Category: Blog

According to BAAPS breast augmentation is the commonest surgical procedure for cosmetic reasons within the UK. One of the commonest questions patients ask is whether to place implants above or under the muscle.

Historically it has been perceived that implants under the muscle may lead to less palpability, rippling and visibility in the upper pole compared with implants above the muscle. Historically there has been a trend to place breast implants under the muscle and more recently into a dual plane position. 

As more cohesive breast implants have been developed the increased cohesion of the silicone has reduced the problems of palpability, rippling and visibility. Anatomical implants are also now widely available, where the upper pole that could also sit under the muscle has less volume than the lower pole, meaning that the chance of palpability, rippling and visibility in the upper pole can be further reduced. There has therefore more recently been a trend to place anatomical cohesive silicone gel implants in the subglandular plane.

 

It is well known that the placement of implants above the muscle in the subglandular plane allows the implants to be placed closer to the midline – a position that aids cleavage. Patients with subglandular implants describe the implants feeling more like a breast whereas implants under the muscle can feel more fixed in position with less mobility. It is believed that implants under the muscle are also more prone to malposition.

A recent study from Brazil has assessed the effect of implants in the subglandular plane vs the dual plane. They assessed the volume changes of the skin, breast and muscle as a result of placing the implants in different planes using MRI imaging at various time intervals. They have shown that 12 months following breast augmentation that implants in the subglandular plane lead to a 22% reduction in glandular volume with no reduction in muscle volume. On the other hand implants under the muscle in a dual plane position showed a 14.5% reduction in glandular volume 50% reduction in muscle volume with no reduction in glandular volume. This is due to atrophy of the pectoralis major muscle. 

 

Reference

 

Roxo AC1, Nahas FX, Salin R, de Castro CC, Aboudib JH, Marques RG. Volumetric Evaluation of the Mammary Gland and Pectoralis Major Muscle following Subglandular and Submuscular Breast Augmentation.

Plast Reconstr Surg. 2016 Jan;137(1):62-9. 

 

It is advised for anyone considering surgery to be at their ideal weight; this means that the results achieved can be maintained and will not change dramatically with any dramatic weight loss or gain. It is also advised that women should have completed their family before considering undergoing any procedure involving their breasts and their stomach, as pregnancy can alter these results. 

 

Undergoing plastic surgery can also be a way to regain your body confidence. If your body has sagged with age or as a result of pregnancy, there are many options available to rejuvenate your body and give a more youthful look. This can increase your self-confidence and can provide you with a new lease of life.

It is also important to do a lot of research into the surgery you wish to have and with the surgeon who will operate on you. Knowing what outcome you want to achieve and how you can go about this is important before deciding on going ahead with surgery. The lasting result of surgery cannot always be reversed, and so if you are unsure of what you want to go ahead with, it is important to discuss your options with your surgeon and be fully confident on what you have done before you undergo any procedure. 

Mr Ross will always make sure his patients are 100% confident in the procedure they wish to go ahead with, and make sure that this procedure is right for that individual patient. Mr Ross tailors all of his procedures to that individual patient to ensure patient satisfaction.

When deciding to undergo a cosmetic procedure, it is important that you have realistic expectations. You must be aware of the result you desire and the achievability of this result. Every surgery has its limitation and absolute perfection cannot be achieved – it does not exist. 

Mr Ross will always be clear with patients about what can be achieved specific to their body type and the procedure they have opted for. It is important for patients to have realistic expectations so that they are not disappointed with their final result. 

 

If you are considering a cosmetic procedure, book in for a consultation with Mr Ross where he will explain all of your options to you and make you aware of your likely results. 

 

For many individuals, getting body rejuvenation surgery is a question of when, not if. If you have decided that a surgical solution to your sagging skin is in your future, remember that everyone ages in a unique way and on an individual timeline. There is no specific point at which it is clear that it is time to undergo surgery. Nonetheless, there are specific indicators that you can watch out for to help you decide when it would be best for you to reap the benefits of this life-changing body rejuvenation surgery.

