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Frequently Asked Questions


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Inaccuracies and falsehoods in Cosmetic Surgery

We are aware of the enormous discrepancies of criteria that abound between different specialists, centres or companies, when concentrating on Cosmetic Surgery and each one of its treatments. As a medical activity in the Private Health Sector, the conflict of interests between the commercial world and the ethical problem does not always lie on the side of safety, professionalism or in the interests of the patient. This situation creates an enormous lack of confidence in the patient wishing to have Cosmetic Surgery treatment. Our philosophy is very clear. The patients are always first, their interests and their needs, in conjunction with the efficiency and safety of our treatments. To this end the medical facet of our activity is supreme. However, in contrast to our practice, many other centres or professionals offer information that is inexact, slanted, market oriented or even completely false and self interested, practising dangerous procedures that are ineffective or obsolete. To prevent unscrupulous actions we list a series of statements that, in our opinion, are inadequate, deceptive, or mere lies, that are frequently used at other centres to manipulate the wishes of the patient to a commercial and unethical end. Some of these are even popular among the very clients of these centres of Cosmetic Surgery, and become the regular thoughts and petitions of these same clients. Naturally, we completely rejects all the statements that can be read under the title of Inaccuracies and Falsehoods for every group of our treatments.

Is my case customary in secondary surgery?

Although the possibilities are numerous, it is true that certain situations are repeated more frequently among those cases received by our Specialists requiring repair. Among the problems resolved with us are the following:

-Encapsulated breast implants: cases of breast augmentation considered lost or irreparable, because they have been operated on once or more occasions in the past and appear hardened, deformed or painful.
-Submuscular implants: cases of breast implants inserted under the muscle that because of its poor characteristic result or a complication, need repairing.
-"Upward and downward movement implants": Cases of breast enlargement in which the technique has not been correctly executed and the implants move up and down with the arm movement or the contraction of the pectoral muscle, named as elevator breasts.
-Dislocated or malpositioned implants: Which are eccentric from the theoretical ideal center of the breast mound landmarked by the nipple, leading to grotesque look of the breasts.
-Misjudgement in implant selection: The width of the implants do not match the theroretical ideal size of the breasts base therefore produce lateral prominence or alternatively cleavage shortage of the implants.
-Renewal of implants: Because they are aged, broken, deficient from the beginning or because the volume is inadequate.
-Mastopexy: Insufficient, poor cosmetic result, or have suffered a complication.
-Sagging breasts: Cases of sagging breasts for which the treatment has only been a breast enlargement, inadequately performed and without having received specific treatment for the sagging.
-Breast reduction: Poor quality cosmetic result, insufficient elevation, slight volume or having suffered complications.
-Neck Lifting: Patients having received obsolete rejuvenation treatments, such as simply stretching the skin. Facial rejuvenation would have to be redone and also the neck would have to be treated which, in many cases does not receive the necessary dedication.
-Eyelids: Cases in which bags have not been completely removed or a cosmetic or even functional distortion has appeared.
-Rhinoplasty: Inadequate nasal corrections that are not very natural or are insufficient, causing breathing problems, sometimes due to poor cosmetic judgement, reconstructions in multioperated noses.
-Otoplasty: Shortage of approximation to the head, deformities, cartilage injuries, skin shortage.
-Liposuction: Poor performances that require removal of skin, technically deficient performances with under or over correction.
-Abdominoplasty: Spare skin, skin necrosis, insufficient muscular work.

What type of anesthetic is most suitable in breast enlargement?

Without hesitation we recommend using the safe techniques of a general or total anesthetic. In a breast augmentation operation the greater safety, absence of pain and best results are obtained by general anesthetic practised in an authorised hospital. Although they continue to be performed in other centres, breast enlargement operations under supposed local anesthetic are a high-risk procedure in the opinion of our team of specialist surgeons and anesthetists. There are several reasons for rejecting local anesthesia. Firstly, because the necessary dose of anesthetic that has to be administered into the breasts is so high it can become toxic, possibly causing serious complications. Also because the application of a local anesthetic is by deep injection into the breasts which is terribly painful; subsequently, on occasions, the anesthetist is obliged to improvise and to apply an uncontrolled general anesthetic which is very dangerous. Finally, we reject these practices under a false local anesthetic because it only allows limited internal work to the Specialist therefore leading to unsatisfactory results, which nowadays is no longer adequate or suitable in relation to modern knowledge. For your safety and in order to achieve the best results, we recommend a general anesthetic in breast augmentation operations, with a day case stay in the clinic.

