Smoothing out wrinkles to give your face a youthful appearance can be reached without surgery and without scars. Botox (Botulinum toxin type A) is the cosmetic form of bacterium Clostridium botulinum. It is mainly used to treat forehead creases, frown lines and crow’s feet.
What is botulinum toxin and how does it work?
Botulinum toxin or “sausage poison” is a substance produced by the bacterium Clostridium botulinum. At first it was used in ophthalmology and neurology. That’s when it was discovered the toxin could be used to diminish wrinkles and stop sweating. The amount of applied substance in cosmetology is 1000 times lower than the toxic dosage. The actual effect of botulinum toxin consists of the blockage of nerve-endings; the muscle is de-nerved and no nerve impulses can affect the area. It is practically “numb,” although over time the muscle does regain its nerve impulses. The effect of botulinum toxin is not permanent.
Why botox Prague?
Prague has many attractive features for those considering botox abroad. Its location in Central Europe is easy to access; its mild climate is conducive to healing and its experienced clinics and botox surgeons ensure you’ll receive the best possible care. Botox Prague costs are often much more affordable than in the UK or with the NHS. For more information about getting to and around the Czech Republic, please visit our handy cosmetic surgery Prague info guide.
Are you a good candidate for wrinkle removal using botulinum toxin?
The two barriers to receiving a botulinum toxin application are pregnancy and lactation. Although most moms probably aren’t too worried about wrinkle removal. If you suffer from any nerve diseases, certain allergies and hemophilia also prevent you from using botox.
The botox procedure
Botulinum toxin is an out-patient procedure that takes several minutes. The actual application takes 5-10 minutes. It is performed without anesthesia but the treated area may be cooled with a frozen compress. The solution is applied with a thin needle under the skin in the specific wrinkled area. The most common place to receive botox is the forehead and the area around the base of the nose and around the eyes. An experienced surgeon is able to work in small areas, and to treat even the beginning of wrinkles in the area of the upper lip.
After the botox procedure
Folowing your botulinum toxin application, you should not lie down for four hours after the procedure. This is so the toxin won’t, for example, get in the eyes and perhaps cause drooping eyelids. The patient should also not wear cosmetics, visit a solarium, receive a massage, etc.
Does botox ever not work?
Yes, in rare cases, the botulinum toxin does not have any effect. These patients may have developed antibodies in the past through a small intoxication of the poison. There are also documented cases of antibodies being created by very frequent applications. In these cases, another type of botulinum toxin might work.
How long does botox last?
The effect of the substance after the first application lasts approximately three months, after the second one around half a year and after the third application approximately 9-12 months. The more the substance is applied the longer the effect lasts. However, the effect of botulinum toxin can’t be guaranteed for more than a year. Many clients return once a year, or even better, learn not to use specific muscles and therefore the period between the treatments is prolonged. Boutulinum toxin application in the same area is not recommended more than twice a year (except in the first year.) In case of very deep wrinkles or defected collagen fibres, total wrinkle removal cannot be expected, but only a wrinkle reduction. Here it is possible to combine the botulinum toxin with a suitable filling material, for example collagen or hyaluron acid.
BOTOX® / DYSPORT®
Uses:
Reduction of laugh wrinkles
Relaxation of frown wrinkles
Reduction of fan wrinkles
Relaxation of an unwanted facial expression (e.g. turned-down corners of the mouth)
Treatment of hyperhidrosis – excessive sweating (axillae, palms, soles and face)
Duration of the effect:
Temporary (3 – 9 months).
Duration of the treatment:
Maximum of 10 minutes.
What is Botox®?
Botulotoxin A is a substance that relaxes muscles. It has been used in medicine for a number of years now and is the most important component of both BOTOX® and DYSPORT®. A special feature of these substances, which are applied by injection, is that they act directly on the cause of wrinkles, namely muscular activity. When BOTOX® or DYSPORT® is injected into a muscle, it temporarily blocks the nerve impulse that causes muscle contraction. The substance therefore acts more effectively against mimicry wrinkles than skin implants do. In addition, it prevents the formation of new wrinkles. The wrinkles become less apparent or disappear completely. Although BOTOX® and DYSPORT® do not have a permanent effect, the treatment can be repeated without difficulty.
The treatment
The application of BOTOX® or DYSPORT® is completely painless. The doctor uses a thin injection needle to introduce the substance into the muscle that causes the wrinkle or unwanted facial expression. The injection produces only a slight burning sensation. Immediately after the treatment, the skin is slightly reddish and swollen. These effects disappear after about an hour. You don’t need to take any time off work and can appear in public almost immediately after the treatment.
Results
The results of the treatment appear after three to six days. The skin is visibly relaxed and the wrinkles are shallower. The effect is optimal after fourteen days, and lasts three to four months. The more frequently the treatment is repeated, the longer the effect (from six to nine months.)
What is Esthelis, Restylane, Juvederm, Surgiderm, Teosyal, Matridex, Matridur?
Esthelis
New generation of injection fillers containing hyaluronic acid. It is prepared from bio fermentative hyaluronic acid by patented process. It is a monocomponent formulation – containing only one substance. Unique polydensified cohesive structure of Esthelis consists of cohesive gel, which is easy to administer. The skin is smooth after its application. Esthelis is supplied packaged sterile and ready to use immediately.
What are the advantages of Esthelis?
Esthelis can be used immediately with no prior skin test. The cohesiveness and elasticity allow treatment without overcorrection. The Esthelis injection is administered by a medical professional, which is trained in such injection fillers application. It takes approximately 30 minutes to perform. The final result is visible in 1 to 2 days. It is stable and long lasting. Its main advantage is the natural structure of the substance, which is own to the body and also degrades in the organism naturally. Therefore there is no risk of allergies and undesirable effects.
What type of treatment can Esthelis be used for?
