WRINKLES TREATMENT

To whom it is facial lipotransference aimed at?

It is indicated for both genders and normally in patients over 40 years old. This
procedure requires a careful individual physiognomic analysis, to evaluate the patient’s features fully.

How long does the effects last?

The effect in expression wrinkles usually last several years. As for the volumes, the effect usually last several years.

Would I have any secondary effects?

It could be temporary redness, inflammation or small bruises in the injected area that
could be camouflage with make-up.

CHIN SURGERY

At what age could the procedure be performed ?

The process of bones ossification finalizes in the face between the ages of 15 and 17. It is recommended for women to wait until they are 18 and for men after 21 years old.

When would I be able to go swimming, go to the gym or do any excercise?

After 2 weeks, but every exercise should be practice with moderation and in a
progressive way

When could I return to work and to social activities?

The next day after the surgery but you must take into account that the treated area would be mildly swollen during approximately 10 days.

How long should you wait to sunbathe or expose to UVA?

It is recommended to wait for a month

In which cases or circumstances are this procedures contraindicated?

These procedures are contraindicated in patients who suffer an illness that might interfere with the surgical procedure or anesthesia and with collagen related diseases.

What post-surgical care do I hace to follow?

After the implant, you must disinfect the area, especially if the implant was made intrabuccal. The bruises may persist for a while, they could improve through lymphatic massage drainage.

Which medicaments should be avoid before and after the surgery?

Just as in any surgery, the patient must abstain from ingesting aspiring or any other anticoagulant during the 3 weeks prior the surgery.

What are the risk of these surgeries and treatments?

First are the common risks to any surgery such as: the derivate from the use of
anesthesia, bleeding and infection. In the particular case of implants (silicone prosthesis), the specific risk is the rejection of the chin prosthesis.

What type of discomfort does the surgery causes?

This operation causes mild discomfort.

Is there any medication prescribed for the post-surgery period?

The usual medications prescribed after any surgery: antibiotics to avoid infection and analgesic (painkillers) to relieve pain.

Do I have to take any precautions before the surgery?

Just as any facial surgery, the skin condition is of importance to the success of the surgery. In the case of the chin buccal infections should be discarded and any other dental infection.

RHYNOPLASTY (NOSE SURGERY)

At what age it is posible to hace a nose surgery?

When the process of bone ossification in the face is finalized, normally between the ages of 15 and 17. Nevertheless it is always recommended to wait until the majority of age (18) to take the decision to have surgery.

when are the definitive results observed?

When the cast is removed, ten days after the surgery, the nose would have a correct shape and good enough to have a normal life. Nevertheless the definitive results regarding details would need a longer time, normally about 6 month to the final look.

Is it painful?

It is not painful. Normally there is no need of analgesic (painkillers) for more than 3 days.

Could the patiente be able to breathe through the nose?

In some cases nasal tamponing is used for 48 hours, in other cases the patient would be able to breathe through the nose; although with some difficulty at the beginning, since some cicatratization tissue could be formed inside the nose and there would be some post –surgical inflammation, which is inevitable. After a few days and with the recommended treatment, the patient could breathe comfortably.

Which post-operative care should I follow?

The post- operative period is not painful, however analgesic – anti-inflammatories are prescribed. If you feel the need to sneeze, do so with your mouth open, letting out the air freely.

When the cast is removed the visible bruises would be disappeared and the nose would be in sufficiently optimal conditions so the patient could resume his/ her life with normality. Nevertheless the aesthetic aspect should follow an evolution that would take a period of at least 6 months.

It is a slow and progressive process that could even go unnoticed. However, it is of great importance to the final result.

Adhesive tape are placed directly in the skin, they act as bandage to help control inflammation, and they should be use for 3 weeks.

What are the risks of the surgery?

The possibility of complications in this type of surgery is very rare. An infection could be produce or bleeding more than normal.

Could I choose the nose I want?

No. No plastic surgeon, as expert as he/she might be, could infer at 100% how the nose would be after de surgery. Confidence should not be place that photographic simulation made in a computer would show us how the nose would look. The face physical structure and the proportions of the chin and forehead among other are used by the surgeon to plan the surgery. Here again, we insist that the relation doctor-patient is, without a doubt, a key to direct the surgical plan.

Could I sunbathe?

If in your case you have a scar in the base of the nose, you should not receive sun ray for a month minimum. Likewise if small bruises persist in the area around the nose, you should be away from the sun until the bruises have disappeared completely.

It would be possible to wear glasses?

