The term Mastectomy refers to the surgical partial or complete removal of one or both breasts in individuals with breast cancer. In the past, complete removal of the breast was the standard treatment of breast cancer, however surgical breakthroughs in recent years have presented patients with more options than ever before. At present, there are a number of different types of mastectomy and whilst every type of mastectomy may not be right for every patient, the type of incision used and the amount of skin removed will affect the aesthetic results of reconstruction.

Factors affecting the type of mastectomy to be adopted are a patient’s age and general health, the size, location and behaviour of the tumour, whether or not the surgery is to prevent cancer instead of treating it, and whether or not the patient intends to undergo reconstructive surgery, either immediately or at some time in the future. According to Dr Allen Rezai, pre-eminent consultant plastic and reconstructive surgeon of Harley Street, London, and breast surgery expert, “There are various types of mastectomy: firstly the Simple Mastectomy, a procedure that removes the entire tissue of the affected breast including skin, nipple and areola, but leaving the underlying muscle intact. Then there is the Modified Radical Mastectomy, a procedure combining removal of the entire breast tissue from the affected breast with the removal of the related axillary lymph nodes of the armpit. The Radical Mastectomy involves removal of the entire breast tissue, the axillary lymph nodes and the pectoralis major and minor muscles behind the breast on the affected side of the body, with only the skin required to close the incision being left in place. The Skin Sparing Mastectomy preserves most of the normal breast skin, the affected breast tissue being removed through an incision made around the areola. Finally there is the advanced technique of the Nipple Sparing Mastectomy, also known as a Subcutaneous Mastectomy, in which the nipple and areola are preserved. This is the most difficult mastectomy procedure to perform but it will provide patients with the best possible cosmetic results when combined with immediate breast reconstruction.”

If a patient is considering reconstruction (a decision that will usually be taken following advice and consultation with their oncologist, and perhaps also GP and breast care nurse), they will have the opportunity to meet a reconstructive plastic surgeon to determine which type of reconstructive procedure will best meet their needs. One of the first choices to be made is whether to undergo immediate or delayed reconstruction. Immediate breast reconstruction is performed during the same operation as the mastectomy, whereas delayed breast reconstruction is only carried out after having fully recovered from the mastectomy, which might be weeks, months or even years following the mastectomy.

There are advantages and disadvantages associated with both options. According to Dr Rezai, “The advantages of immediate reconstruction include overall better aesthetic results, smaller scars, often fewer surgeries, and only one anaesthetic and recovery period, together with a decreased risk of related emotional and social difficulties. The advantages of delayed reconstruction include the staggered surgery, resulting in easier and shorter recovery after each procedure. Patients also have more time to consider their breast reconstruction options and to make choices. And any additional cancer therapy required after mastectomy will not cause problems at the reconstruction site. However, regardless of whether an immediate or delayed approach is used, it is important for the patient to understand that it may take several procedures to achieve the desired final aesthetic result.”

There are two main types of breast reconstruction: Implant Breast Reconstruction and Autologous Breast Reconstruction, the former employing an artificial implant to recreate the breast mound, and the latter using the patient’s own tissue from another part of the body to recreate the breast. It is generally recognized that Autologous Breast Reconstruction regularly produces reconstructed breasts with the most natural look and feel possible. Furthermore, a breast reconstructed from natural tissue is there for life, whilst reconstruction using synthetic implants often requires their replacement over time. According to Dr Rezai, “The advantages of Implant Breast Reconstruction are a short and relatively simple surgery, a short anaesthetic and recovery time, no operating on healthy tissue or additional scars elsewhere, and no missing tissue elsewhere in the body. Its disadvantages are a resultant less symmetrical shape match with the remaining natural breast and a breast texture that is not so natural. The technique is also unsuitable for reconstructing large breasts. Autologous Breast Reconstruction produces breasts with the most natural feel and best aesthetic results. It is the most durable and benefits from employing no artificial materials. On the other hand, Autologous Reconstruction is a major operation involving additional scars and possible complications from surgery at other body sites. It also requires a longer hospital stay.”

At consultation, a patient’s chosen reconstructive surgeon will explain the different types of reconstruction most suitable for them based on considerations of anatomy, prior surgeries, current medical condition, cancer treatment needs and personal preference. The surgeon will normally work closely with the oncologist and radiologist to form a collaborative partnership designed to give the optimum level of care. However it is important to understand that all reconstructive options have both risks and benefits, and each option regularly requires multiple procedures to attain the final desired result.

For more information about reconstructive breast surgery and the options available, including before and after photographs and details of other breast surgery procedures performed by Dr Rezai, reference can be made to his website at allenrezaimd.co.uk

The post Breast Reconstruction Options following Mastectomy appeared first on Allen Rezai MD | Consultant Plastic, Aesthetic & Reconstructive Surgeon.

Rhinoplasty surgery (commonly known in the media as a nose job) is one of the most frequently requested cosmetic surgery procedures. But how is it performed, what choices are available and, most importantly, which rhinoplasty surgeon is best for you? Dr Allen Rezai, pre-eminent consultant plastic and reconstructive surgeon of Harley Street, London, and an expert rhinoplasty surgeon, sheds some light on this operation and discusses the available options.

