Is it possible to prevent capsular contracture?

capsular contracture prevention

No operation is ever entirely risk-free and complications can occur no matter how skilled the surgeon is, simply because it is impossible to predict how someone will respond to surgery. The physiological differences affect how quickly they heal and also affects how likely they are to develop complications following surgery.

Scarring after surgery is particularly difficult to predict. Some patients suffer from keloid or hypertrophic scarring, where an overproduction of collagen means the scar tissue exceeds the original wound, resulting in a large, raised, hardened scar.

There is also a form of internal scarring that can present as a complication after breast implant surgery. Known as capsular contracture, it roughly affects less than 10% of patients in the first few years after surgery to some degree.

What is capsular contracture?

This complication is caused by the patient’s ability to grow scar tissue. In ‘normal’ cases, when a wound or incision is made then the body works to repair itself. It creates scar tissue, which is firmer and harder compared with the original tissue. When a patient has a breast enlargement, the body will react to the operation by creating scar tissue around the wound and the foreign bodies it detects – the implants. Normally, this is actually a good thing. The harder, firmer tissue actually helps keep the implants in place.

For patients who experience more significant capsular contracture, however, the scar tissue forms too tightly around the implants, which can compress them, change their appearance, make the skin look or feel uneven and sometimes may even cause discomfort. The degree of capsular contracture can be graded:

Grade 1: very mild capsular contracture that often the patient is unaware of. The breasts remain soft to the touch and there is no change to their shape.

Grade 2: the patient may be aware of very minor cosmetic changes to the breast. The shape is still relatively normal, and the breasts may feel slightly firmer to the touch.

Grade 3: the patient notices obvious cosmetic symptoms including changes to the breast shape and the breasts feel very firm.

Grade 4: the breasts feel very hard and misshapen and the patient will usually experience a degree of discomfort.

Is capsular contraction prevention possible?

The good news is that the risk of serious complications follow cosmetic surgery is really rare. The advances in medical technology in the decades that these procedures have been practised for have ensured that the medical profession are extremely skilled and proficient in the procedures that they carry out. Coupled with this, advanced in medication, pain relief and antibiotics have improved, as has our understanding of pre-care and after-care.

In regard to capsular contracture prevention, there are certain steps your plastic surgeon can take to minimise the risk.

  • Using the correct size of implant for your body shape and frame: placing a too large implant in a patient with insufficient breast tissue can increase the risk of capsular contracture
  • Type of implant material: gel implant with a textured surface rather than a smooth surface is thought to lower likelihood of developing capsular contracture
  • Implant placement: placing implants under the muscle also reduces the risk
  • Minimal implant handling: it’s now thought that a low-grade bacterial infection can be introduced to the breast cavity during surgery and this creates a ‘biofilm’ around the implants. By reducing the handling of the implant during surgery, the lower the risk of this bacterial contamination occurring. A recent study found that the use of a Keller Funnel to insert the implant significantly lowered the risk of capsular contracture

For more advice on breast implant surgery and capsular contracture prevention, call 020 7118 6887 to speak to the experts at the Clarence Clinic.

Am I a good candidate for a breast uplift?

good candidate for a breast uplift

For women who are unhappy with the size, shape, look or feel of their breasts, there are a number of cosmetic breast procedures that are designed to help. Women often have a preconception about how they would like their breasts to look and if they are not meeting these expectations it can lead to confidence issues and low self-esteem.

One of these procedures is breast lift surgery which is a surgical procedure also known as a mastopexy. The operation lifts the breast tissue and the nipple and also takes away excess skin. The breasts are reshaped after the procedure and sometimes this operation is conducted alongside a breast enhancement surgery where implants are inserted as part of the reshaping process.

This is not always the case though it depends on the volume of the breast and the look that the patient is hoping to achieve. Breast lift surgery is typically sought by women who have gained and lost a significant amount of weight, who have had multiple pregnancies with breastfeeding, or whose breasts are naturally lower than they feel they would like them to be.

Who would be a good candidate for a breast up020 7118 6887lift?

The first thing to say about suitability for a breast lift is that it depends entirely on how you feel and how comfortable you are with your own breasts. There is no such thing as a ‘normal’ shape and size; breasts come in all shapes and sizes and each woman’s breasts are unique. The real question is whether you feel unhappy with your own breasts, because if you do then there are definitely options that can be explored to make you feel happier about your appearance.