What type of anesthetic is most suitable in breast elevation or reduction?

Without hesitation we would have to recommend and practise the safe techniques of a general or total anesthetic. For breast uplift and reduction, greater safety, absence of pain and the best results are achieved administering a general anesthetic in an authorised hospital. Although still being practised in other centres, breast uplift or reduction treatments performed under a supposed local anesthetic are high-risk procedures in the opinion of all our team of specialist surgeons and anesthetists. There are several reasons for rejecting a local anesthetic. Firstly, because the dose of anesthetic to be introduced into the breasts is so high it could become toxic, possible causing serious complications. Also because the application of the local anesthetic is by deep injection into the breasts that are tremendously painful; in these circumstances the anesthetist is often obliged to improvise administering an uncontrolled and very dangerous general anesthetic. Finally, we reject these practices under a false local anesthetic because it only allows for insufficient and obsolete techniques to be performed, which nowadays is no longer adequate nor correct in modern science. For your safety and in order to achieve the best results, our Specialists recommend a general anesthetic for breast elevation and reduction surgeries, with at least a day case stay in the clinic.

Will any scar be visible on the skin following breast elevation or reduction?

Breast elevation and reduction techniques require lower glandular work that holds the breast in its new position in conjunction with the removal of the excess skin and gland that regularly exists in these cases. To achieve this incisions are made around the areola and to the lower part of the breast, that generally produce very high quality cosmetic scars. Incisions made to the lower furrow of the breast remain hidden by the fold created by the natural shape of the breast. Different techniques exist that our Specialists work with regularly to achieve the best results. They will give you precise information about your own individual case.

How long should I wait between two surgical procedures?

When a patient has to undergo 2 or more different operations separatedly, for Cosmetic Surgery or any other speciality, recommended waiting period is a minimum of 1 to 3 months when they are done on different anatomical areas, and 6 to 12 months for the same body region.

What attitude should I take if my result is unsatisfactory?

The best attitude is not to form too precipitate an opinion, as certain situations may seem totally incomprehensible to the patient that we, in Medicine, know exist, and that the patient could be guided to mistaken conclusions. The first thing to do is to advise the surgeon who performed the operation of the situation, asking him/her to evaluate the results and an explanation for them, because sometimes the result is the procedure has been performed correctly. Your surgeon is the one who can best be aware of the reasons why the result is unsatisfactory and is therefore the first person for you to talk to. In Medicine, which is not an exact science, when an unexpected or conflictive situation arises it is vital to have a second opinion. We offer you an evaluation without obligation by our Specialists with wide experience in problematic cases of Cosmetic Surgery.

Will there be any visible scars following the operation of breast enlargement?

The incisions into the areola produce scars of a very good cosmetic quality that, if necessary, the patient can hide permanently using micropigmentation techniques. When the line of the lower furrow on the breast is the area for the insertion, the incision is hidden by the natural fold of the breast itself.

What is capsular contracture or encapsulation of breast implants?

Around the implant a scar is formed, which is natural and beneficial for the outcome of the operation. The phenomenon known as capsular contracture means that this scar shrinks and contracts the implant, leaving it a firm and hardened texture. Years ago the problem occurred in a high percentage of patients due to obsolete implants and low skill in techniques, and nowadays it is still a potential problem with implants inserted above or underneath the muscle, however unlikely thanks to modern implants and current trends in surgical refinement. We have unbeatable statistics in breast enlargement that makes the problem of encapsulation almost obsolete in terms of symptomatic levels. The risk for it to appear is higher in patients not keeping the recommended resting period, whenever significant bleeding might be present, when the skin is tight and not elastic and in tuberous or tubular breasts. Should the situation arise we have effective treatments to resolve the problem, with massages and potentially with surgery.

If the result is not what I expected have they operated on me incorrectly?

Not necessarily. On occasions the organism has a reaction in which the repair to the tissue is deficient, or it may be too efficient resulting in imperfections. This is something that in Cosmetic Surgery we have been able to reduce to the lowest possible percentage. Our professionals have an exceptionally low level of repeat and touching up operations, reflecting their high quality level.

