Facial fat transfer

Every year gives us more wisdom and knowledge, broadens our circle of friends and adds beautiful moments; however, wrinkles around the eyes, corners of the mouth turning down or saggy cheeks often provoke the thought if wisdom really has to reflect in our face?

As skin ages, it not only loses elasticity but also transforms: the adipose tissue degenerates, part of the fat cells migrate to other places (for instance, the cheeks that were chubby due to the accumulation of the adipose tissue in the lateral area of the lower eyelid at young age become saggy with ageing and give a tired expression of the face).

Facial rejuvenation with fat transfer – a worldwide acknowledged and approved treatment – has become popular in our clinic too. For low invasiveness this procedure is often called fat injection. It is a safe treatment because the patient’s autologous fat cells are used and the body does not reject them, no allergic reaction or immune problems occur. The main advantage of this method is the natural aesthetic result. Scientific research proved that the adipose tissue is rich in stem cells that rejuvenate the facial skin.

This treatment not only apparently corrects the desired areas of the face (eye corner wrinkles, saggy cheeks, sunken eyes, hollowing of the temples, deep tear troughs), but also improves the contours in the areas where fat is harvested for the transfer (usually abdomen, waist, buttocks).

The treatment is done with intravenous anaesthesia and takes between one to two hours to complete. The surgery most often involves hypercorrection, i.e. a bigger than needed amount of fat is injected because not all transferred fat cells take root. After the surgery the patients are usually released home on the same day. During the first week the patient may expect to be swollen, a bit bruised, and a little sore both at the treatment site and the donor site, therefore rest at home is recommended. In the second week the swelling subsides quickly, pain and bruises disappear. Physical activities should be avoided one to three weeks following the treatment.

The results of the treatment are already visible after three weeks although the final result will be pleasing 3-6 months following the treatment. Facial rejuvenation by fat transfer is noticeable, long-lasting and reliable.

The clinic applies a new unique lip contour correction method Boca® when a special dissolving thread is used, which is inserted into the lip tissue to form a desired shape of lips for a long time. The procedure is performed under local anesthesia and takes 15-40 minutes. The surface of the thread has micro bumps, which firmly attach to the lip tissues and do not allow thread migration.

Procedure results are immediately visible, the maximum effect is observed after 2-3 weeks, and remains from 5 to 6 years (depending on the individual characteristics of the body). The long-term duration of the procedure is ensured by the scarring processes occurring in the body, which form a denser tissue maintaining the contour of the lip in the area of thread insertion.

The postoperative period is short and easy: it is recommended to limit the facial muscle activity from 2 to 3 weeks after treatment, to limit strenuous physical load for one month, and to avoid facial massage procedures for one month.

This thread does not change the natural facial features; the soft mouth tissues acquire the desired contour.

This lip-shaping correction procedure can be successfully combined with hyaluronic or botulinum injections when adjusting other areas of concern. After the outcome of the procedure, it is possible to repeat a similar procedure or use other methods of lip shape correction – hyaluronic injections or fat transplantation on the lips.

Lovely lips are a very important facial feature, just look into any woman’s purse and chances are you’ll find a lipstick as proof of that. Lipstick alone, however, sometimes is not enough to achieve the fullness and youthfulness of the lips. Injection of special tissue fillers can be used to augment lips or correct their form.

Lips that are too thin can be enlarged with the specially formulated fillers Surgilips®, Juvederm Ultra® or Restylane Lipp®. With the aim of minimising the feeling of discomfort for the patient our Centre performs this procedure using local anaesthesia.

The injection causes lip swelling which disappears in 1-3 days. The patient may apply make-up on the next day after the procedure. The effect of the procedure lasts 9-12 months.

Most women are happy with the result, i.e. fuller and younger lips.

Women who wish to have a permanent lip correction are offered special soft lip implants Permalip®, which enhance lips forever. The implant is inserted through minor sections made in the inner part of the lip which is done in local anaesthesia.

After this surgery lip swelling can persist for several weeks. The major advantage of this surgery lies in the fact that to enjoy the changed form of your lips for a long time you will need just a single minor surgery.

Examples of this kind of surgery can be found in our gallery.

Cosmetic ear surgery is a procedure to reshape the ear and give it a more normal appearance. The procedure often treats ears that are too large or protrude from the head.

It is usually performed on both ears so they appear symmetrical. The surgery is done on adults under local anesthesia. It may also be performed using general anesthesia for others and for children.

The procedure involves cutting the back side of the outer ear shell. The ear shell cartilage is then weakened so that it can be folded and stays in its proper position. Sometimes excess skin or cartilage is removed.

After surgery, head bandages are applied. When these dressings are removed, the patient must wear a headband for a few weeks to prevent ears from any possible traumas.

The patient is usually able to leave the hospital and recuperate at home or in a nearby hotel. Other possible complications include bleeding, small irregularities, visible scars, asymmetry, and temporal sensibility loss.

After several weeks, swelling and bruising gradually go away.

Travelling abroad is advised only after 5 days following the surgery.

Examples of this kind of surgery surgery can be found in our gallery.

Cosmetic nose surgery is a procedure to straighten, reshape, or open passages of the nose. Because the nose is a central feature of the face, many patients wish to improve their appearance by changing the shape or size of their nose. Surgical experts can recommend measures, which include the following:

• Removing the hump on the bridge of the nose
• Narrowing the nose
• Refining or reshaping the tip of the nose
• Correcting a deviated septum, the cartilage separating the two nasal passages
• Within limits, many features of the nose may be modified to make it more attractive or regular.

The surgery is mostly done under general sedation. It may also be performed using intravenous anesthesia. This procedure may be performed at the same time as other cosmetic facial procedures.