Signs to Look For

Certain signs of aging can be valuable indicators that it may be time for you to consider Mummy Makeover surgery. The signs usually include sagging breasts and sagging skin around your tummy area; these effects usually take place after childbirth. Skin laxity is extremely common after childbirth and a Mummy Makeover can give your body a more youthful and rejuvenated appearance.

If you have observed these things, schedule your initial consultation for Mummy Makeover surgery so that Mr Ross can help you determine whether now is the right time for your surgery.

Important factors to bear in mind

When considering whether to undergo breast and abdominal rejuvenation surgery it is important that you have completed your family in order to sustain the results you will achieve. It is also important to be at a stable weight and at your ideal weight, as any large fluctuations in your weight may also alter your results. It is also important to keep up a healthy lifestyle in order to get the best results from your body.

 

The right age for body rejuvenation surgery is determined by individual needs. If you think it may be time for you to get this surgery, request your personal consultation with Mr Ross today by filling out our online enquiry form.

 For many individuals, getting facelift surgery is a question of when, not if. If you have decided that a facelift is in your future, remember that everyone ages in a unique way and on an individual timeline. There is no specific point at which it is clear that it is time to undergo a facelift. Nonetheless, there are specific indicators that you can watch out for to help you decide when it would be best for you to reap the benefits of this life-changing facial rejuvenation surgery.

Aging Signs to Look For

Certain signs of aging can be valuable indicators that it may be time for you to consider facelift surgery. These usually do not include the first signs of nasolabial folds and the early signs of facial sagging. Instead, you should be on the lookout for moderate to severe signs of facial aging. Loosened facial muscles, deeper furrows and folds, lax skin, sagging jowls, and sagging skin and muscles on the neck may all require surgical correction with a facelift. Patients should be on the lookout for these more advanced signs of aging in the lower face. If you have observed these things, schedule your initial consultation for facelift surgery so that Mr Ross can help you determine whether now is the right time for your surgery.

 

The Role of Age in Facelift Surgery Timing

Age plays an important role in determining the timing of your facelift surgery. A facelift corrects signs of aging that typically appear in patients between the ages of 50 and 60. Therefore, most patients who undergo facelift surgery are within this age range. However, some individuals with particularly good skin laxity, favourable genetics, and a healthy lifestyle may be able to achieve their desired results by undergoing facelift surgery even into their 70s. Others with signs of premature aging, especially those who smoke or have extensive sun damage to their skin, may be younger candidates for facelift surgery. 

The right age for facelift surgery is determined by individual needs. If you think it may be time for you to get this surgery, request your personal consultation with Mr Ross today by filling out our online enquiry form.

Breast augmentation trends change all the time, and some women desire different aesthetic looks to others. Some women want a subtle increase in their breast size, while still appearing very natural, and other women wish their breasts to be larger and more obviously augmented. There are so many options it is important to consider all of your options and decide what are right for your taste and your body shape. 

A specialist breast surgeon like Mr Ross has treated hundreds of women of all shapes and sizes and knows pretty quickly what implant type is going to suit you. Any surgeon should do their utmost to accommodate your wishes and give you that chest you’ve always dreamed of. However, in certain cases it is not medically advisable or even safe to go for certain looks. Your current breast size and chest/shoulder width are taken into account. You need to consider your health and wellbeing above anything else; Mr Ross will know what’s going to look and feel right and discuss this with you fully.

Don’t let anyone talk you into a size that you are not happy with. That could be friends, family, partners or even the surgeon. Don’t be afraid to get a second opinion, have a look on sites like Realself and look at the surgeon’s reviews. Weigh up all the information and make sure your decision is for you; after all it’s your body.

Your lifestyle is key. How active you are may play a part in your decision. If you play a lot of high impact sport you may not want large breasts getting in the way. That being said some bodybuilders get on perfectly well. Be sure to raise this at your consultation so that your expectations can be managed and met.

Mr Ross prides himself on taking the time to go through all of your options with you, because in truth there is no ‘perfect’ implant size. You have to take into account your figure, the best implant shape for you and the look you are trying to achieve. Make sure you’re doing it for you and that you are 100% confident and comfortable with your surgeon, that you’ve researched the surgeon, the hospital, and have truly considered how your new breasts will suit you and your lifestyle. That way your final result will be perfect for you.

