Tummy Tuck or Abdominoplasty

Overview of the surgery:

Tummy tuck  (appropriately known as abdominoplasty), is a major surgical procedure that gets rid of excess fat and skin, tightening muscles in your abdominal wall and designed to flatten the abdomen.

The best candidates for this procedure are physically fit and healthy individuals who suffer from loose skin and excess fats in the lower portion of the abdomen which is typically the result of single or multiple pregnancies in women whose abdominal tone were lost after pregnancy or considerable weight loss and age related looseness of skin may also be corrected.

It usually requires a long incision across the abdomen from hip bone to hip bone and around the belly button. The shape of the incision is like a smile, with a flat bottom. The skin is separated from the abdominal wall, up to the ribs, exposing the vertical abdominal muscles (rectus muscles). These muscles have usually been stretched apart by previous pregnancies. The rectus muscles are then stitched into a new position, tightening the muscles and reducing the waistline. After the muscles have been repositioned and tightened, the excess skin is stretched and removed.The remaining skin is redraped over the abdominal area and sutured in place. The belly button is then brought out through the overlying skin in its new location.

Duration of the operation:

The procedure will take about 2-5 hours. A partial tummy tuck may take about 1-2hours.

Post operative care:

1. Patients are required to take a rest for about 1-3 weeks before returning to work and a normal schedule.
2. A day after the surgery, patient must have light to moderate physical activities.
3. Some incision will be left open and drainage is inserted.
4. Patients can start light to moderate activity after four weeks. After six to eight weeks, most people can resume all exercise and activity.
5. Patient will be given pain medication as needed. This typically entails narcotics for the first few days after surgery and then non-narcotic pain relievers after that.
6. The abdomen is swollen and sore for the first few days.
7. The abdominal scars will appear to worsen during the first three to six months. They may take nine months before they flatten and lighten in color. The scars never disappear completely, but clothing can hide them easily.

Recovery period:

You may be able to go back to work after 2-4 weeks. More strenuous activities for 4-6 weeks or more. Fading and flattening of scars for 3 months to 2 years.

Possible risk and complications:

These potential complications can be prevented if you carefully follow surgeon's instructions. Listed below are the potential complications:

·         Anesthetic medications

• Tissue loss
• Infection
• Collection of blood beneath the skin (hematoma)
• Collection of fluid under the skin (seroma)
• Blood clot to the lungs
• Aspiration pneumonia
• Bleeding under the skin flap
• Insufficient healing that may result in the need for a second surgery
• Death
• Unfavorable scarring
• Poor wound healing

Anesthesia use:

Abdominoplasty is often performed with general anesthesia and can also be done using a local anesthetic with a sedative.

Hospital admission:

This procedure may be performed in the cosmetic surgeon’s office-based facility, an outpatient surgery center, or at a hospital. This procedure is usually done on an outpatient basis

Preparation for surgery:

• Assessment of the medical history (any allergies, serious medical condition and all medications taken both prescribed and non-prescribed), physical examination, and laboratory tests will be performed during consultation.
• Blood and urine samples will be collected for routine preoperative laboratory tests.
• Smoking must be avoided for about 3-4 weeks prior to surgery, as nicotine interferes with circulation and will greatly affect healing process.
• You will likely to be asked to stop drinking alcohol, a week before the surgery and throughout your recovery period.
• Avoid taking any medications such as hormones, anticoagulants, anabolic steroids and supplements at least 4-6 weeks to prevent complicating medical factors prior to surgery. Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding.
• If general anesthesia or sedation will be used, and the surgery will be in the morning, fasting from midnight the night before is required. If only local anesthesia will be used, fasting is not required
• Maintain the best of health and hygiene in the weeks prior to surgery. Colds, virus, throat infection or other illness can result to rescheduling of surgery.
• Eat a well balance diet several weeks prior to surgery. Over eating and crash dieting can greatly affect overall health status and well being of the patient
• Daily exercises are an important factor to help enhance posture and strength at least 3-4 weeks prior to surgery.

