(continued)

 

 

 

 

We are very happy to welcome you as Doctor Philippe Chout’s private patient.
Please find attached this 40 pages information pack that you requested regargind our practice.
Its content is as follow :

P.2 : Credentials of Doctor Philippe Chout

P 3-4 : Price policy and price list: cost of cosmetic surgery procedures

P 5-6 : Information concerning anaesthetic methods

P.7 : Treatment for lines: muscle relaxing injections

P.8-9 : Skin mole or scar removal

P.40 : Beauty Design : a new concept of Beautyfication and rejuvenation

face :

P.10-11 : Temporal Lifting surgery

P.12-13 :Face lift ( neck lift and Facelift )

P.14-16 : Eyelid cosmetic surgery : blepharoplasty

P.17-18 : Esthetic surgery of the nose : rhinoplasty

P.19-20 : Ears pinning surgery : Otoplasty

P.21 : fuller or thinner Lips

P.22 : chin & jaw augmentation or reduction :genioplasty

body :

P.23 : Breast Augmentation, breast enlargment with implant

P.27: Breast reduction or breast uplift

P.29 : Fat removal by Liposuction or Liposculpture

P.30 : Fat transfer (filling)

P.31-32 : Tummy Tuck (abdominoplasty), arms or thigh lift

P.34 : Labiae Vagina (labiaplasty)

P. 37: The buttocks lift

P.38  :  General pre and postoperative recommendations

 

 

 

 

Dr Philippe Chout AIHP, ACCAHP, MD
Specialist in Plastic and Cosmetic Surgery
Registered with the UK General Medical Council n° 4783516.
Registered with the French Medical council n°64900
Email: mrchout@yahoo.co.uk
Tel: +44 207 193 8382     +447 947 022 907
www.doctorchout.com

 

 

BREAST AUGMENTATION

 

This fact sheet is for women who are considering having an operation to enlarge their breasts by Dr Philippe Chout.. A breast augmentation (also known as breast enlargement) operation usually involves placing an artificial implant either under your breast tissue, or under your chest muscle behind your breast.

Why have a breast enlargement operation?

The reasons why you may choose to enlarge your breasts include:

• feeling that your breasts are too small
• loss of breast volume after pregnancy (although enlargement will not lift them)1
• a difference in size between your two breasts
• reduced breast size after losing weight

 

Breast enlargement surgery may also be offered if you are having surgery for breast cancer or other conditions that may affect the size and shape of your breasts. Keywords: breast enlargement, breast augmentation, silicone implant , saline, bra cup size B, 36c, 34c, 34D, 34DD.

The implant
Your breast implant will be made of an outer layer of firm, elastic silicone, but may be filled with silicone gel or salt water (saline). Dr Philippe Chout your surgeon will discuss the various options with you.

Can the breast implant leak?

Breast implants leak in around 10 percent of women and this usually starts six or more months after surgery. The breast implant often has to be removed. The contents of the implant can either leak slowly through the coating, or suddenly if the implant breaks open. This can lead to pain and an abnormally hard feel to the implant in the breast. The body naturally forms a fibrous capsule around the implant, which helps to contain the contents of the implant. The newer designs of breast implants have features to reduce the likelihood of the implant leaking or breaking. There have been concerns that leaking breast implants may be linked to serious health problems such as cancer but there is no conclusive evidence to support this.

Can I breastfeed with implants?

Having breast implants does not usually interfere with breastfeeding, and there is no evidence that silicone is found in breast milk.2,3 But, it is important to tell your surgeon before your operation that you plan to breastfeed because this can affect the decision about where to make the cuts for your operation.

Will the implant affect mammography?

Breast implants interfere with mammography, a low-dose X-ray of the breast tissue used to detect cancer.3 You should let the radiographer or nurse know that you have implants as special X-ray views can be taken to minimise this interference.

How long will the implant last?

Silicon filled Breast implants generally last for about 15 years (no more than 20 years). You will need further surgery later in your life either to remplace the implant or to lift the breast at the same time because eventually your breasts will probably sag again and some of the advantages of the implants could be lost. You may need further surgery to lift the breasts.

What happens before a breast enlargement operation?
It is important to discuss with your surgeon what you are hoping to gain from the operation and the result you can realistically expect. Your surgeon will discuss how to prepare for your operation. For example, you may be asked to stop smoking before surgery. Smoking increases the risk of chest infection, deep vein thrombosis (DVT) and slows the healing of wounds.

 

What should I expect in hospital?

Before surgery you will talk to your surgeon about the operation and you will be asked to sign a consent form. This confirms that you understand the risks, benefits and possible alternatives to the procedure and have given your permission for it to go ahead.