Even if it is not visible, the edema caused by the surgery persist for a long time. This could be noted by wearing glasses, since they leave a deep mark in the point of support of the nose. There is no contraindication, but it is recommended to not wear them often during the first 2 months after the surgery. Glasses could be wear in on and off periods, leaving time for the mark to recover.

EAR SURGERY

At what age could this surgery be performed on children?

Since 6 years old.

How will the scars be?

The scar would be in the posterior side of the ear, this makes it imperceptible even using short hair or a tied stile .

How long to resume normal life?

Few days after the surgery, exercise could be resume after 3 weeks.

Is it painful?

It could be some discomfort to contact or when pressure is applied during the first month.

What are the post-operative cares I do need to follow?

The first 21 days after surgery, a light compression garment (cotton and elastic band) should be wear to protect the ears of blows or abrupt gestures.

EYE LID SURGERY

Which medicaments should be avoid before and after the surgery?

You should avoid anticoagulants (aspirin), vitamin E.

When could I get back to work?

Normally between the fifth or seventh day after the surgery.

When could I used make up?

One week after the surgery, when the stiches have been removed. It is convenient to use sunscreen that can be used as base for the makeup.

What are the post-operative cares I do need to follow?

You have to keep your head elevated (half sitting position). Cold compress should be applied several times a day for the first 48 hours (you could use cold chamomile). Sunglasses have to be used for 24 hours, avoid watching TV or using the computer for 24 hours. Avoid the sun for a month minimum.

What are the risk of the blepharoplasty?

Very rare, but possible such as: Bleeding, infection, eye irritation, reminiscence of eye bag, among others.

Do I have to take any other precaution before the srugery?

The skin must be well hydrated and clean, free from cosmetics and with not lesions. Regarding the eyes there should not be any infection. There is no need to go to the ophthalmologist before the surgery. Suspend alcohol ingest and smoking for a week before the surgery. The surgeon should be inform if you use contact lenses, if you are allergic to any medicament or if you are consuming any medication .

LASER LIPOSUCTION

How is the scar from the lipsculpture?

Normally, the small incisions made are not bigger than 5 millimeters and they disappear almost in its totality after 3 months. Other precaution that must be taken is to make the incisions in strategic places (skin creases), aiming for them to be disguised in its totality.

How long is the Hospitalization period?

Normally is an ambulatory surgery. If it is performed with another surgery of bigger scale, it is recommended for the patient to be hospitalized.

What are the areas that can be treated?

  • Jowl
  • Arms
  • Abdominal Region
  • Waist
  • Back
  • External side of the thighs
  • Internal side of the thighs
  • Buttocks

When should I do the self-donation of blood?

The self- donation is not a transfusion from one person to another. It consist in extraction a small amount of blood from the patient, preferably 3 days before the surgery, so the red cells that are extracted with the bold will be replace in such time for the surgery.

The extracted blood, is safe in the clinic’s blood bank and it is reinjected in your organism immediately during the post- surgery. This technique allows to restore, with your own blood, the volume that could be lost during surgery. This technique will allow the recovery time will be faster, with no unbalance in the blood volume and without the risk of catching a contagious disease.

Could I have children after the surgery?

The results could be preserved after the gestational period, as long as your weight is controlled by a specialist. If you do not develop too many stretch marks or the flaccidity is not major, the shapes obtained with the liposculputure are preserved.

Is there any compression garment (girdles) I should use?

When the type of surgery entails the extraction of great amounts of fat, it is recommended to use a compression garment during 4 to 6 weeks after the surgery.

Is the liposuction dangerous?

The liposuction rarely brings complications. The danger is not greater or lesser than with any other surgery, as long as it is performed with attention to all the technical applicable norms. There must be special attention to not extract great volumes of fat. As an international level stablished by plastic surgeons, it is recommended not to extract more than 5 to 7 percent of the body weight. Today, for surgeries when the extraction is considered a great volume, the self- donation of blood is recommended.

Is the post-surgery period painful?

Generally it is not. The pain could be relieve with analgesics (painkillers).

When would I see the results?

All surgery passes a dis-inflammation period. It depends on the patient and the areas that were treated. During de first 30 days of post-surgery, the patient will possibly not observe the results in its totality. After this period, the dis-inflammation of the area starts and tree months thereafter we could an excellent result. It is recommended to realize post-surgery therapies (lymphatic drainage and/ or exercises), oriented to mold and reduce the inflammation of the tissues.

How manu pounds would I lose with the surgery?

The focus should not be the amount of pounds lost, but the reductions of sizes. Normally the patient could lose between 8 to 13 pounds, but it is really the reduction of sizes in pants, bra, shirts, etc., where the change is noticeable.

