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Body Contouring Brochure

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					Body Contouring
contents
Why choose Birkdale

Welcome to Birkdale Clinic

Introduction

About Abdominoplasty

Other Body Lifting Procedures

Liposuction & Fat Removal

What Next




Why you should choose Birkdale
Experience & Expertise


     At Birkdale we’ve delivered in excess of 150,000            space in - to perform your procedure. Birkdale’s
     highly    specialised      surgical    procedures   &       own network of private hospitals boasts leading
     consultations to both the Private Sector & the NHS.         technology, and is staffed by a full compliment of
     Our expertise is recognised throughout the medical          specialist staff. By owning and managing our own
     sector, and is the reason why people consistently           hospitals we can ensure you receive the absolute
     pick Birkdale as their number 1 choice.                     highest standard of medical care available, and full
                                                                 support from our teams of dedicated professionals.
     In the UK, the Healthcare Commission regulates all
     cosmetic surgery providers, but Birkdale is also an         Our ethical policy: Birkdale will only undertake
     accredited provider of consulting & surgical                proven surgical procedures. Birkdale will not
     expertise to both the Department of Health, and the         endorse or promote techniques that have not been
     NHS. Birkdale employs some of the finest, fully             tested or proven. Birkdale will not deliver ANY
     registered, cosmetic surgeons in the world.                 procedure that we feel could prove harmful to a
                                                                 patient or not in a patient’s long-term interest. We
Aftercare & Support                                              go to great lengths to identify the best equipment
                                                                 and most effective techniques to deliver your
     Birkdale offer a comprehensive 3-year aftercare             procedure. Your safety and satisfaction is our
     program on all cosmetic surgery procedures. We              primary concern.
     also provide our patients with a 24-hour a day, 7
     days a week medical response line, so we are            0% Finance
     always on call.
                                                                 Birkdale offers 0% Finance on all cosmetic surgery
Safety & Assurance                                               procedures (backed by the UK’s largest finance
                                                                 house). This allows you the option to spread the
     Birkdale deliver their procedures through their own         cost of your procedure at no additional charge
     national network of private hospitals. Many                 (subject to status, written details available on
     Cosmetic      Surgery      companies     can   appear       request).
     impressive, often meeting with you in lavish ‘sales’
     consulting rooms, but once you book your
     procedure with them, you are often sent to a
     hospital that they have simply rented temporary
body contouring


Welcome to Birkdale -
Our appearance shouldn’t bind us, it should set us free         This brochure introduces procedures that aim to:


The desire to improve our appearance is completely                   Reduce areas of fat or cellulite (especially those

natural. How we look can have a real impact on how we                resistant to exercise or diet).

feel about ourselves; it can significantly raise or lower our
                                                                     Resolve problems of sagging/Excess skin (often a
self-confidence. The shape and appearance of our body
                                                                     result of age or dieting).
can affect the choice of clothing we wear - or choose not
to wear, even down to how self-conscious we feel walking
                                                                     Tighten up sagging tummy muscles to treat the
on to the beach whilst on holiday.
                                                                     appearance of a sagging or bulging tummy.

At Birkdale, we aim to provide you with a carefree              We call this group of procedures ‘Body Contouring’.
approach to your life, and your wardrobe. We want you to
look and feel great.
                                                                So what is Body-Contouring Surgery?

Introduction                                                    Body Contouring Surgery is the term used to ‘group’
                                                                together the cosmetic surgery procedures that are
No matter how much detail we include in this brochure, it       designed to improve the size, shape, and appearance of
will not match the level of advice & detail you can receive     the body (rather than the face). Individuals who seek such
from a private consultation with a specialist cosmetic          procedures are often seeking particular improvements to
surgeon. This brochure is simply an introduction; we would      one, or a number of areas of their body.
always advise that you take the time to sit down with a
specialist cosmetic surgeon to fully discuss any                Modern state-of-the-art body contouring offers any single,
surgical procedure, along with any associated benefits or       or any combination of the following five areas of focus:
risks.