For more information about the procedures you may contact International Marketing Coordinator: osias05@hotmail.com or call mobile phone: +66816572522, Tel: (662) 753-9206

Liposuction

Overview of the surgery:

Liposuction, also known as lipoplasty, liposculpture suction lipectomy or simply lipo ("suction-assisted fat removal") is the most common cosmetic surgery operation that removes pockets of fats from many different sites on the human body. It can remove stubborn areas of fat that do not respond to traditional weight loss method but remember it is not a substitute for dieting and exercise. It also involves the use of a stainless steel suction tube called a cannula. The cannula is pushed and pulled through the fat layer, breaking up the fat cells and suction them out by a powerful suction pump, thus improving body contour and enhancing self image. Areas of the body where liposuction is performed are: abdomen, hips, outer and inner thighs, flanks, love handles, back, knees, arms, submental (chin), Gynecomastia.

The ideal candidates for liposuction are those who are physically fit, who exercise regularly and are not more than 20 pounds overweight. They may have bulging and flabby areas of the body from fat deposits, especially the abdomen, arms, thighs, and neck. Individuals with certain medical conditions may not be suitable candidates for liposuction.

In all types of liposuction methods, there are certain things that should be considered when having the surgery. It maybe performed as an outpatient procedure or the procedure that will be done in a hospital and may require an overnight stay.

The procedure is performed using a suction devise attached to a small, stainless steel tube called cannula. Through a small incision, the small bore cannulas is inserted into fat layer between skin and muscle by alternately pushing and pulling it through the fat layer then suction it out by the use of a vacuum pump or a large syringe. The duration of the surgery will vary according to the amount of fat to be removed.

Duration of the operation:

The duration of liposuction Thailand depends on the number of areas, the size of the area and the amount of fat to be removed.

Post operation care:

1. A compression garment must be worn for two to four weeks.
2. If patient had liposuction by local anesthesia, he/she may resume usual diet immediately.
3. Drink adequate amount of water at least 8- 10 glasses a day or fruit juices to prevent dehydration.
4. Bed rest is recommended for the first few hours after surgery.
5. If non-absorbable sutures are placed, the surgeon will remove sutures after 5 to 10 days.
6. Pain killers will be prescribed to control pain that may last as long as 2 weeks depending on the extent of procedure.
7. Keep incision clean. Take a shower once or twice daily. Wound dressings need to be changed often. After one to three days, small self-adhesive bandages are sufficient.
8. Do not apply ice-packs or a heating pad to skin overlying the areas treated by liposuction.     
9. Do not apply hydrogen peroxide or plastic Band-Aids to incision sites. Liposuction incision sites heal faster and better without topical antibiotics.
10. Do not soak in a bath, Jacuzzi, swimming pool, or the ocean for at least 7 days after surgery in order to minimize the risk of infection.
11. Patient taking Aspirin and Ibuprofen for at least 3 days after surgery. NSAIDs promote increase the risk of bleeding by impairing platelet function and depress immune response to infection.
12. Drainage is placed for about 3-7 days depending upon the extent of surgery.
13. Patient must maintain a proper diet and exercise regimen because the remaining fat cells could still enlarge and form cellulite thus creating irregularities.

Recovery period:

Depending on the extent of liposuction, patients are generally able to return to work between 2 days-2 weeks. Bruising will fade after 1-2 weeks. Swelling will occur and increase 5-10 days after surgery and should subside gradually over 2 weeks- 2 months while numbness persists for several weeks.

Possible risk and complications:

With any type of liposuction procedure, complications may arise beyond the minor side effects but they are rare. Some possible complications include infection, allergic reaction to medication or material used during surgery, excessive fluid loss, thromboembolism, injury to the abdominal organs, and excessive loss of body heat (hypothermia), excessive intravenous fluids, aspiration pneumonia and cardiac arrest.

It is the surgeon’s responsibility to give the written list of signs and symptoms to watch for, along with instructions for post-op self-care.

Anesthesia use:

The procedure uses local or general anesthesia

Hospital admission:

This procedure may be performed in the cosmetic surgeon’s office-based facility, an outpatient surgery center, or at a hospital. This procedure is usually done on an outpatient basis

Preparation before the surgery:

1. Patient and the surgeon will agree ahead of time on exactly which area(s) will be treated and both will discuss what outcome to expect. Assessment of the medical history, physical examination and laboratory tests will be performed during the consultation as well as the explanation of the course of surgery, recovery period, risk and complications.

2. Eat a well balance diet several weeks prior to surgery. Over eating and crash dieting can greatly affect overall health status and well being of the patient.