The procedure involves making incisions inside the nose or through small cuts beside the nose. Any scars are usually out of sight or inconspicuous. The skin is separated from the supporting bone or cartilage, which is then reshaped to the desired profile. Natural elasticity of the skin allows it to take its new position. To conclude the procedure, a small splint is placed over the nose for support and to reduce swelling. Gauze to absorb bleeding may be packed into the nose, and is removed after one or two days.

The patient is able to recuperate, with adult assistance, at home or in a nearby hotel. The splint is taken off after five to seven days. Stitches to close incisions remain in place for about ten days. Swelling and bruising around the nose and eyes is normal for several weeks following surgery. Temporary loss of feeling or sense of smell usually returns gradually over this period. Swelling may take as long as six months or more to go down completely. Depending upon the final result, a second, revision procedure may be required to correct minor irregularities.

In rare cases, infection or bleeding may delay the healing or result in scar tissue. Thick or oily nose skin may be less adaptable in cosmetic surgery.

The surgery corrects deformities of the nose framework under the skin, can change the shape of the nostrils or change the angle between the nostrils and the lip.
Depending on the extent of the problem, the surgery can be performed with different incisions. To address problems with the tip, sometimes a small incision is made between the nostrils. If the nostrils are too wide they can be reshaped during the procedure.
	Splints on the outside and perhaps inside the nose might be necessary after the surgery.

Examples of this kind of surgery can be found in our gallery.

Eyelid rejuvenation is a surgical procedure to remove excess skin or fatty deposits from eyelids. The treatment usually gives eyes a more youthful, rested appearance. Both eyes are treated to keep a symmetrical appearance. Either upper or lower eyelids may be treated, or both, as desired. Other facial surgery such as face-lift or skin resurfacing may be performed at the same time. However, to keep procedures from affecting each other, they may be scheduled separately.

The procedure takes between one-half and two hours, usually under local anesthesia. Intravenous sedation may be given if the patient wants it. A general anesthesia is used if a face-lift is also performed. The lid is cut along the eyelid fold, across to the smile lines. A parallel cut removes an excess skin fold. Fatty tissue in the lower lid is removed through an incision just below the eyelash or an incision on the inner surface of the lid. Stitches close the incisions. A weak eyelid muscle may cause an eyelid to droop, called blepharoptosis. This condition can also be treated, with or without eyelid rejuvenation.

After surgery, swelling may keep the eyelids from completely closing and causing eye dryness. This temporary condition can be relieved by applying artificial tears or ointments. Patients who have dry eyes before surgery should consult an ophthalmologist before considering eyelid rejuvenation. Stitches are removed after four to seven days. Discoloration usually goes away after several weeks; swelling may require slightly longer to completely go down.

Eyelid rejuvenation is a relatively safe and straightforward. Temporary blurred vision usually clears up within a few days. Rarely, a drooping or retracted eyelid, or darkening of the lids may be caused by blood residue, but can usually be treated satisfactorily. On extremely rare occasions, blindness in an eye may occur.

For more information please visit our FAQ section.

The amount of extra skin to remove around the eyes is estimated conservatively before the surgery.
	If part of the problem involves the bulging fat pads, these are conservatively removed in order to avoid the “hollow” eye look.
The skin is brought back together leaving small scars that are well hidden in the upper eyelid crease and just below the eyelashes in the lower eyelid.

Examples of this kind of surgery can be found in our gallery.

The human face not only reveals the character qualities and the emotional state but also reflects the person’s age, experience and the general processes in his or her body. The human face should always be in harmony with the whole body and with one’s inner self – it should shine and radiate energy.

To achieve this aim our Clinic performs facelift, fat grafting, eyelid and lip augmentation surgeries. We also perform otoplasty for children.

• Blepharoplasty (eyelid surgery)
• Otoplasty
• Rhinoplasty (nose surgery)
• Facial fat transfer
• Lip augmentation
• Lip/lips lift

Examples of face surgeries performed at our clinic can be found in our gallery.

Please also visit our FAQ section for more information.

Circumcision is a surgical removal of a narrow foreskin (prepuce).

What are the reasons for circumcision?

The most frequent medical reasons for circumcision include:

• Phimosis – a very narrow foreskin which cannot be pushed down exposing the head of penis (glans), bulging of the foreskin during urination, difficult urination;
• Balanitis, posthitis – recurring inflammations of the glans and foreskin (balanitis, posthitis);
• Tearing and bleeding frenulum after sexual intercourse;
• Emergency circumcision in case of paraphimosis – retracted foreskin that cannot be brought forward over the glans which is compressed and starts swelling.

Circumcision can be also performed at the patient’s request.

How is surgery done?

Having consulted an urologist and anaesthetist, the patient shall come to the clinic on the scheduled date for surgery. The surgery is performed under a local or a general anaesthesia. The surgery involves cutting and removal of the foreskin which inner and outer layers are then brought together placing individual sutures (whether absorbable or non-absorbable). The length of the surgery is 30-60 min. After the surgery, a bandage is applied over the glans to the area of incision. The patient shall be monitored at the clinic for 3-6 hours and discharged thereafter to continue treatment as an outpatient provided, however, that the post-operative course is normal. Patients are provided detailed information concerning further care upon discharge.

What are likely complications?

At the early postoperative period, there is a risk of bleeding or infection, like in case of any other surgical intervention. The risk for such complications is low, accounting for 1-2%. Occasionally, the sensitivity of the glans may increase after the surgery or decrease during later postoperative periods. The risks of long-term complications include scar formation, partial aesthetic satisfaction with the surgical outcome.

