Do not take arnica or aspirin two weeks prior to surgery.

Male pectoral implants

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BEFORE AFTER

Many men can achieve a superb upper chest area by undertaking male pectoral implants. This procedure is becoming increasingly popular for men. The implant is made from soft, flexible silicone. It is inserted in an incision made in the armpit and placed directly under the pectoral muscle.

The surgery can be done on a day basis and after the surgeon has completed the post-operative examination patients are allowed to be taken to the aftercare centre on the same day.

Dressings and stitches are removed after approximately 5 days. Patients can anticipate some discomfort and tightness for up to 2 weeks, and are advised not to work out for around 6 weeks after surgery.

Do not take aspirin or arnica for two weeks prior to surgery.

Your caregiver will monitor progress 24 hours a day and return patients to the surgeon for suture removal.

Gynacomastia - breast reduction for men

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BEFORE AFTER
‘ink on body are surgeons markings for procedure'

Plastic surgery to correct gynecomastia is technically called reduction mammaplasty, and reduces breast size, flattening and enhancing the chest contours.

In cases where gynecomastia is primarily the result of excess fatty tissue, liposuction techniques alone may be used.

This requires insertion of a cannula, a thin hollow tube, through several small incisions. The cannula is moved back and forth in a controlled motion to loosen the excess fat, which is then removed from the body by vacuum suction.

There are various liposuction techniques that may be used; the technique most appropriate in an individual's case will be defined prior to the procedure .

In severe cases of gynecomastia, the weight of excess breast tissue may cause the breasts to sag and stretch the areola (the dark skin surrounding the nipple). In these cases the position and size of the areola can be surgically improved and excess skin may be reduced.

Excision techniques are recommended where glandular breast tissue or excess skin must be removed to correct gynecomastia.

Excision is also necessary if the areola were to be reduced, or the nipple repositioned to a more natural male contour. Incision patterns vary depending on the specific conditions and surgical preference. Sometimes gynecomastia is treated with both liposuction and excision.

Any surgical treatment to correct gynecomastia will require incisions. While most incision lines are concealed within natural contours, some may be visible and are a necessary result of breast reduction surgery.  All scars however, fade over the passage of time.

Do not take arnica or aspirin for at least two weeks prior to surgery.

The care giver will collect patients from the clinic and ensure comfort 24 hours a day whilst recuperating.

Aesthetic treatments for skin

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Medical skin practitioner: Mariet Herselman (Specialist Practitioner view image to left) Works exclusively in conjunction with Cosmetic Surgeons registered with the Association of Plastic and Reconstructive Surgeons of South Africa. Practiced in USA, Europe, Canada and South Africa. Vast Experience and highly qualified. For consultations email Mariet personally on dermalrejuvenation@gmail.com or telephone her on 0824472469.

OVERVIEW OF SOME PROCEDURES
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Blue Peel: The Blue Peel is a TCA based "skin Rejuvenator" highly recommended for anyone who wants to appear younger and thus reverse the aging process. Those who have blemish prone skin, lines and wrinkles, pigmentation, sun damage, acne scarring or general poor skin quality will benefit enormously from this treatment. This Peel can be utilised on any area of the body and is superb for the removal of light scarring. Some skin types will need to prepare the skin with topical agents for 2-8 weeks prior to procedure. The Blue Peel is performed under conscious sedation, which means that no pain or discomfort will be experienced. Afterwards the skin will look slightly swollen and red but will not be painful. Recovery is 7-10 days, after which the new skin is evident and the glow of youthful skin is recaptured.  Long after the healing, collagen continues to be produced in the dermis and the skin continues to improve.

Dermagenesis Dermabrasion: Microdermabrasion is a treatment that entails jetting fine crystals across the skin and by the transfer of Kinetic energy the crystals are able to detach dead and damaged skin cells which are then vacuumed and removed. This process will, over a period of time and a series of treatments, remove traditional skin abnormalities of the aging process, fine lines and wrinkles, pigmentation problems, post acne scars, and dull blemished skin. Seborrhoea and psoriasis have also been successfully treated. After the procedure, the skin may be slightly warm and pink as if having been exposed to the sun. 
This 'pinkness' erodes very quickly and thus this is a treatment that clients return to work immediately.

Glycolic Acid Peels: Glycolic acid is derived from sugar cane. This natural sugar acid penetrates through the skin and stimulates the collagen to rejuvenate and remodel. The surface of the skin appears more lustrous and healthy. Glycolic acids are widely utilised because they affect not only the surface of the skin but also the collagen. Typically a number of glycolic peels are performed over a period of several weeks. These are often referred to as "lunch time" peels. They are extremely effective and truly enhance the appearance of the skin.

VI Peels: A generation peel for all skin types, this innovative peel combines TCA, Phenol, Retinoic acids, vitamins and microelements to effectively remove skin problems with a minimal amount of discomfort. It boasts no down time. The VI Peel effectively combats cellular damage.

Hair Removal: Remove unsightly hair permanently and safely with the Cynosure Alexandrite Laser. This therapy utilising Thermo Kinetic Selectivity is a thoroughly tested, clinically proven method of hair removal. Treatment is relatively quick and removes unwanted hair whilst protecting the surrounding skin. All areas of the body can be treated to achieve the desired smooth appearance.  Also recommended for the permanent removal of facial hair i.e. upper lip, nasal area, between eyes.

Permanent Makeup: Define the features of ones face by enhancing the shape of lips and eyebrows. Subtly emphasise eyes with permanent eyeliner. Never again be without makeup on the beach or the pool or have make up streak when wet.

A wide range of shapes and colours are available to choose from. All dyes are non-metallic, hypo-allergenic and organic.