Many things can have an impact on the way our body                   The removal of excess fat from certain areas
looks and the way it changes throughout the various
                                                                     Dealing with 'skin-sag' in certain areas
stages of our lives. Some of the changes that may
develop (as a result of ageing, pregnancy, or even dieting)          Resolving issues of poor muscle tone and definition
we may find less than pleasing. So if there’s an area of
                                                                     Treating skin appearance and cellulite in certain sites
your body that you are less than satisfied with, we can
help.                                                                Treating excess general weight and obesity
Each of these five elements is dealt with separately, on
their own merits. Many patients may find they only require
one procedure, liposuction for example. Others may
require any combination of these five factors to achieve the
results they desire. Here are some examples:


Example 1:
A woman with localised excess fat around her buttocks
and thighs, but with saggy skin on her arms (perhaps after
determined weight loss), may be best suited to
liposculpture to the former and an arm lift to the latter.


Example 2:
A woman with both excess fat and saggy skin on her
abdomen (perhaps after pregnancy) would be best suited
by a tummy tuck with abdominal fat removal.


The key is to tailor the treatment to the individual’s own
situation, wishes, and expectations. A consultation with a
specialist surgeon will clearly define a realistic picture of
what can, and more importantly, what cannot be achieved.


A word of guidance

There are a large variety of procedures available as part of
body contouring surgery. Please don’t feel overwhelmed
by the number of options; they are simply presented here
to give you a better insight into some of the aspects of
cosmetic surgery.


The decision on which procedure is most suitable for you
should only be made after you have spoken with a
specialist cosmetic surgeon. The surgeon will be able to
offer you comprehensive advice and guidance, explaining
the procedure most relevant to your individual situation.
abdominoplasty
abdominoplasty

About Abdominoplasty

This group of procedures includes:                                Repair of any abdominal hernias

                                                                  Excision of other abdominal scars
    Abdominoplasty
                                                           The very best candidates for abdominoplasty are men or
    Modified Abdominoplasty
                                                           women who are generally in good health, but who are
    Apronectomy
                                                           concerned about either loose skin or a large fat paunch
    Standard Abdominoplasty                                over their abdomen. The most common clinical situations
    Extended Abdominoplasty and Flankoplasty               are:

    Endoscopic Abdominoplasty
                                                                  Women who after several pregnancies have loose
    Upper Arm Lift
                                                                  skin and poor muscle tone
    Inner Thigh, Hip and Buttock (Lower Body) Lift
                                                                  Older patients with slight obesity who may also have
Abdominoplasty (tummy-tuck)                                       poorer skin tone through ageing


Abdominoplasty, more commonly known as a ‘tummy                   Patients who have lost significant amounts of weight,
tuck’, is a surgical procedure designed to remove excess          but who have been left with unsightly sagging skin
skin and fat from the middle and lower abdomen. It is a           and stretch marks
very popular cosmetic surgery procedure, and can
dramatically improve the size and shape of the abdomen.    If you intend to lose weight in the future, or if you have not
Abdominoplasty has always been a very popular              yet finished your family, then you should postpone your
procedure, with more than 40,000 operations performed      abdominoplasty until afterwards.
each year.
                                                           There are several technical variations on the general
In addition to removing the surplus skin and fat, other    principle of abdominoplasty, as follows:
procedures may be added as required, including:




    Surgical tightening of the abdominal muscles
    (plication)


    Liposuction to excess fat elsewhere on the abdomen
    and waist
abdominoplasty


Modified Abdominoplasty (mini-tuck)                          Standard Abdominoplasty




In a modified abdominoplasty, only the excess skin above     In this form of abdominoplasty, the surgeon removes all
the pubic bone is removed. In this case, the umbilicus       the skin and fat from between the pubic bone and the
remains undisturbed. The procedure is performed under        umbilicus. This leaves the umbilicus itself in place.
general anaesthesia, takes sixty to ninety minutes, and is   However, in drawing the skin at the level of the umbilicus
occasionally done as a day case. However, most patients      down to the pubic level, the umbilicus must be brought
stay in hospital overnight.                                  through the new skin lying over it.



                                                             Consequently, this form of tuck results in a long curved
Apronectomy                                                  scar at the pubic level, along with a circular scar around
                                                             the umbilicus. The procedure is performed under general
                                                             anaesthesia, and may take up to three hours to perform.
                                                             Drains may be used, and patients remain in hospital for at
                                                             least one night.




Apronectomy is a form of modified mini-tuck, in which the
patient has a large excess of skin and fat (the apron)
hanging down over the pubic area and genitals. It is this
surplus of tissue that is removed. Again, the umbilicus is
undisturbed. The procedure is performed under general
anaesthesia, taking up to two hours to perform.
Extended Abdominoplasty and Flankoplasty




In this more radical extensive procedure, the incision is
continued around the waist and onto the back. Surplus
skin and fat are removed from this wider area around the
flanks, resulting in a longer scar. As with the standard
abdominoplasty (of which this is a modification), the          Before
umbilicus must be brought through the skin, resulting in a
scar around it.