Dr Rezai explains: “There are basically two varieties of this procedure, known as Open Rhinoplasty and Closed Rhinoplasty, and the selection of which method should be used is for some patients a major issue. Open Rhinoplasty involves making a small incision externally at the base of the nose, whilst the Closed variety involves any number of incisions concealed within the nostrils. There is frequently an element of fear about the Open Rhinoplasty incision and whether or not it will be noticeable. Patients might even have seen examples of excessively visible scars from an Open Rhinoplasty. The fact is however that over-visible scars can indeed result when poor technique is used. Some Rhinoplasty surgeons are more experienced and proficient in one technique than the other, and some are equally experienced and proficient in both. So what should be uppermost in a patient’s mind is not so much the technique that will be employed, rather the experience and proficiency of the individual plastic surgeon in obtaining the desired result.”

Dr Rezai elaborates further concerning the two types of Rhinoplasty: “The first thing to know is that access to the nose provided by the Open technique is far superior to that available in a Closed Rhinoplasty, therefore diagnosis and treatment of problems involving the tip of the nose can be more accurate. Closed Rhinoplasty, which might be excellent for removing a bump on the bridge of the nose, does not allow the surgeon to see the cartilages of the nose tip nearly as well, so it is much more difficult to achieve symmetry in the tip, which in the long term can result in more problems.

“The Open Rhinoplasty method in fact facilitates several different techniques that enable a surgeon to reliably shorten the nose tip resulting in a smaller nose. This is much more difficult to achieve using Closed Rhinoplasty. Indeed work on the nose tip, bridge, and septum can all be accomplished in Open Rhinoplasty through the same external incision.

“Since the risk of visible scarring is one of the reasons why some patients request Closed Rhinoplasty, it should also be mentioned that the incisions made by this technique can in theory also pose healing problems. Some of these incisions are made near the narrowest part of the nasal airway, so even a small quantity of excess scar tissue could seriously compromise breathing. However in reality a highly experienced surgeon will produce results with no visible scarring or scars well concealed within the nasal folds.”

“One slight disadvantage to Open Rhinoplasty,” concludes Dr Rezai, “is that the operation will take somewhat longer. But every surgical technique has its advantages and disadvantages. Patients should not be over-concerned as to whether their preferred surgeon suggests an Open Rhinoplasty or a Closed Rhinoplasty. What is more important is the outcome of the procedure and that your surgeon can achieve exactly what is right in your particular circumstances.”

For more information about rhinoplasty and the options available, including before and after photos and details other facial surgery procedures performed by Dr Rezai, reference can be made to his website at https://allenrezaimd.co.uk

He can also be contacted directly through his London clinic at the following address:

Dr Allen Rezai
40 Harley Street
London
W1G 9PP
United Kingdom

The post Nose Jobs Proliferate Amongst the Stars but Choosing the Best Rhinoplasty Surgeon is the Key to Success appeared first on Allen Rezai MD | Consultant Plastic, Aesthetic & Reconstructive Surgeon.

Breast drooping or sagging, known medically as ptosis, can result from any one, or more likely a combination, of several possible factors. Ageing, pregnancy, breastfeeding, smoking and weight loss all take their toll, and particularly the stretching of the tissues due to breast enlargement during pregnancy, with multiple pregnancies having a more pronounced effect. Breast ptosis is also influenced by heredity, which determines a woman’s skin elasticity, breast size, and the balance of adipose and glandular tissue.

Some women still mistakenly believe that ptosis comes about because the breasts themselves provide insufficient support, and that sagging can be prevented by the regular wearing of a bra. However there have been numerous studies disproving this. We spoke to Dr Allen Rezai, renowned Consultant Plastic and Reconstructive Surgeon of Harley Street, London, and specialist breast surgeon who confirmed that “there is no medical evidence that wearing a bra can prevent breasts sagging. The breast itself is not muscle so keeping it toned up is impossible. Women’s breasts begin to droop with age and extremely large-breasted women are generally more seriously affected. However, sagging has only very little to do with the ligaments. It is more a function of the weight of the breasts and skin elasticity.”

The severity of breast sagging is categorised by evaluating the position of the nipple relative to the fold beneath the breast, known as the infra-mammary fold, the point at which the underside of the breast attaches to the chest wall. Dr Rezai explains that “plastic surgeons describe the degree of breast sagging using a ptosis scale, such as the Regnault ptosis scale in which Grade I represents Mild Ptosis with the nipple at the level of the infra-mammary fold and above most of the lower breast tissue. Grade II represents Moderate Ptosis, with the nipple located below the infra-mammary fold but higher than most of the breast tissue. Grade III is Advanced Ptosis, where the nipple is below the infra-mammary fold and at the level of maximum breast projection. Grade IV represents Severe Ptosis, and here the nipple is far below the infra-mammary fold, pointing downwards. There are also two other conditions that are taken into account. The first is referred to as Pseudoptosis in which the nipple is located either at or above the infra-mammary fold whilst the lower half of the breast sags below the fold. This is most often seen when a woman stops nursing. And then there is the condition of Parenchymal Maldistribution in which the lower breast tissue is lacking fullness, the infra-mammary fold is very high, and the nipple and areola are quite close to the fold. This latter condition is usually a developmental deformity.”