Your surgeon will measure your breasts and assess their shape, your skin and the position of your nipples. He or she may also draw on your breasts to mark the operation site. Your surgeon may want you to have a mammogram taken. He or she may also suggest that you have a photograph taken of your breasts before the operation so that the results of surgery can be compared with your original appearance. If you are having a general anaesthetic, you will be asked to follow fasting instructions. Typically, you must not eat or drink for about six hours before a general anaesthetic. However, some anaesthetists allow occasional sips of water until two hours beforehand.

The operation

Breast enlargement usually takes between one and two hours and is done under general anaesthetic, which means that you will be asleep throughout the procedure and will feel no pain.1,6 Usually it requires an overnight stay in hospital, but occasionally may be done as a day-case, which means you can have the operation and go home the same day. Your surgeon will make some cuts, the exact position of which can vary. They may be in the crease under your breast, around your nipple or towards your armpit. Your surgeon will then make a space, or pocket, for the implant. The pocket will probably be beneath your breast or under your chest muscle. The cut will be closed with stitches. If these are not dissolvable, they will be removed about a week after surgery. Bandages or dressings will be applied over the operation area.

Illustration showing the position of breast implants
What to expect after the operation
You will be given painkillers to help relieve any discomfort as the anaesthetic wears off.
Before you go home your nurse will give you advice about caring for your breasts, hygiene and bathing. He or she will also give you advice about wearing a special supportive bra in the days after the operation.

 

Recovering from a breast enlargement

Once home, you can take more painkillers if you need to, as advised by your nurse or surgeon Dr Philippe Chout..
There are some important things to remember while recovering from a breast enlargement:

• don't shower for four to seven days after the operation
• don't lift heavy objects
• don't do any strenuous activity for the first two to three weeks after the operation as advised by your surgeon - if the implant is placed under the muscle, activity may be restricted for longer

 

Deciding on treatment

It's important not to rush into the decision to have any cosmetic operation according to Dr Philippe Chout. And it's sensible to discuss the options with your GP. Breast enlargement is a commonly performed and generally safe operation. For most women who want the operation, the benefits in terms of improved appearance outweigh the risks. However, if you are deciding whether or not to have this procedure you need to be aware of the possible side-effects and the risk of complications. Side-effects are the unwanted but usually temporary effects of a successful procedure. An example is feeling sick after the general anaesthetic.
Anyone having a breast enlargement can also expect:

• pain, swelling, tenderness and bruising for at least a few days
• a burning sensation in the nipples for a few weeks, but this should go away as you heal

Complications are unexpected problems that can occur during or after the procedure. Most people are not affected. The main complications of any operation are bleeding during or soon after the procedure, infection and an abnormal reaction to the anaesthetic. Specific complications of breast enlargement include those listed below.

• There may be a difference in size between the two breasts, possibly caused by natural differences that are highlighted by the surgery.
• You may get an infection in the breast. If this happens, the implant may need to be temporarily removed to allow the infection to be completely treated.
• Abnormal scar tissue can form around the pocket in which the implant sits. This may squeeze the implant and cause firm, painful breasts. This is known as capsular contracture. If the breast goes hard, further surgery may be required.
• There is usually a temporary difference in skin and nipple sensation following breast enlargement but this can be permanent.
• Fluid can build up around the implant. This is called a seroma and may require further surgery to remove.
• Haematoma and infection, skin necrosis, localized permanent loss of sensitivity, chronic pain - Some leakage of liquids like lymph or silicone is a very rare event, they causes the replacement of the implants. Skin necrosis, re-opening of the wound, poor scarring, and keloid scar, double bubble, rippling or perceivable folds. Implant moving while the pectoralis muscles are contracting, is more a side effect than a proper complication.
• A shell (capsular contracture) if important can lead to a second operation. A shell can occur is approximately 10% of cases. Then the breast becomes harder, rounder and higher. Sometimes it can become painful. Fluid can build up around the implant.
• There may be a difference in size and shape between the two breasts, possibly caused by your previous natural differences that are highlighted by the surgery.
• Remember exceptional cardiovascular, neurological complications, respiratory or immunoallergic, are sometimes lethal or invalidating with anaesthesia, they can evolve unto themselves.

 

 

 

 

 

 BREAST REDUCTION OR BREAST UP-LIFT

 

The principle of this procedure is to reduce the amount of skin only (up-lift) or also breast tissue itself at the same time, and to place the breast higher by reducing the skin excess. The scars involved by this operation are permanent. You should inform your partner about all the aspects of the operation.

