Breast surgery and nipples: all the questions you wanted to ask

breast surgery and nipples

If you are planning on having cosmetic breast surgery one of the most common questions women ask is what will happen to their nipples. There are a number of things to consider before deciding the nature of the surgery that feels right for you, all of which should be considered thoroughly and discussed with your surgeon before you go under the knife.

Life stage and future life choices

If you wish to undergo a breast uplift, this has a big effect on your nipples as they are often repositioned as part of the operation. This is an important part of the aesthetics of the operation, as it is necessary to ensure that they are positioned in the correct place when the new size and shape of your breasts is determined. This can often affect woman’s ability to breastfeed as the tiny milk ducts can be damaged by this process. Depending on when you’re planning to start a family and whether you hope to breastfeed, you may choose to delay this procedure until later.

A breast uplift is the operation that carries the greatest risk to the chance of affecting the ability to breastfeed. Having breasts enhanced with implants does not mean you will not be able to feed a child, but this is something you need to discuss with your plastic surgeon when planning the procedure. 

The incision you choose and where the implant is placed in the chest area can have an impact – having the implant inserted in an ‘inframammary incision placement’ is best for women who wish to go on to breastfeed in the future. 

Nipples are likely to feel different after breast surgery

No matter what type of breast operation you have chosen, your nipples could feel different following your operation. Even if they have not been affected directly, if they are stretched over enlarged breasts due to a breast enhancement then the nerves that surround the nipples can be left feeling extremely tight and sensitive. This is perfectly natural and expected with operations of this nature, and it will settle down as your body adapts to the new size and shape of your breasts. 

Conversely, some women report a loss of nipple sensitivity after a breast uplift, reduction or augmentation. For most women, this is a temporary problem and it is a small minority of patients.

Breast surgery is a good opportunity to fix other problems

Some women suffer from inverted nipples, which isn’t always problematical from a medical perspective but can affect their self-confidence. Inverted nipple correction is a simple and quick procedure which involves a small incision and then the opportunity to turn the nipple to face outwards. It can be performed as a standalone procedure or planned as part of a more extensive cosmetic breast surgery operation.

Women are often dissatisfied with the appearance of their nipples – whether due to weight fluctuations, genetics, ageing or pregnancy and breastfeeding, they feel that they are too large and disproportionate or even misshapen or asymmetrical. Areola reduction or nipple reduction can also be performed as a standalone procedure or in conjunction with a breast uplift, reduction or augmentation.

During your consultation with our London plastic surgeon, every aspect of your cosmetic breast surgery procedure will be discussed in full.

Trim labiaplasty vs wedge labiaplasty

Trim labiaplasty vs wedge labiaplasty

Labiaplasty is becoming an increasingly popular cosmetic procedure – the size and shape of a woman’s labia can often affect how they feel about their body as a whole. If they feel it is larger or more elongated than normal then this can have two possible implications. Firstly, it can cause discomfort; causing pain during intercourse, during some sports and also sometimes if they are wearing too tight clothing. The other problem can be is that the look and feel of the labia can cause women to feel self-conscious. 

A plastic surgeon can help address both of these problems with a procedure known as a labiaplasty. This is where the labia can be reshaped so that it is smoother and smaller, directly targeting the physical issues they may be suffering from, as well as greatly boosting self-confidence. 

There are two ways in which this can be achieved: the ‘wedge’ approach and the ‘trim’ approach. 

Trim labiaplasty surgery

The trim technique is the most commonly practised. An incision is made into the outside of the inner labia and part of the skin is removed. This aligns the size and shape of the inner labia more closely with the outer labia and makes the area tidier. The part of the inner labia that is removed is often darker in colour too, which is one of the reasons some women report feeling self-conscious about this area. 

Any risks?

All surgeries carry a certain amount of risk and the main challenge with a trim labiaplasty is ensuring that the two sides of the inner and outer labia match up accurately and are nicely aligned. There are the usual risks of bleeding and infection after the operation, although the risks are small as the incision is not significant. Maintaining good personal hygiene while you’re healing and wearing loose fitting clothes to aid circulation are both advised.  There will also be a scar present along the length of the labia, but this is well hidden and most patients feel the scar is far less unsightly compared with overlylarge natural labia. 