The procedure is again performed under general
anaesthesia, and may take more than three to five hours to
perform, especially as the patient has to be turned.
Patients remain in hospital for at least one night.




Endoscopic Abdominoplasty

In this procedure, the surgeon uses an endoscope to
tighten the abdominal wall muscles. It is generally best
suited to younger patients who may have only a moderate
degree of muscle laxity, small localised fat deposits in the
                                                               After
lower abdomen, and only a minimal amount of surplus
skin.
other body-lifting procedures


Upper Arm Lift (Brachioplasty)

Many women are concerned about sagging of the upper
arms with increasing age. If the problem is due to an
accumulation of fat, then liposuction may be all that is
required. However, if the skin is of poor quality, and there
is not a particularly large collection of fat, then an upper
arm lift is recommended.




                                                               For Inner Thigh Lift, long incisions are made along the
                                                               inner aspect of the thigh and / or in the groin crease




For Upper Arm Lift, long incisions are made along the
inner and under surfaces of the arm, often from armpit to
elbow




Inner Thigh, Hip and Buttock (Lower Body) Lift
                                                               A Buttock Lift usually involves incisions in the buttock
These areas are considered together, as many patients
                                                               crease
request a combination of these body-lifting procedures.
These procedures are becoming increasingly popular,
particularly in the United States. A combination of all of
these procedures is referred to as a Lower Body Lift. It is
also possible to combine these procedures with
abdominoplasty – in a sense a ‘Whole Body Lift’.
                                                              Resume normal activity within four to six weeks


                                                              The results are permanent, so long as the patient
                                                              maintains his / her weight


                                                              Whilst the scars associated with Lower Body Lift
                                                              are long, it must not be thought that liposuction
Outer Thigh or Hip Lift involves ‘high leg’ incisions, with   is therefore a better option. If the problem is one
scars similar to the cut of a French bathing suit             of sagging skin, then liposuction is unlikely to be
                                                              of great benefit, and in fact may make the
                                                              problem worse


Technical Considerations for Body Lifting                     It may take up to a year for the scars to settle
Surgery
                                                              Of all the scars created by cosmetic surgeons,
    These operations are generally performed                  those associated with body lifting procedures are
    under general anaesthesia                                 amongst the most noticeable. However, most
                                                              patients consider them well worth it, given the
    Both skin and excess fat are removed                      enormously beneficial effects that their surgery
                                                              produces
    The operations take between two and five hours
    depending upon the extent of the surgery


    Patients stay in hospital overnight or longer


    A tight support garment is often recommended
    for two weeks or more


    Sutures are removed after about ten days


    Expect to take up to two weeks off work


    You will not be allowed to undertake any
    strenuous activity or lifting for at least two weeks
liposuction / liposculpture
liposuction / liposculpture


LIPOSUCTION AND FAT REMOVAL

Liposuction in all its various guises has always been one
of the most popular cosmetic surgery procedures. But,
before we go into details about how Liposuction is
performed, lets take a brief look at the problem itself – Fat.

                                                                    Fig 1. The fat cell        Fig 2. The same fat cell
                                                                                                      containing more fat
About Fat

Fat is an efficient way for our body to store energy.


The basic unit of fatty tissue is the fat cell; technically
known as an adipocyte. This simple form of cell consists of
little more than a (membrane) bag within which sits the
nucleus of the cell surrounded by fat. Throughout our
childhood and into early adolescence, we continue to
develop more and more fat cells. However, by our late
teens to mid-twenties it is believed that we stop making
new fat cells.

                                                                 If we take a very simplistic view of an area of the body, then
So how do we still put on weight as we get
                                                                 one might imagine the skin, with subcutaneous fat on the
older?                                                           inside, with muscles and other structures underneath.

The answer, is unfortunately, very simple. We just increase
the amount of fat stored in each of these fat cells. They
simply balloon, sometimes to many thousands of times
their original size.
liposuction / liposculpture


                                                                 As a result of these localised deposits, many people are
                                                                 extremely self-conscious about particular areas of their
                                                                 bodies. They often relate that persistent exercise and
                                                                 dieting do little, if anything, to improve their abdominal
                                                                 paunch, or their saddlebags etc.