To correct drooping breasts and return them to a youthful look, essentially two options are available: firstly the surgical procedure of Breast Uplift alone, known medically as Mastopexy. And then there is the procedure of Breast Uplift combined with implants, known medically as Augmented Mastopexy. According to Dr Rezai, the assessment of ptosis using the Regnault classification scheme provides some useful guidance in determining whether or not the patient requires a combined procedure, and if so, which approach should be used. Minor degrees of ptosis can be adequately corrected by breast augmentation alone using implants. However, once the ptosis has reached a point where the nipple is at or below the level of the breast crease, an Uplift procedure is the only way to restore the youthful high nipple position.
Dr Rezai explains further that “Breast Uplift, in addition to re-locating the nipple to a higher position, also tightens the skin to give the breasts a firmer feel. Combing Uplift with implant augmentation will also increase the volume of the breasts. Together these procedures can restore the breast to its natural fullness, firmness, shape and position.”

Breast uplift will involve a certain amount of scarring. Dr Rezai explains that “The extent of incision required depends on the droopiness of the breasts and is determined by the amount of skin to be removed and how much the nipple must be raised. These scars may be restricted to the area around the nipple, when using what is known as the circumareolar incision, extend down towards the breast crease, when using the lollipop incision, or also continue along the breast crease, when the  anchor incision is employed. In my practice I make every effort to use limited incisions hence minimise scarring while achieving an aesthetically pleasing breast shape.”

When considering who might be a good candidate for Breast Uplift surgery, Dr Rezai explains that “women whose breasts are pendulous but satisfactory in size, or whose breasts lack substance and firmness, or whose nipples and areolae point downwards, particularly if they are positioned below the breast crease, or if the tissue surrounding the nipple or areola has become stretched. Indeed any of these circumstances either alone or in combination can indicate that someone is a suitable candidate for Breast Uplift. Sometimes these conditions may be inherited traits. In certain cases the breasts may have developed differently so that one breast is firm and well-positioned while the other is not. There may also be differences in the size of the breasts as well as their shape,” says Dr Rezai, who adds that “there are many women who feel restricted by the way that their sagging breasts interfere with their confidence to choose certain items of fashionable clothing, and women whose self-esteem, social confidence or relationships are affected by concerns about the appearance of their breasts. These are all reasons why some women might consider breast surgery of one type or another.”

According to Dr Rezai, the procedure for Breast Uplift, with or without implants, will be carried out under a general anaesthetic and will take from 60 to 90 minutes. The majority of patients stay in hospital overnight. A return to normal physical exercise can be expected within 4 to 6 weeks. There are also various surgical options that depend upon the wishes of the patient, technical considerations and also the preferences of the surgeon. These will all be discussed in detail prior to the operation at consultation with the surgeon.

Dr Rezai further explains that “following the operation, as the healing process is gradual, patients should expect to wait at least several weeks to get an accurate picture of the results of their surgery. Incisions will fade over a number of months until they become barely visible, although it is important to remember that no surgical scar will ever totally disappear. For most women, the results of their surgery will last for very many years. Although there are certain factors that may reduce this period, including having larger, heavier breasts that tend to sag again somewhat earlier. Also when larger size implants are selected. Or in women who gain significant amounts of weight following surgery. Also women who later become pregnant may develop significantly larger breasts that again sag,” says Dr Rezai.

For more information concerning Breast Uplift surgery, breast implants and the options available, and also other types of plastic and aesthetic surgery performed by Dr Rezai, referral can be made to his website at https://allenrezaimd.co.uk

The post Breast Uplift Surgery Returns Drooping Breasts To Their Youthful Perky Shape appeared first on Allen Rezai MD | Consultant Plastic, Aesthetic & Reconstructive Surgeon.

 Breast Enlargement Using Textured Breast Implants Leads The Way

With the market for breast enlargement procedures set to rise once again, safety considerations involving breast implants are to the fore, and according to a recent study, capsular contracture was found to be significantly more frequent in smooth breast implants compared with textured implants. Dr Allen Rezai, a leading Consultant Plastic and Reconstructive Surgeon of Harley Street, London, assesses the study’s findings and provides advice to those considering undergoing breast enlargement surgery with implants.

Dateline November 8^th 2013, London, UK – According to a report by IMCAS, a French-based forum for plastic surgeons and dermatologists, the scandal last year involving faulty implants made by the French-based Poly Implant Prothese (PIP) company which employed unauthorized silicone filler significantly reduced the growth of breast enlargement procedures, which in 2012 grew only at a modest 1.9% worldwide and declined 9.2% in Europe. However it is anticipated that the market for breast augmentations will recover and post an annual growth of 5.2% between 2013 and 2017.

With this forecast growth in mind, the attention of many potential breast enlargement patients is more than ever focused on safety considerations. And safety is not only impacted by the the quality of the surgery but also by the quality of the breast implant materials themselves. Amongst the foremost considerations when selecting the most appropriate type of breast implant is the issue of capsular contracture.

A recent study presented at the last annual Toronto Breast Surgery Symposium, found capsular contracture to be substantially more frequent when employing smooth implants compared to textured implants. According to a further study, the re-operation rate one year following primary breast enlargement was 14.2%, with the most common complication cited as being capsular contracture.