Before The Operation
The amount of skin and breast tissue to be removed will be measured by palpation.  Some photographs will be taken before and after the intervention.  A mammography will be performed if you are over the age of 35
(prescribed by your GP).

The operation will take place for the most part under general anaesthetic, a consultation with an anesthesiologist, before the operation, is therefore necessary.  The duration of the operation is approximately 3 hours. During the operation you won’t breathe spontaneously, but through a machine. You must stop taking oral contraceptives (the Pill) one month before the intervention, and must wait 2 months after the intervention before re-starting. 
You must allow at least 12 months between the time of the operation and the beginning of a pregnancy. Breast feeding is generally impossible after mammary plastic surgery to the posterior pedicle.
The duration of hospitalisation (average of 3 days) depends on the secretion in the drains.  It is recommended to come to the clinic with a nightshirt that closes in the front and a wire-less bra that also closes in the front.
The model triumph sport Tri-action is a good bra that is available in all large department stores.  Their size does not pre-determine the size of your bras after the intervention.

After The Operation
The days following the operation are generally not very painful.  Very frequently, the operation improves the back pain suffered by women with very large breasts.  This also makes sport and clothes shopping easier.  It does not eliminate stretch marks of the superior quadrants of the breasts.
The sutures used are essentially re-absorbable; those that are not will be removed in the course of the first month, during the consultations that will take place after your discharge from hospital.
Asymmetrical bruising and swelling are common and normal with this surgery, they disappear within three weeks.
The areas undermined or incised regain their sensitivity in the few months following the operation. Areola sensitivity will remain modified.
During the months following the intervention you should take a shower each day, during which you wash the breasts with a gentle antiseptic soap and gauzes.  The quality of this care determines the overall results.  After the shower you must place dry gauze on the breast, which is held in place with the bra, which will be worn day and night for a period of one month post-operatively.

You must avoid to strain yourself postoperatively                                                            
Professional activity can continue a minimum of two weeks after the intervention.
Carrying heavy burdens is prohibited for five weeks.
Sports activities can be resumed after five weeks.
Obviously, sex relations during this period should not involve the breasts. Or should be avoided.
Breast-feeding after this surgery is usually not possible.

Scars are permanent even if they are discrete.  They are situated horizontally in the crease below the breast, vertically from that crease to the areola, and around the areola.  In the case of very extreme reductions, they may go beyond the furrow under the mammary.
Their evolution is rather stereotyped, with a period of inflammation and itchiness during the first trimester. Painful and visible (Keloid scar).
Sometimes tattooing (at the patients  expenses) will help to make the scars less visible.
Massaging the breast and squeezing the scars helps to soften the scars.

The main complications are rare, but include the following:
Haemorrhaging, Haematoma and infection that could call for surgical intervention
A prolonged lymphoma or lymphorragia.
Necrosis of the areola and of the nipple are rare.
The disunion of the scaring contours is minor complications, but not rare, that regresses with simple repeated dressings done by a Registered Nurse .
Excess of Fibrous tissue
Chronic pain, loss of sensations and sensitivity.
A defective scar, keloid or dystrophy of intrinsic origin can alter the cosmetic results and call for retouching.
The definitive aspects of the scars are not predicable.
For the record cardiovascular respiratory or neurological complications of general anaesthesia, deep vein thrombosis, thromboembolism or immuno-allergic, sometimes lethal or invalidating from anaesthesia which can evolve independently.

The morphological results can be estimated at a minimum of three months after.
The first weeks after the intervention, the breasts are placed high and rounded at the superior part.  They place themselves and round themselves out from the first month on.  At the end of the first month you must begin day massaging of the scares with gentle almond oil.
The final aesthetic results are obtained in the 9th month. 
This intervention brings about, most of the time, a large comfort and an aesthetic
improvement to the women that are benefiting from it.
A retouch under a local anaesthetic in order to improve tiny details is sometimes necessary (seldom).

Nipple Correction
In the case of inverted nipples or big areola or nipple, this procedure can be done alone or with a breast reduction. The incision is located around the areola or below the nipple.
It is necessary to have a dressing for a few weeks. Sometimes inverted nipple could go back in after the operation.

 

 

 

LIPOSUCTION / LIPOSCULPTURE

 

Liposuction is a procedure to treat excess adipose tissue, i.e., the deep, thick deposits of fat forming a thick subcutaneous layer that modify the body outline, such as for example “jodhpur thighs “. It cannot eliminate the “ peau d’orange” aspect (pigskin oedema) of the skin, which corresponds to real cellulites, or stretch marks. Best results are obtained on rather slim women who are embarrassed by one or two moderate localised fat deposits, particularly when her weight is stabilized or after she has lost 2 – 3kgs.  Liposuction does not give good results when important dietary problems exist, and is not a treatment for obesity or bulimia of which treatment is nutrition according to Dr Philippe Chout.. keywords: fat removal ,liposuction uk, liposuction cost ,lipo.

