Surgical/Procedure Name

• Abdominoplasty

Common Name

• Tummy Tuck

PRICE (THB)

• 165,000

Introduction

A tummy tuck, or abdominoplasty, is one of the most common cosmetic surgery procedures performed today. Factors such as multiple pregnancies, genetics and even substantial weight loss can contribute to the development of loose skin, fat deposits, and stretch marks in the abdominal region.

Surgical Procedure

To smooth out the abdomen, the surgeon makes a low abdominal incision across the pubic area, from hip to hip, and sometimes from the navel down. The excess skin together with the subcutaneous fat is then pulled over the abdomen, cut and removed. The navel remains intact and attached to the abdominal wall so the surgeon must make a new opening that is the new proper position.

If loose skin and muscle weakness are limited to the area below the navel, a slightly different procedure – which usually leaves a smaller scar and no scarring around the navel – may be performed. Abdominoplasty can be combined with liposuction to help reduce the areas of fat accumulation. The skin and fat excision is sometimes called Panniculectomy but many times the surgeon will have to include repairing the separated abdominal wall muscle that could positively help tighten the bulging of viscera which could not be corrected by Panniculectomy only.

Hospital Admission

At least three nights

Duration of Operation

Four to six hours

Anaesthetic

General anaesthesia

Pre-operative Care

Before any surgery, remember to :

1. Inform your surgeon of any medication/s that you are taking (both prescription and nonprescription), any allergies, all medical conditions (such as bronchial asthma, diabetes, hypertension, blood clotting abnormalities, etc…)
2. Stop taking Aspirin, medications containing Ibuprofen, all vitamins and herbs for at least 2 weeks prior to surgery to eliminate the chance of post-operative bleeding.
3. Stop smoking for at least 2 weeks prior to surgery as this will prolong your healing process from vasoconstriction.
4. NO food and any liquid intake for at least 6 hours prior to surgery.
5. Absolutely no alcoholic beverages for at least 24 hours prior to surgery.
6. Make sure you do not wear any jewelries, piercings, make up and nail polish to surgery.
7. You should shower the morning of your surgery, wash your hair and do not apply any perfume, lotion, powder, cream or deodorant.

Day of Admission

Preop laboratory examination (Blood test, Chest Xray, EKG). Consultation with an internal medicine specialist if there is some abnormality detected. Preop photo taking and surgical markings will be made.

Post-Operative Care and Recovery

Immediately post-op, you will be brought to the recovery room. You will have one or two drains placed at the time of surgery to help remove fluids and blood that collects under the skin. Whilst in bed you will be advised to sleep on your back, head elevated and knees bent with a pillow underneath them. This will help reduce the strain on the abdominal area. The abdomen may be dressed with bandages and you will experience some compression across the abdomen. You may not be able to stand straight for some time due to the compression, but it is important that you start walking for short periods as soon as possible after surgery to reduce swelling and eliminate the chance of developing clot in your leg veins.

DAY 1-2-

Pain and nausea will be most intense that needs intravenous medication.

Surgical wound will be cleaned daily.

Discomfort may be intense in the first few days.

You will start to feel pain, soreness, numbness of the skin in the abdominal area, discomfort in the incision and this could last for several weeks

Bruising and swelling will be noted. This will subside in 6-8 weeks. The extent of the post operative swelling and bruising depends on whether you tend to bruise or swell easily. Every person is different.

DAY 3-4-

Removal of all the drain catheter and cleaning of the surgical wound.

You may shower and bathe as normal hours after removal of the drains. But do not submerge in swimming pools and bath tubs.

Discharge from the hospital with take home oral medications and the necessary materials for self wound dressing. Please be reminded that it is important to complete the full course of antibiotic therapy.

DAY 5-7- (At Home)

You have to try to keep the wound clean and dry, so the environment should be dry and cool.

You must clean your wound at least twice a day.

You may shower and bathe as normal but do not submerge in swimming pools and bath tubs.

You should avoid strenuous activities that could disrupt the internal muscular suture and the external skin suture. Avoid lifting up things greater than 2 kilograms in the first week. The wound strength will return to the normal level around 3 months. Your surgeon will discuss with you when you can return to your normal daily activities.

DAY 7-10-

Check up with your doctor and stitches will be removed

Day before departure from Phuket-

Outpatient appointment and photo recording.

A light surgical support garment must be worn for approximately 3 months to support the tightened area following surgery.The recovery period is usually about 2 weeks. While there may still be some swelling and bruising, most people are happy with the result and return to work after approximately 4 weeks. You should consult your surgeon as to when you may return to work.

When to call

It is important that you know the signs of infection This includes fever ( temperature over 37.8&degree;C), pain not relieved by meds, increased redness along the incision, yellowish or greenish fluid collection on the wound edge or notice a foul odor, excessive swelling, excessive tenderness. When signs and symptoms of infection is noted or there is bleeding from the incisions that is difficult to control with light pressure, call the nurse or your doctor without hesitation.