Wedge labiaplasty surgery

This is a much newer technique and one that uses a very different approach. A ‘wedge’ is cut from the top of the labia which takes skin from both sides, reducing it in size and shape. The remaining area is then sewn back together to make the smoother, more compact finish that most are looking for from this procedure. This is often recommended if you have an uneven or imbalanced labia

Any risks?

As with the trim approach, care has to be taken when healing to ensure that the area is kept clean and dry. The other main difference is that this does not remove any of the darker colour to the labia, so some women may still be dissatisfied with the look of their labia, even when it has reduced in size. 

Which labiaplasty procedure is best for me?

As with any procedure, the clearer you are in explaining your expectations to your surgeon, the better the chance is that you will end with a result that you are happy with. Both techniques can yield satisfactory results and your surgeon will be able to recommend the best approach for you once they are clear about your own personal motivations and preferences. 

How quickly will I recover from a labiaplasty?

labiaplasty recovery

A labiaplasty is a cosmetic surgery technique which changes the appearance of the folds of the skin that surround the vulva. There are two parts of the labia – the labia minora and the labia majora, both of which (or either) can be altered as part of the procedure. The operation is usually chosen to reduce the size of the labia, either because it is felt to be unsightly or because it causes pain or discomfort.

What to expect from the labiaplasty recovery phase

As far as cosmetic surgery procedures go, a labiaplasty is relatively straightforward and is typically an outpatient operation. In terms of recovery, the pelvic area will be most uncomfortable in the first 72 hours following the operation and, in addition to taking regular painkillers, you may wish to wrap ice in a towel and use this to soothe the area and to help reduce swelling. It’s important to remember that this is a sensitive area of the body anyway, so it is very normal to find that it sore after this kind of procedure.

It is generally recommended that you should wait 48 hours before taking a shower, just to allow the area to begin healing. Generally speaking, swelling should have gone down within two weeks after the procedure, and most patients can go back to work after two or three days.

Wearing loose-fitting clothing is recommended so that the area can heal without being rubbed. Loose, cotton underwear is also recommended as this is the most hygienic (compared with other man-made fabrics).

Labiaplasty recovery and returning to exercise

It is advised to refrain from sexual intercourse for at least six weeks to allow the area to heal. Gentle exercise can be resumed after a couple of weeks but anything that puts pressure on the affected area (such as horse riding or mountain biking) should be avoided for around six to eight weeks.

Once the bruising and swelling has gone, most women find that the wounds heal quickly and leave very little scarring. In time, it is often very hard to see where incisions have been made. Some report that this can be as quickly as a few weeks after the operation, whereas others take longer to heal, and it can be serval months.

As with any operation, allow yourself sufficient time to heal and be patient with your body as it adapts to the changes. Mr Paul Tulley will give you advice and guidance about how to heal effectively, so follow this and don’t be afraid to ask questions if you have any concerns about your recovery. If you have further questions about the labiaplasty procedure, call 020 7118 6887 to arrange a consultation at the Clarence Clinic.

Weighing the benefits of laser vaginal rejuvenation

laser vaginal rejuvenation

Laser vaginal rejuvenation is one of the newer cosmetic surgery procedures and it has been growing in popularity in the last few years. There are a number of options available to women who are unhappy with changes that have occurred to the look, feel or functionality of the vaginal canal, vaginal wall or pelvic floor muscles. These changes often occur after giving birth, having received treatment for certain cancers or during the menopause.

What can be done to help?

Laser vaginal rejuvenation techniques use lasers or radiofrequency to help repair damaged tissue. They aim to encourage collagen growth in the vaginal and vulval areas, improving the tone of the vaginal wall and vulva, regaining firmness, elasticity and lubrication.

As with all new innovations, there are those who support and those who oppose, and the American FDA (Food and Drug Administration – the body responsible for protecting and promoting public health) has recently published its concerns that these products may not be 100% safe, and those wishing to undergo these procedures should exercise caution.

