Plastic Surgeons
Dr. Muhammad Afzaal Bajwa
MBBS (KE), FACS (USA), FCPS (Plastic Surgery),
MS (Plastic Surgery), MS (Burn & Health Nutrition),
MPhil (Public Health) PhD Scholar (Germany)
American Foreign Scholar Award (SESPRS)
Fellowship in Body Contouring (Germany)
Plastic Surgeons
Dr. Waseem Humayoun
MBBS (KMU), M.P.H, M.S (UHS)
Plastic Surgeon & Cosmetic Surgeon Fellowship in Paediatric Plastic and Burn Surgery
Procedure & Services Available
Facial Plastic Surgery
Eye bag removal
Facelift
Nose reshaping
Midface Lift
Fat Transfer
Ear Reshaping (Otoplasty)
Eye bag Removal: (Blepharoplasty)
This procedure is to reduce eyelid bags and also removes fat and the appropriate amount of surplus skin from around the eye due to loss of elasticity. Due to ageing, the skin may develop deep creases on the lower lids, loose folds on the upper lids, and the muscles may become slack and thickened causing fat to bulge in the form of eye bags. Even prior to skin changes taking place, eye bags can occur due to thyroid disease.
A more youthful look can be achieved with this operation, and by removing the excess skin and fat, the eyes may appear more open and alert, including less morning swelling. Blepharoplasty can be performed on the upper, lower and both eyelids.
Facelift:
This procedure is carried out to lift the facial skin and the layer above the muscles to give the face a smoother and younger appearance. As we age the layer above our facial muscles slacken and loose elasticity giving and aged appearance. The effect of gravity, exposure to the sun and stress also show on our face, so as folds and lines deepen, drooping occurs at the sides of the mouth. Skin on the neck also becomes looser, the jaw line becomes saggy, and the first sign of skin ageing is fine wrinkles around the outer eye area and lips. However, the rate at which this occurs differs from person to person. A facelift helps in you looking younger and as a result feeling younger.
Nose Re-shaping: (Rhinoplasty)
Rhinoplasty or Septo-Rhinoplasty, the procedure is to re-shape the nose and also to increase or decrease the size of the nose. It is also to carry out to alter the appearance of the nose tip, bridge and nostrils. A rhinoplasty may be chosen for many reasons such as dislike of the size or shape due to inherited characteristics or to restore a flattened nose after an injury. As the nose is centrally positioned structure on the face, it is considered by many people to be a focal point. If someone is unhappy with the size or outline of their nose, they may wish to alter it to make them less self-conscious or to help self-esteem.
Midface Lift:
This procedure is carried out to lift up the facial skin and muscles to give the face a smoother and younger appearance. As we age our facial muscles slacken and loose elasticity, thus creating lines and folds. The effect of gravity, exposure to the sun and stress also show on our face, so as folds and lines deepen. In addition, drooping occurs at the sides of the mouth. The mid facelift has more focus on improvement from the cheekbone to the upper lip area. Due to ageing the fullness of the cheeks are lost, with skin and underlying fat starting to sag from the lower eyelids. This procedure can be carried out with a lower eyelid blepharoplasty, (eye bags reduction), and also in conjunction with a standard facelift. Another benefit is that there may be some decrease in the creases, which extend from the side of the nose to the corners of the mouth (nasolabial folds). On some occasions softening of the jowls maybe seen.
Fat transfer:
The phrases fat transfer and lipo-filling are synonymous and are used interchangeably when performing this type of surgery in all areas of the human body. They describe the moving of fat from one fat rich area of the body to another, which is lacking in it.
As we get older, we tend to lose fullness from our face; the cheek area being the most susceptible for such loss of volume. This loss varies between individuals and can make us look gaunt and tired looking.
The fat transferred has to acquire blood supply in the recipient area for it to survive. The fat retained when moved from one site in the body to another is usually 50-60% of the volume transferred. Hence it takes more than one treatment to achieve the desired outcome, in the majority of patients 2-3 treatments.
However, in the face due to its rich blood supply the fat retained will be more in the region 80-90%. As a result, the number of treatments to achieve the desired outcome are less; and often 1-2 episodes are suffice to obtain the wanted cosmetic look.