Capsular contracture is the medical term used to describe an abnormal immune system response to foreign materials introduced into the human body. It describes the formation of capsules of tightly-woven collagen fibers created by the body’s immune system in responding to the presence of surgically-installed foreign objects in the body. Capsular contracture in the context of breast implants results when the collagen capsule tightens and squeezes the implant. For the patient the effect can be both uncomfortable and painful, perhaps even distorting the aesthetics of the breast implant and the breast itself.

Although the precise cause of capsular contracture is not known, common associated factors include contamination by bacteria, rupture of the implant’s shell, leakage of the silicone filling, and internal bleeding.

One surgical implant method that has significantly reduced the incidence of capsular contracture is implant placement below the muscle, and employing either textured or polyurethane-coated implants.

Dr Rezai, himself an expert in breast and facial plastic surgery, states that he has found that by employing only textured breast implants, a dramatic reduction in the rate of capsular contracture has been observed. And according to another study, the rate of capsular contracture actually reduced to only 1% for textured implants.

For more details concerning breast enlargement surgery and textured breast implants from Dr Rezai of Harley Street, London, UK, refer to his website at https://allenrezaimd.co.uk

He can also be contacted directly through his London clinic as below:

Dr Allen Rezai
40 Harley Street
London
W1G 9PP
United Kingdom

Tel: +44 20 7580 8001

The post Breast Enlargement Using Textured Breast Implants Leads The Way appeared first on Allen Rezai MD | Consultant Plastic, Aesthetic & Reconstructive Surgeon.

The now familiar trade name Botox is derived from the natural protein known as Botulinum Toxin, and medical use of this protein has a long and interesting history. It was a certain Doctor Justinus Kerner who in 1822 first conceived of the therapeutic use of Botulinum Toxin and coined the name botulism (from the Latin word for a sausage) for the related medical condition. He described it as a “sausage poison” because the bacterium that produces the toxin would often cause poisoning by growing in unhygienically handled meat products. But it was not until the late 1960s that doctors in San Francisco developed a standardized Botulinum Toxin preparation for therapeutic purposes. The cosmetic effect of the toxin on wrinkles was first documented in 1989 by Dr Richard Clark, a plastic surgeon from Sacramento in the USA, and thence began its ever-growing general use in aesthetic medicine.

But in addition to being a highly effective treatment for wrinkles, Botox has many other uses, both medical and cosmetic. Some of these are outlined here by Dr Allen Rezai, who is both a qualified Doctor of Medicine and an internationally renowned Plastic and Reconstructive Surgeon, a specialist in both surgical and non-surgical facial treatments. “Since 1989,” says Dr Rezai, “Botox has in fact been approved for 20 indications in more than 75 countries and is prescribed to patients who suffer from a range of serious or debilitating disorders, as well as to those with cosmetic needs. In the UK, Botox is licensed for use in treating several therapeutic indications including those involving the muscles around the eyes, such as blepharospasm, an uncontrolled twitching of the eyelid, focal spasticity in paediatric cerebral palsy, upper limb spasticity in adult post-stroke patients, and also severe axillary hyperhidrosis, which in layman’s terms can be simply stated as excessive underarm sweating.

“The use of Botox in the treatment of hyperhidrosis,” explains Dr Rezai, “ is a particularly interesting application that is far from obvious. In this treatment a small amount of Botox is injected into 10 to 15 places about 1 cm apart and spread evenly in each area. It actually works through blocking the actions of the nerves that supply the eccrine glands, thus preventing them from producing sweat. Botox blocks the nerve endings, but over about 4-8 months new ones will grow to replace them, and so repeated treatment is necessary to maintain the result. Nevertheless, it will typically last around 6 months before further injections are required.

“In my own practice,” continues Dr Rezai, “I have also used Botox in the treatment of chronic migraine. It was licensed specifically for the treatment of this condition in 2010 by the UK Medicines and Healthcare Products Regulatory Agency, or MHRA. It is a particularly effective treatment that is generally well-tolerated.”

“However in the world of aesthetic treatments, Botox was first granted a licence by the UK MHRA for the temporary improvement in the appearance of moderate to severe glabellar lines, which are frown lines occurring between the brows, in adult women and men aged 65 and younger. Indeed it is a highly effective treatment option capable of achieving a naturally refreshed and relaxed upper face rejuvenation that today so many people are seeking. And when administered by a qualified and experienced practitioner, it scores very highly when it comes to patient satisfaction,” states Dr Rezai.

“Botox can also temporarily reduce or eliminate forehead creases, crows feet near the eyes and thick bands in the neck,” explains Dr Rezai. “It works by blocking the nerve impulses, temporarily paralyzing the muscles that cause wrinkles whilst giving the skin a smoother, more refreshed and youthful appearance. It is suitable for both women and men who are not yet ready for forehead or brow lifts or other cosmetic and plastic surgeries to improve their appearance and who want a simple and fast procedure to eliminate wrinkles with little downtime and recovery period. An advantage of Botox treatment is that untreated areas of the face aren’t affected, so you can still smile and frown, but the skin on the treated areas won’t wrinkle as much as usual.”

New uses for Botox are being found all the time. In fact a recent study by researchers at the University of Southwest Texas, Austin, announced in the Dermatology Times of April 1st, 2014, has found that botulinum toxin injections also possess significant longer-term anti-depressive properties which last beyond the cosmetic effects.