Risks and complications

Risks are inherent to any surgical procedure. The most common risks are swelling, bruising, bleeding, infection, fluid, scarring, numbness, or a loss of sensation to the affected area – this should improve after nerve damage has repaired itself, which may take up to 12 months. The most common risk particular to this surgery is long and heavy scarring.

The incision may heal slowly causing crusting and scabbing along the scar. All precautions are taken to avoid these risks. Once the healing process is complete, it is essential to maintain a balanced diet. An unhealthy diet will invariably lead to weight gain which will stretch the skin and increase the possibility of heavy, permanent scarring. In most cases abdominoplasty produces excellent results, and with a balanced diet and regular exercise, the results are long lasting.

Surgical/Procedure Name

• Areola Reduction

PRICE (THB)

• 20,000 – 40,000

Introduction

The areola is the dark pigmented skin that surrounds the nipple. Large areolas may look out of proportion with the rest of the breast – this is especially noticeable if the patient has had a breast reduction or breast lift, but it can also occur naturally (often after childbirth). There are no medical complications associated with having large areolas, but self-esteem and body image can be greatly affected.

Areola reduction can help women looking for a smaller diameter and rounder areolae or those who would like to reduce puffy or bulging areolae.

Surgical Procedure

The doctor will begin by examining your areolae to decide on the best technique to perform the surgery. A round ring-like strip of excess areola will be removed on the peripheral part of the operated areola. The edge of the new smaller areola will be sutured to the outer normal skin that will create many small pleat around the created areola. If the pleat is too much, the surgeon may decide to include the vertical removal of the skin strip under the areola to avoid too many pleat formation that will resolve itself in a few months.

Hospital Admission

Out Patient procedure. No admission necessary.

Duration of Operation

One to two hours

Anaesthetic

Local anaesthesia

Pre-operative Care

Inform your surgeon of any allergies, all medical conditions, and any medication that you are taking (both prescription and non-prescription).

Avoid aspirin and blood thinning medication such as brufen for two weeks prior to surgery to eliminate the chance of post op. bleeding. You should not smoke for 2 weeks prior to surgery as this may affect your reaction to the anaesthetic and prolong the healing process. Patients who suffer from hypertension must inform the surgeon prior to surgery.

Post operative care

Dressings and a light gauze bandage must be worn for several days. You will be able to shower the following day but as long as the sutures are not yet removed from the surgical site, you should avoid dirty water and sweat to get inside the wound by applying antibacterial ointment before showering.

Extra-sensivity to pain and touch may be felt and will subside in a couple of weeks.

Recovery time will depend on the patient, but most patients can return to work and resume their normal activities within a day or two.

Results

Following surgery your areolae will be balanced and proportionate in size and shape to the nipples. In the first week they will already have a natural and presentable appearance, and over the next few months they will continue to improve. The results will last for the rest of your life.

Risks and Complications

Risks are inherent to any surgical procedure. The most common risks are swelling, bruising, bleeding, infection, fluid, numbness, or a loss of sensation to the nipple and areola, however they are rare and almost always temporary.

The most common risks particular to this surgery are minimal pain and scarring. Your surgeon will administer painkillers and any soreness will usually disappear by the second or third day. Scarring will be made as inconspicuous as possible by cutting the smallest incision possible. For some this may be faint, for others it can be quite obvious. Please discuss scar treatments with your surgeon in advance so you know how to take care of them while the scar tissue is forming. Dissolving sutures will be used to minimise scarring so that you won’t need to come back to have sutures removed.

This treatment does not normally affect the ability to breastfeed.

Surgical/Procedure name

• Botulinum toxin injections

Common name

• Botox injections

Introduction

Botulinum toxin, often referred to by its trade name, Botox®, is a non-surgical injection that can diminish or even completely eliminate non-desirable lines and creases on the face and neck. The cosmetic form of Botox® temporarily blocks nerve impulses and paralyzes the muscles that cause wrinkles. The skin is left looking smoother and more refreshed. The usual areas for treatment include frown lines, forehead creases, crows-feet near the eyes and thick bands in the neck. Research has also shown that Botox can relieve migraine headaches, excessive sweating and muscle spasms in the neck and eyes.

Procedure

Your doctor will assess where to administer the injections by examining your ability to move certain muscles in your brow area.

Hospital Admission

Out patient procedure. No admission necessary.

Duration of Procedure

Thirty minutes to one hour

Anaesthetic

Anaesthetic cream

Pre Care

During your consultation please inform your doctor of any allergies, all medical conditions, and any medication that you are taking (both prescription and non-prescription).

After Care

There is no recovery period with Botox® treatment. You may leave the hospital immediately after treatment.