Another factor that affects the suitability for a breast lift operation is generally based on where the nipple is located on the breast. If the nipple is situated in line with or above the fold underneath the breast, the breast shape may be acceptable or a breast augmentation should be sufficient to achieve a pert look. If the nipple is now south of that line, for whatever reason, then you are likely to require to be a good candidate for breast lift surgery.

If you have finished having children, you are also regarded as being more suitable for this kind of operation because changes to the breasts through pregnancy and breastfeeding means that if you choose to have this type of operation before you have finished your family then the work done by surgeons may alter throughout the course of future pregnancies.

Next steps to consider

If you feel that breast lift surgery is something that you would like to consider then book an appointment to talk through the options that are available. You may wish to consider a lift in isolation, or you may feel that a lift coupled with implants is the right route for you. Mr Paul Tulley will be able to talk to you about the different options and together you will be able to make the correct choice for you and your body.

Cosmetic clinics urged to screen for mental health problems before offering cosmetic treatments

patient safety

Anti-wrinkle injections and dermal fillers are popular procedures and are readily available in clinics across the UK. As these procedures are deemed ‘non-surgical’ or ‘minimally-invasive’, the eligibility criteria are quite relaxed, with many people being regarded as suitable to choose to have this type of cosmetic work done. This is all set to change, with a tightening up of the rules that is welcomed by those who regulate the aesthetics industry and wish to ensure patient safety.

Mental health assessment before cosmetic treatment

Cosmetic surgery regulators and the NHS have previously voiced concerns that people suffering from negative body image perceptions should not have such an easy route to access cosmetic treatments. They are concerned that these people may have a skewed perception of how they look and how these procedures can help address this. The challenge for people suffering from body dysmorphia is that they are rarely pleased with the results that they achieve, meaning that the surgery does not help improve how they feel or how they believe they look.

The Joint Council for Cosmetic Practitioners believes that “practitioners should be trained to recognise vulnerable individuals who are looking for “quick fixes” and to assess their suitability for the procedures.” It is their belief that clinics have more of a responsibility to their patients and should be screening people for warning signs ahead of agreeing their suitability for surgery.

According to a report published in the Guardian, “clinic staff will be trained to understand the issues around people’s appearance and how to spot signs that a would-be customer may have a mental health problem. Anyone who appears vulnerable could be advised to seek help and directed to nearby NHS mental health services.”

Widespread support for these patient safety measures

Professional bodies such as the Royal College of Surgeons and the British Association of Aesthetic and Plastic Surgeons (BAAPS) believe that these measures are a necessity and would like to see them rolled out even more widely. At the moment, clinics that are members of the trade body the Joint Council for Cosmetic Practitioners will be given training and guidance to ensure they know how to correctly identify those in the higher risk categories when it comes to mental health screening.

BAAPS has developed an ‘ABCDE’ screening tool for its members which aids surgeons in performing necessary checks on patients’ suitability before they are approved for surgery. Part of the assessment involves studying the patient’s behaviour, motivations and expectations from the surgery, to ensure that they are meeting appropriate mental health markers.

Even though treatments such as anti-wrinkle injections and dermal fillers are non-surgical, they can still result in serious complications and less than satisfactory results, so this move to introduce similar standards to the aesthetics industry is welcomed by cosmetic surgery professionals and professional bodies who often see examples of botched aesthetic procedures in their clinic.

Am I a good candidate for labiaplasty surgery?

candidate for labiaplasty

A labiaplasty is a cosmetic procedure that is designed to reduce the size and shape of the labia. There are two reasons women choose to have this type of operation – cosmetic or medical. For some who are considering this procedure, changing the size and shape of the labia can be linked with personal preference and confidence. If they feel the labia looks too big or too long, or is a darker colour than the rest of the skin in that area, a labiaplasty can address these cosmetic concerns and help improve how you feel about it.

For others, there may be discomfort while sitting, exercising or wearing particular clothes, there may be pain during intercourse or when inserting a tampon or even pain when simply walking around. Whatever your concerns, whether these be cosmetic or medical, these are the first indicators that you could be a good candidate to undergo a labiaplasty.

Being in good health

If you tick either box in terms of your motivations for this procedure, it will be time to begin talking with a cosmetic surgeon, and there will be a series of things that they will need to check before agreeing that you are suitable to proceed. They will want to see that you are in a good state of general health as this will help the healing process and reduce the risks of any complications arising after the operation. This does not mean you need to be at the peak of physical fitness, but what they will want to see if that you look after yourself, undertake a reasonable amount of exercise and eat a balanced and varied diet.

It is also important that you don’t have any other serious medical conditions that could affect what is needed to carry out the operation or could affect your body’s ability to heal afterwards. Any pre-existing medical conditions need to be discussed up front so that your surgeon can be fully aware of your medical history.