However, new patients seeking treatment for lines and wrinkles should be aware that Botox is a temporary treatment, the effects of which wear off naturally over time. Dr Rezai explains that “following treatment with Botox, visible results are usually seen within four to seven days, however it can take up to two weeks to obtain the full result. Also, depending on a person’s lifestyle and how their muscles react to the treatment, the effects of Botox may last from three to six months and the treatment should not be repeated more than two or a maximum of three times per year.”

As time passes it is becoming clear that Botox is a highly versatile product with an ever widening range of both cosmetic capabilities and therapeutic properties being discovered with increasing frequency. It is entirely possible that even more fascinating and unforeseen uses are just around the corner.

In fact Dr Rezai is highly experienced in providing a wide range on non-surgical rejuvenation procedures, of which Botox treatment is just one example. His clinics in Harley Street, London, in the north of England, are at the forefront of facial rejuvenation, offering a wide range of treatments many of which are at the leading edge of aesthetic medical technology: procedures such as the 8-Point Facelift and the Vampire Facelift and Rejuvenation treatments.

For more information about available Botox treatments, together with other procedures and treatments, both surgical and non-surgical, performed by Dr Rezai, reference can be made to his website at https://allenrezaimd.co.uk

He can also be contacted directly through his London clinic at the following address:

Dr Allen Rezai
40 Harley Street
London
W1G 9PP
United Kingdom

The post Botox – Not Just A Treatment For Wrinkles But A Versatile Product With Many Medical And Cosmetic Uses appeared first on Allen Rezai MD | Consultant Plastic, Aesthetic & Reconstructive Surgeon.

Mr Allen Rezai shared with us the strategies and methods he uses to help fight off and ameliorate the signs of ageing in his patients, taking into consideration genetics, age range, lifestyle and skincare.

According to Mr Rezai, for the best understanding of the most suitable options, it is convenient to consider specific broad age groups and what their typical needs are found to be. And this applies not only to women but also to men, whose skin care needs is not dissimilar to those of females. Men are increasingly concerned about their appearance and many today turn particularly to non-surgical rejuvenation treatments in order to retain or regain their youthful image and with it their self-esteem and confidence.

Ageing: The Early Years

Young people are more aware now that damage done today can result in future skin issues, accor

ding to Mr Rezai. Despite this knowledge however, adolescents and young adults are still the most likely to tan and use tanning beds.
Mr Rezai explains that “When in your twenties, your skin is generally the most important area on which to focus. Even though the twenties is the prime time for your skin, having left behind adolescent acne and looking and feeling youthful and radiant with a well-toned epidermis, it is also the best time to guard against future damage. Protecting the skin from the sun, wind, pollution and other environmental factors is the best way to prolong a youthful appearance and to minimise the long term effects of ageing.”

Beautiful skin in your forties and fifties starts when you’re in your twenties!

“Our initial goal is to educate our patients on the importance of minimising sun exposure and practicing sun safety as UV damage is one of the main causes of extrinsic ageing. If a person’s skin takes the brunt of unprotected UV exposure from their teens onward, their skin can appear discolored, dehydrated and aged far earlier than someone who chooses to wear broad-spectrum sun protection every day.

Damage prevention is better than cure, and protecting and caring for your skin now by having a good skin care routine and applying broad spectrum sunscreen daily is fundamental to preventing premature wrinkles, age spots and skin cancer caused by harmful exposure to the sun. It is important to be aware that most of the damage to a person’s skin that becomes visible in their thirties and forties has actually been there since their twenties – it simply wasn’t visible. So if the skin isn’t looked after in earlier years, the visible signs of damage will appear in the future.” says Mr Rezai.

So what should Young individuals do to protect their skin and prevent Pre-mature ageing?
The skincare regimen for teenagers and individuals in their 20’s should typically be simple and basic, starting with products that are not overly abrasive and contain adequate humectants to preserve moisture. Preventative products such as antioxidants, and a good topic vitamin C and E product, should also be introduced to individuals in their 20’s.
Mr Rezai is strongly against exposing young individuals to non-surgical cosmetic procedures such as Botox and dermal filler wrinkles treatments or strong peels, as in almost all cases there is no right indication to start these types of treatments when in your 20’s.

Ageing: The Later Years

Generally, people who are not seen for skin conditions in their teens or 20s will wait until outward signs of ageing begin to appear before visiting a cosmetic surgeon or dermatologist.

30’s is the time when physiological changes characteristic of ageing begin to manifest. Mr Rezai explains that “In the thirties, skin becomes thinner and finer, and collagen starts reducing. The complexion also begins to dull, resulting from the slowing down in the speed of cell regeneration. Fine lines and wrinkles start to develop, particularly around the eyes and mouth, and there may be some discolouration caused by sun damage or melasma due to excessive oestrogen. Even those who have taken good care of their skin when younger are still likely to have skin that is uneven and less radiant.

People in their thirties will generally focus on treatment, not prevention, and I tell them that they should still be equally as focused on prevention.” says Mr Rezai.

Moving into their 40’s, according to Mr Rezai, people start noticing cumulative sun damage resulting in blotches, red spots and ruddiness. The skin also becomes less elastic and will retain less moisture. Now the main areas of concern are the eyes and brow region. The effects of ageing and sun damage develop further, resulting in loss of facial volume and moderate to deep wrinkles in the areas of repetitive expression such as the forehead, brows, and eyes.
Mr Rezai goes on to explain that “For women, menopause also plays an important part in how the skin changes, as the decreased oestrogen slows the production of sebum, resulting in decreased protection and drier skin. Facial hair can also begin to appear, due to an imbalance of male and female hormones.