Risks and Complications

The most common side effects associated with Botox® treatment include eyelid droop and nausea, however they are temporary and should disappear with 24 hours. Localized pain, infection, inflammation, tenderness, swelling, redness, and bleeding or bruising have also been associated with the injection, but occurrences are not common and usually temporary. Patients with certain neuromuscular disorders such as ALS, myasthenia gravis, or Lambert-Eaton syndrome may be at increased risk of serious side effects.

Results

Results may vary, but you should see an improvement within days.

Surgical/Procedure Name

• Brachioplasty

Common Name

• Arm lift

PRICE (THB)

• 120,000

Introduction

There are generally three types of candidates for whom brachioplasty could be a beneficial procedure; the first group are young women with arms that are out of proportion, and don’t fit short-sleeved shirts and blouses. They usually have firm skin, and just want to bring their arms into proportion with the rest of their body. This can be easily corrected with liposculpture.

The second group consists of middle-aged men and women looking to turn back the signs of aging a little. They typically have a moderate amount of loose skin and tissue thickening. The incision can usually be hidden in the crease of the armpit depending on the extent of the loose skin. Sometimes the incision may need to be made a short way down the arm.

The third group of people that can significantly benefit from brachioplasty are men and women, of any age, who have lost a considerable amount of weight. Weight gain will stretch the skin, and weight loss will leave skin loose and redundant. With this procedure, the incision is made right down the arm, from the arm pit to the elbow. There will be a faintly visible scar, but this will fade in time.

Surgical Procedure

Your surgeon will first mark the area of excess skin. Then after the anaesthetic is administered, incisions are made on the inner and under arm, usually in a zig-zag pattern. Skin is usually cut off in an elliptical or triangular shape. Fatty tissue is often suctioned at the same time.

After the loose skin and fat have been removed, the remaining skin is stretched and sutured into place. Occasionally a drain is used to lead excess fluids from the site of incision, allowing the skin better to adhere to the tissue beneath. The incisions
are then bandaged.

Hospital Admission

One night

Duration of Operation

Four to five hours

Anaesthetic

General anaesthesia

Pre-operative Care

Your surgeon will direct you on preparation for surgery. You will be given instructions on eating and drinking, smoking, and taking or avoiding vitamins, iron tablets and certain medications.

If you develop a cold or an infection of any kind, especially a skin infection, your surgery may have to be postponed. Patients that suffer from hypertension must inform the surgeon prior to surgery. To eliminate the chance of post op. bleeding you should avoid aspirin and any medication containing aspirin or brufen for two weeks prior to surgery.

Communication with your surgeon is very important. You must clearly discuss your desired look with the surgeon so that he or she can determine with you what can realistically be achieved.

Post Operative Care

After surgery your arm(s) will be covered with a compression garment designed to hold them in shape whilst the newly sculptured skin heals to the tissue beneath. You will have sutures, possibly with a drain inserted to help the skin and tissue heal. Some of the sutures will absorb, and some may have to be removed by your during a follow-up visit.

Following the procedure you may feel some discomfort as there may be some swelling, bruising and stiffness. For young women with out of proportioned arms, recovery should not take more than a day or two.

For middle-aged patients wishing to hold back aging, the recovery time is about three or four days. Candidates who have lost a lot of weight and therefore require surgery may need a week or so before returning to work.

Risks and Complications

Risks are inherent to any surgical procedure. The most common risks are swelling, bruising, bleeding, infection, fluid, numbness, or scarring.

The most common risk particular to this surgery is pulmonary embolism due to the freeing of fat or blood clots into the bloodstream, however this is very rare.

An arm lift is not recommended for patients who have had a mastectomy. The drainage of fluid from the arm may already be damaged, and further surgery may lead to persistent swelling.

Patients who have repeated infections in the armpit, or suffer from excessive sweating, may also not be good candidates for this surgery. For some people, liposuction may be a better way to reduce the thickness of the whole arm.

Results

You will see a noticeable difference in the balance and contour of your arm(s) quite soon after surgery. However, improvement will become evident gradually as the swelling has subsided. You will also feel more confident and comfortable in different types of clothing.

Surgical/Procedure Name

• Augmentation Mammaplasty

Common Name

• Breast Augmentation
• Boob Job
• Breast Implants Surgery

Conditions to be treated

• Small Breast (Hypoplasia)
• Mild Involutional Changes (Glandular Ptosis) due to aging, multiple pregnancy, significant weight loss.

Price (THB)

• 130,000

Introduction

Over time, age, genetics, pregnancy, weight changes, sun exposure, and gravity can cause the size and shape of breasts to change. Breast augmentation can help women who are dissatisfied with the size of their breasts, or who have experienced changes in the appearance of their breasts.

It is one of the most common plastic surgery procedures performed today, however you should carefully consider whether breast augmentation is suitable for you before deciding to go ahead. You may ask your surgeon any questions that you may have and he or she will give you guidance and advice to make sure that your choice is fully informed.

Information provided is intended to inform clients of expected procedures and outcomes. However, not all patients, procedures or surgeons are the same, and information may not be applicable to all procedures. PIAC reserves the right to vary the way that a procedure is performed or which technique is used.