If the exc ess of fat is fairly moderate and localised to one area, surgery is performed under local anaesthesia after the patient has been given oral sedatives. In this case, the patient enters the clinic early in the afternoon and leaves three hours after surgery. In case of larger fat deposits general anaesthesia or epidural block is preferred and will require 24 – 48 hours hospitalisation.
Pre and post-operative pictures of the patient’s body contours are always taken.
Before surgery, the surgeon draws a series of guidelines around the areas to be reduced, as evidenced by palpation, and marks the position of short incisions, which average15 mm.
The principle of the procedure done by Dr Philippe Chout.is to suck subcutaneous fat through multiple tunnels made by the suction tubes.  After surgery, the skin rewrapped itself to the new underlying volume, results being obviously better on a young and elastic skin. An older or slackened skin may require further surgery to smooth out the skin by cutaneous resection, under tension; this is called dermolipectomy.

After liposuction, postoperative swelling and bruising masks the final results for six weeks. Do not expect to look any thinner before 6 weeks! The patient must wear a tight girdle (day and night) for 4 weeks, in order to compress he operated areas and to eliminate the oedema. Results become visible after 60 days and totally achieved after 6 month depending on the treated areas. Obviously result can be discussed with Dr Philippe Chout.only if the patient did not put weight back on due to improper food regimen. If the patient put weight back on due to improper food regimen (weight above the initial weight minus the amount taken off) no comment or claim is receivable.
Bruising and swelling ( ecchymosis, and oedema) are normal and usual after this type of surgery they will stay during a few weeks. The swelling will hide the results during six weeks.  Oral prescription of arnica and local applications of Arnica help accelerate bruising resorption.
Painkillers are administered over the first few days to reduce pain and discomfort. The patient can usually resume work after a week with Mister Chout advice.

             This operation is one of the most frequently performed. Complications are rare, such as fainting, lymphorrhagia, lymphoedema, deep vein thrombosis, pulmonary embolism, fat embolism haemorrhaging anaemia transfusion, infections,mrsa, scar contracture, asymmetry, and surface irregularities such as rippling or hollow.
One must also remember other possible complications: cardiovascular complications, respiratory or immunologic to the used medications, are sometimes lethal or invalidating with anesthesia, they can evolve unto themselves.

Dr Philippe Chout.

 

 

FAT TRANSFER / LIPO-FILLING

 

Fat removed by liposuction can be used to fill in a hollow cavity in the buttocks or the face.
Fat being very fragiel must be handle gently during surgery in order to stay for a long time. This very good technique is very skill dependant as well.
Fat transfer to the face can help to reduce the appearance of nasolabial folds, increase cheekbone area volume, chin projection and therefore create a more chiselled look.
Fat can also help to increase the volume and height of the buttock when injected in, or below the muscle. This operation is called a Buttock Lift.
Re-injection is made through a small incision. This allograft is called lipofilling.
As only 80 % of the injected fat remains in place permanently (in the best case scenario), the defect must be over-corrected if enough fat tissue is available. Otherwise an additional lipofilling procedure will be required later.This operation is relying on the surgeons skills because fat is so fragile.
On the other hand, postoperative oedema, which is often spectacular for about two months, will temporarily mask results, due to transitory local swelling. One must be patient and realise that 20% of the injected volume will eventually disappear. The patient must be aware of this usual delayed evolution, and must inform the partner and relatives.
Complications are rare, such as failure of the graft with total disappearance of the injected volume, asymmetry, lymphorrhagia, infection, protracted oedema, scar.  One must also remember the complications of liposuction.

To sum up, lipo-filling is an elegant and natural way to fill up unwanted, poorly aesthetic hollow cavities or other lack of volume. Results are appraised after the 3rd month and are durable, because swelling may occur initially at the injection site.