All in good time

There are concerns among British plastic surgeons about spurious marketing campaigns, that promote the benefits of the treatments but without fully explaining the potential risks or implications.

The British Association of Aesthetic Plastic Surgeons recently published advice to the British public, reiterating the importance of all new techniques being thoroughly tested before being fully released to the commercial market and supported with accurate and clear information for consumers: “There has been an exponential rise in the interest in women’s health and sexual well-being and whilst this should be encouraged, it is vital that any educational and treatment initiatives are provided in a sensitive manner free of any misleading or marketing hyperbole.”

Leading London plastic surgeon Mr Paul Tulley’s view is that laser vaginal rejuvenation techniques can serve a valuable purpose, helping women who are suffering from a number of physiological vaginal complaints. However, he feels these treatments should be closely monitored and agrees that practitioners offering these procedures should have the appropriate training. It is important that they are conducted by qualified and regulated cosmetic or gynaecological surgeons, not offered as a quick fix by commercial ‘cosmetic clinics’, that don’t necessarily have the same strict adherence to surgical quality.

New study identifies ‘normal vulva’ for labiaplasty procedures

labiaplasty surgery

Researchers at a Swiss hospital have spent the last couple of years examining over 650 women to establish guidelines for external female genitalia in light of the increase in popularity of labiaplasty surgery. What was interesting was that it was found that there seemed to be no ‘normal’ that could be assigned, meaning that your feelings about and expectations of how you should vulva looks, should always be personal to you.

From August 2015 to August 2017, 657 women were studied at the Cantonal Hospital in Lucerne, Switzerland; their labia major and minora were measured as well as their clitoral gland and the length of the vulva. All data was considered against their age and BMI. The researchers found that there was so much variety in terms of the physical appearance of a healthy vulva that it was impossible to establish normal guidelines.

So, why would you want a labiaplasty?

It’s important that women know that there is no ‘perfect’ vulva they should be aspiring to, but there are many reasons why women choose to undergo labiaplasty surgery. Women may experience discomfort and pain from the twisting and tugging of the labia minora when they are having intercourse or playing sport. They may also experience itching and irritation and some women may be very self-conscious about the size and shape of their labia when they are in certain clothes such as gym leggings or swimsuits.

Pregnancy and childbirth can often change the shape, size or colour of the labia minora and many women wish to undergo surgery to restore the appearance of their vulva.

What does a labiaplasty entail?

A labiaplasty aims to reduce the size of the labia minora, particularly if they hang below the labia majora, or outer area of the vulva. It can also reduce asymmetry which can be common. A labiaplasty is performed under a general anaesthetic – it is a relatively short procedure so is performed as a day-case procedure.

Mr Paul Tulley’s aim is always to produce a very natural appearance after surgery and any scarring will be hidden in the natural folds of the labia, preserving the outer edge of the labia. The procedures should not affect clitoral sensitivity.

Recovery is also typically straightforward. Surgical pads are won and changed regularly and we will give you comprehensive advice on how to care for the area and maintain hygiene. Topical antibiotic ointment and oral antibiotics are prescribed for the first week or so. Any mild swelling should quickly dissipate and the stitches are absorbable so will drop out in the first couple of weeks. We will also give you instructions on when you can resume sexual intercourse and exercise.

We avoid terms such as ‘designer vagina surgery’ and it’s great that studies such as the Swiss one reinforce the belief that there is no perfect vagina. However, for women that are uncomfortable or self-conscious because of the appearance of their vulva, a labiaplasty can be a fantastic procedure, greatly boosting self-esteem. Call 020 7118 6887 to book a consultation and find out more.

Protect your investment: how to look after your facelift

facelift results
With anything you purchase, the better you look after it, the longer it will last and the principle is true for cosmetic surgery. There are some simple steps that can be taken when you have undergone procedures such as a facelift that will ensure that the work you have had done will last for as long as possible. This handy checklist gives a few easy hints and tips for how to ensure your facelift will last as long as possible.

