..Before & After Cosmetic: Body
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A Work in Progress: The photos at right will remind you that this patient is presented elsewhere in this website (Topics: “Improved Shape vs. Scarring” and ‘’Breast Reduction’’). We have completed her breast reduction and are in the middle of a series of liposuction procedures. We have 2 more such procedures to go . Both the patient and myself are very pleased with our progress so far. Her entire body habitus has changed to a much more athletic and dynamic one which was one of our primary goals when we began in this former athlete. | |
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Please compare the relative projections of breasts versus abdomen in the two profile views at left and of course the breast shapes themselves. The post op breast silhouette has a beautiful shape compared with the pre op view. Please note that the breasts are not bottomed out in any way yet the nipples point up ever so slightly, giving them a very youthful appearance in this sixty year old. In our next procedure, I will concentrate on her lower body primarily, in particular, the collection of fat at the top of her buttocks (arrow). After removing this, her buttocks will curve out gracefully from the small of her back , giving her an even more slender yet curvy silhouette. | |
Liposuction for Gynecomastia (breast fullness in men) |
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This is an example of liposuction for gynecomastia. You can see that this young man had lots of breast fullness in the pre op photos at upper left. In the post op photos, he is devoid of that fullness. Pre-operatively, he was very uncomfortable in any situation where he had to remove his shirt (eg on the athletic field, at the beach or by a pool) and chose to forgo those fun activities for fear of embarrassment. He even related that he was uncomfortable in a t-shirt. Postoperatively, he is very happy and looks forward to joining his friends soon. | |
Abdominoplasty (tummy tuck) |
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This gorgeous model and actress sent me this picture to show me the areas of her tummy she wanted fixed. The result of her tummy tuck is below. Where is the scar? I always ask my patients to bring in their favorite smallest bikini the morning of surgery. I trace it and make sure I keep her scar inside the lines. She is very happy with the final result as am I. She has three full-grown children and now has the figure of a college girl. This was a so-called “Mommie Makeover” as I also did her breasts.
Next Patient
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This was the first tummy tuck I ever did (back in the States when I was working as a general surgeon). I hadn’t even seen one at that point. I apologize for the poor quality photos. They were taken back in 1996 before I had a digital camera or a scanner. They are photographs of old printed photos. This woman was only 25 but had been through hell before coming in to see me. She had a Cesarean section and developed necrotizing fasciitis during the post-op period. This is one of the worst things that can happen to a post-op patient and has a mortality rate of 50 %. She survived but was left with an awful scar around which she deposited fat. This operation was next to impossible to do since the abdominal wall was attached like concrete to the fascia due to scarring. Somehow I was able to get it done and even managed to give her a nice hourglass shape by tightly plicating her rectus fascia (cinching in her waste). She is pictured on post-op day two. Her staples are still in as are the drains which were removed the following day. I have rolled down her panties to show the low-lying scar which will easily be hidden by a little bikini. This may be the only tummy tuck in history covered by medicaid and if I remember correctly, the reimbursement was a whopping $200. | |
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This French lady kept herself very slim after the birth of her three children but couldn’t get her tummy flat no matter how much she exercised. (no one can if the problem is due to a lax fascia as it was in this case.) So a tummy tuck, not liposuction, was indicated. This was the first tummy I did in Cambodia. In those early days most of our out of town patients came from France. Nowadays the majority come from Australia, Hong Kong, Singapore, China , Canada, and of course, the U.S. | |
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As you can see, this friend of mine had an umbilical hernia pre-operatively which was getting angry-looking with a purple tint to the overlying skin. It was of the dangerous size; large enough to transmit a loop of bowel yet small enough for that bowel to get incarcerated and if not released in time, strangulated , leading to perforation and sepsis. Pictured one week after surgery, it is all fixed now and as you can see, I performed a tummy tuck on him concurrently. I do this combination frequently on both women (pregnancy leads to it) and on men. This friend is in the patient care profession also and as such, expected a lot which I was very happy to deliver. The scar is very prominent at one week but will fade to a thin “pencil line” with time. | |
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The books used to teach that you can’t do liposuction at the same time as a tummy tuck. I knew they were wrong because it didn’t make sense according to surgical principles. So all the other plastic surgeons were getting limited results compared to us. As I have been doing for many years, I combined the two procedures here. The specimen I removed from his abdominal wall (all the skin and fat, hip to hip from above his belly button to his pubic area) weighed 22 KG = 48.4 lbs. I could barely lift it off the table. I also removed 4 liters of fat by liposuction. This tummy tuck/lipo combination took an hour and a half longer than my usual two hours but it was worth it as this good friend told me: ‘’It has transformed my life.’’ | |
Buttock Augmentation |
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This beautiful runway model from Beijing complained that when she wore a cocktail dress, it hung straight down and that her jeans looked too flat in the back. She requested a buttock augmentation but didn’t have enough fat to do it by transfer. So I placed buttock implants of 300 cc’s on each side. She is a little too sore to stand up straight as it is only post op day 2. 23 years old 5’10” 122 lbs | |
Brachioplasty (Arm Lift) |
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This sweet American lady came to Phnom Penh to have a procedure by me and was so happy with the result, she ended up staying for five! Pictured above is the before and after result of one of those procedures, a brachioplasty or ‘’arm lift’’. These procedures are most commonly performed on those patients who have undergone massive weight loss of 150 pounds or more after one of the gastric banding procedures. Since this was not the case here, and her arms were very bulky (making adequate skin resection impossible), I performed liposuction prior to the resection of her excess skin (‘’bat wings’’ as she liked to refer to them). After the removal of 1000 cc’s of fat, I proceeded with the resection. If you study the ideal arm, you will notice that the forearm is actually wider than the arm in this view even though the forearm is distal to the arm. Pre-operatively, this is not the case in this lovely lady but post-operatively, I’m proud to say, it is. I had warned her that, when we removed her bandages , revealing her slimmer arms, she would shed a tear or two (of joy) and later, she admitted that, yes, she had. The after picture is quite swollen and bruised still at post-op day four (especially near the axilla) but I couldn’t resist giving you a peek.This amazing lady underwent liposuction from six locations (removing a total of six liters of yellow fat), a face lift, the arm lift shown above, and a breast reduction. All of these procedures, with the exception of the breast reduction, were performed painlessly under local anesthesia with I.V. sedation even though each one took about three hours to complete. | |