Once in their late forties and up, individuals will typically benefit from a comprehensive skincare regimen, collagen induction therapies as well as injectables, to restore the facial volume and elasticity that is lost with age,” Mr. Rezai says. “The best solutions for those in their late forties and up are treatments that combat wrinkles, uneven skin tone, age spots and sun damage. Lifting and plumping of the skin with fillers, fat grafting or the non-invasive 8 Point Facelift will also help achieve a more supple, toned and youthful complexion.”

And what about men?  According to Mr Rezai, “Male skin is generally thicker, has less underlying fat and higher collagen density than female skin and since collagen content is directly related to the signs of skin ageing, it is believed a woman’s skin is about 15 years older than a man’s of the same age. However, usually the “15-year” skin age difference is not noticed as men are less concerned about skin care, especially the use of sun screen, and as we all know UV damage from the sun can add years to the skin and negate the benefit of slowed loss of collagen. And as men age, their skin elasticity decreases and it becomes rougher and dryer”

Premature skin ageing Prevention and Lifestyle

Mr Rezai explains that his preference is for a comprehensive and holistic approach to skin care involving first of all prevention and protection, then following up with correction where needed. Research shows that ageing skin is the result of more than just natural ageing. Exposure to environmental elements like sunlight, smoke and air pollution are extrinsic factors causing pre-mature ageing of the skin which not only leads to the formation of lines, wrinkles and discolouration, but can also lead to serious skin conditions, including skin cancer.

Lifestyle choices, including smoking and alcohol use, can detrimentally influence skin ageing, but the most important factor in the prevention of pre-mature skin ageing is UV protection, which includes minimising sun exposure, using sunscreen, and wearing sun-protective clothing, according to Mr Rezai. In support of a healthy lifestyle, diet and exercise can also benefit skin appearance. “Nourishing your body is essentially nourishing your skin. Exercise has been proven to reduce the instance of many diseases and bone loss, as well as slowing the onset of dementia. Increased heart rate and blood flow, the results of exercise, also help to flood the skin with oxygen, which is necessary for healthy skin to function optimally.

So the person who exercises, keeps a balanced diet, and drinks plenty of water will naturally look better and have healthier skin than someone who doesn’t” Mr Rezai says. “All of these aspects come together to determine how someone’s skin will age.

Damage Prevention to skin is better than a Cure, by applying adequate sun protection, having appropriate skincare routine and maintaining a healthy lifestyle and diet, one can keep premature signs of ageing at bay and age gracefully. And when the indications of ageing appear, there are various non-invasive Anti-Ageing Solutions available which can be specifically tailored to suit the individuals need for a Youthful but Natural Appearance.” concludes Mr Rezai.

The post Skin Anti-Ageing – What’s Right at What Age? appeared first on Allen Rezai MD | Consultant Plastic, Aesthetic & Reconstructive Surgeon.

There is easy access via London Underground with nearby tube stations located conveniently at

• Oxford Circus (Central, Bakerloooo, Victoria lines)
• Great Portland Street (Circle, Metropolitan, Hammersmity & City lines)
• Regent’s Park (Bakerloo line)

The clinic is also easily accessible via taxi from all parts of central London.

Click the following map to calculate the journey from anywhere in London…

For address and contact details, please click here…

Dr Allen Rezai is a consultant Plastic and Reconstructive Surgeon, specialist in all aspects of breast surgery, facial surgery and non-surgical aesthetic treatments.

Breast Surgery

• Breast Enlargement
• Breast Uplift
• Breast Lift with Implants
• Breast Reduction
• Breast Reconstruction

The post Cosmetic Breast Surgery – Harley Street, London UK appeared first on Allen Rezai MD | Consultant Plastic, Aesthetic & Reconstructive Surgeon.

The characteristics of an aging face include wrinkling of the skin due to sun exposure and loss of elasticity, sagging of the soft tissues due to the effects of gravity, and loss of volume making the face seem haggard and hollow. By combining a face lift with fat grafting, not only can the skin be tightened with wrinkles and folds being reduced, but also lost volume in areas of the face can also be replaced, thus restoring it to its overall natural, youthful appearance.

The benefits of facelift surgery have been well recognised for many years with millions of women, and more recently an increasing number of men, worldwide having undergone this procedure. Fat grafting is a more recent technique capable of enhancing the face yet further. But up until now a problem with fat grafting has been the tendency of the body to re-absorb some of the transferred fat meaning that there was always an element of uncertainty in the final result. However with the recent development of Platelet Rich Plasma (PRP) technology which uses a patient’s own blood cells containing stem cells and growth factors, much of the former uncertainty is removed, and the fat cells, stem cells and growth factors work together symbiotically to produce an enduring naturally youthful appearance.

Whilst many people are aware of the fundamental principles involved in traditional facelift surgery, it is likely that the vast majority know little or nothing about fat grafting. In fact facial fat grafting is in itself a minimally invasive technique that can be used for correcting or improving thin or asymmetrical areas of the face, sunken eyelids and tear trough hollows below the eyes, thinning lips, the soft tissues of the chin and cheeks, areas around the temples and jawline, and also facial scars caused by acne or trauma. It is therefore an ideal procedure to employ in combination with a facelift.

