FAQs

Technical explanations

I don’t currently favor buttocks implants, given the frequent and disproportionate complications compared to the result.

Breast implants are currently the best option for treating breast hypoplasia, but butt implants provide a less natural or even visible result, depending on the position of the body and the thickness of tissues (muscle and fat) of the buttocks.

There are other solutions to address flat or sagging buttocks, such as lipofilling, weight training or a buttocks lift.

Some procedures can be performed at the same surgical time, provided this does not increase the risk of general complications. One should avoid combining two procedures that are each individually more likely to cause thrombosis, such as a tummy tuck with a thigh lift. 

However, other combinations are possible and will be discussed during consultation. 

The combined procedures are typically: liposuction and breast surgery, tummy tuck and breast surgery, tummy tuck and liposuction, breast surgery and arm lift, etc.

Surgery is never insignificant. Even for aesthetic purposes, it still bears risks and potential complications, though rare and mostly do not lead to a long-term problem. However, it is important to be aware of the risks before undergoing surgery.

During the consultation, the anesthesiologist and I inform you of these risks.

Below an incomplete list of potential complications:

Poor scarring:

Surgery always leaves a permanent scar. The scarring process requires maturation, which lasts several months (6 to 12 months but can also last up to 3 years) before reaching a steady state. 

Initially, the scar is thin. A month later, it becomes red and thickens, and can cause itching (inflammatory phase). These phenomena vary from one individual to another. 

After this stage, the scar evolves slowly towards its final stage, by becoming flat, soft and white.

When the scar is red or pink, it must be protected from the sun, or else it can become pigmented. The final appearance of a scar is unpredictable. Some areas of the body heal differently, mainly because of the tension on the scar, regardless of the suture technique used.


Edema and ecchymosis:

Edema is the accumulation of serous fluid in the tissues, affecting particularly the skin tissue and mucous membranes (causing swelling). 

An ecchymosis (or bruise) is caused by the escape of blood into the subcutaneous tissue and appears on the skin as a blue spot. 
These phenomena are benign and almost constant, and their extent is unpredictable. They disappear spontaneously within a few weeks.

Hemorrhage or hematoma: 

Hemorrhage is the active discharge of blood from the vessels.

A hematoma is the collection of blood outside the vessels in the surgical area.

These complications may require surgery, sometimes urgently, to stop the bleeding or evacuate the internal accumulation of blood. The need for blood transfusion is rare.

Seroma:

Seroma is the accumulation of lymphatic fluid in a tissue or a surgical area.It may require draining during consultation.

Hyperpigmentation:

After a bruise that is slow to heal, local spots can form and take several months to disappear. It is then important to protect them from the sun, or else they may persist or even worsen over a year or more.

Infection :

Superficial infection may be treated by local care, while deep infection may require surgical drainage and / or antibiotic treatment. It leads to an enlarged scar that can be corrected after one year.

Sensitivity disorders:

Small cutaneous nerve endings are inevitably severed during a surgical procedure, which can cause a temporary decrease (hypoesthesia), or increase of sensitivity (hyperesthesia) in the surgical area. Nerve regrowth being slow, these phenomena normally disappear after 3 to 6 months.

Venous thrombosis and pulmonary embolism:

Following a lack of physical activity, a blood clot may form due to stagnant blood in the veins of the lower limbs, mainly in legs; the phenomenon is called a thrombosis. If a clot has formed, it can detach and travel towards the heart, where it will be projected to the pulmonary vessels: it is pulmonary embolism, which is a severe, sometimes fatal, complication. Preventive measures include: physical activity after surgery, compression stockings, or injection of subcutaneous anticoagulants, to be determined according to patient’s personal history.

Skin or fat necrosis:

Necrosis is the premature death of part of the skin or fat, caused by a lack of adequate blood supply. Though rare, it may occur after important skin undermining and is favored by smoking.

Necrosis requires local care and possibly further surgery long after initial surgery.

The rectus abdominis muscles are two parallel muscles of the abdominal wall, extending vertically from the ribs to the pubis, surrounding the umbilicus, with their inner edges joined together in the midline. Sometimes, both sides vertically dissociate from each other, resulting in the "diastasis recti", which can extend from the xiphoid process until below the pubis, or can cover only the area under and around the umbilicus. Diastasis recti is diagnosed by abdominal palpation, especially during coughing.

By definition, an eventration is the protrusion of part of the abdomen through a non-natural cavity of the abdominal wall. The protrusion of an organ through the cavity that normally contains it, is a hernia. 

Eventrations usually happen through the cavities which are the result of surgery in 95% of cases, or trauma in 5% of cases.

It is the study of macroscopic and microscopic lesions in tissues from a living or deceased subject. 

In plastic surgery, breast tissues removed during a breast reduction, all skin lesions and scars from previous cancer surgery are systematically sent for analysis. 