What happens after the surgery?

Postoperative pain is usually not acute and, if necessary, can be managed taking oral analgesics. If the bandage slips, it is not necessary to place it back unless bleeding has not stopped. There may be some tingling when first urinating after the surgery. Yet, these symptoms are usually not expressed and short-lasting. There also may be some skin intumescence and redness of the glans which are normal postoperative symptoms.

The bandage shall be removed the next day after the surgery and antiseptic baths shall be applied thereafter. Absorbable sutures usually disappear in 2-3 weeks after the surgery. Sometimes, sutures need to be removed 3-4 weeks later in case of failed absorption. Non-absorbable sutures have to be removed after about 10 days.

Some patients may have painful erections during the early postoperative period. Therefore, sexual stimulation should be avoided. It is recommended to resume sexual activity 4-6 weeks after the surgery.

In case of the normal postoperative course, driving is not recommended for 2-4 days. Patients can usually return to work after 2-4 days, unless they do heavy manual work in which case it requires one week to be back to work.

Our cosy and small clinic can easily ensure privacy and confidentiality desired by patients with regard to this type of consultations. Therefore, patients wishing to avoid discomfort experienced at large or state medical institutions choose our clinic for such surgeries.

While discussions of buttocks or breast shapes attract great attention and time among women, correction of the calves is a challenge for both men and women. Women face problems in finding proper clothing or shoes, and suffer from unappealing legs while wearing a skirt; men keep sweating in sports clubs trying to correct their too slender calves.

Unfortunately, the shape of calves is almost completely determined by genetic factors (rarely, by illnesses or other diseases suffered), and it is very difficult to reshape them to the desirable level.

There are two methods of augmentation applied for calves in plastic surgery: fat transfer and implants.

In the case of fat transfer into calves, the amount of fat required is an average of 75 to 150 ml of fat, usually transferring bigger amount of fat (hypercorrection performed) as not all fat survives after the transplantation. At least a double amount of fat should be taken for transfer because ony a part of it survives. Therefore, this procedure better suits the patients who have excess fatty tissue in other regions of the body (such as the abdomen, flanks, or thighs). As this minimally invasive procedure uses person’s own fat it entails lower complication risks.

Augmentation of calves with implants enjoys no less popularity due to obvious and well seen results. Implants of calves can shape well-expressed contours both in the inner and outer sides of calves. The contours in proportion to the body are shaped by using implants of different sizes and projections.

Calves augmentation with fat transfer or implants is performed under general anaesthesia. The surgery lasts from 1.5 to 2 hours. Patients can usually return to work after one week, but it is recommended to limit physical activity for 4-6 weeks. After the surgery patients are advised to wear compression stockings for several weeks.

Choosing a proper method of surgery not only allows to achieve aesthetically pleasing results, but also to get rid of the lack of self-confidence. The size of calves is said to be ideal if it equals two ankle sizes. Shall we go for it together?

Examples of this kind of surgeries can be found in our gallery.

People who loose a lot of weight often have a lot of excess sagging skin, which makes body look unattractive and often creates a multitude of problems such as daily hygiene and finding clothes that fit properly. With significant weight loss over a relatively short period of time (usually 15-18 months), the remaining skin often does not retain the elastic qualities necessary to “shrink back down” to your new underlying shape.

Your plastic surgeon can help you realize the new shape that is hidden beneath the excess skin that remains after your goal weight has been achieved. An excess abdominal skin and a laxity of the muscles of the abdominal wall will necessitate abdominoplasty, while hanging skin under the arms will require arm lift (brachioplasty). Wrinkling and excessive bagginess of the thighs often requires lift of the inner thighs.

During your consultation, your plastic surgeon will assess your anatomy as well as your own priorities to help you develop a comprehensive plan for your body contouring. Women who have had a mastectomy should not have an arm lift. If you have had phlebitis (inflamed blood vessels) in either of your legs, you may not be a candidate for thigh lift surgery, as well. Of course, like any operation, there are potential complications, which will be explained by your doctor.

While you are standing, your plastic surgeon will make marks on the skin identifying certain landmarks as well as the intended incisions. It also allows you to review the operative plan one more time with your surgeon before undergoing the procedure.

General anesthesia is preferred for most of these procedures. Depending on the combination of procedures you choose, surgery will probably last between 2-6 hours. After the incision has been made skin and fat are elevated off the underlying structures. For a tummy tuck, the muscles of the abdominal wall are usually tightened. After removing the excess skin and fat, your plastic surgeon will redrape the skin over the underlying structures. One or more drains may be placed beneath the incisions, what assist in draining any fluid that may accumulate beneath the incisions and delay your healing.

For thigh lifts, excess skin is lifted and removed through incisions made in the inner thigh and/or high upper outer thigh. The incisions are extensive but are usually not visible when clothing is worn. Simultaneous lifting of the thighs and buttocks is done when necessary, though buttock lift is not a common procedure, because it requires leaving scars across the buttock or in the fold. This is usually not desirable and patients opt for liposuction instead.

Arm lift (brachioplasty) is designed to remove excess, sagging skin and fat from the upper-inner arms. The incision is generally placed within the upper-arm from the armpit to the elbow. If a patient has no loose skin of the upper-inner arms but only has localized areas of fat, then he or she may be a candidate for liposuction alone without removal of skin.

Compression garment is applied to the region of the body being treated. This compression garment helps support your incisions during healing, decreases postoperative swelling, and helps decrease any bruising that may occur. You should plan to wear this garment for three weeks following surgery. Most probably you will stay overnight in the hospital. You should be up and walking the day following surgery, although you will be sore for several days. Applying cold compresses or ice packs will reduce swelling and relieve discomfort. You will be able to shower in about week after surgery and you should be able to resume your normal daily activities within several days following surgery. All of your physical activities are allowed within three to four weeks of surgery. Your plastic surgeon will remove the drainage tubes within several days following surgery as the drainage decreases.