 

DERMOLIPECTOMIES
=  abdomninoplasty (tummy tuck)/ Thigh Lift / arm lift

When there exists an excess of skin, in addition to an excess of fatty tissue – for example on the abdomen or thighs – a simultaneous resection of the loose and wrinkly skin and of the fatty tissue by use of an undermoining and  detachment. Post-operative follow-up is not as simple as after liposuction.
It means that a large incision will be done and will leave a permanent scar.
The amount of skin to be removed is easy ot assess : it is the amount of  hanging loose skin that one can grab when you are sitting on a chair. Removing this amount of skin often involves transfering the belly button .
All the possible complications of the lipo can be seen after that procedure and are even more frequent.
Complications of abdominal dermolipectomy can include haemorrhaging protracted lymphorrhagia, leakage of lymph, poor scarring, infection, delayed healing making repeated dressing by nurses necessary, deep vein thrombosis, thrombophlebitis with a risk of pulmonary embolism and cardiovascular failure.
There is always an inflammatory period for the scar between the 1st and the 4th months, during which unpredictably pigmentation of the scar may occur. The loss of sensitivity above the scar area is usual. It is not a complication but an unavoidable consequence of a large skin removal.

Dermolipectomy by Dr Philippe Chout will require at least four weeks of absence from work and for recovery.

 

 

 

 

ABDOMINOPLASTY
Tummy Tuck / dermolipectomy

 

This fact sheet is for people who are considering having an abdominoplasty (tummy tuck) operation.
Abdominoplasty, commonly called a "tummy tuck", is an operation to remove excess fat and skin from the abdomen. The surgeon may also tighten the tummy muscles. The aim is to produce a tighter, flatter stomach and it may partially reduce the appearance of stretch marks. The Tummy tuck procedure does not include a liposuction but this can be combined with the tummy tuck operation, either of the abdomen alone or of a different or multiple areas according to Dr Philippe Chout.

Why have a tummy tuck?
The reasons why someone may choose to have a tummy tuck include having excess skin, stretch marks or loose abdominal muscles which may happen after:
-Losing a lot of weight through dieting and exercise
- Pregnancy
- Successful surgery to treat obesity
A tummy tuck is not a treatment for weight control and is not a substitute for regular physical activity and a healthy balanced diet.

What are the alternatives?
For some people, an alternative is liposuction (or liposculpture), where fat is sucked out through small holes in the skin, but if the skin is very loose it will remain loose and rippling.  The liposuction alone is therefore not a rea alternative but is rather a treatment for the less unfortunate if the skin is of a good quality, without stretch marks or looseness. For more information, please see the separate fact sheet on Liposuction.
Many creams, diet supplements and beauty treatments claim to reduce stubborn areas of fat and even cellulite. However, there is no scientific proof that they work.

What happens before a tummy tuck?
It is important to discuss with your surgeon what you are hoping to gain from the operation and the result you can realistically expect. The surgeon will discuss how to prepare for your operation. For example, you may be asked to:

• Lose weight if you are overweight - a tummy tuck gives the best results in people who are the correct weight for their height.
• Stop taking the contraceptive pill six weeks before surgery and use an alternative method of contraception as this reduces the risk of blood clotting (thrombosis) after the operation.
• Give up or cut down on smoking - smoking increases the risk of chest infection and slows the healing of wounds.

 

What should I expect in hospital?
Most people stay in hospital for one to three days.
Your surgeon and anaesthetist will visit you before the operation. This is a good time to ask any questions about the operation. Your surgeon may draw on your tummy to mark the operation site.
You may also be measured for an elastic garment to wear around your tummy for the first month after the operation, to reduce swelling.

The operation

The operation is performed under general anaesthetic, which means that you will be asleep throughout the procedure and will feel no pain. Typically, you must not eat or drink for about six hours before a general anaesthetic. However, some anaesthetists allow occasional sips of water until two hours beforehand.

During a tummy tuck, the surgeon will do a large and long incision and removes excess fat and skin from the lower tummy and if necessary, tightens the muscles of the abdomen. Liposuction may be carried out in the same operation. Fat removal and loose skin removal.
You will be left with a scar around the tummy button (which will often be moved to a higher position) and a long scar along the bikini line, which can usually be hidden within your large underwear.

A diagram showing the abdominoplasty incisions and scar lines

After the operation

When you wake up after the operation you will find a drip in your arm. This is to give you fluid while you can't eat and drink. There will be a drainage tube in each side of your lower tummy to drain any blood or watery liquid that collects from the operation site. These drains are usually removed a few days after surgery. You may also be wearing anti-thrombosis compression stockings to help the circulation in your legs and help prevent blood clots forming (deep vein thrombosis or DVT).
Your doctor or nurse will give you painkilling tablets or injections to reduce any pain that you have after the operation.  For the first few days, you will be asked to keep your knees and hips bent when you sleep at night to reduce strain on your stitches. Stitches in your skin will normally be removed in five to seven days and deeper stitches closing the operation site may be taken out two to three weeks after surgery.