Esthelis can be used in filling treatment for wrinkles around nose, eyes, cheeks and forehead. It can also be used for augmentation of the lips, cheeks or chin. There are two types of Esthelis. The basic formulation is particularly suitable for fillings of larger areas and for wrinkle removal. The cohesive structure of Esthelis allows bio-interactive positioning of the implant within the dermis, and a lifting effect on the epidermis.
Restylane
Restylane is a favorite, hyaluric acid based preparation. Restylane is a temporary implant (6-12 months) that accomplishes wrinkle smoothing, scar correction, improvement of the contours of the lips and the vertical lip furrows, reduction of turned-down corners of the mouth and fuller lips. Juvederm and Surgiderm are semi-permanent products. Results are visible immediately after the treatment. Teosyal belongs to a new range of wrinkle filling products, hyaluric acid based, highly bio-compatible, with long-time absorption. The preparation is applied to the area of the whole face, décolletage, neck and hands. It restores tissue hydration, heals tiny skin splits, sculpts face contours and restores facial volume to its natural beauty. Teosyal is quite safe and helps to achieve immediate, natural and long-term results.
RESTYLANE®
- Reduction of wrinkles
- Improvement of the contours of the lips and the vertical lip furrows
- Fuller lips
- Reduction of turned-down corners of the mouth
- Reduction of scars
Temporary (6 – 12 months).
Duration of the treatment
About 30 minutes.
What is Restylane®?
RESTYLANE® is hyaluric acid, which is natural to the body. This substance occurs throughout the body and ensures the hydration and elasticity of the skin. Over time, however, the production of hyaluric acid decreases, wrinkles form and the skin becomes less flexible. RESTYLANE® replaces natural hyaluric acid. It forms cushions under the skin that completely fill the wrinkles and furrows. Three kinds of RESTYLANE® (RESTYLANE®, Restylane Touch® or Restylane Perlane®) are used, depending on the depth of the wrinkles. The products are virtually identical: they differ only in the size of the acid beads. Smaller ones are used for minor wrinkles, and larger ones for deeper furrows and for renewing volume.
The treatment
The doctor applies RESTYLANE® to the skin using a thin needle. The slight burning sensation this causes disappears immediately after the substance has been applied. The skin is desensitized with cream at sensitive places, like the lips.
Results
The result of the treatment– smooth skin and fuller lips – can be seen immediately. Although the skin may be slightly swollen directly after the treatment, the swelling disappears within one or two days. The body completely decomposes RESTYLANE® within six to twelve months, at which point the effect of the treatment disappears. However, the treatment can be repeated without difficulty.
Varices are caused by inferiority of venous wall leading to aneurysm, which is visible under the skin. The reasons for removing of varices are aesthetic as well as medical. Plastic surgery offers several methods to remove them.
Why to treat varices?
Untreated varices lead to development of thrombi and risk of venous ulceration. Medicine can heal these pathological veins and prevent risks caused by this disease.
Types of varix treatment
There are several possibilities how to treat varices: miniinvasive operation CHIVA, laser treatment and process of sclerotisation.
Miniinvasive operation CHIVA
It is a highly efficient method of removing varices. The choice to use this method does not depend on age, but rather on your state of health. It has a big advantage, because it does not require residential treatment.
Are you a suitable candidate for minioperation CHIVA?
If you look for a gentle miniinvasive treatment of varices, are in a good state of health and in a good mental condition, you will probably be a suitable candidate for this treatment.
Operational procedure
With the help of this operation, it is possible to remove varices of all sizes. A small stab or cut, with size of approximately 1-3 mm, will be done on precisely chosen places to tie up the varices, cut them short and remove some of them. The operation will be supplemented by sclerose or laser treatment. The target of this method is to remove all varices which are unnecessary and will not be missed after the operation.
In most cases, it is not necessary to suture the cuts or stags, patch suture is sufficient.
Before the operation
During the first consultation, the doctor is going to check your state of health and examine clinically the vascular system of lower limbs – it means arteries, deep and surface veins. You will probably have to undergo a duplex ultrasonic scan. On the base of these examinations, the doctor is going to suggest the method of treatment. More techniques can be used.
As a part of pre-operational preparation, you have to organize your transport home.
Anesthesia
Miniinvasive operation CHIVA is a very gentle treatment and the removing of varices is usually done under local anesthesia. There will be an injection of an anesthetic to the treated places or you may get some tranquillizers. You will be awake during the operation, but with a relaxed feeling and without pain. You may feel a very light pain, which can be reduced by cooling the skin surface.
If you require it, the surgeon can choose in some cases short general anesthesia. Then you will sleep during the whole operation. You may have to stay overnight in the hospital.
After the operation
In case of treatment under local anesthesia, it is possible to go home in approximately 2 hours after the end of the operation.
It is recommended to wear bandages or compression stockings at least 14 days after the treatment, but preferably longer.
It is necessary to avoid sport activities as skiing, rowing, dancing in the first 4-6 weeks. Common exercise can be done in 2-3 weeks after the operation. Your doctor is going to inform you about all the details, the measures are highly individual and depend on the extent of the treatment.
The stabs or cuts caused by the treatment will usually heal in one week. Small bruises disappear in approximately 2-6 weeks. A little bit lower sensation at the place of the stab soon returns to the normal.
A small scar can remain at the place of the cut or stab. It fades out soon but never disappears completely. The disappearing of the bruises can be sped up by a heparin ointment recommended by your doctor.
Results of varix removing through miniinvasive operation CHIVA
The method is highly efficient, however the varices may appear again. It depends on the genetic quality of venous walls. But even if they do appear, it is mostly in a much smaller extent than previously.
Laser treatment
Laser treatment is a modern non-operative method suitable for treatment of large-scale varices.