Surgical Procedure

During breast augmentation, a breast implant is placed either under the breast tissue and over the chest muscle, or under both
the chest muscle and the breast tissue. Your surgeon will advise you on the most suitable procedure for you. This helps to increase or balance the size of the breasts, restore breast volume, or restore the shape of breasts after partial or total loss. Please note that breast augmentation cannot correct significantly sagging or drooping breasts. In these instances, a breast lift is often necessary, which may be performed in conjunction with this procedure.

All breast implants are made with a silicone based non-reactive casing but they are filled with either silicone gel or saline. The outer silicone case may be smooth, shiny, polished, or a slightly rough texture. The type, style, and size of breast implants you choose are determined by your lifestyle, body contours, the amount of breast tissue you have, and the cup size and appearance that you would like to achieve. You should talk to your doctor about choosing the breast implant option that is right for you.

We offer the most commonly used methods of incision and insertion; at the nipple, under the breast or under the armpit and it may be more than a simple case of aesthetics as to which option is chosen. Your surgeon will advise you about best procedure to suit you.

Hospital Admission

One night at least

Duration of Operation

Two to three hours

Anaesthetic

General anaesthesia

Pre-operative Care

During the consultation, you will have to make a choice and in agreement with your surgeon about

1. your desired cup size
2. placement of the implant
   1. under the breast tissue and over the chest muscle
   2. under both the chest muscle and the breast tissue
3. placement of incision
   1. armpit incision
   2. areola incision
   3. crease incision or under the breast (inframammary fold)
4. type of implant content = silicone – filled or saline – filled
5. shape of implant = round or teardrop (anatomical), moderate or high projection
6. your expectations after the surgery

When assessing the size and placement of the implant our aim is to augment your breasts in proportion with your body and to maintain a natural look. The size and placement of the implant chosen depends on many factors, such as your lifestyle, your desired cup size, your breast asymmetry, desired upper breast pole fullness, existing degree of breast ptosis.

If you have a small amount of breast tissue and want to augment as much as possible, it is recommended that a large implant is placed below the muscle, in order to prevent the feeling or appearance of the implant. There is also less chance of capsular contracture (hardening).

If you have large chest muscles and thick enough subcutaneous fat or breast tissue, the implant should be placed above the muscles in order to allow for comfortable movement and a natural look.

For patients with mild to moderate breast sagging, a larger implant would be placed over the muscle but your surgeon will evaluate and give you final opinion case by case. This enables a full and natural augmentation. In many occasions, breast lift or Nipple Areolar Complex Repositioning is recommended additionally for a better outcome.

Remember to :

1. Inform your surgeon of any medication/s that you are taking (both prescription and non – prescription), any allergies, all medical conditions (such as bronchial asthma, diabetes, hypertension, blood dyscrasias, coagulopathy, etc…)
2. Stop taking Aspirin, blood thinning medications like Ibuprofen, all vitamins and herbs for at least 2 weeks prior to surgery to eliminate the chance of post-operative bleeding.
3. Stop smoking for at least 2 weeks prior to surgery as this may affect your reaction to the anaesthetics and will prolong your healing process from vasoconstriction.
4. NO food and any liquid intake for at least 6 hours prior to surgery.
5. Absolutely no alcoholic beverages for at least 24 hours prior to surgery.
6. Make sure you do not wear any jewelries, piercings, make up and nail polish to surgery.

Post-Operative Care and Recovery

In some cases, prolonged hospitalization may be secondary to pain sensitivity and vomiting from anaesthetic drugs.

1. Drains, dressings, bandages are removed on the first or second day following the surgery. Afterwards you are free to bathe and
   shower as usual.
2. It is highly encouraged to start walking as soon as possible after surgery. This will help your circulation thus reduces
   swelling and eliminates chances of developing clots in your leg veins.
3. Bruising, swelling, soreness and discomfort are not uncommon on the first few days up to a week after surgery. This will resolve within 2 weeks.
4. Mild numbness, burning sensation and extra sensitivity to your nipples may be noted for a few days or weeks.
5. Upon discharge from the hospital you will be given oral antibiotics, make sure you complete the full course of antibiotic therapy. Wound dressing materials, pain and anti-swelling medications will also be provided. Change the wound dressing at least twice a day. But some surgeons do not need the patient to change the dressing until the follow up day.
6. Do not submerge in swimming pools, bath tubs for at least a week or while incisions are not completely closed. Small openings in the wound serve as portal of entry for bacteria which may cause infection.
7. A moist environment is inviting to some bacteria, so it is important that you keep the wound or the incision dry and stay in a cool room especially if you have the armpit incision.
8. Know the signs of infection. This includes fever (temperature over 37.8°C), pain not relieved by meds, redness, pus formation, excessive swelling, excessive tenderness. When signs and symptoms of infection is noted, call your doctor immediately.
9. Sutures will be removed at least 1 week post surgery.
10. Vigorous activities should be avoided for at least 4 to 6 weeks.
11. Wearing of sports bra day and night for the first 3 to 4 weeks is advised.
12. Underwire brassiere may be worn 6 weeks after surgery to prevent from rubbing against the incision.
13. Breast massage is advised differently depending on the surgeon or the type of implants. Usually it may be started on the third day following surgery. This is performed at least twice daily, 10 to 15 minutes for each breast for 3 months. If swelling is noted on the first few days of massage, you should stop the exercise and resume after a few days.
14. If you have the armpit incision Avoid sudden pushing of the breast upward for 3 weeks
15. You may be able to resume exercise and normal physical activities within a month or two, after any residual soreness has
    subsided.