Adopt a good skincare regime

Finding a good moisturiser is a great idea and getting a little bit of help from the experts is well worth it. The skincare market is a multi-billion pound industry worldwide, so this means that your choices are extensive. Getting the right balance of retinoids (components that contain vitamin A which helps encourage skin rejuvenation), peptides (these contain amino acids which help construct protein and collagen – the latter helps keep skin looking young and fresh) and antioxidants (certain antioxidants have skin firming credentials) to suit your skin type can make a real difference to the effectiveness of your moisturiser.

Limit sun exposure and take necessary steps to protect your skin from UV

The sun’s rays are one of the main factors that can accelerate the ageing process and make subtle changes to your skin over time. Ensuring that you wear sun cream regularly will help prevent the harmful UV rays getting through. Many foundations and daily moisturisers also contain sun cream these days so can help easily weave this into your morning routine.

Eat a healthy, balanced diet

Making sure that you look after the inside of your body as well as the outside can have a big effect on how well conditioned your skin is. Ensuring that your diet is rich with vitamins and minerals is important for ensuring your skin has all the nutrients it needs to stay nourished and supple, which will help keep it looking firm and youthful for longer. Getting at least five portions of fruit and vegetables per day will keep your vitamin intake high and also look for foods that are rich in antioxidants.

It’s not just what you should eat but also what you shouldn’t be consuming. In recent years, there have been more and more studies that have linked sugar and accelerated ageing. In a process known as glycation, sugar bonds with the proteins in your body, hardening collagen and elastin and slowing down further production. All of this means your skin becomes less elastic and wrinkles start to appear.

Avoid negative lifestyle choices

Your life choices can also impact on the overall condition of your skin and there are some big culprits that can affect the longevity of a procedure like a facelift. Gaining weight (and then losing it again) affects your skin’s natural elasticity and can affect the work done by a facelift – it can essentially undo the good work done by the surgeon. Poor sleep patterns and stress also have an impact on skin quality

However, the biggest enemy to preserving youth when it comes to facial ageing is smoking. Nicotine in cigarettes causes the blood vessels in the upper layers of your skin to constrict, slowing down blood flow and reducing the amounts of oxygen and nutrients that are being delivered to the dermis. The chemicals in cigarettes damage collagen and elastin which provide skin elasticity and, furthermore, repeatedly pursing your lips when inhaling gives you those awful wrinkles around your mouth. So if you’re a smoker, consider cutting down or quitting.

When you undergo a facelift with Mr Paul Tulley at the Clarence Clinic, giving up smoking before and in the post-surgery healing period is essential, so why don’t you take the opportunity to quit the habit for good.

Half of all women want to ‘turn back the clock’ and male cosmetic surgery on the rise

male cosmetic surgery growth

Market research is pivotal across all industries to ensure that they keep up with the expectations, needs and wants of the current and prospective customers. The world of cosmetic surgery is no different, and research is constantly helping the industry ensure it is keeping up to date with the latest trends and requirements.

Women not keen to simply accept the ageing process

A recent survey asked 2,000 people what their motivations were for undergoing cosmetic surgery and found that half of the women who took part in the survey claimed they wished to ‘turn back the clock’ to their youth – with many citing their 20s as the golden era that they wished to be able to return to, or replicate, in terms of their appearance.

Women reportedly found that in their mid-late forties they felt that their appearance was letting them down, and they didn’t receive the same interest or attention from the opposite sex as they once had.

Male cosmetic surgery growth

Whereas women were traditionally more likely to take the bull by the horns and do something about this (according to the British Association of Aesthetic Plastic Surgeons, 91% of plastic surgery procedures UK in 2017 were for women), men are starting to dabble in this industry more and more, and there has been a marked increase in the amount of interest men have shown in different cosmetic surgery in recent years with figures for male cosmetic surgery procedures going up in the UK.

In the US, this growth is even more marked particularly in the field of body contouring procedures. Statistics show that liposuction for men was up 23%, tummy tucks up 12% and male breast reductions have increased by 30% over the previous year.