The procedure of laser removing of varices
The method of catheterization is used: a laser sensor is brought to the vein through a small stab, the sensor seals the vein, which causes varices, from the inner side and makes it impassable.
The varices can be subsequently removed operationally or left to disappear naturally.
Before the treatment
You should discuss the possibilities of this method with the doctor during your consultation. The type of your varices may be unsuitable for being removed with this method.
The doctor is going to recommend a duplex ultrasonic scan, which is going to prove, whether this type of operation is suitable for you.
The operation can be done without residential treatment. As a part of pre-operational preparation, you should organize your transport home and eventually someone to help you for 1-2 days.
Are you a suitable candidate for laser removing of varices?
If the ultrasonic scan proved that the type of your varices can be treated by this method, you are in a good state of health and good mental condition, you may be a suitable candidate for this treatment.
Inform your doctor about all health complications, above all if you suffer from deep vein thrombosis, ischaemic disease of lower limbs or if you are pregnant. Your age does not matter much, important is above all your state of health.
Anesthesia
Combined methods of anesthesia are used in most cases, for example analgosedation or local anesthesia through an injection of an anesthetic to the treated places or you may get some sedatives. This methods are very gentle compared to the conventional general anesthesia.
After the treatment
In most cases, it is possible to go home in approximately 2 hours after the end of the operation, accompanied by another person. If the treatment is more complicated, you may have to stay in hospital for a longer time.
How long will the results last?
The laser method is highly efficient, however the varices may appear again. It depends above all on the quality of venous walls, which is determined genetically. In case of larger veins, the laser method may not be sufficient.
Sclerotization
The procedure of sclerotization is recommended if you suffer from microvarices, it means varices with diameter 1mm or less.
The treatment includes an injection of a special substance directly to the veins with thin needles. The veins are then absorbed. Sclerotiazation is used as an additional process during the operation or thereafter.
If the client has only isolated varices, it is possible to do just sclerotization with subsequent recommendation to wear elastic compression stocking (II compression class) for a time period, which is specified individually according to the extent of the varices. Sclerotiazation is also a method recommended to prevent further spread of varices.
Are you a suitable client for Sclerotiazation ?
If your varices are not suitable for an operation, you may be a candidate for this method. However, if your varices can be operated, it is not recommended to undergo sclerotization, because the varices appear after this treatment very often again. Sclerotization does not bring the required cosmetic effect in this case. It is therefore necessary to discuss openly with the doctor which method is suitable for you.
Before the treatment
Before the treatment, it is necessary to observe darker traces at the place of small veins. It is caused by pigmentation from pathological veins. It is necessary to realize that this traces will be more visible for some time after the treatment, but disappear later. This process always depends on the individual healing capacity. It is important to consider that this pigmentation may last for a long time and sometimes never disappears.
After the treatment
Sclerotization is efficient only if the limbs are bandaged with elastic bandage, compression stocking or special covers. The compression prevents return flow of blood to the sclerosed vein and its re-bulge. The compression period is always individual, depends on the extent of the treatment and size of treated veins. Minimum compression period lasts for 1 month.
It is necessary to repeat sclerose 2-4 times in 2-6 weeks. Small bruises (hematoma) disappear in 2-4 weeks.
An abnormal sized labia(lips of the vagina)can cause discomfort during hygiene, sport activities and sexual intercourse. Labioplasty, often spelled labiaplasty, allows for the reduction of internal or external labia, which are often augmented and asymetrical. Surgery of the external labia, which may be losing size or elasticity, can also be done.
What is labiaplasty?
The female external genitalia consists of the vaginal opening, urinary opening and a peak with many sensitive nervous endings called the clitoris. This whole area is covered on all sides with gentle folds of skin tissue. The inner lips (labia minora) come together in the area of clitoris. The female external genitalia is covered on all sides with larger skin folds with fat cushions, known as the outer lips (labia majora). The outer lips usually cover and protect the external genitalia. Sometimes the labia minora grows larger in size or length and thus protrudes between the labia majora.
Usually this overlap is not too big so it doesn‘t cause any discomfort either aesthetically or functionally. If the inner lips protrude too much they can cause discomfort in an aesthetic way and also in everyday life. Sometimes it is difficult to fit an abnormally enlarged labis into tight underwear or a swimsuit, sometimes it can cause discomfort during sport activities – for example bicycle riding. It can also cause problems with intimate hygiene and this “defect” can also represent a psychological obstacle during intercourse. Labiaplasty is effective with good results. Sometimes a plastic surgeon can meet the request for a modification or reduction of the outer lips, although these procedures are rarely performed.
Why labiaplasty Prague?
Prague has many attractive features for those considering labioplasty abroad. Its location in Central Europe is easy to access; its mild climate is conducive to healing and its experienced clinics and labiaplasty surgeons ensure you’ll receive the best possible care. Labioplasty Prague costs are often much more affordable than in the UK or with the NHS. For more information about getting to and around the Czech Republic, please visit our handy cosmetic surgery Prague info guide.
Preparation for labioplasty
Labioplasty patients must be adults. All potential labioplasty patients should have a thorough consultative examination with a labioplasty plastic surgeon. Here, the patient should not only receive an examination but also detailed instructions on how the labiaplasty will be performed and what the patient can expect. In most cases the patient will agree on her requirements for the size or shape of the operated area with the plastic surgeon. The date of the surgery should then be scheduled so that the patient will receive the labioplasty shortly after menstruation has ended. The labioplasty surgeon will also instruct the patient on proper intimate hygiene in the period following the surgery.
Labioplasty surgery
The labiaplasty is almost always performed under general anesthesia, on an operating table with the patient in a gynecological position. The surgeon precisely measures the direction of the surgical incisions before the surgery so that the final scars will not be visible and so they won’t cause discomfort to the patient. Great attention should be paid to the area of the clitoris so the gentle nerves that give special sensitivity to this area will not be damaged.