Ear reshaping: (Otoplasty)
This procedure is suitable for men, women and children over the age of 5 years who consider their ears to be too prominent and shaped irregularly, often being inherited. This type of corrective surgery is in fact one of the most common procedures carried out on children. If protruding ears are left untreated, they may prove to be a point of unwanted attention, especially at school and amongst adolescents. Teasing can be known to be psychologically harmful and may lead to a loss of self-confidence.
Breast Procedures:
Breast Enlargement
Breast Reduction
Breast Uplift
Male Breast reduction
Breast Enlargement:
His procedure is to enlarge and enhance the breasts, and women who decide to have this may have breasts which they feel are not in proportion with their body. Breast size is determined by a number of factors which includes breast feeding, pregnancy and weight change.
Sometimes a breast may become more developed than the other; this equates to some difference in size and or shape. The breasts may also lose their shape and droop because of the aging process. Breast shape and size can affect self-confidence greatly, therefore breast enlargement can help. Breast implants can make the breasts fuller and larger and come in many sizes and shapes. They are made from an outer layer of silicone and are filled with either silicone gel or salt water. The surgeon will discuss with you the most appropriate option. However, they may stay in for a much longer period with no complications.
Breast Reduction:
Genetics are one factor which affects the size of a woman’s breasts. However, hormones and weight also influence this. Feeling that your breasts are not in proportion with your body can cause problems such as struggling to find clothes and underwear to fit, having difficulties taking part in certain sports activities and generally feeling self-conscious.
Additional problems such as neck and backache and postural problems are often associated with large breasts, and may cause distress to lots of women. Therefore, breast reduction can reduce the size and weight, make them firmer thus creating smaller, more proportionate and attractive breasts.
Breast uplift: (Mastopexy)
This procedure is carried out to up-lift the breasts which have become droopy or sagging due to ageing, weight loss, gravity, pregnancy and breast feeding. A mastopexy is effective in re-shaping and raising the breast to give a firmer and more youthful appearance by removing skin from the areas of excess which are usually around the areola and underneath the breast to tighten the tissue and raise the nipple. In addition to the removal of the skin the breast tissue is repositioned to enhance the fullness of the breasts. A breast implant could be used in some patients to obtain the desired effect. However, on occasions a small reduction may be necessary in achieving a more cosmetically pleasing result.
Male Breast reduction: (Gynaecomastia Correction)
Gynecomastia or the enlargement of the male breast reduction. This procedure describes the removal of tissue (glandular/soft tissue) and reduction of the male breast. Mostly there is not a known cause for this enlargement to the breast, but as many men are very self-conscious of this, the operation can be extremely helpful. This condition is common but is not often openly discussed. However, more males are now seeking a solution to the problem. Many boys during their teenage years experience some enlargement in a breast or both breasts, but by adulthood in most cases this does not remain. The procedure can give the chest a flatter and more contoured appearance and may also enhance self-esteem whilst reducing unwanted embarrassment.
Body Surgery:
Liposuction
Abdominoplasty
Thigh lift
Arm lift
Liposuction:
This procedure is used to alter the shape of the body and is suitable for both men and women. Stubborn areas of fat along with non-desirable deposits of fat may prove difficult to eliminate with diet and exercise alone. It cannot improve stretch marks or cellulite, but can change the shape of the body effectively. Common areas of fat deposits are on thighs, abdomen, arms, neck, loins, inner sides of knees and ankles. Fat may also develop under the nipples of men, causing enlarged breasts to occur (gynecomastia).
Liposuction involves removing this deposited fat through small skin holes with help of liposuction cannulas. It leaves only a tiny scar which usually requires no or one stitch and generally heals well. One would require to wear elastic garments post surgery for several weeks to boost the results.
Tummy tuuck: (Abdominoplasty)
This procedure is the removal of excess skin and fat from the abdominal area. It is used to improve the appearance of the stomach including the umbilicus, and to tighten the anterior abdominal wall muscles and bring them closer. A tummy tuck is not a substitute for exercise, but is beneficial after considerable weight loss and pregnancy, where the skin may appear loose and has developed stretch marks. Even after frequent exercise some women are unable to tighten the abdominal wall, therefore a flatter and smoother abdomen can be achieved with this procedure. The best results are obtained by already being the correct weight in proportion to height. During the operation, your abdominal wall may also be tightened to achieve a flatter stomach.