Potential complications include bleeding, infection and healing problems, which can lead to heavy scars. Some lack of symmetry also may occur. Because the skin is undermined, there is a slight risk of inadequate circulation and loss of some skin. This risk is greater in smokers and in patients with specific kinds of old scars. Patients should quit smoking for 14 days prior to and following surgery, and stop taking aspirin 14 days before surgery.

You will notice an improvement in your body contour immediately. However, your shape will continue to improve in the following weeks as the mild swelling subsides. As a result of your body contouring, you should be able to look as good as you feel and enjoy your new body shape.

Brachioplasty, or an arm lift surgery is a procedure to remove excess skin and fat deposits, creating a more youthful contour of upper arms. Due to the aging process, skin becomes loose and saggy, therefore arm lift surgery is recommended.

Usually, patients who undergo this surgery are people, who have lost a lot of weight. Although this surgery is not only for people, who are overweight or have slimmed worn, but for those who want to tighten loose skin as well. Patients with thse problems are mostly of an elderly age, with loose skin all over the body, not only upper arms.

Methods for the surgery:

• For patients, who have small amount s of fat deposits in upper arm areas but no excess skin, only liposuction is performed.
• For patients, who have small amount of loose skin on upper arm areas and it is more localized to underarms, skin tightening is performed. Leaving barely visible scars lesser amount of upper arm skin is removed.

• For patients, who have a larger amount of excess skin because of lost weight, excess skin is removed making larger cuts – from the elbow through the upper arm’s inward surface to the armpit and extending cuts to the chest.

Usually brachioplasty is performed under general anesthesia and lasts for 2 – 3 hours. It is recommended to limit physical activities for at least 10 days; compressive sleeves should be worn for 8 weeks. More intense swelling can be felt for 2 weeks, scars begin to fade after 8 – 10 weeks and become barely visible.

Possible complications after arm lift: bleeding, infection, pronounced scars, arm swelling.

After the surgery patients can enjoy more beautiful arm contours, increased self-esteem, can wear short sleeved clothes without embarrassment.

Most men and women, consider the ideal body type for women to be characterised as a combination of prominent breasts, slender legs and a round butt. The latter part of the body should not be undervalued. Women often complain of too flat, too small or disproportionate buttocks. This results in psychological dissatisfaction or causes problems with “filling up” clothes. Imperfect butt shapes can be determined by genetic factors, sagging buttock skin after weight loss or age.

Sometimes intensive exercising and balanced diets can help improve the contour of buttocks, though medical methods are often applied too. In recent practices, a very popular and effective buttock reshaping method is Brazilian Butt Lift.

This buttock reshaping method has many advantages:

• A person’s own fat is used;
• Not only the contour of buttocks is improved, but also of the regions where fatty accumulations are removed from;
• It is the safest and the most natural buttocks augmentation method;
• Buttock has a much more natural look than augmented with implants;
• Minimal, hardly visible incisions.

Buttocks augmentation with fat usually involves transferring of 250–350 ml of fat to each buttock, about 700 ml for both buttocks (this is usually done with hypercorrection, i.e., a larger amount of fat is transferred because not all fat cells survive after the transplantation). Typical donor regions are the abdomen, flanks, back, and thighs. General anaesthesia is commonly used during buttocks augmentation; rarely intravenous sedation is also possible. After the surgery, patients stay at the clinic for one night.

The recovery period of buttocks augmentation with fat transferred depends on the scope of the surgery, but it is recommended to limit physical activity for 1-2 weeks. Patients can usually return to work after 10-14 days. The final result after the surgery can be seen 3 months later, but some fat can keep resolving during a year.

Today fat grafting procedures that reshape your body and increase your self-confidence are very widely used and considered not only for buttock augmentation, but also for the correction of face, breasts, calves, and other body areas.

For more information please visit our FAQ section and see examples of surgeries performed at our clinic in our gallery.

Women often develop excess abdominal skin, fat, and stretched abdominal muscles as a result of pregnancy or weight loss. Abdominoplasty, surgical removal of loose skin and excess fatty tissue, corrects these problems. If the patient’s only complaint is excess fat in the abdomen, the problem can sometimes be corrected by liposuction alone.

Abdominoplasty is usually performed under general anesthesia and takes two to three hours. The patient usually must spend one night in the clinic. When discharging the patients, doctors prescribe oral pain medication to control typically mild to moderate pain. The patient also is given an abdominal binder to provide support while healing.

Abdominoplasty is performed through an incision across the lower abdomen. An incision is made around the belly button, leaving it attached to the abdominal wall. The skin and fat are then elevated from the abdominal wall and muscles to the level of the rib cage. Surgeons may remove some fat from the flanks with supplemental liposuction and, if needed, the abdominal muscles are tightened by suturing them together in the midline and shortening them. Surgeons remove excess skin and fat at the upper line of the incision. The belly button is then brought out through a small incision and sutured to the new skin in its normal position.

Drains are left beneath the skin for 3-14 days  following surgery.

Following surgery, patients should restrict their activities for two to three weeks, and exertion is prohibited for four weeks. The stitches generally are removed in one to two weeks following surgery.

It may be months before all the swelling has completely subsided. Patients often experience reduced sensation in the abdominal area and the upper thighs. This generally subsides in the months following the procedure. The scars around the belly button and the lower part of the abdomen will gradually fade and become less visible.