In addition to very gentle and careful work, it is necessary to stop any bleeding during labiaplasty. After the modification, a very tight but also gentle suturing of the surgical wound is necessary. To stitch the wound, various types of suturing material are used; sometimes absorbable, sometimes nonabsorbable (such sutures have to be removed after the wound is healed.) Which suturing material is used depends on the plastic surgeon and his/her experiences. Labiaplasty takes about one hour, depending on the extent of the surgery, and is not especially difficult on the patient. Soreness after the procedure is normally not a large problem; most patients only describe unpleasant, but not overly strong, burning in this area.
After labiaplasty
Patients usually go home the next day following their labioplasty. It is good to stay relaxed for about one week, avoid sitting for long periods of time, including long car drives, and to perform hygiene several times a day. We recommend showering and washing with an intimate hygiene soap or with a good and gentle antiseptic soap after each toilet use and to cover the area with a pad. Some patients heal better if the wound is left totally uncovered. The operated area can often swell, but usually the swelling disappears after several days. It is best to be regularly checked by your surgeon. The healing process takes a minimum of 10 but usually 14 days, sometimes even more. Smaller swelling can stay for a longer time and the operated area settles into its final shape approximately six weeks later. After this period, the patient can resume her sexual life again.
Labioplasty results
Labiaplasty almost always brings satisfactory results to the patient. Of course, much depends on the experiences of the labioplasty surgeon so that he/she is able to avoid possible complications. It also depends very much on the cooperation and discipline of the patient so that she can fulfill all the recommendations following the surgery. Some doctors – sexologists – don’t like these surgeries too much as they are afraid of a possible reduction of sexual sensation in women who have undergone labioplasty. When labiaplasty has been performed here, the opposite has been seen. Women who have had the surgery mention mostly improved sensations during sexual intercourse. Also by having the surgery, any psychological problems with their genitalia appearance is removed. This contributes to a more relaxed and improved sex life.
Temporary trend – an effort for perfect body – forces women to pay attention also to parts of their bodies that are mainly fully hidden from the eyes of public. For last few years the plastic surgeons have come up with aesthetic modifications even in the most intimate places – external part of female genitalia.
What does female genital surgery consist in?
The female external genitalia consists of vaginal opening, urinary opening and a peak with many sensitive nervous endings – clitoris. This whole part is on sides covered with gentle skin folds of tissue – the inner lips (labia minora) that come together right in the area of clitoris. The female external genitalia is on sides covered with bigger skin folds with fat cushions – the outer lips (labia majora). The outer lips usually cover and close the external genitalia. Sometimes it happens that the labia minora grows into bigger size or length and thus they can protrude between the labia majora. Mostly this overlap is not too big so it doesn‘t cause any discomfort neither aesthetically nor functionally.
If the inner lips protrude too much they can cause discomfort in aesthetic way and also in everyday life. Sometimes it is difficult to fit this abnormally enlarged labis into tight underwear or swimsuit, not even mentioning underwear of “tanga“ type, sometimes it can cause discomfort by sport activities – for example bicycle riding. It can also cause some problems with intimate hygiene and this “defect” can represent also a psychic obstacle during the intercourse. The labiaplasty is then effective with good results. Sometimes the plastic surgeon can meet the request for modification or reduction of outer lips, although these procedures are performed relatively rarely. Sometimes there is even request for hymen reconstruction surgery that can also be performed.
Relatively frequent request for modification or reduction of vagina is although already part of gynecological procedures.
Preparation for the surgery
As a necessary condition for the procedure is an adult patient. Another necessity is thorough consultative examination with plastic surgeon when the patient gets not only the examination itself but also detailed instruction how the surgery will be performed and what is to be expected. In most cases the patient can agree on her requirements for size or shape of the operated area with the plastic surgeon. The date of the surgery should be then scheduled so that the patient will be operated shortly after the ended menstruation. The plastic surgeon has to instruct the patient also about the need of right intimate hygiene in the period after the surgery.
The surgery itself
The labiaplasty is performed almost always under general anaesthesia, on the operational table in gynecological position. The surgeon measures precisely the direction of surgical incisions before the surgery so that the final scars will not be visible and mainly that they will not make any discomfort to the patient. Great attention should be paid to the area of clitoris so the gentle nerves that give special sensitivity to this area will not be corrupted.
Beside very gentle and careful work it is very necessary to cease the bleeding during the surgery. After the modification very tight and also gentle suturing of surgical wound is necessary. To stitch the wound various types of suturing material are used, sometimes absorbable othertimes nonabsorbable (such sutures have to be removed after the wound is healed). Which suturing material is used depends always on the plastic surgeon and his/her experiences. The surgery takes according to the size of the procedure around one hour and is not especially difficult to the patient. Also soreness after the procedure is normally not big, the patients mention only unpleasant but not that strong burning in this area.
After surgical care
The patients after the labiaplasty usually go home next day after the surgery. It is good to stay calm in the next period for about one week, to avoid long sitting, including long car drive and to have the opportunity of perfect hygiene several times a day. We recommend showering and washing with a soup for intimate hygiene or with good and gentle antiseptic soup after each visit of the toilet and to cover the area with pad.
Although some patients heal better if the wound is left on countrary totally uncovered or “free“. The operated area get relatively often quite swelled, but usually the swelling disappears after several days. It is better if you are regularly checked by your surgeon. In any case you should know that the healing process takes minimum 10 but mostly 14 days, sometimes even more. Smaller swelling can stay even for longer time and the operated place gets its final shape approximately after 6 weeks, after this period the patient can start with her sexual life again.
Results
The labiaplasty brings almost always very satisfactory results to the patients. Of course it very much depends on the experiences of the plastic surgeon, so that he/she is able to avoid possible complications that are nevertheless not too common. It also depends very much on the cooperation and discipline of the patient so that she can fulfill all the recommendation in the period after the surgery.