How to perform the breast massage:

Imagine that you divide your breast into four quadrants

1. upper outer quadrant
2. upper inner quadrant
3. lower outer quadrant
4. lower inner quadrant

Remember to move your implant in all the four quadrants using a slow steady movement.

1. Position your palms on the outer quadrants of your breasts and press slowly inward. You can feel and see the implants bulge toward the inner quadrants of the breast. Press and hold for 20 to 30 seconds. Repeat four times.
2. Press the breasts slowly outward such that a bulge on the outward quadrants of the breast will be noted. Press and hold for 20 to 30 seconds, repeat four times.
3. Position your palms on the lower quadrants of the breast and push slowly upward. Bulging of the implant on the upper quadrants of the breast should be noted. Press and hold for 20 to 30 seconds. Repeat four times.
4. Do the same for the downward movement.

Results

Breast augmentation increases breast size which can enhance your self esteem and confidence. The procedure will leave you with a better figure and help to balance your body proportions. For many women, including those who may have undergone a mastectomy, child birth or weight loss, you will notice a magnificent improvement and initial scarring will gradually fade.

In 2006, both Silicone and Saline implants were both approved by U.S. health officials. Implants manufactured by Inamed and Mentor – the two leading marketers of implants – were considered safe and effective for continued use.

Risks and Complications

Since 2006, statistics show that a low number of silicone or saline implant recipients have experienced complications.

Capsular contracture occurs if the capsule or shell around the implant begins to tighten and thicken. This will cause the breast to feel hard and appear unnatural. This can be prevented by regular self massage. Should this occur, removal of the capsule is required or perhaps implant may need to be replaced.

If the breast does become infected from collection of blood or deflated, the implant must be removed immediately. You will need to wait for several months before repeating the operation. With the advent of silicone gel filled implant, chances of deflation has been eliminated.

Despite bleeding generally being minimal during the operation, there is a possibility that continual bleeding after surgery may result in a blood clot formation which needs to be removed. This is uncommon and it is suggested you remain in Thailand for approximately 2 weeks for your surgeon to monitor your improvement after surgery. Infection is uncommon, but possible. Your surgeon should provide you with antibiotics prior to surgery to eliminate this possibility.

Implants do not cause breast cancer but may obscure its detection. For women with silicone implants an annual mammogram is advised to ensure that implants are not leaking, as silicone leaks out slowly unlike saline – which is easier to rupture and will deflate fairly quickly. The new generation of cohesive gel will not leak out easily but can have some reactions. If there is a leakage or break in the implant, it should be replaced. Inform the radiology technician that you have implants if you need an X-ray

Autoimmune Risks

According to scientific research, women with breast implants are not at any increased risk of autoimmune or connective tissue diseases. Although some patients have claimed of complications to their health due to ruptured silicone implants in the past, studies have not conclusively indicated that implants bring about increased risks of any rare diseases.

Surgical/Procedure Name

• Mastopexy

Common Name

• Breast Lift

PRICE (THB)

• 130,000

Introduction

In recent years breast lift has become a very common procedure. Factors such as genetics, the aging process, pregnancy and breast feeding, weight gain or loss, and even hormonal fluctuations can cause breasts, that were once firm and shapely, to sag and droop. A breast lift, or mastopexy, can help restore a firmer, shapelier breast and improve body contours.

Surgical Procedure

During surgery, the surgeon removes excess skin and tightens the remaining skin. The surgeon starts by assessing the required lift and fullness needed to achieve the desired result. This is done by marking a new nipple position. Using a scalpel, the surgeon then makes an incision along the pre-marked lines and separates the skin from the tissues below. The excess breast fat is then removed, the nipple relocated to its new position and finally the new breast shape is reconstructed. The incision is usually made around the nipple and under the surface of the breast, like an upside down T, however a different technique may be used depending on the degree to which your breasts sag.

If you decide to have implants with your breast lift, they will be placed directly under the breast tissue or chest muscle.