With so many people not prepared to ‘age gracefully’, it is clear to see why the cosmetic surgery industry is booming. Not only that, there really is something for everyone. Procedures can start from something extremely simple, for example, some of the non-surgical, temporary fixes can be done in a less than an hour, whereas there is a whole range of cosmetic surgery that can have life-altering benefits for a patient’s self-confidence.

How to minimise the risk in cosmetic surgery

minimising cosmetic surgery risk

The vast majority of cosmetic surgery procedures are elective – people have chosen to have them rather than require them due a genuine medical need. They are growing in popularity and have been for many years and so many of these procedures are now regarded as commonplace. It can sometimes be easy to forget that there are serious risks associated with any surgical procedure, cosmetic or not.

Any form of medical or surgical intervention carries risks. Depending on the nature of the procedure, these can be small, or they can be significant, but whatever the risks are, it is important that patients fully understand them before making the decision to go ahead. But, is it possible to minimise these risks?

Minimising cosmetic surgery risk: cosmetic surgeon choice

Who you choose to carry out your surgery is the most significant way you can mitigate potential risks.

There are a number of ways that you can be reassured by the calibre of the plastic surgeon you are thinking of choosing:

  1. Trust recommendations. Do you know someone else who has undergone a similar operation with the same surgeon? Can you access independent, up-to-date reviews of other patients’ experiences? Listening to the experience of others is really important to ensure you are choosing the right practitioner for you.
  2. Check the surgeon’s credentials. In the UK, cosmetic surgery (like any field of medical practice) is heavily regulated, and this information is publicly available. The General Medical Council (GMC) holds a database of registered plastic surgeons, so check that your surgeon is listed on this register. They should also be a member of one of the leading professional associations for plastic/cosmetic surgeons in the UK, such as the British Association of Aesthetic Plastic Surgeons (BAAPS) or the British Association of Plastic, Reconstructive and Aesthetic Surgery (BAPRAS).
  3. Check on their level of experience. It is also worth asking how many times they have performed this particular operation before. There is no golden rule for how many previous examples is ‘sufficient’, but this type of information helps build a picture of the surgeon’s experience and skill set.

Minimising cosmetic surgery risk: the consultation

The consultation stage is an incredibly important part of the patient journey and key to minimising any possible risks. As well as a comprehensive medical assessment to ensure you are fit for surgery, your cosmetic surgeon will also discuss your motivations for having surgery. If you have unrealistic expectations, then however ‘successful’ the procedure is in the eyes of others, you risk being dissatisfied with the outcome.

They will also give you advice on how best to prepare for surgery; the most important advice will be to give up smoking as this is one of the biggest factors in increased surgical risk during the procedure and in terms of how you heal afterwards.

Minimising cosmetic surgery risk: the recovery period

Finally, the last thing that can be done to help minimise risks sits back with the patient again – and that is to properly follow the aftercare plan. The aftercare is recommended based on the official medical guidance for each procedure, and it will also be customised based on your personal well-being and overall health. Ensure you are fully understand everything you are being asked to undertake and contact your cosmetic surgeon and their team if you have any concerns or questions.

Communication and care are important factors alongside results in positive cosmetic surgery reviews

positive cosmetic surgery reviews

We are all very accustomed to reading, and providing, reviews when we have experienced any form of service. Trip Advisor was one of the first companies to really elevate the importance of showcasing what others thought of the experiences they had paid for and giving others the chance to read firsthand about the pros and cons.

Since then, the prevalence of customer reviews has grown exponentially, and consumers now expect to be able to read reviews from other customers, and regard these as an integral part of the research process when choosing a service provider.

New research study into cosmetic surgery reviews

A new study undertaken ASPS Member Surgeon Dr John Kim of Northwestern University Feinberg School of Medicine and colleagues has taken an original approach toward evaluating cosmetic surgery reviews and the value of online feedback given to cosmetic surgery practices. The study was a ‘content analysis’ exercise which looked at which areas of the cosmetic surgery process featured in the most positive and most negative customer reviews. The results were very interesting and suggest that the outcome of the surgery itself, albeit important, is not the only factor that can leave patient feeling positively or negatively with their experience.