Some doctors – sexologists – don’t like these surgeries too much, they are afraid of possible reduction of sexual sensation in operated women. The experience of last years, when labiaplasty has been performed here, the opposite has been seen. Women who undertook the surgery mention mostly improved sensation during sexual intercourse. Also that by the surgery their psychic problem of their genitalia appearance is removed contributes to global relaxed and improved experiences in their sexual life.
Varices are caused by inferiority of venous wall leading to aneurysm, which is visible under the skin. The reasons for removing of varices are aesthetic as well as medical. Plastic surgery offers several methods to remove them.
Why to treat varices?
Untreated varices lead to development of thrombi and risk of venous ulceration. Medicine can heal these pathological veins and prevent risks caused by this disease.
Types of varix treatment
There are several possibilities how to treat varices: miniinvasive operation CHIVA, laser treatment and process of sclerotisation.
Miniinvasive operation CHIVA
It is a highly efficient method of removing varices. The choice to use this method does not depend on age, but rather on your state of health. It has a big advantage, because it does not require residential treatment.
Are you a suitable candidate for minioperation CHIVA?
If you look for a gentle miniinvasive treatment of varices, are in a good state of health and in a good mental condition, you will probably be a suitable candidate for this treatment.
Operational procedure
With the help of this operation, it is possible to remove varices of all sizes. A small stab or cut, with size of approximately 1-3 mm, will be done on precisely chosen places to tie up the varices, cut them short and remove some of them. The operation will be supplemented by sclerose or laser treatment. The target of this method is to remove all varices which are unnecessary and will not be missed after the operation.
In most cases, it is not necessary to suture the cuts or stags, patch suture is sufficient.
Before the operation
During the first consultation, the doctor is going to check your state of health and examine clinically the vascular system of lower limbs – it means arteries, deep and surface veins. You will probably have to undergo a duplex ultrasonic scan. On the base of these examinations, the doctor is going to suggest the method of treatment. More techniques can be used.
As a part of pre-operational preparation, you have to organize your transport home.
Anesthesia
Miniinvasive operation CHIVA is a very gentle treatment and the removing of varices is usually done under local anesthesia. There will be an injection of an anesthetic to the treated places or you may get some tranquillizers. You will be awake during the operation, but with a relaxed feeling and without pain. You may feel a very light pain, which can be reduced by cooling the skin surface.
If you require it, the surgeon can choose in some cases ??? or short general anesthesia. Then you will sleep during the whole operation. You may have to stay overnight in the hospital.
After the operation
In case of treatment under local anesthesia, it is possible to go home in approximately 2 hours afterthe end of the operation.
It is recommended to wear bandages or compression stockings at least 14 days after the treatment, but preferably longer.
It is necessary to avoid sport activities as skiing, rowing, dancing in the first 4-6 weeks. Common exercise can be done in 2-3 weeks after the operation. Your doctor is going to inform you about all the details, the measures are highly individual and depend on the extent of the treatment.
The stabs or cuts caused by the treatment will usually heal in one week. Small bruises disappear in approximately 2-6 weeks. A little bit lower sensation at the place of the stab soon returns to the normal.
A small scar can remain at the place of the cut or stab. It fades out soon but never disappears completely. The disappearing of the bruises can be sped up by a heparin ointment recommended by your doctor.
Results of varix removing through miniinvasive operation CHIVA
The method is highly efficient, however the varices may appear again. It depends on the genetic quality of venous walls. But even if they do appear, it is mostly in a much smaller extent than previously.
Laser treatment
Laser treatment is a modern non-operative method suitable for treatment of large-scale varices.
The procedure of laser removing of varices
The method of catheterization is used: a laser sensor is brought to the vein through a small stab, the sensor seals the vein, which causes varices, from the inner side and makes it impassable.
The varices can be subsequently removed operationally or left to disappear naturally.
Before the treatment
You should discuss the possibilities of this method with the doctor during your consultation. The type of your varices may be unsuitable for being removed with this method.
The doctor is going to recommend a duplex ultrasonic scan, which is going to prove, whether this type of operation is suitable for you.
The operation can be done without residential treatment. As a part of pre-operational preparation, you should organize your transport home and eventually someone to help you for 1-2 days.
Are you a suitable candidate for laser removing of varices?
If the ultrasonic scan proved that the type of your varices can be treated by this method, you are in a good state of health and good mental condition, you may be a suitable candidate for this treatment.
Inform your doctor about all health complications, above all if you suffer from deep vein thrombosis, ischaemic disease of lower limbs or if you are pregnant. Your age does not matter much, important is above all your state of health.
Anesthesia
Combined methods of anesthesia are used in most cases, for example analgosedation or local anesthesia through an injection of an anesthetic to the treated places or you may get some sedatives. This methods are very gentle compared to the conventional general anesthesia.
After the treatment
In most cases, it is possible to go home in approximately 2 hours after the end of the operation, accompanied by another person. If the treatment is more complicated, you may have to stay in hospital for a longer time.
How long will the results last?
The laser method is highly efficient, however the varices may appear again. It depends above all on the quality of venous walls, which is determined genetically. In case of larger veins, the laser method may not be sufficient.
Sclerotization
The procedure of sclerotization is recommended if you suffer from microvarices, it means varices with diameter 1mm or less.
The treatment includes an injection of a special substance directly to the veins with thin needles. The veins are then absorbed. Sclerotiazation is used as an additional process during the operation or thereafter.
If the client has only isolated varices, it is possible to do just sclerotization with subsequent recommendation to wear elastic compression stocking (II compression class) for a time period, which is specified individually according to the extent of the varices. Sclerotiazation is also a method recommended to prevent further spread of varices.
Are you a suitable client for Sclerotiazation ?