Hospital Admission

One night

Duration of Operation

Four to six hours

Anaesthetic

General anaesthesia

Pre-operative Care

Before surgery please inform your surgeon of any allergies, all medical conditions, and any medication that you are taking (both prescription and nonprescription). To eliminate the chance of post op. bleeding you should avoid aspirin and any medication containing aspirin or brufen for two weeks prior to surgery. You should also not smoke for 2 weeks prior to surgery as smoking can affect your reaction to the anaesthetic and slow down the healing process. Patients that suffer from hypertension must inform the surgeon prior to surgery.

In your consultation you should discuss your expectations of the outcome of the surgery and listen to the surgeon’s opinion. You will probably be required to send photos of your breasts to the surgeon prior to the consultation. This will enable the assessment and also serve as a reference following surgery.

Post – Operative Care

When you wake after surgery you will be wrapped in elastic bandages, gauze dressings and a surgical bra. A small tube may be placed in each breast to drain blood and fluids for the first day or two. The extent of the post operative swelling and bruising depends on whether you tend to bruise or swell easily. Every person is different. Application of cold compresses or ice packs will reduce swelling and relieve discomfort.

A couple of days after surgery the pressure bandages will be removed. The surgical bra must be worn at all times for several weeks, until the swelling and bruising subsides, or until your surgeon advises you otherwise. You should only remove the surgical bra to bathe and to wash the garment. Usually, sutures will be removed in the first week. Sometimes the surgeon will use dissolvable sutures. If the breast skin is very dry following surgery, a moisturizer can be applied several times a day. Vitamin E cream is extremely effective and also helps the scarring to heal, however the suture area must be kept dry at all times, particularly after bathing.

For the first few months it is important not to place tension on the wound by performing strenuous activities like lifting or stretching your arms above your head, as this may increase scarring by stretching the tissue. You will need assistance to carry your groceries or hang your washing!

Your surgeon will try to ensure that your incisions as subtle as possible, however it is important to remember that the scars are extensive and permanent. They may be red for months, and then slowly become fainter, eventually fading to thin white lines. In most cases the scars are positioned so that they would not be seen if you wear low-cut tops and dresses.

Recovery usually takes about two weeks. Most people are back to work within three weeks.

Risks and Complications

Risks are inherent to any surgical procedure. The most common risks are swelling, bruising, bleeding, infection, fluid, scarring, numbness, or a change in sensation to the nipple. The most common risk particular to this surgery is damage to the nerve and blood supply of the nipple. In some cases this could lead to a loss of feeling in the nipples, however a breast lift does not prevent future breast-feeding as a breast reduction can.

Scars will fade gradually but nipple numbness may take up to 12 months before sensation returns.

Surgical/Procedure Name

• Reduction Mammaplasty

Common Name

• Breast Reduction

PRICE (THB)

• 180,000

Introduction

In recent years breast reduction has become a very common procedure. Very large and heavy breasts can lead to a variety of medical problems, such as back and neck pain, skin irritation, skeletal deformities and breathing problems. As well as medical problems, unusually large breasts can also make women feel extremely self-conscious. The aim of the procedure is to produce smaller, shapelier breasts, which are in proportion with the rest of the body. The size of the areola, the darker skin surrounding the nipple, can also be reduced.

Surgical Procedure

During surgery, breast fat, glandular tissue, and skin are removed, to make the breasts smaller, lighter, and firmer. An incision is usually made around the nipple and under the surface of the breast, like an upside down T. The nipple and areola are almost always left attached to their blood vessels and nerves. The skin from above the nipples is then pulled down to shape the new breast and a hole is cut for the new nipple and areola. If the breasts are particularly large the nipple may need to be completely removed and grafted to a higher position – this results in a loss of sensation to the nipple and areola.

Hospital Admission

Two nights

Duration of Operation

Four to six hours

Anaesthetic

General anaesthesia

Pre Operative Care

Before surgery please inform your surgeon of any allergies, all medical conditions, and any medication that you are taking (both prescription and nonprescription). To eliminate the chance of post op. bleeding you should avoid aspirin and any medication containing aspirin for two weeks prior to surgery. You should also not smoke for 2weeks prior to surgery as smoking can affect your reaction to the anaesthetic and slow down the healing process. Patients that suffer from hypertension must inform the surgeon prior to surgery.

In your consultation you should discuss your expectations of the outcome of the surgery and listen to the surgeon’s opinion. You will probably be required to send photos of your breasts to the surgeon prior to the consultation. This will enable the assessment and also serve as a reference following surgery.

Post Operative Care

When you wake after surgery you will be wrapped in elastic bandages, gauze dressings and a surgical bra. A small tube may be placed in each breast to drain blood and fluids for the first day or two.

The extent of the post operative swelling and bruising depends on whether you tend to bruise or swell easily. Every person is different. Application of cold compresses or ice packs will reduce swelling and relieve discomfort.

A couple of days after surgery the pressure bandages will be removed. The surgical bra must be worn at all times for several weeks, until the swelling and bruising subsides, or until your surgeon advises you otherwise. You should only remove the surgical bra to bathe and to wash the garment.