                                                                 As weight is put on, all fat cells become larger (obesity). As
                                                                 weight is lost, these cells shrink again. However, in these
As weight is put on, the fat cells increase in size, with the    specific stubborn areas, the greater number of cells
result that the area becomes generally larger. Should            remains constant even after dieting. Hence, these areas
weight be lost, then the weight tends to come off                may reduce a little as the fat cells shrink, but are still
uniformly also.                                                  relatively larger.


                                                                 This results in the classic liposuction patient, who
                                                                 describes that from a relatively early age these larger
                                                                 areas have been present. They have usually been
                                                                 inherited from a parent. If the patient puts weight on, it
                                                                 seems to focus on this area. If they lose weight or exercise,
                                                                 it makes considerably less difference (if any) to this area.
                                                                 Even at his or her lowest weight, this area persists. It can
                                                                 make buying clothes difficult, and can often be an area of
                                                                 considerable dissatisfaction.


                                                                 However, these stubborn areas of excess fat may be
                                                                 easily, and permanently, treated by liposuction. To
                                                                 reiterate, this is because, for any adult, the total number of
Certain individuals have collections of fat in specific          fat cells is relatively constant. This means that they do not
anatomical areas (e.g. saddlebags etc). When these               re-grow and are not replaced following their surgical
patients put weight on, they feel that it has become             removal.
localised to these areas. In fact, it is just that the greater
number of fat cells accentuates the problem.
Suction-Assisted Lipoplasty
“Suction-Assisted Lipoplasty” is the term that might be            In conventional liposuction a vacuum machine is used to
applied to a group of operations that are intended, in             help the surgeon remove the fat. In liposculpture, a
broad terms, to suck out the excess fat content of                 hand-held syringe is used. The surgeon uses whichever
localised areas on a person’s body. Their purpose is, in           technique, or combination of techniques, that he is
almost all situations, to improve the contour or shape of          experienced with. It is entirely wrong to say that
the body.                                                          liposculpture requires a day case local anaesthetic, whilst
                                                                   liposuction requires a general anaesthetic and an
In this sense, the term can be considered to encompass             overnight stay. Both can readily be done under local
all the following operations:-                                     anaesthetic as a day case. Both, in certain circumstances,
                                                                   may require general anaesthetic and an overnight stay.
Liposculpture
                                                                   Ultrasound-Assisted Liposuction
Liposculpture     is   a   more    modern      refinement    of
conventional liposuction. It uses far smaller cannulae and
                                                                   In this technique, much discussed recently, the probe that
involves the surgeon suctioning fat from much nearer the
                                                                   is used consists of two parts. The outer sheath and tip is
surface of the skin. As a result, it leaves far less fat behind,
                                                                   an ultrasound producing device that fires ultrasound
and in experienced hands produces much more smooth
                                                                   waves into the fat, helping to break it down. The inner part
aesthetically pleasing results. Further, by producing such
                                                                   is a conventional suctioning cannula attached to a suction
thin skin flaps, skin tightening is much more effective and
                                                                   machine.
predictable. The suction may be applied either by a
machine, or in a much gentler fashion by a simple
                                                                   External Ultrasound-Assisted Liposuction
hand-held     syringe      (so-called   superficial    syringe
liposculpture). By using such small instruments, the
surgeon really is able to sculpt the body in a gentle              In this technique, an ultrasound probe is used on the

controlled way.                                                    outside of the skin to attempt to soften the fat prior to the
                                                                   surgeon undertaking liposuction or liposculpture. The

Liposuction                                                        nature of the probe means that there is minimal risk of skin
                                                                   burns or other complications. Few experienced body
This was the original form of fat removal, and is the              contouring surgeons consider this technique to produce
technique used by the majority of UK surgeons. It usually          significant benefits in terms of end result for the patient.
involves the use of much larger cannulae and
conventional suction machines. The aim is generally to
remove only the deeper layers of fat. As a result, it is often
associated with residual fat deposits.
liposuction / liposculpture


Overall

Our specialist surgeons will advise you on the most
appropriate lipoplasty technique for your particular
situation. Some patients may undergo a combination of
techniques during the same operation. Your Procedure will
be tailor-made to meet your personal needs.