One of the United Kingdom’s foremost exponents of natural facial rejuvenation is Dr Allen Rezai, Consultant Plastic and Reconstructive Surgeon of Harley Street, London, and facial surgery expert. Dr Rezai explains that “fat grafting procedures are also sometimes referred to as free fat transfer, autologous fat transfer, fat injections and lipofilling. The procedure itself is minimally invasive and involves the patient’s own fat being harvested from one area of the body, typically the abdomen or waist, but sometimes also from the hips or the buttocks, and re-implanted where needed. In this case and most frequently, this is in regions of the face, but it can also be employed to correct atrophic aging of the hands and post-surgical and post-traumatic defects.”
Dr Rezai goes on to explain that “when combined with a facelift, facial fat grafting is typically performed under a general anaesthetic and the procedure is likely to last over two hours. One or two nights will also be required in hospital. For those not involved in physical work, as with a traditional facelift, they can expect to return to work within two weeks and resume normal physical exercise within three to four weeks.”

To further explain the details of the facial fat grafting component of the operation when combined with PRP, Dr Rezai elaborates: “The procedure essentially comprises three parts. The first part being the harvesting of the fat and preparation of the PRP, with the fat being harvested from regions of the body where it is most tightly packed, such as the abdomen or the buttocks, using a cannula connected to a syringe in a process very similar to that of liposuction. For preparation of the PRP, the patient’s own blood will be drawn and the plasma isolated in a centrifuge. The second part involves purifying the fat either mechanically or manually so as to obtain the necessary fat cells, and its subsequent combination with the PRP ready for transfer. The final part involves preparation of the areas for the graft and injecting the combined fat cells and PRP blend via another cannula. The injection will be repeated in each region to be treated until the desired correction is achieved.

“The fat grafting with PRP component of this combined procedure is very versatile and can indeed also be carried out either alone or in combination with other facial surgery procedures besides facelift, such as a browlift or eyelid surgery,” explains Dr Rezai. “It is also a procedure with relatively few risks and infrequent complications, firstly because it is only minimally invasive and secondly, since we are using the patient’s own blood and fat cells, the risk of an allergic reaction is almost negligible. Furthermore the PRP contains a concentrated amount of white blood cells, which are the body’s natural defense against infections.”

For more information about facelift in combination with fat grafting and PRP, and also details of other facial rejuvenation procedures performed by Dr Rezai, reference can be made to his website at https://allenrezaimd.co.uk

He can also be contacted directly through his London clinic at the following address:

Dr Allen Rezai
40 Harley Street London
W1G 9PP
United Kingdom

The post Advanced Facial Rejuvenation Procedure Combines Facelift with Fat Grafting and PRP appeared first on Allen Rezai MD | Consultant Plastic, Aesthetic & Reconstructive Surgeon.

Dr Allen Rezai, a leading Consultant Plastic and Reconstructive Surgeon of Harley Street, London, and specialist breast surgeon, explains the various implant placement options, clarifying both the advantages and disadvantages of each method, which often relate to a person’s body type and lifestyle.

Dr Rezai explains that “today there are essentially four locations within the breast where implants can be located, each with its advantages and disadvantages. These are regularly referred to as sub-muscular, sub-glandular, dual plane and sub-fascia placement. The choice of which location to use is a function of the patient’s anatomy, their lifestyle, and both patient and surgeon preference.

“In sub-muscular placement the implant is placed below both the pectoral muscle and the overlying breast tissue. This involves separating the pectoralis major and pectoralis minor muscle from the chest wall and inserting the implant in between the two. This location is more appropriate when the patient has a smaller amount of breast tissue since there is less risk of the implants being seen, providing a more natural slope, with the implants being less palpable. This location also has the advantage of offering less obstruction during mammography. Furthermore, if a woman later undergoes a change in weight, perhaps due to pregnancy, the muscle supports the implant and so the breasts and implants are less prone to sagging.”

As to the disadvantages of this location: “sub-muscular placement can be less advisable for women of an athletic build, since their pectoral muscles can be somewhat overdeveloped, and the implant will distort when making certain types of movement, such as during swimming or getting out of a pool. It also requires a slightly longer recovery time than needed for other implant locations,” says Dr Rezai.

Concerning the sub-glandular placement option, Dr Rezai explains that “in sub-glandular placement the implant is placed over the pectoral muscle and under the breast tissue. If the patient has sufficient breast tissue to cover the implant then this type of placement is easily achievable with less pain than in sub-muscular placement and requires a much shorter healing and recovery time. It is also helpful for patients with mildly sagging breasts who do not wish or need to undergo a simultaneous uplift procedure. Furthermore it imparts a more natural feeling to the implant when the chest muscles are used, since there is no distortion.

“Since placement sub-glandularly positions the implant closer to the breast surface,” continues Dr Rezai, “it is not recommended for patients with lesser amounts of breast tissue, since there is a greater risk of the implants being noticeable, including the highlighting of any rippling should it occur.”