 

A breast reduction is the removal of excessive breast tissue and is often associated with shoulder pain, backache, shoulder grooves due to bra straps and postural changes.  The excessive weight can interfere with exercise and sporting activities. Furthermore the psychological well-being and sexuality of women can be affected negatively by increased breast size.

 

With improved techniques breast reduction has become not only a functional operation but also an aesthetic operation. Various sizes and shapes can be obtained depending on the individualised needs of patients with surgical techniques varied to meet the needs of every patient. Although there are risks of the surgery often the benefits far outweigh the negatives and overall breast reduction is one the most rewarding plastic surgery procedures. Although not 100% guaranteed improvements in symptoms can be dramatic and lead to improvements in quality of life.

 

Patients need to be taken through the various options and shown examples of the variety of results so that they can be empowered to make a decision to proceed. Often results are related to patients anatomy and an experienced surgeon will be able to explain what is possible and give an idea of what can be achieved.

 

In a recent study from Iran the authors looked at the effect of breast reduction on patients and their partners. They assessed the sexual function of the women and their partners were evaluated using the Index of Female Sexual Function (IFSF) and the International Index of Erectile Function (IIEF). 

The authors found that there was a significant improvement in the mean IFSF and IIEF scores after surgery in both patients and their partners. In addition, patients expressed high levels of satisfaction with the results of surgery in terms of physical and psychological scores. 


Reduction mammoplasty is one of the commonest and most rewarding breast operations and can have a dramatic effect on physical and mental health in women with large breasts. 

The results suggest that breast reduction surgery has a positive impact on the quality of life of the patients. In addition, sexual dysfunction in the women and their male partners improved after reduction mammoplasty. The postop analysis was performed after 6 months.

Mr. Ross offers a variety of different breast reductive techniques. He does not use any dressings or drains and patients can mobilize immediately following surgery. The improvements in surgical techniques have made the recovery from breast reduction surgery more rapid and often patients are able to get back to normal every day life almost immediately. Patients are advised to avoid sexual activity for the first few weeks postoperatively. 

Reference. 

Impact of reduction mammaplasty on sexuality in patients with macromastia and their partners. Emami SA, Sobhani R.J Plast Reconstr Aesthet Surg. 2016 Oct;69(10):1335-9. 

The term cosmetic has traditionally been applied to the cosmeceutical industry. Cosmetics are another term for make up and used to enhance the appearance or fragrance of the body (as per Wikipedia). 

The widespread use of the term cosmetic followed by doctor, surgeon, and surgery are terms that mystify patients. Advertising and marketing strategies utilizing these terms do not offer patients any reassurances as to the training, accreditation and regulatory framework for the treatments these patients wish to consider. Patients assume that those offering cosmetic surgery have suitable training. Unfortunately there is no specific training for “cosmetic surgery” and patients should take no reassurance from the use of this terminology in finding a suitable “cosmetic surgeon”. 

Plastic surgery is a surgical specialty involving the restoration, reconstruction, or alteration of the human body. It includes cosmetic or aesthetic surgery, reconstructive surgery, craniofacial surgery, hand surgery, microsurgery, and the treatment of burns. (As per Wikipedia)

Plastic surgery techniques have also been incorporated within many different surgical disciplines including ENT / Maxillofacial  / Ocular and Breast Surgery.

Patients must understand that training, accreditation and a regulatory framework exists for plastic surgery. Many of these surgeons offer “cosmetic surgery” within this regulated framework.

Training / Accreditation and Regulatory Framework in Plastic Surgery.

After finishing medical school, trainee doctors will spend two years gaining experience in a variety of specialties in order to acquire full registration with the General Medical Council. After a minimum of two further years surgical training, the trainee can apply for a plastic surgery training programme.  If successful plastic surgery trainees will undergo a minimum of six years plastic surgery training. 

Plastic surgery trainees are required to pass the Intercollegiate Specialty Examination (FRCS Plast). Those who successfully complete the training programme gain their Certificate of Completion of Training (CCT), and are then eligible to be placed on the GMC specialist register for plastic surgery. 