In almost all cases, the procedure will be performed as a
day case. This means that you will almost certainly be
allowed to go home on the same day (often a few hours
after the procedure). In a small group of patients (probably
about 10%), patients may be kept in overnight. This group
of patients might be summarised as:

                                                               Before
     Most patients having general anaesthesia;


     Patients having the largest volumes of fat removed;


     Patients with certain medical conditions;


     Patients who live alone;


     Patients who live a long distance from the clinic;


     Patients requesting an overnight stay from the outset;


     Patients who take some time to recover from the local
     anaesthetic and sedation.


The operation takes anything from 30 minutes to four           After
hours or more depending on the volume of fat to be
removed. Patients should wear tight support dressings for
several weeks
Technical Considerations                                        after the procedure). In a small group of patients (probably
                                                                about 10%), patients may be kept in overnight. This group
                                                                of patients might be summarised as;-
     Suction-assisted Lipoplasty may be performed under
     either local anaesthesia; local anaesthesia with
                                                                     Most patients having general anaesthesia;
     sedation; or general anaesthesia

                                                                     Patients having the largest volumes of fat removed;
In almost all cases, the operation is performed under local
anaesthesia and sedation. This means that your
                                                                     Patients with certain medical conditions;
Consultant Anaesthetist will administer, via a drip in your
arm, heavy sedatives and strong pain-killers. You may
                                                                     Patients who live alone;
sleep during the procedure. Most patients are just very
drowsy, and drift in and out of sleep. You may be aware of
                                                                     Patients who live a long distance from the clinic;
occasional feelings and discomfort. However, it is very
unlikely that these feelings will distress you. You will be
                                                                     Patients requesting an overnight stay from the outset;
able to tell the anaesthetist of any discomfort, and he/she
will be able to give you more of the appropriate medicines.
                                                                     Patients who take some time to recover from the local
Further, one of the side effects of the sedatives is that you
                                                                     anaesthetic and sedation.
will have little concept of how long the operation has gone
on, and will probably remember very little of the operation.
                                                                     Small (5mm) stab incisions are made in the skin

In approximately 5 to 10% of cases, a general anaesthetic
                                                                     Anaesthetic fluid is injected throughout the area to be
may be required. The patients that receive general
                                                                     operated upon
anaesthetics might be summarised as:-

                                                                     The fat is aspirated through fine cannulae
     Patients that request a general anaesthetic from the
     outset;
                                                                     The operation takes anything from 30 minutes to four
     Patients with certain medical conditions;                       hours or more depending on the volume of fat to be
                                                                     removed
     Patients having the largest volumes of fat removed;

     Patients after a failed attempt at the procedure under          Many patients go home the same day. Larger cases
     local anaesthetic;                                              remain in hospital for one or two nights

In almost all cases, the procedure will be performed as a            Patients wear tight support dressings for several
day case. This means that you will almost certainly be               weeks
allowed to go home on the same day (often a few hours
What next?

Initial Consultation:                                             Your Procedure:
The first step is to simply take advantage of a completely        Should you decide that a procedure is right for you, your
free   initial   consultation   with   one   of   our   patient   patient co-ordinator will arrange a date with you for your
co-ordinators.                                                    procedure. Your patient co-ordinator will support and guide
                                                                  you throughout the entire process, and will be your point of
The initial consultation is designed to be warm and               contact throughout your journey with us.
informative, and you are very welcome to bring a friend,
partner, or relative along with you. Your patient co-ordinator
will be able to answer many of the questions you may have,
and will offer you objective advice or guidance.


The initial consultation is simply designed to give you more
information (specific to you), and allow you to think more
about what it is you would like to achieve through body
contouring surgery. It is also very valuable because it helps
you to think of questions you may wish to ask your surgeon
- should you decide to progress to the next stage. At no
point are you under any obligation to progress any further
– the patient co-ordinator is simply there to act as your
guide.


Specialist Consultation:
Should you decide that you would like to progress further            To arrange a free initial consultation,
we would arrange for you to meet with a specialist                   simply call:
cosmetic surgeon, where you will be able to discuss your
procedure in-depth. The surgeon will fully explain the
surgical options available, and which would be most suited
to you. Your surgeon will also discuss your medical history,
                                                                     0500 44 22 22
and any associated risks. Once again, you are under
                                                                     or email:
absolutely no obligation to take this consultation any
further.
                                                                     cosmetic@birkdaleclinic.co.uk

                                                                     It’s your body, you choose.
  0500 44 22 22 | www.birkdaleclinic.co.uk | cosmetic@birkdaleclinic.co.uk




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