Age and maturity

Another factor to consider is your age. This procedure isn’t suitable to this who are under 18, your body must have stopped growing/developing before you consider a procedure like this. Surgeons will also want to be reassured about your expectations from the operation. Ideally, you’ll have given this plenty of thought and thoroughly researched what to expect and where you want to have it done. You must also be choosing this operation for the right reasons.

To find out if you’re a suitable candidate for a labiaplasty, call 020 7118 6887 to arrange a consultation at our central London cosmetic surgery clinic.

New device could minimise cosmetic surgery scarring

cosmetic surgery scarring

All cosmetic surgery procedures entail making incisions in the skin, which means that scarring is always a question that patients ask during their consultation. Understanding the nature of scars patients will be left with, and what they can do to help them heal, is an important part of the discussion that will take part between the plastic surgeon and the patient.

Understanding cosmetic surgery scars

Firstly, to understand more about scarring we need to understand more about the skin. In the simplest terms, it is made up of two key layers, the epidermis and the dermis. The epidermis is the top level, and if this is damaged in any way then a naturally-occurring component called collagen helps the skin to fuse back together.

The dermis is a deeper layer underneath the skin, which contains nerve endings, blood vessels and thicker tissue. If an incision is made through the dermis then it takes much longer to heal and there is a greater risk of visible scarring afterwards.

No two cases are the same

A good cosmetic surgeon will plan the procedure carefully to ensure that any incisions made are neat, as small as possible and placed in the optimal position. From a surgical perspective, this will give the scar the best chance of healing and fading in time. The other elements are a bit harder to predict, as how well a scar forms and heals is heavily influenced by the patient’s own healing response and how healthy they are. Some people’s skin heals faster due to high levels of collagen and a good blood supply, others find it takes longer and the scar is more visible.

A new device could now help with cosmetic surgery scarring

Researchers in the US have developed a new tool which could potentially help reduce scarring left from cosmetic surgery procedures. It is well known that the skin is made up of lines of cells, which stretch effectively in one direction, and not in the other. In simple terms, it is like cutting into a steak – if you cut along the grain then it is much easier to cut compared with cutting through it, crossing the lines. The same principle is true for the way the skin is made up.

Surgeons use these lines to plan where to make incisions, as the researchers explain, “if you make incisions across the direction that collagen is aligned, the risk of keloid scar formation (raised scars that can grow larger than the original injury) is increased. Cut along the direction of the aligned collagen and wounds heal better and produce less scarring.”

Until now, knowledge of exactly where the lines fall has been limited; “surgeons currently use either skin tension line maps (of which there are many, and often different) or manual manipulation to find the local orientation of skin tension. Manual manipulation is often inaccurate, and our research demonstrates that skin tension line directions differ between people – so maps are only approximate.”

With this knowledge in mind, researchers have developed a device which quickly scans the skin and enables surgeons to know exactly where the tension lines fall. This is likely to have a significant impact on how well an incision can be made and it will give the body the best possible chance of healing effectively from a surgical incision.

During your cosmetic surgery consultation, potential scarring from your procedure will be discussed in depth as well as advice given on how best to speed up the healing process and minimise scarring. To arrange your consultation at our central London cosmetic surgery clinic, call 020 7118 6887.

Will I be left with visible labiaplasty scars?

labiaplasty scars

It is important to be mentally prepared ahead of any cosmetic surgery procedure, and part of that involves understanding what the area will look like once the surgery has been completed and the body has fully healed. An important pre-surgery question that patients should be asking their surgeon about is the amount of scarring that will be left after the surgical site has healed, so we explore what the answer is for patients who are choosing to have a labiaplasty.

Small operation, low risk of visible labiaplasty scars

The good news is that compared with some of the more invasive or larger-scale operations, a labiaplasty is a small, quick procedure so the risk of scarring is small. The incisions that are required are often very small, so the body does not need to work excessively hard to heal from a labiaplasty operation.

Two different surgical approaches

It is important to understand that there are two ways that surgeons can perform labiaplasty operations, and the healing for these is slightly different. Some will use a straight line incision, commonly known as a trim labiaplasty, which means that the scar is around the edge of the labia. The other technique is known as a wedge approach, which leaves a scar through the centre of the labia and a little bit to the side. Talk to your surgeon fully at the consultation stage to ensure you understand which approach is best for you and how you can expect the area to look afterwards.