The training in aesthetic surgery (or more commonly referred to as cosmetic surgery) is overseen by the Royal College of Surgeons and recommends that consultants certify within their areas of specialism. It is anticipated that these areas of specialism will also become visible to patients via the GMC specialist register.  Consultants are appraised on an annual basis and revalidated on a 5 yearly basis.

In plastic surgery the national organizations of British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS) and the British Association of Aesthetic Plastic Surgeons (BAAPS) only offer full membership to those who have completed their training and are on the GMC specialist registrar for plastic surgery. All members are voted in by their peers and offer the public a means of locating surgeons within suitable training in aesthetic surgery. 

 

Patient Empowerment

 

Patients are often mystified as to how to access a suitably trained and accredited “cosmetic” surgeon. The popular press regularly documents the unfortunate plights of patients who have received substandard care, some of which have been placed in jeopardy because of lack of training and improper practices.

Patients need to empower themselves to do their due diligence on the individual they choose to consult with.  For patients, locating suitably trained “cosmetic” surgeons is difficult. Social media may divert patients to those that advertise and market the term cosmetic. The public need to look for those trained in plastic surgery that are listed in the GMC specialist register for plastic surgery.

 

Reassurance to Patients consulting with Mr Ross for “cosmetic surgery”

 

Mr Ross is a plastic surgeon who underwent specific training in plastic surgery. Mr Ross successfully completed his FRCS(plast), obtained his CCT and is listed on the GMC specialist Register for Plastic surgery (Number 4220633). Mr Ross has a vast training in aesthetic surgery throughout his plastic surgery training including  the  techniques utilized in “cosmetic surgery”. Mr Ross is a full member of BAAPS and BAPRAS and is regularly appraised on an annual basis. He has successfully revalidated and “cosmetic surgery” is an established part of his scope of practice. 

Sagging skin can be the result of many different effects on the body; weight loss patients can experience sagging skin, along with women who have given birth to their children. Sagging skin can also be a side effect of aging, as we age we lose the collagen and elasticity in our skin which can cause it to sag, and some patient’s skin sags more than others. This excess skin can be removed through body lift surgery.

Body lift surgery focuses on toning the body and helps to tackle those stubborn areas of fat and skin that you cannot shift through weight loss or exercise. The concept of this surgery is to remove, lift and reshape the body.

Consultant Plastic Surgeon Mr Gary Ross offers many different options to tackle your sagging skin and rejuvenate your body’s appearance.

 

Upper Body Lift

These procedures focus on toning anything on the top half of your body including:

Breasts –An uplift procedure (mastopexy) can be performed if you feel that you have a loss of volume in your chest area and would like to have a fuller, lifted chest.

Arms –If you are suffering with excess skin or fatty tissue in the inner arm area, (more commonly known as ‘bingo wings’) surgery can be performed via liposuction or a skin tightening technique called an arm lift.

Mid back – Via Liposuction.

 

Lower Body Lift

These procedures focus on toning the lower areas of the body, including:

Tightening of your tummy – This can involve either a full or mini tummy tuck depending on the amount of excess skin in the abdominal area. Mr Ross can also offer a Fleur De Lis tummy tuck, which tackles excess skin in the upper part of the abdomen.

Buttocks – Through Liposuction or lifting.

Thighs – thigh lifting surgery

 

 Full Body Lift

This can be considered if you are looking at toning areas in both the upper and lower body.

 

Mr Ross’s patients are treated on a case-by-case basis as everyone’s individual needs are different. If you were considering this type of surgery we would recommend a consultation with Mr Ross where a full assessment would be carried out on the areas in which you were looking to have rejuvenated.  To find out more about Body Lift surgery or to book a consultation, please call 0161 401 4033 or fill out an online enquiry form.

 

Liposuction is one of the procedures that has increased dramatically and there are many different options available. It is important to run through your suitability during a consultation, understand the pros and cons and be empowered to make a decision to proceed. By following these simple steps below you are likely to achieve desirable results.

• Be realistic- Do not think that liposuction will transform you from a size 14 to a size 8. Liposuction is generally suitable for individuals with stubborn fat deposits, such as ‘love handles’. Unfortunately for some of us no matter how much we diet and exercise we acquire fat pockets that just won’t budge. Be aware of the fact that although you may not drop 4 dress sizes, your clothes are likely to fit significantly better and subsequently your confidence levels are likely to rise. 