Good customer service is an absolute must

According to analysis undertake by Dr Kim, the dealings that patients (and even prospective patients) have with their surgeons has a huge role to play: “We found that that patients will write negative reviews without ever having had the surgery. It’s not just the aesthetic outcome but also the patient’s interactions with surgeon and staff that provide the impetus for positive or negative reviews.”

Another interesting finding was that those who left the most negative reviews tended to leave much longer reviews. The detail that they included in their review was far more extensive and, subsequently, the overall word count spiralled. This said, good news for the cosmetic surgery industry as a whole, there were significantly more positive reviews (these rating 4 or 5 out of 5 stars) compared with those who were really unhappy (those rating 1 or 2 stars out of 5).

In the most positive reviews, features that were mentioned include (in descending order from most frequently mentioned):

  • cosmetic results
  • good bedside manner
  • friendly/helpful office staff
  • surgeon’s expertise
  • listening to the patient

It’s interesting food for thought that the outcome of the cosmetic procedure, although clearly important, is only one element in a whole host of important factors when people are considering leaving a positive or negative review.

The many uses of anti-wrinkle injections

uses of anti-wrinkle injections

Anti-wrinkle injections have become synonymous with eradicating wrinkles and continues to be the most requested anti-ageing treatment around the world.

Anti-wrinkle injections use a neurotoxic protein that prevents the release of neurotransmitters that cause the muscles to relax and contract. Put simply, when injected it results in temporary paralysis of the muscles below the surface, which then gives a firmer, smoother effect to the appearance of the skin.

Although it is widely used within the cosmetic industry as it is effective and low risk for patients, there are many other uses for anti-wrinkle injections, some of which might surprise you…

Anti-wrinkle injections can help scars to heal

This is an interesting one, as when formed scars can be challenging to treat and can greatly affect people’s self-confidence. The body is very good at healing itself, but as a scar forms, it is often put under pressure from the body’s natural movements, particularly in areas such as the face. Anti-wrinkle injections have the ability to cause temporary paralysis of the target area makes it ideal for helping scars to heal. By creating a paralysed area around the area of trauma, anti-wrinkle injections give the tissue some uninterrupted time to heal, which can speed up the healing process and result in a ‘better’ scar.

New research published in the March issue of Plastic and Reconstructive Surgery evaluated the effectiveness of this use of anti-wrinkle injections. In a clinical trial carried out at a Shanghai University, use of anti-wrinkle injections during the healing of a facial scar was compared to a placebo and the treated scars were lower and narrower than the placebo ones.

Anti-wrinkle injections can help treat hyperhidrosis – overactive sweat glands

Over time, surgeons noticed that patients who were having facial anti-wrinkle injections as an anti-wrinkle treatment were noticing a welcome side effect, they were no longer sweating as much in the areas where the anti-wrinkle injections were administered. The short-term paralysis was affecting the sweat glands as well, which prompted a wave of medical testing to see just how effective anti-wrinkle injections could be as a treatment for hyperhidrosis. Tests provided effective and safe for patients, so anti-wrinkle injections are now used as a treatment for problem areas such as under the arms, on the palms of hands and soles of feet.

It can help prevent teeth grinding

This last one is still in its infancy in terms of research and a clear understanding of how anti-wrinkle injections really help here, but a recent study has shown that injecting this product into the jaws of patients who suffer from the involuntary grinding of their teeth, can reduce the problem.

Teeth grinding often happens overnight and patients regularly don’t realise that they are doing it until a partner becomes aware of the sound or they experience the side effects of nightly grinding. It can be really painful – headaches, jaw ache and damaged teeth can all result from grinding our teeth in our sleep, and the causes of it are usually psychological – often caused by underlying stress.

The ability of anti-wrinkle injections to smooth away lines and wrinkles was originally discovered as a side effect to its initial application to treat muscle spasms and it seems that the applications for this product continue to evolve.