Recovering after a tummy tuck

In general, healing can be slow, particularly in the central part of the operation site and sometimes dressings are needed for a few weeks. You may experience some tightness around the operation site, but this is more common in patients who are overweight and who smoke. You should try to be careful not to strain or stretch the operation site when you first get home as this will increase fluid accumulation and reduce healing. As soon as you feel able, you should try to walk a little each day. This will also help to prevent a chest infection, and blood clots forming in your legs. If you find getting around particularly painful or difficult, talk to the hospital or your doctor about effective pain relief.
You may find that wearing an elastic garment helps to reduce the swelling and makes you feel more comfortable in the first month. Most people are able to return to work between two to four weeks after the operation, but vigorous exercise is not recommended for at least six weeks by Dr Philip Chout.

Deciding on treatment

It's important not to rush into the decision to have a cosmetic operation. And it's sensible to discuss the issue with your GP. A tummy tuck is a commonly performed and generally safe surgical procedure. For most people, the benefits in terms of improved appearance are greater than any disadvantages. However, in order to give informed consent, you need to be aware of the possible side effects and the risk of complications. Side effects are the unwanted but mostly temporary effects of a successful procedure. For example, feeling sick as a result of the general anaesthetic. Anyone having a tummy tuck can also expect that:

-There will be swelling, which may not completely settle for a few months.
-The incisions will leave permanent scars, which will be pink and noticeable at first, but should become finer and less noticeable after a few weeks. The final appearance of scar is not totally predictable.

Complications are unexpected problems that can occur during or after the procedure. Most people are not affected. The main complications of any operation are bleeding during or soon after the procedure, infection and an abnormal reaction to the anaesthetic. It's also possible for a blood clot to develop in a vein in the legs (deep vein thrombosis or DVT).
Specific complications of a tummy tuck are uncommon but can include those listed below.
Numbness in the lower part of the tummy which often reduces over the next 6 to 12 months following the operation but is often permanent.
- Poor healing, which results in noticeable scars, may mean you need more surgery.
- Final position of the tummy button may be off-centre.
- Bleeding can occur under the skin, causing the area to swell and become painful. This is called a    haematoma. Sometimes it is necessary to return to theatre to stop the bleeding, remove the blood and help avoid infection.

Other serious complications of tummy tuck operations are rare. They include the following.
-The formation of fat or blood clots in the blood vessels this is called deep vein thrombosis. These can break off and move to the lungs. This is called a pulmonary embolism and can be life-threatening. Complications of abdominal dermolipectomy can include haemorrhaging haematoma, protracted lymphorrhagia, leakage of lymph, infection, delayed healing making repeated dressing by nurses necessary, deep vein thrombosis, thrombophlebitis with a risk of pulmonary embolism and cardiovascular failure. It could also involve deep organs, herniation, occlusion,  deep organ perforation, peritonitis, infection, Mrsa, allergy ,necrositis, delayed scarring.
There is always an inflammatory period for the scar between the 1st and the 4th months, during which unpredictably pigmentation of the scar may occur. The loss of sensitivity above the scar area is usual. It is not a complication but an unavoidable consequence of a large skin removal.
Dermolipectomy will require at least four weeks of absence from work and for recovery.

The chance of complications depends on the exact type of procedure that is being performed and other factors such as your general health. Your surgeon Dr Philippe Chout.will be able to explain how the risks apply to you.

 

 

 

 

LABIAPLASTY
Vagina Labiae Reduction

 

Labiaplasty is also known as labiaeplasty, vaginal lip reduction, vaginal rejuvenation, female genital surgery, and a host of other names. In this surgeon's hands, it basically involves reducing the size and changing the shape of the Labia Minora, the inner vaginal lips.  Why?  Enlarged vaginal lips can be the source of several problems including:

•  Embarrassment with sexual partners
•  Discomfort in tight clothing or underwear
•  Functional difficulty during intercourse or pain
•  Hygiene problems including thrush

Labiae reduction or Labiaplasty refers to any operation that changes the Labia. I perform it specifically to correct the above-mentioned problems in women. Despite the fact that it has several functional indications, health insurance does not cover it. It is not as simple as cutting off the vaginal lips. The manner of the removal, closure and repositioning (if needed) is unique in each case.  The procedure is performed without the requirement for admission to a hospital (therefore, performed as an outpatient) either under local anaesthesia with sedation or under general anaesthesia.  The exact operation is tailored to the patient's specific problem and desires, within reason.