Thigh Lift:
This procedure reduces fat and loose skin on the thighs, most commonly occurring after substantial weight loss. Unfortunately, such sagging skin may not be improved by a healthy diet and exercise alone, therefore a thigh lift should help to tighten and raise the skin to give a more firm and lifted appearance.
Arm lift:
Due to the natural ageing process, skin on the upper arms may become loose and flabby as a result of loss of elasticity. Additionally, substantial weight loss may be another cause of excess loose skin to this area (also referred to as bingo wings). Often such sagging skin cannot be improved by regular exercise or healthy diet alone, and may cause embarrassment resulting in long tops being worn to cover up the problem area. An arm lift can help to restore the area by giving younger looking skin with a firmer and more youthful appearance.
Skin Lesions:
Lesions are lumps or bumps such as moles, cysts, lipomas (fatty lumps). Most are benign (non-cancerous). Excision refers to removal of a skin lesion by completely cutting it out.
Most lesions do not cause serious problems, but you may want to have them removed due to them being painful or unsightly. Surgery is recommended to remove skin lesions that show any sign of turning cancerous or to diagnose the cause of the lesion.
There are number of skin cancer conditions which would require resection and reconstruction of the defects with grafts or flaps. It also involves reconstruction at vital areas such as eyelids, and lip reconstruction. All such services are available.
Non-Surgical Procedures:
Wrinkle relaxing injections:
Botox:
This treatment effectively reduces the appearance of wrinkles caused by the ageing process, damage from the sun and other environmental toxins, for example smoking. Facial expressions such as laughter and frowning contribute to crows feet, forehead and frown lines, which can give a stressed appearance. The treatment can soften and eliminate wrinkles by temporarily weakening the facial muscles, and is one of the most effective non-surgical procedures for smoothing expression lines. Excessive sweating of armpits/palms of hands may also be treated using this type of injection.
Dermal Fillers:
Sometimes when creams and lotions are not sufficient, but having surgery seems too drastic, a dermal filler may help to achieve a younger and smoother complexion. Dermal fillers are a safe and popular choice as they can effectively diminish the signs of ageing, rehydrate the skin tissue and the results can be seen immediately. This is a non-permanent treatment which aims to add volume and soften the creases of the skin by adding dermal filler directly to lines or furrows, softening the signs of ageing and restoring definition to the face. Hyaluronic acid is contained in dermal fillers, which is used to keep the skin smooth and is found naturally in large amounts throughout our bodies when we are young. As we get older, this amount decreases causing our skin to lose the ability to retain moisture, plumpness and the ageing process also causes our skin to sag.
Chemical Peel:
Chemical peel is the method to treat the certain skin condition to improve its appearance by using certain chemical agents in different proportions. It is used to treat the following patient concerns:
- Acne scars
- Sun damage
- Wrinkles
- Pigmentation
- Uneven complexion
- Aged looking skin
Daily exposure to UV light from the harmful rays of the sun and ageing cause the growth of healthy cells to slow down, with elastin and collagen levels also gradually breaking down. This method aims to correct sun damage by pushing dead skin cells to the surface to be replaced by new fresh cells with a healthy glow.
Chemical peel can be performed on the face, neck or chest and takes approximately thirty minutes to apply to eliminate the thin layers of damaged and aged surface skin. It takes 1-2 weeks to regrow new surface of the skin. Once the new skin layer is visible, there should be a noticeable improvement to the complexion, which should progress further over the next four to six weeks, aiming to reveal youthful, clearer, healthier and smooth looking skin.
Lasers:
Laser stands for Light amplification by simulated emission of radiation. This light can be used for different purpose by different machines. Its common usage are;
Laser hair removal
Skin rejuvenation or tightening by treating various skin wrinkled areas
Tattoo removal
Vascular condition of the skin
Laser are generally safe and required multiple sessions to achieve the desired results.