How long does the surgery last?

The time of the surgery will depend on the extension of the area to be treated. The average is between 1 to 3hours.

When could I take a shower/bathe?

The day after the surgery you could take a shower. If the procedure has been done with another surgery, then you should consult your surgeon.

What is the type os anesthesia applied?

Most cases are performed under general anesthesia, thus obtaining better results.

ABDOMINOPLASTY

What is the type os anesthesia applied?

Epidural anesthesia, with sedation or epidural and general anesthesia, or only general anesthesia.

What is the analgesic post-surgery therapy?

It is a type of anesthesia that is applied from the operation room and it allows the patient not to experiment pain or discomfort waking up. The anesthesia is applied by the anesthesiologist, could be keep for a few more days according to the case.

What are the post-operative cares I do need to follow?

  • Use the compression garment at least for 4 weeks after the surgery
  • Perform the post- operative therapies suggested by the doctor.
  • Take the necessary rest. Even if you feel well the day after the surgery, you must avoid carrying weight for 15 days after the surgery.
  • Procure to walk slightly bent during a week to avoid putting pressure on the scar.
  • Change constantly the position in bed, since coming out of the OR, move the feet, flex the legs. This maneuvers will increase the blood circulation flow on the legs.
  • Cover the operated area during shower / bath.
  • Take care of the wound after the stiches have been removed, ten days after the surgery.
  • It is possible to make exercise such as walks in the third week. However, You must wait until the fourth of fifth week to carry weight.

Could I smoke before or after the surgery? Which medicaments should I not consume?

You must avoid cigarettes for at least 10 days before and 15 days after the surgery. The nicotine is a potent vasoconstrictor (obstruct the blood vessels) that will ruin your surgery and will make cicatrization more difficult, in some cases it could lead to complications. Be precautions and take care of your surgery. You must not take aspirin or similar medicaments before the surgery. If you are under any treatment you must notify your doctor.

Would I lose the surgery if I decide to get pregnant?

The result could be preserved as long as the patient do not exceed in her gestational weight.

What is abdominal surgery?

A great amount of skin and fat that are in excess or flaccidity are eliminated. During the surgery, the abdominal muscles (defined abdomen in athletes) are sutured, joining them in the medial part so that they gain strength and tone, this is how the waist would be more curved, which will produce the sensation in the abdomen of having performed exercise for a long time. The navel is harness and positioned in the same place it was previously.

How many pounds would I lo se with the surgery?

Naturally, you would lose a few pounds, but the most determinant is that you would gain a harmonic figure with a well-proportioned abdomen equilibrated with your torso and extremities.

How long does the surgery last?

Normally, this surgery would last between 1 to 3 hours. The time would depend on the magnitude of the tissue to be removed.

How would the scars be?

According to the patient’s characteristics/ features, there will be a normal abdominoplasty or a mini abdominoplasty. The patient will be inform of the length of the scar that would be determine by the characteristics of the abdomen.

Will the scar be visible?

Currently, the scar leaved by the surgery is easily disguised, since it is inside the bikini area. This are very discrete scars. Imagine a C-section scar more elongated to the sides. With this technique the C-section scars and scar from previous abdominal surgeries could be eliminated.

BREAST AUGMENTATION

What type of anesthesia is necessary?

The breast augmentation is performed under general anesthesia because it is more comfortable and safe for the patient and the doctor.

Would I require hospitalization?

This surgery is ambulatory. This means the patient arrives to the clinic in the morning hours and during the afternoon might be returning home.

At what age can breast implants be placed?

When the person has finalized the development of the breast. Some women had it complete by the age of 17. The woman needs to be emotionally mature and know all the pros and cons of the surgery.

Which would be the volumen of my implant?

The one that is most comfortable and goes with the harmony of the patient’s body. There should be an agreement on the desired size between the doctor and the patient. There must be taken into account that no always the patient’s expectations would be the adequate ones. Not all patients have the same torso measurements, breast tissue, dimensions and muscular capacity to cover the implant. A resource that helps the surgeon to calm the patient’s concern is to use testers in the consultation.

When the stiches are remove?

The sutures used are intradermic (inside the skin) and are removed between 8 to 15 days after the surgery. In some cases, absorbable sutures can be used.

How long does the surgery last?

In average it last between 1 to 2 hours. There must me consider the time needed to prepare the patient before surgery and the time to recover from anesthesia.

How long do the implants last? When should I change it?

The implants are actually for live, they have a guaranty of ten years in case of rupture or encapsulation. With the past of time the breast can fall in a natural way and many patients decide to change implants to reaffirm the breast again.