Potential complications of abdominoplasty include bleeding, infection and healing problems, which can lead to heavy scars. Some lack of symmetry also may occur. Because the skin is undermined, there is a slight risk of inadequate circulation and loss of some skin. This risk is greater in smokers and in patients with specific kinds of old scars. Patients should quit smoking for 14 days prior to and following surgery, and stop taking aspirin 14 days before surgery.

For more information, please visit our FAQ section and see examples of performed surgeries in our gallery.

A typical patient will have extra skin and/or fat in the abdominal area. The length of the scar varies, depending on how much extra skin is present. It is usually placed within the bathing suit (bikini line) area.
	If the muscles underneath have stretched because of pregnancy, they are brought together.
The extra skin is pulled down like an apron and removed. The belly button, if a full tummy tuck is performed, is brought through the skin at the normal location (usually at the hip level).
	The scars are hidden in the bathing suit line but they do exist. Because of tension scars can stretch with time. These can be improved through a “scar revision” about one year following the surgery.

 

Areas that can be well treated by suction lipectomy include the abdomen, flanks, buttocks, thighs, knees, neck, face and some other parts of the body.

Removing body fat using suction has proven to be a safe and effective surgical alternative that can result in a better body contour with minimal scarring. The procedure gives the best result when used to remove localized areas of unwanted fat after someone has reached a desirable weight through diet and exercise.

Except for removing very small amounts of fat, this procedure must be performed under general anesthesia. For smaller cases it can be done as an outpatient procedure. When plans are to remove large amounts, it is safer to stay overnight at our clinic.

Initially the doctor will mark areas for liposuction on your body. Before the surgeon begins the liposuction, the area to be suctioned is infused with large quantities of a special fluid. This is called the tumescent technique. It has been in widespread use for many years and is a great advance to liposuction. It makes it easier for the surgeon to remove the fat and there is less bleeding and postoperative bruising and pain. Patients recover faster and are back to their normal activities sooner than after the older technique.

A small, 2-5 mm incision is made near the area where the fat is to be removed. A thin, blunt-tipped, hollow rod is inserted under the skin and carefully manipulated through the fat tissue. The hollow rod is attached to a high-vacuum hose that sucks out the unwanted fat cells. When the desired fat is removed, the incisions are closed and dressings are applied. The length of the procedure varies depending on how much fat is removed and it takes from 1 to 4 hours.

Patients wear a pressure garment over the suctioned area. This minimizes swelling and discoloration and helps the healing process. In spite of this, there will be some swelling and discoloration. The discoloration subsides in several weeks, but the swelling may take months to disappear.

Following surgery, oral medication will usually control the pain. Patients should drink plenty of fluids the first few days after surgery. Sport drinks containing electrolytes are recommended. Patients can return to near normal activity in about one week, but it may be several weeks before strenuous exercise can be resumed.

As in any operation, complications can occur but their degree and number are relatively small. Occasionally, antibiotics are required for minor infections. The most common problem is waviness or sagging skin, which is caused by irregular fat removal or inadequate skin shrinkage over the newly contoured areas. In some cases, there may be depressions from too much fat removal. Cellulite (dimpling) and other surface irregularities that were present before surgery will still be present afterward.

The best results can be achieved in younger people who have good skin tone; however, many older people may have excellent results if they recognize the limitations of the surgery and have realistic expectations. Sometimes a minor secondary procedure is necessary to achieve desired results.

Depending upon the procedure you may recuperate overnight at our clinic under the care of our nursing staff, return home or stay in the near by hotel.

Examples of this kind of surgeries performed at our clinic can be found in our gallery.

	The abdomen, thighs, knees and arms are all good targets for liposuction. Small incisions are made ( 2-5 mm) in natural crease lines if possible and the tumescent fluid is injected in the fat.
“Love handles” and “saddle bags” are also areas where liposuction can produce excelllent results.
	The fat is aspirated using specially designed canulas.
Compression garments are necessary to produce smooth, even results. The garments need to be used for up to 4 weeks following the surgery. You are allowed to take the garments off for brief periods of time to shower.
	Usually results are obvious right away but over the following 8 to 12 weeks continious improvement will be visible as the swelling diminishes.

For more information please visit our FAQ section.

Body contours may be corrected using a variety of techniques – from modelling creams and diets to exercises and even surgeries.

The Clinic performs liposuction surgeries for the removal of local fat accumulations (in the waist area, abdomen, pubis, thighs, knees, upper back (shoulder blades), upper arms and under the chin). Abdominoplasty as well as thigh and arm lift surgeries are designed to remove excess skin due to weight variations (after pregnancy or gastric bypass procedures). These surgeries produce obvious and long-lasting results.

• Liposuction
• Tummy tuck (abdominoplasty)
• Brachioplasty
• Thigh lift
• Calves correction by fat grafting
• Fat transfer to buttocks

Examples of body sculpting surgeries performed at our clinic can be found in our gallery.

Please also visit our FAQ section for more information.

Statistically, about 30 – 50 % of men suffer from gynaecomastia. It is not a serious illness, but can cause psychological discomfort and the loss of self-esteem. Neither sports nor any diet helps to escape from it, since gynaecomastia is not necessarily caused by excess localized fat.

Gynaecomastia is the enlargement of glandular and/or fat tissue in males. There are many reasons that can cause these symptoms, starting from physiological such as hormone imbalance (appears in new-borns, during puberty and in older males), pathological reasons (in case of testicular, thyroid, liver or kidney function, the presence of tumours) and concluding with other reasons concerning the usage of medicine.

When diagnosing gynaecomastia it is important to evaluate patient’s complaints and to base on the objective results of examinations (in most cases – breast ultrasound).