Usually, sutures will be removed in the first week. Sometimes the surgeon will use dissolvable sutures. If the breast skin is very dry following surgery, a moisturizer can be applied several times a day. Vitamin E cream is extremely effective and also helps the scarring to heal, however the suture area must be kept dry at all times, particularly after bathing.

For the first few months it is important not to place tension on the incisions by performing strenuous activities like lifting or stretching your arms above your head, as this may increase scarring by stretching the tissue. You will need assistance to carry your groceries or hang your washing!

Your surgeon will try to ensure that your incisions are as subtle as possible, however it is important to remember that the scars are extensive and permanent. They may be red for months, and then slowly become fainter, eventually fading to thin white lines. In most cases the scars are positioned so that they would not be seen when wearing low-cut tops and dresses.

Recovery usually takes about two weeks. Most people are back to work within three weeks.

Risks and Complications

Risks are inherent to any surgical procedure. The most common risks are swelling, bruising, bleeding, infection, fluid, scarring, numbness, or a change in sensation to the nipple. The most common risk particular to this surgery is damage to the nerve and blood supply of the nipple. The possibility of breast feeding may decrease after surgery. Breast reduction is recommended for people that have had children already and do not wish to have any more. Breast reduction does NOT increase the risk of breast cancer and indeedmay slightly decrease the risk.Mammograms will still be possible after surgery.

Scars will fade gradually but nipple numbness may take up to 12 months

Surgical/Procedure name

• Lateral Brow Lift
• Coronal Brow Lift
• Coronal Brow Lift under G.A.

Common name

• Brow Lift
• Forehead Lift

PRICE (THB)

Brow Lift (Under L.A.)

• 40,000

Brow Lift (G.A.)

• 90,000

Coronal Brow Lift (Forehead Lift), (GA)

• 110,000

Introduction

A brow lift can leave you looking younger and help to get rid of the horizontal lines and furrows that sometimes give people an angry, sad or tired appearance.

This procedure can be combined with a facelift or eyelid surgery, however a brow liftmay actually correct the problems that made you consider these other procedures in the first place.

Surgical Procedure

This procedure involves raising the eyebrows and underlying muscle, to smooth the forehead,minimise frown lines and correct abnormally low eyebrows to their original position. The incision usually starts at ear level, runs across the top of the forehead (hidden behind the hairline) and then back down the other side. Once the incision has been made and the underlying tissue has been removed, the brow will be lifted and the excess skin at the incision removed. The wound is then sutured or stapled closed.

This procedure may also slightly stretch the upper eyelids, resulting in a younger appearance.

Hospital Admission

One night

Duration of Operation

One hour

Anaesthetic

Local anaesthesia unless candidate prefers not be awake during surgery, in which case general anaesthesia can be used.

Pre Operative Care

Before surgery please inform your surgeon of any allergies, all medical conditions, and any medication that you are taking (both prescription and nonprescription). To eliminate the chance of post op. bleeding you should avoid aspirin and any medication containing aspirin or brufen for two weeks prior to surgery. You should also not smoke for 2 weeks prior to surgery as smoking can affect your reaction to the anesthetic and slow down the healing process. Patients that suffer from hypertension must informthe surgeon prior to surgery.

If you have short hair, you may wish to let it grow so that you will be able to easily conceal the scar while it is healing.

Post Operative Care

Your surgeon will remove any dressings within 24 hours of your procedure.

The stitches or staples will usually be removed after 1 week.

You may experience some discomfort, which can be controlled with pain medication. Each individual is different. You may have no discomfort other than a feeling of tightness. Infections are extremely rare; however antibiotics are administered to avoid any potential risks. Theremay be some swelling and bruising around the eyes, but this will generally fade within 2 weeks of the surgery.

For the first month patients should avoid any strenuous activities such as jogging, bending, heavy housework, sex, or any activity that may increase your blood pressure. Exposure to the heat or sun should be limited for several months following surgery, including spas and saunas.

Results

Almost all patients are happy with the results and achieve a younger appearance. The procedure can minimise the effects aging for years.

Risks and Complications

The most common risks are swelling, bruising, infection, scarring, bleeding and numbness, or change in sensation, due to nerve damage. Although youmay experience a change in sensation or numbness this is usually temporary and gradually rectifies itself within 12 months of the procedure.

If you have fine or thin hair, the scar may be more visible than with candidates who have thick hair. Hair does not grow through scar tissue, although if necessary there is a very reliable procedure to correct this later by hair transplant. These risks are reduced, but not eliminated, with a new procedure where the brow is lifted endoscopically.

Very occasionally, nerve damage may lead to a loss of ability to raise the eyebrows or wrinkle the forehead. Additional surgery can correct the problem. Loss of sensation along or around the incision is also common, but this is usually temporary. Rarely does this affect patients permanently.