It is an examination performed by a radiologist, consisting of a clinical examination, a mammography and in many cases, an ultrasound. It is advisable to undergo a breast screening annually as of the age of 40.

Breast screening is recommended before considering breast surgery ( breast reduction, augmentation or corrective surgery).

“Iatrogenic” refers to a disorder or disease caused by medical treatment or medication.

Once a foreign object is introduced into the human body, the body forms a lining or capsule around it; it is a constant and normal scarring response. The breast implant is no exception to the rule. However, in some cases and for an unknown cause, the capsule will contract and shrink. The implant is then compressed and the breast looks distorted and can become hard and painful.

The risk of a capsule formation is totally unpredictable.

The Baker Grading System is commonly used to distinguish the 4 stages of capsular contracture:

- Grade I: The breast looks normal and is normally soft;

- Grade II: The breast looks normal but is a little firm;

- Grade III: The breast looks normal or slightly distorted, but feels firm

- Grade IV: The breast has become distorted in shape, feels hard and might be painful.

In 20 to 30% of cases, surgery is the solution.

Once a foreign object is introduced into the human body, the body forms a lining or capsule around it; it is a constant and normal scarring response. The breast implant is no exception to the rule. However, in some cases and for an unknown cause, the capsule will contract and shrink. The implant is then compressed and the breast looks distorted and can become hard and painful.

The risk of a capsule formation is totally unpredictable. 

The Baker Grading System is commonly used to distinguish the 4 stages of capsular contracture: 
- Grade I: The breast looks normal and is normally soft; 
- Grade II: The breast looks normal but is a little firm; 
- Grade III: The breast looks normal or slightly distorted, but feels firm
- Grade IV: The breast has become distorted in shape, feels hard and might be painful.

In 20 to 30% of cases, surgery is the solution.

Outpatient surgery allows the patient to return home on the same day of surgery, taking into account his/her safety.

General anesthesia: Drugs are administered intravenously and/or by inhalation. The patient is unconscious and does not feel pain, breathing through a tube inserted into the trachea (tracheal intubation) or throat (laryngeal mask). This type of anesthesia can only be performed by an anesthetist.

Regional anesthesia: A local anesthetic is injected around the nerves responsible for the sensitivity of the surgical area. It aims to prevent the spread of pain by blocking nerve transmission as close as possible to where it arises. Major types of regional anesthesia include spinal or epidural anesthesia and peripheral nerve blocks. It is often performed with sedation with a low dose of benzodiazepine or a hypnotic and the patient remains fully conscious. The overall risk to life is no different from general anesthesia and spinal anesthesia. This type of anesthesia can only be performed by an anesthetist.

Local anesthesia: A local anesthetic is directly injected into the surgical area; sometimes a gel or cream is applied. This type of anesthesia can be performed by the surgeon himself.

Sedation: A sedative is administered to ease pain in order to ensure the physical and mental comfort of the patient. It is often used to complement local anesthesia or spinal/epidural anesthesia.

The surgeon extracts fat from the patient and re-injects it to fill hollows, furrows and depressions, or restore the volume of a thin face by correcting imbalances. The procedure can also be performed in combination with a facelift to improve the overall harmony of the face. This technique can also be used in reparative surgery, particularly to fill post-trauma depressions.

In most cases, lipostructure is performed under local anesthesia or associated to sedation. Initially, the fat is removed using a fine aspiration tube. It is then placed in a centrifuge for a few minutes to isolate the fat cells to be transplanted. Finally, these micro-particles of fat are re-injected using a micro-tube. The transplanted cells will live as long as the tissues in which they are grafted.

It is a surgery to remodel the chin bone to improve its appearance. The surgeon may cut the bone to reposition it (osteotomy), use an implant, or place a bone graft or cartilage. Genioplasty can be performed in combination with a nose surgery or a facelift, as  correcting an unsightly chin restores the harmony of the profile.

It is a fibromuscular layer, similar to a net, interlinking between the facial skin and deep structures. 

Glossary

Columella: Vertical column of the nasal septum separating the nostrils.

Nose wings: Outer walls of the nostrils.

Concha: Deep bowl-like cavity of the external ear.

Retroauricular fold: Skin crease behind the ear.

Glabellar complex: Space between eyebrows.

Platysmal bands: Strained muscular cords in the neck, caused by a relaxation of the platysma and its skin, which give the neck an ageing look.

Dermis: Layer of the skin just below the epidermis (which is the most superficial and external layer of skin), rich in collagen and elastin fibers, responsible for skin resistance and elasticity.

Areola: Pigmented circular area surrounding the nipple, of a diameter of around four centimeters.

Nipple-areolar complex: The areola and the nipple.

Submammary fold: Crease between the lower part of the breast and chest.

Fascia: Fibrous connective tissue surrounding any anatomical structure. It is a dense girdle-like tissue, rich in collagen fibers.

Aponeurosis: Fibrous tissue surrounding and separating the muscles.