If your varices are not suitable for an operation, you may be a candidate for this method. However, if your varices can be operated, it is not recommended to undergo sclerotization, because the varices appear after this treatment very often again. Sclerotization does not bring the required cosmetic effect in this case. It is therefore necessary to discuss openly with the doctor which method is suitable for you.
Before the treatment
Before the treatment, it is necessary to observe darker traces at the place of small veins. It is caused by pigmentation from pathological veins. It is necessary to realize that this traces will be more visible for some time after the treatment, but disappear later. This process always depends on the individual healing capacity. It is important to consider that this pigmentation may last for a long time and sometimes never disappears.
After the treatment
Sclerotization is efficient only if the limbs are bandaged with elastic bandage, compression stocking or special covers. The compression prevents return flow of blood to the sclerosed vein and its re-bulge. The compression period is always individual, depends on the extent of the treatment and size of treated veins. Minimum compression period lasts for 1 month.
It is necessary to repeat sclerose 2-4 times in 2-6 weeks. Small bruises (hematoma) disappear in 2-4 weeks.
A forehead lift or “browlift” is a procedure that restores a refreshed look to the area above the eyes. The procedure corrects drooping eyebrows, hooding over eyes furrowed forehead and frown lines by removing excess tissue, altering muscles and tighten.
What is forehead lift (brow-lift)?
In a forehead lift, the muscles and tissues that cause the furrowing or drooping are removed or altered to smooth the forehead, raise the eyebrows and minimize frown lines.
Your surgeon may use the conventional surgical method, in which the incision is hidden just behind the hairline; or it may be performed with the use of an endoscope, a viewing instrument that allows the procedure to be performed with minimal incisions. Both techniques yield similar results-smoother forehead skin and a more animated appearance.
The forehead lift (browlift) surgery
Anesthesia
Most forehead lifts are performed under local anesthesia, combined with a sedative to make you drowsy. You’ll be awake but relaxed, and although you may feel some tugging and mild discomfort, your forehead will be insensitive to pain.
Some surgeons prefer to use general anesthesia, in which case you’ll sleep through the entire operation. Typically, people are requested not drink, eat and smoke for about 6 hours before the general anesthetic and may need overnight stay in hospital.
The surgery
Your surgeon will help you decide which surgical approach will best achieve your cosmetic goals: the classic or “open” method, or the endoscopic forehead lift. Make sure you understand the technique that your surgeon recommends and why he or she feels it is best for you.
The classic forehead lift
Before the operation begins, your hair will be tied with rubber bands on either side of the incision line. Your head will not be shaved, but hair that is growing directly in front of the incision line may need to be trimmed.
For most patients, a coronal incision will be used. It follows a headphone-like pattern, starting at about ear level and running across the top of the forehead and down the other side of the head. The incision is usually made well behind the hairline so that the scar won’t be visible.
If your hairline is high or receding, the incision may be placed just at the hairline, to avoid adding even more height to the forehead. In patients who are bald or losing hair, a mid-scalp incision that follows the natural pattern of the skull bones is sometimes recommended.
By wearing your hair down on your forehead, most such scars become relatively inconspicuous. Special planning is sometimes necessary for concealing the scar in male patients, whose hairstyles often don’t lend themselves as well to incision coverage.
If you are bald or have thinning hair, your surgeon may recommend a mid-scalp incision so the resulting scar follows the natural junction of two bones in your skull and is less conspicuous.
Working through the incision, the skin of the forehead is carefully lifted so that the underlying tissue can be removed and the muscles of the forehead can be altered or released.
The eyebrows may also be elevated and excess skin at the incision point will be trimmed away to help create a smoother, more youthful appearance.
The incision is then closed with stitches or clips. Your face and hair will be washed to prevent irritation and the rubber bands will be removed from your hair.
Although some plastic surgeons do not use any dressings, your doctor may choose to cover the incision with gauze padding and wrap the head in an elastic bandage.
The endoscopic forehead lift
Typically, an endoscopic forehead lift requires the same preparation steps as the traditional procedure: the hair is tied back and trimmed behind the hairline where the incisions will be made.
However, rather than making one long coronal incision, your surgeon will make three, four or five short scalp incisions, each less than an inch in length. An endoscope, which is a pencil-like camera device connected to a television monitor, is inserted through one of the incisions, allowing the surgeon to have a clear view of the muscles and tissues beneath the skin. Using another instrument inserted through a different incision, the forehead skin is lifted and the muscles and underlying tissues are removed or altered to produce a smoother appearance.
The eyebrows may also be lifted and secured into their higher position by sutures beneath the skin’s surface or by temporary fixation screws placed behind the hairline.
Are you the best candidate for fore head lift (browlift)?
A forehead lift is most commonly performed in the 40-60 age range to minimize the visible effects of aging. However, it can also help people of any age who have developed furrows or frown lines due to stress or muscle activity. Individuals with inherited conditions, such as a low, heavy brow or furrowed lines above the nose can achieve a more alert and refreshed look with this procedure.
Forehead lift is often performed in conjunction with a
facelift to provide a smoother overall look to the face. Eyelid surgery (blepharoplasty) may also be performed at the same time as a forehead lift, especially if a patient has significant skin overhang in the upper eyelids. Sometimes, patients who believe they need upper-eyelid surgery find that a forehead lift better meets their surgical goals.
Patients who are bald, who have a receding hairline, or who have had previous upper-eyelid surgery may still be good candidates for forehead lift. The surgeon will simply alter the incision location or perform a more conservative operation.
Remember, a forehead lift can enhance your appearance and your self-confidence, but it won’t necessarily change your looks to match your ideal or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them in detail with your doctor.
Before your surgery
If you decide to consult a plastic surgeon, he or she will first evaluate your face, including the skin and underlying bone.