I rarely perform the simple "cut off the excess" operation that many gynaecologists perform. My preferred technique involves the removal of tissues from the sides and central portion of the labia. This leaves the edge of the structure looking untouched, while allowing reduction of the offending portion. It is the best technique to limit post-operative pain and sensory loss. Some women prefer the removal of more tissue making the lips "flat" against the adjoining Labia Majora. The alternative procedures for a given woman's preference are discussed at consultation. Interestingly, women are quite variable with regards to their desires. More interesting is the variation in the size and configuration of the Labiae and Clitoral Hood.  Labia Minora (inner lip) reduction surgery is an often-performed procedure.  You are able to decide about the size of your labia yourself. However, it is important to remember the biological function of the labia minora, which is to protect the vaginal orifice when spreading the thighs.  Therefore, over correction is best avoided. A short protective rim of labia is usually left in place, covered by the greater lips.

During the consultation the surgeon will examine your vagina, pull the lips out, and draw with a marker the limits of the incisions. You will then see exactly what will be removed and what will stay. During the procedure, the inner lips of the vulva are reduced, or made to look more symmetrical.  Although the procedure is usually aesthetic, in order to improve vaginal self-image, it may also be indicated because of pain during intercourse, cycling or sport.

Sometimes abnormalities need to be corrected, such as severe overgrowth, asymmetry or scarring. We focus on the aesthetic appeal of the labia minora. Scars are minimal and normally only visible to the trained eye. Sensitivity is normally not interfered with: psychological and relational components of dysfunctional vaginal experience can neither be caused, nor treated by surgery. I do not operate on the clitoris directly such as to preserve sensation. Therefore the skin close to the clitoris will remain untouched. Reduction in the size of the vaginal lips and occasionally reduction of the hood around the clitoris is possible and well tolerated however, but we do that very rarely.  intimmate surgery by Dr Philippe Chout..

 

 

Procedures

• Labia Reduction:               Most patients are happy after simple removal of the redundant labia.
• Labiaplasty:                          A more complicated technique preserves some of the outer, dark

   brown skin, by removing more of the internal skin.

• Clitoral Hood Reduction: When desired, redundant skin protruding from the clitoral area can
                                                 be surgically removed.  Please note that clitoral surgery is done           
                                                           solely for the personal benefit of the individual patient. We
                                                 absolutely do not do any form of female circumcision or genital
                                                 mutilation, regardless of one's cultural beliefs.

Aftercare
Most patients feel fine immediately after surgery. However, the most common complication is after bleeding in the first few hours after surgery. Therefore we urge you to stay at our clinic, or in the area, for at least four hours after surgery. After the procedure you wear a panty liner + a large pair of cotton underwear. A daily bath or gentle shower using GYNHYDRALIN ensures quick healing (within 10 days). You will need to clean your self with an antiseptic tissue each time you will go to the toilet.
SEX IS ABSOLUTELY FORBIDDEN FOR FOUR WEEKS.
The sutures dissolve spontaneously so there is no need for physical removal. Normal activity can be recommenced after 2 weeks in case of labia reduction or 4 weeks in case of full labiaplasty.

Complications to this surgery are rare, however they can lead to the need to re-operate: Haematoma, haemorrhaging and infection, skin necrosis, scar disunion and delayed healing, localized permanent loss of sensitivity, chronic pain - Remember cardiovascular, neurological complications, respiratory or immunologic or allergic adverse reactions, are sometimes lethal or invalidating with anaesthesia, they can evolve unto themselves. Dr Philippe Chout.

 

 

 

BUTTOCKS LIFT

 

Background on Buttock Lifts

As we age, our buttocks gradually change shape by drooping and sagging. This can have harmful effects on one’s self image and sense of attractiveness.  In the past, nothing could be done to correct this unfortunate circumstance. However, there is a way to reverse nature’s aging process through plastic surgery.  Buttock lift surgery can help an individual regain the confidence and youthful appearance aging has prematurely taken away.

Best Candidates for a Buttock Lift

The best candidates for buttock lift surgery have poor skin tone in the buttock area. This is characterized by loose or excess skin, stretch marks and cellulite.  Patients who suffer from poor skin quality cannot benefit from liposuction and can only improve the appearance of their buttocks through buttock lift surgery. Ideal candidates should also be in good physical and mental health and have realistic expectations about what plastic surgery can do for them.

Uncertainty and Risks of a Buttock Lift

Any form of surgery has an amount of uncertainty and risk involved, and buttock lift surgery is no exception.  Fortunately, when performed by a qualified surgeon, the procedure is remarkably safe. Your plastic surgeon will address any concerns you may have during your consultation.

Planning for Buttock Lift Surgery

It is important to be honest about your expectations and goals while speaking with your plastic surgeon.  As you plan the buttock lift surgery together, you will discuss the size, shape, and skin characteristics that you and your surgeon hope to obtain through the operation. Your health history will be evaluated and the procedure will be planned and explained so that your plastic surgeon can operate safely and provide you with the results you desire.