3. Daily exercises are an important factor to help enhance posture and strength at least 3-4 weeks prior to surgery.

4. Smoking must be avoided for about 3-4 weeks prior to surgery, as nicotine interferes with circulation and will greatly affect healing process. Patient must be free of nicotine patch or nicotine based products for a minimum of 4 weeks prior to surgery.

5.  Patient should avoid taking any medications such as hormones, anticoagulants, anabolic steroids and supplements at least 4-6 weeks to prevent complicating medical factors prior to surgery.

6. Maintain the best of health and hygiene in the weeks prior to surgery. Colds, virus, throat infection or other illness can result to rescheduling of surgery.

7. If general anesthesia or sedation will be used, and the surgery will be in the morning, fasting from midnight the night before is required. If only local anesthesia will be used, fasting is not required.

Side effects:

·        Bruising: Can be painful in the short term, and should fade after a few weeks.

·        Swelling: is due to an inflammatory reaction to surgical trauma. This will occur and increase 5 to 10 days after surgery and should subside gradually over a month or two.

·        Scars: will vary in size depending on the particular procedure, and should fade over the weeks. Scarring is an individual thing, partly dependent on heredity. For some, scar healing may take as long as a year.

·        Pain: should be temporary and controlled by either over-the-counter medication, or by a prescription.

·        Numbness: sometimes persists for a few weeks.

·        Limited mobility: will depend on the exact procedure.

·        Nausea and vomiting: are among the side effects that may be associated with liposuction. Nausea can be caused by antibiotics, lorazepam, or local anesthesia.

·        Slight temperature elevation during the first 48 hours after surgery is a natural consequence of the body's reaction to surgical trauma.

·        Itching: may occur as part of a normal healing process. To help relieve itching, patient may try taking Benadryl as directed by the doctor

• Assessment of the medical history (any allergies, serious medical condition and all medications taken both prescribed and non-prescribed), physical examination, and laboratory tests will be performed during consultation.
• Blood and urine samples will be collected for routine preoperative laboratory test.
• Smoking must be avoided for about 3-4 weeks prior to surgery, as nicotine interferes with circulation and will greatly affect healing process.
• You will likely to be asked to stop drinking alcohol, a week before the surgery and throughout your recovery period.
• Avoid taking any medications such as hormones, anticoagulants, anabolic steroids and supplements at least 4-6 weeks to prevent complicating medical factors prior to surgery. Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding.

For more information about the procedures you may contact International Marketing Coordinator: osias05@hotmail.com or call mobile phone: +66816572522, Tel: (662) 753-9206

Male to Female Sexual Reassignment Surgery

Overview of the surgery:

Male to female Surgical Procedure:

Sex change surgery for male to female involves the removal of the penile muscle and testicles reshaping it to appear more female thereby constructing a vagina. An incision is made into the scrotum, the flap of skin is pulled back and the testis is removed. The skin is stripped from the penis but is left attached and the urethra is cut. The excess skin is used to create the labia and the vagina.

Duration of the operation:

The surgery usually takes 6-8 hours to complete according to the extent of the procedure.

Post operative care:

·        After surgery patient should remain on bed for the first 24 hours.

·        The surgeon will perform the necessary care and do the dilation at least 2 weeks.

·        Patient must dilate to achieve the desired depth and width of the newly made vagina. If patient will not dilate properly, the result would be narrowing of the width and depth of the newly made vagina due to scar contractures.

·        After each dilation session with the doctor, wound dressing should be performed to speed up healing process.

·        Patient should avoid strenuous activities which can interfere with the circulation.

• The vaginal packing, all drains and urinary catheter are usually removed on the fourth or fifth day following surgery.

·        Increase fluid intake at least 8-10 glasses per day to promote urination.

·        Wound dressing is done daily to prevent infection.

·        The surgeon will remove the stitches after 5-10 days.

Recovery period:

• The patient should stay in Thailand at least 2-3 weeks to complete the whole process and allow proper healing and at least 1 week hospital stay for observation and management.
• Patients can resume taking hormonal medications in 10-14 days after the surgery. Consult the doctor for adjustment of the dosage.
• Patient can start vaginal dilatation 2 times a day for the first few of months about 1 hour each time with an adequate amount of lubricant. Vaginal stents typically range in size from about 1-1/8 to 1-1/2 inches or more in diameter (28 to 38 mm), and must be inserted to full depth (4 to 6 inches or more). 