Reconstructive Surgery
Burn surgery
Scar and contracture management
Hand surgery
Skin, soft tissue & bony defect reconstruction
Breast reconstruction
Cleft surgery
Chronic ulcers
Vascular malformations
Hidradenitis Suppurativa
Pressure ulcers
Burn Surgery:
Burns surgery involves acute and chronic burn management. In acute, condition it involves emergency burn resuscitation and initial care with dressings or surgery. IN the chronic condition, it involves burn scar management, contracture release and Z Plasty to improve the burn scar look as easy of mobility especially around the joints.
Scar and Contracture management:
Scars from burns, injury or previous surgeries can be improved by Plastic surgery. They are not fully removed but their appearance can be significantly improved by various plastic surgery procedures such as skin grafts, skin flaps, scar revisions, serial excisions or tissue expansion techniques. This not only improves the scar look but it also improves the body function and enhance its utilization.
Acne scar is another condition requiring multiple methodologies to improve such as laser, micro-needling with PRP, dermabrasion, fat grafting etc.
Hand surgery:
Following hand surgery services are available;
– Congenital hand condition such as fused fingers (Syndactyly), Multiple additional fingers or toes (Polydactyly), short fingers (Brachydactyly).
– Lumps on hand or fingers such as ganglions, cysts, lipomas etc.
– Finger contracture (Dupuytren’s contracture)
– Nerve compression in hand and elbow such as Carpal Tunnel Syndrome or Cubital Tunnel Syndrome
– Finger-tip injuries
– Tendon injuries
– Nerve injuries
– Finger replants post amputations
– Toe transfers for absent or missing toes
Skin, soft tissue & bony defect reconstruction:
These large defects which are produced post trauma, or elective surgery such as cancer resection or burns cannot be closed directly and will require different plastic surgery methods to achieve adequate soft tissue and bony continuity. These methods include, skin grafting, skin or muscle flaps or free tissue transfer involving soft tissue of bony transfer of a similar looking tissue from another part of body with its blood supply and re-establishing the blood supply at the recipient site. This is a complex procedure requiring lot of patience and expertise. Such services are also offered.
Breast Reconstruction:
This service involves reconstruction of a breast post breast resection due to breast cancer. It is a staged procedure and involves reconstruction of mission breast using multiple methods such as autologous boy tissues such as muscle and skin, fat or silicon implants. At a later stage nipple reconstruction is performed. It also involves dealing with other breast to achieve symmetry.
Cleft Surgery:
This involves in dealing with children born with cleft in the lip or palate. This condition is also called hair lip. It also involves multiple surgeries at different stages of child growth. First surgery involves correction of cleft lip and is performed at the age of 3 years. However, the correction of cleft palate is more complex and timing of surgery is decided according to severity of the condition. Normally first surgery for isolated cleft palate is performed at the age of 6-9 months.
Chronic Ulcers:
Long standing non healing ulcers is another challenging condition to deal with. There are number of reasons which promotes the formation of such ulcers like diabetes or vascular insufficiency. It requires not only dealing with ulcer itself but also to deal with causative factor as well. Once the reason is corrected, usually ulcers heals itself and don’t come back.
Vascular Malformations:
Vascular malformations could be of different types, they could be arterial, arteriovenous, venous or capillary origin. Each requires investigations to establish the right diagnosis and than treatment plan is set according to the cause. Some requires laser treatment, some require surgical excision, some require embolization by a radiologist as some settles on their own with time such as hemangiomas.
Hidradenitis Suppurativa:
This is a challenging condition presented with development of multiple pussy lesion in the axilla, groin, breast bone, perianal area. The reason is development of infection in the sweat glands of the involved area. It has various degree of severity. Light condition can be improved by multiple medications and improvement in lifestyle, however moderate to severe condition require surgical excision and reconstruction of the defect with flaps or grafts. Surgery provides the only viable solution to deal with this complex condition.
Pressure ulcers: (Bed sores)
This is a condition which involves formation of long-standing ulcers on the lower back, hips, heels, shoulder blade area or back of head. Mostly they are produced due to immobility of that area due to pressure of the bed against prominent portion of the bone and various degree of soft tissue necrosis is established. It can also be developed in a tight plaster cast against prominent portion of bone in the fracture management. The treatment includes removal of the cause and improve general condition and nutrition status of the patient. However, certain condition requires surgical input such as wound debridement, application of vacuum assisted closure technique, or local flap reconstruction.