Gynaecomastia can be classified into three degrees dependently on the amount of excess localized fat and the ability to feel the gland. When the cause and degree of a problem is decided, medical (treating the illness that has caused gynaecomastia) or surgical treatment can be applied.

There are three types of surgical treatment according to the degree of gynaecomastia:

• The 1st degree gynaecomastia – glandular tissue is removed;
• The 2nd degree gynaecomastia – liposuction from the breast area together with glandular tissue removal is performed;
• The 3rd degree gynaecomastia – liposuction from the breast area together with glandular tissue removal and excess skin removal is performed.

This surgery is not recommended for patients under 18, because any signs of gynaecomastia, which appeared during puberty, may disappear naturally after hormone adjustment.

Dependently on the volume of the surgery, gynaecomastia can be performed either under intravenous or endotracheal anesthesia and takes 1 – 2 hours. Patients are usually discharged from the clinic on the same day. A special band has to be worn for 3 – 4 weeks, resuming daily activities is allowed 4 – 6 weeks after the surgery. Barely visible scars remain after this surgery.

Possible complications: bruises, inverted nipples, scarring, uneven breast contours caused by insufficient liposuction.

The results of gynaecomastia correction are visible in two months and patients can enjoy manly chest, attractive bodylines and their increased self-esteem.

Examples of this kind of surgeries performed at our clinic can be found in our gallery.

An inverted nipple is a nipple that appears to be pulled inwards rather than pointing outward. It can be caused by shorter than usual milk ducts, by prior surgery to the nipples or breast, or by an infection or inflammation of the milk ducts beneath the nipple.

Some people may have nipples that will protrude and point outward when stimulated, but then invert again when the stimulation stops. Inverted nipples can occur in both men and women and sometimes a person can have just one nipple inverted. Most women with inverted nipples are able to breastfeed successfully, although there might be a bit more discomfort initially. In fact, breastfeeding can be an effective process for inverted nipple correction for some women.

Generally, an inverted nipple is a cosmetic problem. However, a nipple that becomes inverted can be a symptom of breast cancer and should be checked out.

The easiest process for inverted nipple repair is to regularly stimulate the nipples to a protruded state. Pull on the nipple to stretch the restricting tissue and hold it for several seconds. Do this several times a day. Regularly using a breast pump or a suction device can also help with inverted nipple correction.

If these methods don’t work, plastic surgery can also correct an inverted nipple. However, inverted nipple surgery can also impair a woman’s ability to breastfeed or prevent it entirely. The surgery may also impair sensation in the nipple.

Inverted nipple surgery is not complicated and can usually be done under local anesthetic in about an hour.

The procedure involves releasing scar tissue or shortened milk ducts. The incision is very inconspicuous. Usually, you can go home several hours after inverted nipple surgery, and can shower on the next day. Stitches are generally removed after 5 days.

Examples of this kind of surgeries performed at our clinic can be found in our gallery.

Nipple hypertrophy is an aesthetic problem causing psychological discomfort in some patients – difficulties in fitting masking clothing, and patients avoid wearing loose-fitting or slinky clothing. This problem may result from a variety of reasons: inheritance, individual properties of the body or hormone imbalance during maturation, labours or menopause.

According to medical literature, an ideal nipple is of cylindrical form and 8 mm in diameter (normal range is 6-10 mm). If nipple height and width is above 1 cm nipple hypertrophy is diagnosed. Generally, nipple hypertrophy is bilateral – symmetrical.

Nipple hypertrophy correction surgery provides a more aesthetic form to the nipples that is proportional to the breasts. Nipple reduction may be performed as an individual surgery (with local anaesthesia) or combined with breast augmentation, lifting, reduction, or other surgeries. Normally nipples are corrected by performing breast augmentation with implants as implants yet more accentuate nipple hypertrophy by pressing the nipple/areola complex from the bottom.

The height or width or a nipple, or both, may be reduced during the surgery that takes about an hour. Prior to the surgery the amount of skin to be removed is marked without reducing the nipples too much. Since milk ducts are not damaged, the breastfeeding function is not affected.

After breast reduction correction the average physical load is restricted for several days, showering is allowed the next day and taking a bath – after 3 days.

Nearly no scars remain after the surgery, they are hardly visible, and sensitivity is unchanged while the patients enjoy a more aesthetic form of the nipples.

Examples of this kind of surgeries performed at our clinic can be found in our gallery.

With time women having breast implants experience various thoughts concerning theirs breasts: either there are dissatisfied with the present aesthetic view which has changed over time or for the peace of mind want to change implants placed many years ago. Unfortunately, some cases prompting to breast implant replacement or removal may be related with health problems.

The most often reasons when implants need replacing or removing include:

–    Leakage or rupturing of the implant. If a saline implant develops a leak then the body will absorb the saline giving a noticeably smaller and softer appearance very quickly. A leak in a silicone implant may only be noticed if a mammogram or MRI scan is carried out;

–    capsular contracture. Suffering from capsular contracture (encapsulation) patient feels the implant hard and painful due to the formation of excess scar tissue around the implant as the body treats the implant as a foreign body. The shape of breast may also look strange.

–    change of size or shape of the breast caused by an infection or bleeding.

Breast implants removal or replacement is generally more straightforward surgery than breast augmentation as the “pocket” or “capsule” for the implant is already formed, although some discomfort is expected. The same as breast augmentation, breast implants are normally removed or replaced under general anaesthesia and requires one to two hours to complete. Patients must stay one overnight in the clinic.