Preparing for your Buttock Lift Surgery

While preparing for buttock lift surgery, your plastic surgeon will provide you with a set of guidelines for you to follow. These guidelines may include instructions on eating, drinking, smoking, and the use of certain vitamins or medications. You should also prepare for the surgery by arranging for someone to pick you up after the procedure, as you will still be feeling the effects of anaesthesia.

Anaesthesia

Buttock lift surgery is usually performed under general anaesthesia so that the patient is asleep and feels no pain during the operation. Anaesthesia is selected based on the patient’s needs so that he or she is as comfortable as possible during and immediately following the procedure.

How the Buttock Lift surgery is performed

There are different buttock lift methods and procedures that can be employed based on the needs of the patient.  Liposuction, implants, and lifts are all used to sculpt the buttock region into a desired shape. During a buttock lift, excess skin is removed and the buttock is raised to a higher position on the body. In combination with a lifet, some patients desire an augmentation that utilizes implants. This additional procedure may be performed at the same time or a later date by Dr Philippe Chout..

 

Post-op

After surgery patients are fitted with a body support garment that aides in the healing process, and helps the skin adapt to its new contours. Patients are able to return to work about two weeks after surgery, but swelling can be noticeable for several months.  However, there is an immediate difference in the shape of the buttocks that is both dramatic and noticeable.  Most patients are very pleased with the long-term results of their buttock lift surgery.

 

 

 

 

PRE OPERATIVE INSTRUCTIONS

Your operation for :

Will be performed on (date):

You will check in at the clinic on (hour) :

You will discharge at:

The first post operative consultation will take place on :

 

You will refrain from eating, drinking or smoking eight hours before entering the clinic.
If you are currently following a medical treatment, you should bring your medicines. It does mean that you will starve after 9.00PM the day before surgery.
You should not take any medication except with your Surgeon’s consent. In particular any medicine containing aspirin should be avoided for eight days before surgery, since aspirin is a platelet aggregation-inhibiting drug, which favours bleeding. All anti-inflammatory drugs will be avoided all of them favour bleeding and infections. Fro the same reason you will avoid nurofen

 

When checking in

• Bring your passport, credit card and chequebook.

Before surgery you will make sure that:

• You read and sign the confirmation letter, the price estimate, information form and the informed consent 

At the time of surgery you should remove:

• make-up
• Moisturizing creams
• nail enamel
• jewellery or piercing
• contact lenses, dentures

Please also bring:

• laboratory tests
• ECG
• prescribed medicines
• panty or brassiere for support
• sunglasses and a scarf if undergoing face surgery
• Large baggy comfortable clothe easy to put on and to remove

When checking out ( discharging) :

• do not drive your car
• do  use public transportation such as tube or train : get a cab.
• follow postoperative instructions
• Buy yourself appropriate antiseptic drugs of the counter such as Chlorexidine and sterile       gauzes as well as Mepore sterile dressings
• respect all postoperative medical appointments ( day 7, day 14 etc)
• do not hesitate to contact us by telephone, we are at your disposal
• Remember that and extra cost for an extra day in a single room is worth  £ 160 in France and £ 500 in London.

 

 

 

POSTOPERATIVE INSTRUCTIONS

• Daily shower: ( when you will be given permission) after showering, dry with a clean towel and use sterile compresses to apply an antiseptic (Betadine, chlorhexidine, Dakin or Héxomédine) on the incisions. Wash your hands; Replace dressing.

• No bathing unless authorized by your Surgeon.

• All usual hygiene rules apply: wash your hands before any medication, use clean underwear, clean towels; no one should touch your incisions.

• All postoperative appointments must be kept.

• No car, no efforts

• No postoperative trips either immediately or soon after the operation.

• No alcohol, no smoking for two weeks, both pre- and postoperatively

• Do not smoke, because smoke severely impairs healing.

• NO ASPIRIN or NEUROFEN in the 8 days following your operation

• Obviously, in the case of breast, abdomen or contour-improving surgery, any sexual activity should be avoided until after complete healing.

• In the case of a rhinoplasty, do not blow your nose out, just wipe it off. Do not wet your cast

• Gym will be stopped for three weeks at least after the operation.

• For one year following your operation the scars will not be exposed to the sun or to sun bed because  they could become permanently dark  and visible.

• Please Book your post-operative consultations before the actual operation via emails : mrchoupa@yahoo.co.uk , use this  phone in case of emergency : 07 947 022 907

 

 

 

 

 

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