Brow Lift Vs Brow Suspension

Brow suspension requires fewer and smaller incisions as the procedure is performed endoscopically. This means that it is less invasive than the traditional brow lift procedure or laser treatment, however brow suspension may only last up to 6 years, and then the proceduremay need to be repeated. Usually two small incisions are made in the brow and another two in the hair line, directly above the eyebrow incision. A catheter is then used to tunnel underneath the skin, between the brow and hair line incisions, pulling the muscle tight. Then sutures are used to hold the eyebrows in an elevated position.

This is a relatively new procedure and it is vital that you obtain a highly qualified and skilled surgeon who has been trained and recognized in this procedure. Younger patients may not need a brow lift as a combination of Botox, New fill and Laser Treatment combined, should provide optimum results.

PRICE (THB)

• 16,000

Introduction

Cheek dimples are commonly considered an attractive feature. The procedure for creating cheek dimples is actually quite simple and is usually performed as an outpatient procedure. During surgery the skin and the cheek muscle are connected so that when the muscle contracts, it pulls the skin inwards to form a dimple, in exactly the same way as a natural dimple.

Surgical Procedure

To create cheek dimples a thin circle of skin is removed from the inside of the cheek. This is done by cutting out a portion of the mucosa (inner cheek skin), the sub-mucosal fat and the cheek muscle using a punch biopsy instrument.

This area of missing tissue is then stitched together using an absorbable suture. The stitch goes through the cheek muscle on one side of the circle of missing tissue, then through the dermis layer of the skin and finally back through the cheek muscle on the other side of the circle. A surgical knot is tied, and a dimple is created, even when not smiling.

Within a week or two, as the suture absorbs, the cheek will flatten out and the dimple will disappear (when not smiling). However, inside the cheek, as scarring occurs, the muscle will connect to the skin and create a dimple when you smile.

This procedure can be performed on any kind of cheek however the best results are seen when the cheeks are not overly chubby. Larger dimples can be created using a bigger punch biopsy to remove a larger circle of tissue.

Hospital Admission

Out Patient procedure. No admission necessary.

Duration of operation

One to three hours

Anaesthetic

Local anaesthesia

Pre Operative Care

Before surgery please inform your surgeon of any allergies, all medical conditions, and any medication that you are taking (both prescription and nonprescription).

You should also not smoke for 2 weeks prior to surgery as smoking can affect your reaction to the anaesthetic and slow down the healing process. Patients that suffer from hypertension must inform the surgeon prior to surgery. To eliminate the chance of post op. bleeding you should avoid aspirin and any medication containing aspirin or brufen for two weeks prior to surgery.

Post Operative Care

You may return to normal activities straight after the procedure.

In the first few months you should regularly rinse your mouth with Betadine oral antiseptic solution or Bactidol (chlorhexidine) solution, and the surgeon may prescribe antibiotics.

Risks and complications

There is very little risk associated with this procedure however you experience some minimal swelling.

Surgical/Procedure name

• Chin augmentation
• Mentum augmentation
• Menton augmentation

Common name

• Chin Implants

PRICE (THB)

• 50,000

Introduction

Chin implants are synthetics or biologicals which are used to improve and enhance facial contours, usually in order to provide more balance to the face. The augmentation of the bone structure at the chin can give more definition to the face, or make an already existing chin structure more prominent.

Surgical Procedure

Your surgeon will choose the correct size and shape of implant to improve your look. He or she will then make a small incision along the inside of the lower lip or just under the chin to create a pocket-like area. The implant will then be placed inside the pocket.

Hospital Admission

Out Patient procedure. No admission necessary.

Duration of operation

One to two hours

Anaesthetic

Local anaesthesia

Pre Operative Care

Before surgery please inform your surgeon of any allergies, all medical conditions, and any medication that you are taking (both prescription and nonprescription). You must have no bone disorders, are not or have not been on Accutane for the last 6 months or sometimes more. To eliminate the chance of post op. bleeding you should avoid aspirin and any medication containing aspirin or brufen for two weeks prior to surgery. You should also not smoke for 2 weeks prior to surgery as smoking can affect your reaction to the anaesthetic and slow down the healing process. Patients that suffer from hypertension must inform the surgeon prior to surgery.

Communication with your surgeon is very important. You must clearly discuss your desired look with the surgeon so that he or she can determine with you what can realistically be achieved.

You should wash the face and neck area with an antibacterial cleanser for a few days before surgery.

Post Operative Care

Usually, the chin is taped after surgery to minimize swelling and discomfort. Sutures in the skin will be removed in five to seven days. If an intra-oral incision is used, the sutures will dissolve.

Risks and complications

Risks are inherent to any surgical procedure. The most common risks are swelling, bruising, bleeding, infection, fluid, numbness, or a change in sensation to the chin. The most common risk particular to this surgery is numbness from the anesthetic and swelling. Please note that as you heal, various areas will regain sensation before others. Numbness of the lips should subside in 2-3 weeks. There is also the risk of asymmetry or “shifting” due to swelling, trauma or haematoma. If this happens a second surgerymay be needed, however this is not very common.