During your consultation, the surgeon will discuss your goals for the surgery and ask you about certain medical conditions that could cause problems during or after the procedure, such as uncontrolled high blood pressure, blood-clotting problems, or the tendency to develop large scars.
Your surgeon will give you instructions to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications. You may be asked not to use any medications containing acetylsalicyclic acid (such as Acylpyrin, Aspirin, Alnogon, Mironal, etc.). It can increase bleeding during and after surgery.
It is assumed that no acute illnesses occurred in the period of at least three weeks before the planned operation (viral illness, cold, etc.). Report any illness to your doctor.
If you smoke, plan to quit at least one to two weeks before your surgery and not to resume for at least two weeks after your surgery.
If your hair is very short, you may wish to let it grow out before surgery, so that it’s long enough to hide the scars while they heal.
Whether your forehead lift is done in an outpatient facility or in the hospital, you should arrange for someone to drive you home after your surgery, and to help you out for a day or two.
After you surgery
The immediate post-operative experience for a patient who has had a classic forehead lift may differ significantly from a patient who had the procedure performed endoscopically.
When the lift is complete, the scalp incisions will be closed with stitches or clips and the area will be washed. Gauze and an elastic bandage may also be used, depending on your surgeon’s preference.
Classic forehead lift patients may experience some numbness and temporary discomfort around the incision, which can be controlled with prescription medication. Patients who are prone to headaches may be treated with an additional longer-acting local anesthesia during surgery as a preventive measure.
You may be told to keep your head elevated for two to three days following surgery to keep the swelling down.
Swelling may also affect the cheeks and eyes – however, this should begin to disappear in a week or so.
As the nerves heal, numbness on the top of your scalp may be replaced by itching. These sensationsmay take as long as six months to fully disappear.
If bandages were used, they will be removed a day or two after surgery. Most stitches or clips will be removed within two weeks, sometimes in two stages.
Some of your hair around the incision may fall out and may temporarily be a bit thinner. Normal growth will usually resume within a few weeks or months. Permanent hair loss is rare.
Endoscopic forehead lift patients may experience some numbness, incision discomfort and mild swelling. Incision site pain is usually minimal, but can be controlled with medication, if necessary. Endoscopic forehead lift patients usually experience less of the itching sensation felt by patients who have had the classic forehead lift.
The stitches or staples used to close the incisions are usually removed within a week and the temporary fixation screws within two weeks.
Although you should be up and about in a day or two, plan on taking it easy for at least the first week after surgery. You should be able to shower and shampoo your hair within two days, or as soon as the bandage is removed.
Most patients are back to work or school in a week to 10 days. Endoscopic patients may feel ready to return even sooner.
Vigorous physical activity should limited for several weeks, including jogging, bending, heavy housework, sex, or any activity that increases your blood pressure. Prolonged exposure to heat or sun should be limited for several months.
Most of the visible signs of surgery should fade completely within about three weeks.
Minor swelling and bruising can be concealed with special camouflage makeup.
You may feel a bit tired and let down at first, but your energy level will increase as you begin to look and feel better.
What is the results duration?
Although a forehead lift does not stop the clock, it can minimize the appearance of aging for years. As time passes, you may want to repeat the procedure.
The average results duration are 5-10 years.
Most patients are pleased with the results of a forehead lift, no matter which surgical method was used. Often, patients don’t realize how much their sagging forehead contributed to the signs of aging until they see how much younger and more rested they appear after the lift.
If your lips are too thin or deflated you can decide to have them augmented with fat injections. Such fat injections can make your lips look plumper and more sensual.
What does lip enhancement by fat application consist of?
The lip enhancement consists of injectable application of fat known to the client’s body to an area that the client wishes to have enlarged. In most cases it is women who undergo the surgery although exceptionally even men do. Lip augmentation by fat application can be performed together with other procedures such as face-lifting, neck-lifting or breast lifting with collagen or fat implants.
Fat application
Transplantation of fat (autologous fat graft or micro-fat injection) means that a small amount of fat is sucked from your abdomen, thighs, buttocks or other parts of client’s body and under sterile conditions injected into the lip.
Are you the right candidate for lip enhancement with fat or collagen?
Collagen or fat injections into your lips may enhance your appearance and self-confidence, however, it is not going to change your visage entirely. It might make your lips look plumper and more sensual. It is necessary to distinguish whether it is the size or the colour of your lips that you are not satisfied with. If it’s the colour that you don’t like, your surgeon may recommend you another procedure, such as a lip tattoo. Injectable fat or collagen application is suitable for patients in a good psychic condition whose expectations are realistic.
Before lip augmentation
During the first consultation the surgeon will check the state of your lips and oral mucosa. He/she is going to talk with you about your expectations and ideas, he/she is going to ask you about your anamnesis, allergies to drugs and is going to check your health state to avoid any potential problems. If you suffer from any active lip or oral cavity infection (herpes, aphtae or a cold) or if you have any unhealed lip injury, the surgeon will probably recommend you to postpone the operation.
Anaesthesia
The anaesthetic agent lidocaine is a mixture of collagen and no additional anaesthetic is thus necessary. Nevertheless, if you are extremely sensitive to pain your surgeon may use desensitizing cream or a combination of local anaesthesia and sedatives. Local anaesthetics desensitize the parts of human body where fat is taken from and where it is inserted. The anaesthesia may be complemented with sedatives. If you decide to have sedatives applied, please make sure that you have a lift back home.
The process of lip augmentation
The whole process lasts from 15 minutes to 1 hour.
Collagen
In the past collagen was used. Today the surgeons use skin implants – hyaluron acid or fat injections to carry the procedure of lip augmentation, the reason is longer persisting effect.Collagen was injected through the mouth corner precisely to the desired place. More mixture had to be applied since the mixture contained a saline solution which the body absorbed within few days.