Is the post-operative of the surgery painful?

Generally there is discomfort the first 72 hours while the muscle adapts to the implant and stretches its fibers, for this the analgesic (painkillers) are helpful. This post- operative is mildly uncomfortable as long as you follow medical instructions, primarily concerning the movement of arms during the first days.

Which complications could I have with the implants?

Bruises: Depending on the magnitude, they could be self-absorb by the organism or they might need a surgical drainage

Infection: It occurs on a very low percentage. You should follow the doctor’s therapeutic recommendations and comply strictly with the antibiotic intake.

Retraction of the fibrous capsule: rupture of the implant occurs in very small percentages.

Saggy breast with the past of time: It can occur if the implant is very large and there is very flaccid skin.

What to do and not to do during the first week after the surgery?

  • You should sleep in half sited position the first days, the sleep on one side or on your back.
  • Keep the post- operative bra day and night at least for four weeks.
  • You can take a shower the next day of surgery, avoiding to get the breasts wet, to achieve this you must wrap them in plastic kitchen film.
  • You can return to work after the third day, as long as the activities you do, do not require physical exercise of any kind.
  • You must perform post- operative therapy after the fifth day.
  • You can drive automatic after the first week; for gear-transmission, after the second week.
  • Sexual intercourse can be restarted once the wounds have completely healed. It is recommended after 3 weeks.
  • Avoid exposure to the sun the first three months after the surgery.

What is the hardening of the breast or fibrous capsule retraction?

Our organism react in a similar way in front of a strange body. The body creates a capsule or wrapping around the implant as defense, aiming to isolate the strange body and not to be in direct contact with it. All the implants are wrap for this fibrous capsule, which might change in thickness (fine, medium thick and other so hard that they tend to calcify). It is unknown exactly the mechanism of its formation and the time it will take them to retract. This retractions sometimes can generate asymmetries and pain in the breast.

What is a breast implant?

It is used to augment the volume of the breast, placed behind the pectoral muscle. The implants are made of silicone, a derivate of silica and they are filled with gel. Today there are different external forms: smooth implants, texturized or from polyurethane. The most expensive implants are the polyurethane ones and the less expensive the smooth ones. Regarding the high, there are high profile and low profile implants, each one has a specific use for the patient. The size is calculated according to the volume units or Cubic centimeters (cc). The shape could be round or anatomic. The implants are placed behind the muscle as shown in the following image.

 

procmam2

BREAST LIFTING

How would the scars be for this type of surgery?

This is one of the aspect that concern patients the most when deciding to get this type of surgery. There are several techniques, which should be discuss previously with the doctor, since is him/her the one to say which ones he/she would apply.

Depending on the size, volume the breasts shape, the color of the skin and the cicatrization antecedents from previous surgeries, we could have a scar just around the areola (highly disguised), and I shape or T shape scar , when the breast are to large or are to saggy ( in most cases the scars are barely visible).

It is very personal the form in which the sutures of the scars are made. Today there are several approaches to try and diminish as much as possible the scars. With our patients we work with minimum tension to obtain the less visible or imperceptible scars as possible.

How long does the surgery last?

Normally, Between 2 to 4 hours. Depending on the technique to be use, it could last less or longer than that.

How long does it take for the appearance of my scars to improve?

It is variable, on each patient it is substantially different. It depends on a number of factors such as: race, nutritional state, the tension of the scar, patient’s age, the presence of associated illnesses, sun exposure, etc. In general terms:

  • The first 30 days: the scar can show redness, with certain reactions to the sutures and to the adhesive tapes.
  • Between 30 days to a year: The scar passes from pink or red to a brown toe, with the tendency to get clearer.
  • After a year: the scar stops been consistent, it turns very soft and whitish, in some cases might be imperceptible to the simple look.

What type of anesthesia does it require?

This surgery has to be done under general anesthesia.

I have heard that some patients are left with visible sacars...

We must differentiate between hypertrophic scars and keloids The hypertrophic scars are thickenings produced by the mistreatment of the skin, poor suture or infection in the scar that can be resected (eliminated) with a new scar finish. This is performed under local anesthesia and is done in the doctor’s office in very short time.

The keloids, if there is a genetic predisposition, would be in any part of the body where you have a scar. In this cases it is convenient to apply radiotherapy within the 48 hours following the surgery. If you are genetically predispose to the formation of keloids, you should tell your surgeon, so he/ she can take the appropriate precautions.

BREAST REDUCTION

How should I sleep the first days after the surgery?