Like all surgical procedures, with breast implant removal or replacement surgery there is always a possibility of complications. Although these complications are extremely rare, they can include infection, adverse reaction to anaesthesia, excessive bleeding, unsatisfactory results. Important to notice, that if the implant shell has been damaged or ruptured it may be impossible to remove all of the escaped gel from the surrounding tissues.

Some other consequences include a longer scar than that which resulted from the original implant-placement procedure and diminished or altered breast sensation. Also, however, it is not possible to predict the breast shape precisely after this surgery.

Recently the media has been flooded with reports concerning breast implants manufactured by French company, Poly Implant Prosthese (PIP). Despite claims that PIP silicone breast implants ‘have no cancer link’ and there is no need for women to have them removed, reliable sources state: “These implants have a higher failure rate so there will be women who might choose to have their implants removed before that happens, whereas others will be happy to be monitored.” (Douglas McGeorge, consultant plastic surgeon and former president of the British Association of Aesthetic Plastic Surgeons (BAAPS) at http://www.bbc.co.uk/news/health-16280458). French government clarifies that PIP implants are made of the industrial grade silicone which is more irritating to tissues if the implant ruptures and advices to replace implants with current approved ones.

Our clinic uses reliable and worldwide acknowledged Polytech and Motiva.

A lot of women want to move fat from their waist or thighs to breasts and to have bigger and more attractive breasts. Now it has become reality! Plastic surgeons have transplanted fat to the breast since 1895, but the methods that are used currently were developed in 1995. Currently, fat transfer to the breast is becoming more and more popular and is considered an option for women who want to enhance their breasts, or improve the appearance of their breasts after breast lift, or to repair implant-related issues like rippling and wrinkling.

The results of this surgery are a completely natural augmentation avoiding breast implants and improving contours of other parts of the body.

Breast augmentation using this technique takes much longer than traditional breast augmentation. Fat grafting to the breast consists of several procedures at a time: harvesting the fat, preparing it and placing into the breasts. A substantial amount of fat is removed manually (by hand, without the use of machines). Then, the harvested fat is specially processed to separate out the unwanted components (blood, oil, water, anesthetics, lipids and medical fluids from the fat). Next, the fat is injected through tiny incisions using blunt infiltration cannulas. The fat cells are carefully injected, drop by drop in dozens of small injections, into the different breast tissue layers. Fat cells must be over-injected to compensate for any necrosis (cell death) that may occur, which results in loss of fatty tissue. To reach the maximum result 2 or 3 surgeries have to be performed.

Fat transplantation to breast is performed under general anesthesia and usually takes about 3 hours to complete. Though postoperative period is not long some bruising and swelling is expected. Active physical activity can be continued after 2-3 weeks.

If the patient is very thin, she may not have an adequate amount of that. In this case she still has the possibility to enhance her breasts with implants.

Examples of this kind of surgeries performed at our clinic can be found in our gallery.

Please also visit our FAQ section for more information.

Women with large, heavy breasts may experience several health concerns related to their breasts: back pain, neck pain, grooves in the shoulders from bra straps, pain in the breasts, and rashes under the breasts.

Some women are bothered by the psychological embarrassment of large breasts. In other situations, athletic, active women and women who are trying to lose weight are inhibited by the size of their breasts. Breast reduction can minimize or eliminate these problems. Excess skin and breast tissues are removed and the breasts reshaped to be smaller and more attractive.

The breast reduction procedure is performed at the hospital with the patient under general anesthesia. When only a small amount of tissue is removed, the procedure can be performed under local anesthesia with intravenous sedation as an outpatient procedure.

The surgeon makes incisions so that scars form around the areola, vertically below the areola, and in the crease beneath the breast. The incisions are designed so the scars will not be visible while wearing normal clothing. The surgeon then repositions the nipple and areola to a higher position on the breast, and removes excess breast tissue and skin. A drain may be left in place at the time of surgery and removed several days later.

The patient can be up and about the day after surgery, and can go home in the next day in most cases. Sutures are removed within the first two weeks following surgery.

Complications of breast reduction can include postoperative bleeding, infection and healing problems. These complications may result in more obvious scars.

Although every attempt is made to obtain symmetry and a natural shape, there may be some irregularities in the final size and shape of the breasts or in the positioning of the areola and nipple. Because separating the nipple from the breast tissue during the procedure disturbs the surface nerves of the nipple, patients may experience a decrease in sensation which basically returns back. Patients also may experience a permanent inability to breast-feed after having the surgery.

Patients most often are very happy with results, enjoy new breasts shape and forget previous problems associated with heavy breasts.

Examples of this kind of surgery surgery can be found in our gallery.

Breast sagging (ptosis) is a common problem following pregnancies, weight loss or aging. Sagging occurs when breast skin stretches, and breast tissue and fat degenerate over time. This results in a less youthful appearance of the breasts. Breast sagging can be corrected with a breast lift (mastopexy).

The mastopexy procedure may be performed under either local anesthesia with intravenous sedation or general anesthesia. The operation takes about two hours, and patients often return home the same day.

During mastopexy, surgeons reposition the nipple and areola to a higher position and remove excess skin from beneath the breast. Closing the remaining skin lifts the breast mound to a higher position and recontours the breast to give it a more projected and youthful appearance.

If there is inadequate breast tissue to fill the skin and achieve the desired size, a saline-filled breast implant may be placed beneath the breast at the same time, achieving the desired size, shape and projection.

Patients may resume limited activities the day after surgery and normal activities in three to four weeks. Pain usually can be controlled with oral pain medication. Sutures are removed one to two weeks after surgery.

When there is marked sagging, the incisions required and resulting scars are similar to those resulting from a breast reduction. In cases of less breast sagging, mastopexy can often be accomplished with smaller scars.