Fat
Having cleansed the places where fat is going to be sucked from and injected in, the surgeon applies local anaesthesia. Subsequently, fat is taken out by an injection and a thick needle or a cannula (which is the same instrument used for liposuction) and is sucked out by a suction device. After that, the fat is adjusted and injected in the lip. Same as with collagen, it is necessary to apply more fat due to its absorbability. Repeated application of fat may cause swelling or itching.
After lip enhancement with fat
In the place where the fat was sucked from bruises or swelling may appear. You can have pulsing sensation in the lip where the fat was applied and the lip might be swollen. You should avoid sun till the swelling and bruises disappear – usually around 48 hours.
How long will the effect of augmented lips persist?
The effect of fat injections is individual but, in general, the effect lasts longer compared to collagen injections.
Interview with Dr. Petra Berger, board-certified plastic surgeon (Frankfurt am Main and Zurich), on implant removal.
Dr. Berger, after seeing a real boom in breast augmentation using silicone implants in recent years, it now seems the opposite trend is ocurring. More and more women are having their implants removed. Am I wrong? What is your experience in your practice?
Dr. Berger: It varies greatly. On the one hand, silicone implants are still a very good choice for women with smaller amounts of fatty tissue, who wish to fulfil their dream of having larger breasts. I have patients who weeks after surgery still stand in front of the mirror every day, congratulating themselves on their decision. On the other hand, there is also an increasing number of desperate women considering implant removal who are turning to me for advice.
And what do you advise these women?
Dr. Berger: That obviously depends on each individual case. Some women want to go too big and are then surprised by the obviously unnatural result. In this situation, one solution might be to change to a natural shaped implant. Then, there are also women where the breast augmentation appears successful and yet despite this they are completely unhappy.
What are the reasons for this?
Dr. Berger: The phenomenon behind this is the feeling of a foreign object in the body. Silicone – and let’s not kid ourselves here – is not a natural material. In some women, it causes a sensation of having a foreign object in the body, which doesn’t go away if you try to convince them otherwise or with time. You cannot predict which patient will suffer this effect. Some have no problem with it, others are troubled by it. When lying in bed on their silicone breasts, when going for a swim or doing some other kind of sport, their thoughts are always fixed on their implants. In this instance, only their removal will help. We’re actually participating in one study in order to learn more about this phenomenon.
Why might it be appropriate to remove the implants?
Dr. Berger: In some cases, implanted silicone gel causes pain, which has been described to me by some patients as similar to being pricked by a thousand small needles. It may be that there is pain in only one breast, while the other is perfectly fine. Another problem is capsular fibrosis (scarring and hardening of the tissue – Editor’s note), which can occur at any time after silicone breast augmentation.
There seems to be reason enough to argue for implant removal. Certainly a lot of women will try and avoid this step for fear of making things worse, but is this fear justified?
Dr. Berger: The result really depends on the initial state of the breasts, but of course it also depends on how they were operated on previously. Nevertheless, I can reassure the patient. Generally we can help make a big improvement with some minor breast remodelling – sometimes even without it. Especially when used in conjuction with insertion of the person’s own fat you can sculpt beautiful breasts.
Does this mean that affected women can choose either a) continuing to live with artificial breasts and the feeling of a foreign object in the body or b) Going back to having small breasts that they were unhappy with before?
Dr. Berger: No, you can choose between a), b) or c).
That sounds promising. What does option C) entail?
Dr. Berger: Breast augmentation using natural materials – for example, Macrolane made with hyaluronic acid. This is a kind of natural sugar, which is broken down if it is not topped up at regular intervals. For women without their own fat stores, it is a method worth considering. For women with their own cushions of fat there is yet another rather innovative option for breast enlargement: lipocondensation.
Please could you explain that in more detail, Doctor?
Dr. Berger: Lipocondensation uses the patient’s adult stem cells as starting material, which then undergo a complex process of enrichment and purification. With that we get very pure additional fatty tissue, which promises yields of 70-90% above average when compared to conventional practices. Certainly because it comes from the patient’s own body cells, the final product is not only suited to breast augmentation, but can be used anywhere on the body. This is so-called BioShaping we’re talking about here.
That sounds really innovative. Patients will certainly not then be able to complain about this sensation of a foreign object in the body. This will give new hope to all concerned.Thank you, Doctor, for your clarification on the subject of implant removal.
Laser-assisted uvulopalatoplasty is a highly effective method for removing the causes of loud snoring. The procedure, which is performed on an outpatient basis under local anaesthesia, lasts a mere ten minutes and can help solve a lifelong problem.
Prior to the procedure sleep apnea screening is performed and the patient is examined by a specialist. A local anaesthetic is injected into the soft palate; while this may be unpleasant, it is not painful and is necessary to overcome the pharyngeal reflex. This is the most unpleasant part of the entire procedure.
Using a laser, the specialist modifies the soft palate to reduce or completely eliminate noise-producing vibrations. The laser removes and remodels excess layers of tissue; the uvula is also reduced in size. With healing the palate moves higher, tightens, and ceases to vibrate.
Because the laser removal of snoring is performed in the oral cavity, the patient must cooperate with the physician and synchronize breathing. The physician works as the patient exhales to prevent the inhalation of the odour and light smoke the laser produces while vaporizing cells. The patient must concentrate on breathing to overcome the gag reflex. The laser removal of snoring must be performed slowly to prevent bleeding.
The patient needn’t feel anything unusual immediately after the procedure; the most frequent sensation is a scratching sensation in the throat caused by unhealed sealed tissue.
The unpleasant sensation in the throat can last one or two days. At this point the patient begins to experience greater pain of the type associated with tonsillitis. The patient’s condition worsens for about a week. Difficulties typically peak on the tenth day and within four or five days the pain usually subsides.
This pain can naturally be reduced with medications and mouth wash. Antibiotics are also given preventively so that healing is not complicated by secondary infection.