Dual plane breast implant placement is sometimes also referred to as sub-pectoral breast augmentation and is a method employing the advantages of both sub-muscular and sub-glandular positioning. According to Dr Rezai, “In dual plane placement the implants are situated partially underneath the pectoralis major muscle in the upper chest, being located simultaneously both under and over the muscle. The surgery is somewhat more complex than that required for other types of placement, however dual plane implants offer a very realistic look and feel together with excellent muscular support and fullness. The feel of dual plane implants tends to be firm at the top of the breast and softer and more pliable at the bottom, very much like that of natural breasts, and the coverage of the pectoral muscle helps to conceal any signs of the implant shell.”

In the case of the more recent technique employing sub-fascia implant positioning, Dr Rezai explains that “this approach combines several benefits of both sub-muscular and sub-glandular placement, which are the two most frequently employed locations. Sub-fascia placement works well in the case of small, thin women who have little tissue to cover the implants, with the fascia layer helping to smooth and contour the implant shell, blending it into the wall of the chest.

“There are several benefits to employing a sub-fascia implant location which offer an advantage over the sub-muscular and sub-glandular approaches, in addition to the fact that it makes mammogram screening less difficult. These include a less frequent incidence of capsular contracture than with sub-glandular placement, no implant distortion when using the pectoralis muscles, and a higher degree of support for the implant. The duration of the surgery is also shorter.

“The potential downsides of sub-fascia placement relate to the fascia layer being somewhat thin, with the resulting possibility of it tearing and the implant position thus becoming sub-glandular. And also, whilst the fascia does provide support for the implant, it is insufficiently thick to provide any additional padding above the implant,” explains Dr Rezai.

Implant size, shape of breast and amount of breast tissue present determine the type of implant placement suitable for the patient. All placements should produce a natural look and feel if chosen according to patient’s suitability.

For more information concerning breast augmentation surgery, breast implants and the options available, and also other types of plastic and aesthetic surgery performed by Dr Rezai, referral can be made to his website at https://allenrezaimd.co.uk

He can also be contacted directly through his London clinic as follows: 40 Harley Street, London, United Kingdom, W1G 9PP

The post Breast Implant Placements and Their Pros and Cons Revealed by Breast Augmentation Expert appeared first on Allen Rezai MD | Consultant Plastic, Aesthetic & Reconstructive Surgeon.

Tuberous breasts, sometimes also known as tubular breasts or medically as hypoplastic breasts, is a congenital abnormality that can affect either one or both breasts in women and in men. According to Dr Allen Rezai, preeminent consultant plastic and reconstructive surgeon of Harley Street, London, and expert breast surgeon, “tuberous breast is one of the most common congenital breast shape deformities and can cause abnormalities of breast volume, volume distribution, breast shape and the size and shape of the nipple-areola complex. Tuberous breasts develop during puberty if the skin does not stretch adequately, resulting in abnormal development of the breast tissue.”

Tuberous breast deformity was first described in the medical literature in 1976, following which a method of classification was developed by Grolleau comprising three grades depending upon which region of the breast is affected: Grade I, mainly the inferomedial quadrant; Grade II, the two inferior quadrants; and Grade III, affecting the whole breast.

Dr Rezai explains that the following indications are characteristic of tuberous breast deformity:
“A breast or breasts that are narrow and cylindrical in shape; breasts with an abnormally constricted base and possessing little or no tissue; an enlarged protruding and puffy nipple-areola complex; breasts separated widely apart producing an unnaturally wide cleavage; and drooping breasts that appear long and constricted due to the crease where the breast joins the chest wall being abnormally high.

The condition can also affect the ability of women to breastfeed, as in some cases the breasts, including the milk glands, will not have developed sufficiently to produce milk. However, the condition does not affect other aspects of fertility and pregnancy.”

To correct tuberous breasts, the degree of severity of the condition influences the type of treatment employed, but in general the treatment will widen the constricted base of the breast to a normal size; lower the infra-mammary fold; increase the skin envelope; increase the size of the breast; reduce the size of the nipple-areola complex; and restore breast symmetry.

According to Dr Rezai, the surgical techniques employed in correcting tuberous breasts are those of reconstructive surgery and will depend upon both their suitability in individual cases and also the surgeon’s preferences. “Either an implant or the patient’s own tissue may be used to provide the volume needed. While the use of breast implants is the more common approach, both perforator flaps comprising skin, fatty tissue and small blood vessels – typically the DIEP flap and TAP flap – and fat grafting methods can be used. By using tissue belonging to the patient themselves, many complications that can arise due to using breast implants can be avoided. However these procedures are longer in duration and have a longer recovery time, with additional scars at the donor site,” says Dr Rezai.

So thanks to the techniques of modern reconstructive breast surgery, many people, men and women, who might have gone through life suffering the psychological traumas of inadequacy and lack of confidence due to this condition, are now able to go about their daily routines in a new happier way and live life to the full.

For more information about the surgical options to correct tuberous breast deformity, including before and after photos and details other breast surgery procedures performed by Dr Rezai, reference can be made to his website at https://allenrezaimd.co.uk

He can also be contacted directly through his London clinic at the following address:

Dr Allen Rezai
40 Harley Street
London
W1G 9PP
United Kingdom

The post Breast Deformity No Longer A Reason For Anxiety Thanks To Tuberous Breast Correction Surgery appeared first on Allen Rezai MD | Consultant Plastic, Aesthetic & Reconstructive Surgeon.