Potential complications of mastopexy include bleeding, infection and healing problems. Patients may experience some decrease in sensation in the nipple. In addition, some patients may notice minor irregularities in the size and shape of the breasts, and in the position of the areola and nipple.

Following mastopexy, patients may be able to breast-feed because the nipple usually is not separated from the milk glands. If an implant is used, however, problems with the implant can occur.

Following the surgery and healing period, the breast will have a more attractive and youthful appearance. With time, however, there may be further sagging that could necessitate a revisional procedure.

The nipple has moved below the breast crease. Breast lift repositions the nipples higher, to a normal position. Sometimes it is helpful to use a breast implant at the same time.
	The skin around the nipple is removed and the nipple is moved to its normal position. The amount of skin removed varies from minimal around the nipple to more extensive depending on the severity.
The skin is brought back together giving the breast a more youthful appearance and fullness.
	The scars will always be visible. It takes about one year for the scars to mature and obtain a color similar to the surrounding skin.
The length of the scars could vary. If minimal skin is removed the scar remains around the nipple. With more skin removal the scar could continue as a straight line below the nipple. If a lot of skin is removed the scar also involves the breast crease. You will be able to get an idea of how extensive the incisions are going to be during the consultation

Examples of this kind of surgeries performed at our clinic can be found in our gallery.

Breast augmentation is surgery to enhance the size and shape of a woman’s breast. The surgery may be done to enhance breast size, correct a reduction in volume after pregnancy or balance a size difference between the two breasts. Surgeons are able to enlarge the breast by placing a silicone filled implant behind it.

Using the most extensive gallery of breast augmentation pictures in Lithuania our patients can visualize postoperative results and measure their needs.

During the initial consultation a thorough evaluation of your skin tone and breasts will determine the most appropriate surgical technique for you. Occasionally, a breast lift (mastopexy) will also be required to reshape and reposition a sagging breast. The surgeon will make recommendations about how the implant should be inserted and positioned based on your anatomy. Implants are available in a round or teardrop shape. Implant manufacturers are heading forwards implementing research findings and answering the changing needs of the clients. Recently breast implant makers opened a new page in the history of breast implants by placing on the market innovative dual-gel breast implants. Key advantages of these breast implants are: they are made of two layers of silicone-gel, both layers of different firmness (the anterior portion is firmer, it provides and maintains the aesthetic form of the breast.; the interior portion is softer) therefore the breast feels very natural; smooth edges conceal the contour of the implant. All these characteristics of breast implants enable to form a very natural shape of the breast even for very thin women. These implants successfully correct hanging tuberous breasts and are used in reconstructive breast surgery.

Our clinic use only reliable and worldwide acknowledged implants like Motiva, Polytech and other.

Breast augmentation is performed under general anesthesia and requires one to two hours to complete. The incision may be made in the crease under the breast (inframammary), around the areola (the dark skin surrounding the nipple) or under the axilla (armpit). After the incision is made, the surgeon creates a pocket for the implant directly behind the breast tissue or behind the chest (pectoral) muscle. The implant is centered behind the nipple and areola.

After the procedure, patients are advised regarding wound care, medication, suture removal and follow-up. Physical activity will be limited for several weeks after surgery. Scars will remain firm and pink for about six weeks and then begin to fade over several months.

Although breast augmentation is a relatively straightforward procedure, there are risks. As with any surgical procedure, excessive bleeding may produce swelling and bruising.

Infection is rare. However, if it occurs next to the implant, it might be necessary to remove the implant to resolve the infection.

In some breasts, firmness develops because scar tissue forms around the implant. This is called a “capsular contracture” and may require secondary surgery to correct.

Sensation change around the nipple can occur, but in most cases it is temporary. Occasionally, the breasts will have slightly different shapes. In most cases, these problems can be treated with acceptable results.

Since the implants are made of plastic, they can rupture but silicone does not cause any significant risk to the body. This can be corrected by replacing implants.

Breast implants have never been shown to cause any form of cancer in women. However, implants do make mammography somewhat less accurate and more difficult to interpret. Women who have breast implants should advise their radiologist before having a mammogram so that the mammogram technique can be modified.

Finally, there is no evidence that breast implants will affect breastfeeding, fertility or pregnancy.
Most women after the surgery enjoy more youthful breasts form, report feeling better about themselves and having more self-esteem.

The incisions can be made in the breast crease, around the nipple or in the axilla (armpit). There are advantages and disadvantages for each incision which you will hear about during the consultation.
	A pocket is created either over or under the muscle and the implant is placed in the pocket. Most augmentations in our practice are done under the muscle. but there are some indications for above the muscle.
Conservative sizes produce the best results. It is very important to select a breast implant size that fits the patient’s body.

Examples of this kind of surgeries performed at our clinic can be found in our gallery.

Please also visit our FAQ section for more information.

Female breasts have always been seen as a symbol of femininity. This is reflected in the global statistics on plastic surgeries (breast surgeries are among the most popular), in works of art often portraying bare breasts to show off femininity, as well as in the whole beauty industry.

The concept of aesthetical (beautiful) may have different interpretations. Taking into account the patients’ needs, our Clinic performs the surgeries of breast augmentation (using implants or fat), breast reduction, breast lift, augmentation and simultaneous mastopexy, asymmetry correction and inverted nipple surgery.

• Breast augmentation with implants
• Breast reduction
• Mastopexy
• Breast correction transfering fat
• Inverted nipple surgery
• Breast implants change
• Breast nipple reduction
• Gynaecomastia

Examples of breast surgeries performed at our clinic can be found in our gallery.

Please also visit our FAQ section for more information.