• Maintain an ideal weight- In order for liposuction to be effective it is advisable that you are at your ideal weight and have maintained that weight for some time. Remember that liposuction is not a weight loss procedure by any means and by entering into a consultation at your ideal weight you will mostly likely achieve the results you desire.

• Patience is a virtue- All good things come to those who wait, right? Therefore, there is no need to panic that you don’t look how you want to look in your bikini 3 weeks after surgery. The results of surgery can take numerous months and post-operative swelling can significantly cloud your results. In addition to the swelling you might want to hold off trying on your bikini due to the bruising, usually you can expect to be bruised for a good few weeks after surgery.

• Let yourself recover- Don’t expect miracles! Liposuction is an invasive surgery and thus requires a recovery period; generally, a week off work with your feet up and a cup of tea in your hand should be sufficient. Postoperatively you will also be advised as to when you can resume your physical activities such as swimming, going to the gym etc. 

• Importance of aftercare- Your surgeon will provide you with an ever so attractive compression garment which you will be required to wear for a good few weeks post-operatively. Such garments are all part of the recovery process and it is vital that you wear it in order for your body to adjust to its new shape. Try and remember that this garment will hopefully improve the final result and will help control the inevitable swelling.

• Liposuction is no quick-fix- I hate to be the one to tell you that weight gain is still a possibility following liposuction. Ultimately, if weight gain occurs you are significantly less likely to gain weight within the treated areas as the fat cells within that area will have been permanently removed. Therefore, eating clean and exercising should still be incorporated in order to maintain a healthy lifestyle.

 

Before and after photographs are an essential means for plastic surgeons to show patients realistic outcomes from “cosmetic surgery”.  Mr. Ross gives patients some tips in viewing preop and postop images.

 

Tip 1 Are the pictures you are viewing the surgeons you wish to consult with?

 

Look at the before and after pictures for the surgeon you wish to consult with. It is imperative that you do not look at generic images or images from clinics / group practices where you do not know who has carried out the procedure. Often these pictures are best viewed on a surgeons individual website. Images from clinics / groups / websites may include the surgeons details although this not commonly practiced within the cosmetic industry. On Mr. Ross’s website all surgery depicted within the preop and postop image gallery has been carried out by Mr. Ross.

 

Tip 2: Quantity 

 

Every surgeon will take photographs of every patient he/she operates on. In Mr. Ross’s practice over 50% of patients are happy for these images to be shared on line. Mr. Ross updates his before and after images on a regular basis with limited selection bias. In the modern era of openness and transparency, the sharing of pictures is an essential part of patient education and one must question why a surgeon would not post his/her before and after pictures. If a surgeon has relatively few pictures there is a good chance they do not have results to show. Patients must look for a surgeon with a large selection of preop and postop pictures. 

 

Tip 3: Look for images that go together

 

Always check that the before and after image are from the same patient. Looking at moles, freckles, eye/hair colors are a good way of checking this. Always check at what point postop the images are taken and also whether there are a mix of photos at various time frames. Visualizing long term results is very important as it not only demonstrates a surgeons experience but also that he/she follows up his/her patients on a regular basis. 

 

Tip 4: Quality

 

Make sure the position of patient in the pre and postop images is standardized. Ideally the lighting should be similar and the image quality similar. Beware if the photos look out of date and always look at the date the images have been posted on the website. Mr. Ross updates his images on a monthly basis and the dates of posting are easily visualized.

 

Tip 5: Look for images similar to you preoperatively.

 

Try not to look at the best postop results only. You are best to look through the preop photos and find those that are most like you and then look at what has been achieved. If the surgeon is experienced you should be able to find a range of results like you. From this you can discuss with your surgeon what you like / don’t like about his/her work. This often helps empower you to make the decision as to which procedure to proceed with. It is useful to let your surgeon know what you desired look although this should not be the priority when you look through an image gallery.

 

Tip 6: What if your surgeon does not show you any preop and postop images?

 

Walk away