You should sleep on your back the first days, then on one side with the post-operative bra for a month approximately.

When this surgery should not be performed?

It could be contraindicated for those people who smoke a lot, since the tobacco impairs capillary circulation and consequently the scarring process, in patients under 18 years old. In case of suffering from an illness that may interfere with the surgical process or anesthesia. It is imperative to perform a previous mammary study (mammogram).

When could I return to work?

It depends on the type of work you do. If you have a desk job or similar, you could return 7 days after the surgery. For jobs that demand movement or large efforts, after 15 to 21 days.

How would the scars be for this type of surgery?

This is one of the aspect that concern patients the most when deciding to get this type of surgery. In the case of a breast reduction the scars are in a T inverted shape, in most cases the scars are barely visible.

It is very personal the form in which the sutures of the scars are made. Today there are several approaches to try and diminish as much as possible the scars. With our patients we work with minimum tension to obtain the less visible or imperceptible scars as possible.

Some patients do end up with visible sacars?

We must differentiate between hypertrophic scars and keloids The hypertrophic scars are thickenings produced by the mistreatment of the skin, poor suture or infection in the scar that can be resected (eliminated) with a new scar finish. This is performed under local anesthesia and is done in the doctor’s office in very short time.

The keloids, if there is a genetic predisposition, would be in any part of the body where you have a scar. In this cases it is convenient to apply radiotherapy within the 48 hours following the surgery. If you are genetically predispose to the formation of keloids, you should tell your surgeon, so he/ she can take the appropriate precautions.

How long does it take for the appearanve of my scars to improve?

It is variable, on each patient it is substantially different. It depends on a number of factors such as: race, nutritional state, the tension of the scar, patient’s age, the presence of associated illnesses, sun exposure, etc. In general terms:

  • The first 30 days: the scar can show redness, with certain reactions to the sutures and to the adhesive tapes.
  • Between 30 days to a year: The scar passes from pink or red to a brown toe, with the tendency to get clearer.
  • After a year: the scar stops been consistent, it turns very soft and whitish, in some cases might be imperceptible to the simple look.

Does he mammograms would be as reliable as they were before the surgery?

The reliability of the mammograms is the same. As control we do recommend to have a mammogram 6 months after the surgery. After that period, you should continue with the normal frequency that your doctor suggest.

GLUTEOPLASTY

Could I sit without problems and receive injections in my buttocks?

Preferably avoid injections in the buttocks if you have prosthesis, since the implants could be puncture.

To sit there is no discomfort, because when sitting the prosthesis adopt a privilege location between the muscles, which prevents them from being crushed.

How would my buttocks look like?

With this surgery you will improve your appearance and self-esteem, but it will not necessarily change the appreciations others have about you or provide a perfect figure. Before you decide, think carefully about your expectations.

Which is the correct location for the gluteal prosthesis?

  • Never subcutaneous (under the fat layer) .
  • The best are the ones that are between the muscles.

Which is the advantage between gluteal implants or injected implants?

The injected implants are being used by a number of people worldwide, plastic surgeons, medical aestheticians, hair dressers and any other who is looking for easy money, without any regard for the complications it might generate.

These injected implants are nothing more than plastic liquids with different names to confuse the community and those who don’t know the complications they carry. The names being used are: expansive cells, methacrylates, biopolymers, methacryl and other trade- oriented denominations. These plastics can never be remove from the body and the complications they cause will be for the rest of your life.

Unlike the injected implants, the gluteal prosthesis can be remove if case and without the complications of the injected implants.

What are the complictions of the gluteal prosthesis?

The most feared is infection, since the gluteal area (for obvious reasons) is highly contaminated.

Other include bruising, unaesthetic shape, skin retraction, suture dehiscence, inconformity with the results.

When is the surgery contraindicated?

In case having any active infection. Alterations of the coagulation, alterations of the cicatrization, immunosuppressed, pregnancy and / or unreal expectations.

How long is the recovery time?

The patients can go home walking. The sensation of pain will disappear with muscle relaxants and the indicated analgesics (painkillers). They could sit after the third day, return to work after a week. Exercises such as walks after 3 weeks. Full recovery after 3 months.

Should I wear a compressive garment (girdles)?

You should use a compressive garment (girdles) for period of 6 weeks, as is routine in cases with liposculpture, so the inflammation decreases in a faster way and the prosthesis are kept the right position.

Does this prohesis need to be changed?

These implants have a guaranty for life, they should be change in cases of rupture o capsular contraction. In some cases patients ask for a change to augment the volume after several years.

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Gerardo Toro Parilli
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