Time is a great healer

Over time, the scars should fade so they are almost unnoticeable – even to you. Although they will be red to begin with, over time the redness fades and the scars become white. You would have to really scrutinise the area to see the scars.

If you’re worried about labiaplasty scars…

If you are concerned about the appearance of scars following your operation then the first thing you can do is to apply hypoallergenic lotion or creams that are designed to help scars fade/heal. Scar tissue takes a while to fully mature so you could expect that the scars will continue to fade over the course of the first year. If you have any concerns though, don’t hesitate to get back in touch with your plastic surgeon to get an expert opinion on how quickly and effectively the area is healing.

Top 5 questions to ask at your labiaplasty consultation

London labiaplasty consultation

All cosmetic surgery procedures begin with a consultation and this is an important opportunity for you to ask plenty of questions. The best advice is to come to your consultation fully prepared, having read around the subject, spoken to friends and/or family and prepared a list of questions.

The list is a good idea because it is very easy to forget your questions once you get into the consultation and begin talking about all the different aspects of your chosen procedure. For patients who are considering this surgery, here are some of the most commonly asked questions at the labiaplasty consultation.

Labiaplasty consultation questions: Is this operation right for me?

Ultimately, only you can really decide whether or not a labiaplasty is the right thing for you, but there are two things that your plastic surgeon will want to assess before agreeing to undertake the surgery. Firstly, a physical assessment will be done to check the current state of the labia and to check the elasticity of the skin surrounding it. This is important to establish that patients will likely heal as required and that their skin will be able to accommodate the changes.

Secondly, they will wish to undertake a check whether you’re approaching surgery with the appropriate outlook. This will involve checking the reasons you wish to have the operation, your expectations of the area once it is done and your expectations about how you think it will make you feel afterwards.

Labiaplasty consultation questions: How long will it take to recover?

A labiaplasty is a relatively simple surgical procedure an as long as you are prepared to follow the aftercare instructions carefully you should expect to heal fully in a few weeks. Bruising and swelling usually heals within a week or two. It is important to note that given how delicate the area is you should refrain from having sex for several weeks to give the area enough time to heal fully.

Labiaplasty consultation questions: How much experience do you have in performing this procedure?

Don’t be afraid to probe your plastic surgeon about their experience; they should be happy to reassure you and to detail how many procedures of this type they perform a year.

Labiaplasty consultation questions: Will I be left with scars afterwards?

This is an important thing to discuss but you would expect to hear that scarring will be minimal. Any operation requiring an incision will leave some form of scar tissue, but the incisions made for a labiaplasty are minimal and the skin tends to heal quickly and effectively.

Labiaplasty consultation questions: What type of anaesthesia is used?

This is a useful discussion to have to ensure you are prepared for what will happen on the day. Typically, a local anaesthetic (one that is administered directly to the area rather than the patient being put to sleep) is used as the area that is being operated on is small and external.

If you have further questions, call 020 7118 6887 to arrange aconsultation at Clarence Clinic.

The positive benefits of a labiaplasty

labiaplasty benefits

A labiaplasty is a relatively simple surgical procedure whereby a woman’s labia is reduced in size, tightened up or altered in appearance. It is a procedure that has been growing in popularity in recent years for a number of reasons including ageing, pregnancy or a general dislike of the natural size or shape of the labia. There are a number of benefits that women see in this procedure and here we look at some of the most common ones.

Labiaplasty benefits: improved self-confidence

Large labia lips can cause some women embarrassment. For some, there is a concern that the labia can be seen through swimwear or tight-fitting clothing, and this can leave some women feeling uncomfortable with their appearance.

Labiaplasty benefits: more positive sexual experiences

Generally speaking, medical experts do not agree that a labiaplasty helps improve sexual intercourse; however, if your labia is particularly elongated then it may be causing discomfort during sex. For some women who have struggled with discomfort during intimate relations, realising that a simple procedure like this can help is really reassuring.

Labiaplasty benefits: improved personal hygiene

A smaller or shortened labia is easier to keep fresh and clean and may leave women feeling that it is easier to achieve good personal health. This is especially true for women who have a heavier frame or who are carrying excess weight.

Labiaplasty benefits: pain relief

A larger labia can cause pain and discomfort during sport and exercise, particularly pursuits such as horse riding, cycling and other activities which involves sitting on hard surfaces. Reducing the size and shape of the labia can help remove this problem and can mean that women can enjoy leisure and sporting activities without feeling uncomfortable.

Your next steps

If you are concerned at all about how your labia looks and feels and any of these concerns resonate with your experience, then it might be time to book an appointment to talk to an expert about options for a labiaplasty.