Can the difference between each breast be corrected in a breast enlargement?

Slight breast assimetry is normal in almost all women and, not only does not need correction but is unfeasible, to try and do so usually leads to inadequate results. If the difference is considerable our Specialists can improve the breasts by introducing implants of a different size or volume, or by other combined techniques. If the assimetry is a complex one, some differences will always persist.

How much time should elapse before repeating the operation?

It is variable and depends on the type of treatment initially received, the condition of the tissue and the correction to be applied. In general terms, it is necessary to wait between 6 and 12 months after the initial operation before performing secondary surgery on a patient. The objective is to achieve a repair of the tissue and vascularization, with a view to obtaining all factors concerned in favour of therapeutic success.

What chances of success does a repeat operation in secondary surgery have?

It will depend on many factors, although in our experience we can attest to the fact that the cases we have repaired are the patients who show us the most appreciation in their satisfaction. In professional hands a repeat operation should only be performed if the repair options are possible and offering sufficient guarantees. We shall only operate again if we think we can correct your problem.

Technical datasheet for secondary mammaplasty

-Anesthetic: total
-Surgical time: 2 hours
-Hospital stay: day case
-Proximity stay: 2 days
-Postoperative pain: 4 (scale from 1 to 5)
-Postoperative bandages: 1 week, then elastic brassiere for 4 weeks
-Sick leave: 3 weeks
-Complementary treatments: infrequently massages
-Cosmetic recovery: 1 month 60%, 3 months 80%, 6 months 90%, 12 months 100%
-Scars: around or inside the areola, alternatively under the breast; concealed or visible

This information is indicative only and does not represent an obligation with customers. This technical datasheet is based in statistical means for large groups of patients, with the variability that implies. Medicine and Surgery are not exact Sciences so it is not possible to stablish the most suitable management for each individual case until the moment the Specialist can evaluate the patient. One medical and/or surgical process can't be predictable 100%, so our Medical Team could modify the management plan at any time, based on the requirements that could be considered as necessary."

Why you be able to resolve what others have not been able to achieve?

Because we are especially dedicated to helping patients who are left feeling deceived and dissatisfied following Cosmetic Surgery. Our team possess a wealth of experience in these cases. We shall listen carefully to your concerns and evaluate the situation, then we shall tell you honestly what the causes of the problem are, the repair options and the possibilities of success. We have helped many people redeem self-esteem and faith in Cosmetic Surgery.

Why is there a lack of authentic Specialists in secondary surgery?

It is due to the complexities of the treatments, the need to master and combine numerous techniques, to have sufficient experience to recognise the large number of possible situations. Also, there is sufficient demand in the market for much simpler operations and those within the capabilities of many professionals. We have one of the few specially trained teams who are dedicated to the repair of consequences and problematic cases in Cosmetic Surgery.

Inaccuracies and falsehoods about Secondary Surgery

If an operation goes wrong it is always because the patient does not heal properly - FALSE
A poor result is always because the operation was badly done - FALSE
Poor results are always inevitable - FALSE
A poor result can be impossible to repair - FALSE
A case can never be improved with another operation - FALSE
There are no professionals specialised in repairing unsatisfactory results in Cosmetic Surgery - FALSE
Any Plastic Surgeon is qualified to resolve cases of secondary surgery - FALSE

Why has my operation not given me the result I expected?

Potential sources of dissatisfaction in Cosmetic Surgery are various. On occasions it is the result of a misunderstanding in communication between the Specialist and the patient, which may be as a result of insufficient or deceptive information from one of the parties. It is true that a professional can make technical errors, although the most common error is that the treatment provided is not the best suited to that particular case, or that it has not been correctly applied. It may also be that the tissue of a patient was not of the quality expected in the operation, and therefore causes the totally inevitable poor result, although it may be susceptible to a future repair. Finally, it may be one or a combination of the above-mentioned factors. If you would like a professional opinion, that is both experienced and honest, do not hesitate to consult our Specialists.

Will differences between each breast be corrected with elevation or reduction?

A more or less remarkable difference in breasts is normal in almost all women and, not only does not need correcting but is unfeasible, to address the problem usually leads to inadequate results. If the difference is considerable the Specialists can improve the breasts by insertion of breast implants with either a different shape, size or volume, and with other glandular treatment techniques. If the assimetry is a complex one, some differences will always persist.

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