This operation is typically done as an outpatient procedure and although it is a particularly delicate and sensitive area, recovery is usually fast. Your cosmetic surgeon will be able to guide you through the best way to approach recovery to optimise the chances of a fast healing process.

What are the risks of a labiaplasty?

labiaplasty risks

It is important for patients to understand the risks associated with any cosmetic procedure, some of which will be relatively safe while others carry significant risk. For those considering a labiaplasty, this procedure sits at the relatively safe end of the spectrum, as it is considered one of the simplest and safest surgical cosmetic procedures that women can undertake. This means that those opting for this type of operation tend to report high satisfaction with their surgery following the initial period of recovery.

Nevertheless, as no cosmetic procedure is 100% risk-free, here we outline the risks that are associated with choosing to have a labiaplasty.

Labiaplasty risks: problems with healing 

As you might expect, for any operation whereby incisions are made, there is always going to be a risk that the wound fails to heal, and can bleed excessively, struggle to heal or become infected. This area of the body benefits from a rich blood supply which means that incisions made during the labiaplasty usually heal extremely quickly and leave very little scarring.

Post-operatively, patients are given information on how best to aid their recovery, and some clear dos and don’ts. Following these guidelines is the easiest way to ensure you’re minimising your own risk, but sometimes you will just be unlucky. There are always going to be certain pockets of the population who are naturally at greater risk compared with others, for example, those who smoke are more likely to have problems when recovering/healing compared with non-smokers.

Labiaplasty risks: pain and discomfort

Some patients report that there is discomfort at the site of the incisions, although this is rarely a problem. Scarring from a labiaplasty is minimal as incisions are usually very small.

Labiaplasty risks: loss of sensation or numbness in the area

This is a surprisingly common side effect for a wide number of operations as anything that requires an incision runs the risk of causing a certain amount of nerve damage. For many operations, even major surgery, this loss of sensation is usually temporary. As the wound and nerves heal over time, sensation will return. Any numbness following a labiaplasty will probably be short term and minimal.

Trust the professionals – only the professionals

It is important to remember that operations such as the labiaplasty are only low risk when they are carried out by fully trained and regulated professionals. It is imperative that you make sure that you only ever consider using a qualified cosmetic surgeon, not a clinic or alternative environment which promises something cheaper or quicker, but who are not bona fide medical professionals.

How best to recover from a labiaplasty

labiaplasty recovery

The labiaplasty procedure is fast growing in popularity, but many women who are interested in finding out more about what it entails are naturally concerned with the recovery process after such intimate surgery.

During a labiaplasty, also known as a labial reduction, our plastic surgeon will reshape and/or resize the appearance of the inner labia or labia minora. It is typically performed under a short general anaesthetic as a day case so you will be discharged the same day all being well. Here’s a general guide to your recovery process once you return home, although every patient can have a slightly different experience.

Labiaplasty recovery: immediately after surgery

In the first few days after surgery, you should experience some mild pain and discomfort, but this should be easily controlled by the over-the-counter pain medication. There will also be moderate swelling and bruising to the area.

One side might feel more swollen than the other and you may experience discomfort when urinating, but this shouldn’t be a cause for concern. You may see ‘spotting’ which is blood from the incisions – a small amount of spotting immediately afterwards is fine, but excessive or continual bleeding isn’t and you should get in touch with the clinic immediately.

Our advice at Clarence Clinic is to rest well during those first two to three days and minimise walking.

Labiaplasty recovery: one to two weeks after surgery

Most patients find that they no longer require pain medication now and although there may still be some swelling and bruising, you should be able to resume normal physical activity and can return to work if you don’t have a particularly strenuous job.

The area may feel itchy as the incisions heal but it is essential that you don’t rub or scratch the area and you may want to use a cold compress to ease any discomfort, although don’t apply ice directly to your skin. We also advise you to wear clothes and underwear that is loose fitting for the first few weeks.

Labiaplasty recovery: up to a month after surgery

Our plastic surgeon uses dissolvable stitches and these should have all dissolved. You’ll have been seen by our plastic surgeon for a check-up to ensure all is healing well and he can advise you on when you can resume more active exercise.

Labiaplasty recovery: six weeks after surgery and onwards

You should be almost fully healed at this point and you can resume sexual intercourse and use tampons safely. By four to six months, all swelling and bruising will have completely disappeared and you can see the final results. Any scarring is usually well hidden in the naturally-occurring folds and creases.

If you have any further questions about the labiaplasty procedure, please call us on 020 7118 6887 to arrange a consultation.