Possible risk and complications:

Patients must keep in mind surgeon’s instructions to prevent potential risk and complications following surgery. Possible complications include: Hematoma (bleeding), delayed wound healing, swelling, scarring and numbness or change in sensation, infection, hypertrophic scarring, partial or complete flap necrosis, intra-vaginal hair growth, recto-vaginal fistula.

Anesthesia use:

The procedure requires a general anesthesia.

Hospital admission:

You will be requested to sign in hospital consent form. Then you need five nights
admission to hospital for recuperation.

Requirements to have sex change surgery?

According to “The Harry Benjamin International Gender Dysphoria Association’s Standard of Care for Gender Identity Disorders “a patient must qualify on the following criteria prior to the surgery:

1.      Legal age of maturity in the patient’s nation. At least 18 years of age and will require permission from parents.

2.      At least 12 months of continuous hormonal therapy for those without medical contraindications. Patient should present a Hormonal therapy certificate.

3.      At least 12 months of continuous full time real life experience in a cross gender role.

4.      Patient should present a Certificate of recommendation from a qualified psychiatrist/psychologist dealing with transsexuals for the diagnosis of gender dysphoria.

5.      Physically fit for the surgery.

The goal of Sex reassignment surgery for Male to Female:

·        To create an erotic sensate area including clitoris, labia minora, labia majora and vaginal opening.

·        To achieve satisfactory vaginal depth.

·        To preserve orgasm during sexual intercourse.

Preparation before the surgery:

Criteria for approval are as follows:

1. Letter of recommendation from a psychiatrist.
2. Discontinued hormonal therapy at least 14 days prior to surgery. Hormones should be stopped before surgery to reduce the risk of thrombosis (blood clots).
3. Physical check up prior to SRS. Laboratory test should be taken. It includes the following: CBC, HIV, FBS, Creatine, Urinalysis, Alkaline phosphatase, SGOT LDH EKG and chest x- ray. You can have your private doctor perform the physical examination and send the results via email.

4.      Patient must stop smoking 2-4 weeks prior to the surgery. Smoking interferes and delays wound healing process.

5.      Patients must stop taking medications such as anticoagulants (aspirin), anabolic steroids and supplements (Vit. E)  at least 4-6 weeks to prevent complicating medical factors prior to surgery.

6.      Assessment of the medical history and physical examination will be performed during the consultation with the surgeon as well as explanation of the course of surgery, recovery period, risk and complications.

7.      No intake of food or water 8 hours prior to surgery.

8.      The surgery usually takes 4-8 hours and is usually done through general anesthesia.

9.      Appointments should be one month prior to the date and time of the surgery.

One month before the surgery:

Prepare and Plan: Put your schedule together for the day before, day of, and first few days.

Appointment: should be one month prior to the date and time of surgery.

Preoperative tests: Make certain all test ordered (CBC, EKG, X-ray) by your surgeon MUST be completed at least 5 days before surgery and no more than 30 days before surgery.  Test results should be received by surgeon for clearance. If medical clearance is not yet received at the expected date of completion, surgery maybe delayed or cancelled.

Stop smoking: Smoking must be avoided for about 3-4 weeks prior to surgery, as nicotine interferes with circulation and will greatly affect healing process.

Stop taking medications: Avoid taking any medications such as hormones, anticoagulants, anabolic steroids and supplements at least 4-6 weeks to prevent complicating medical factors prior to surgery. Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding.

Stop drinking alcohol: You will likely to be asked to stop drinking alcohol, a week before the surgery and throughout your recovery period.

Vital information: A preoperative visit or call is essential to review your health, your goals and any vital information including allergies and health considerations.

One week before the surgery:

Confirm your day of surgery: Review all orders and instructions and put your schedule together a few days before the surgery.

Continue to practice healthy habits: No smoking, no drinking alcohol and stop taking medications to ensure safety.

Relax: Get plenty of rest.  Anxiety is common over the thought of surgery, so don’t hesitate to contact our office.  We are here to support you and answer all of your concerns regarding surgery.

One day before surgery:

Pack your personal belongings for the day of surgery.

Nothing by mouth. No candy, gum or mints. Anything more than a small amount of water as needed for brushing teeth or swallowing medication may result in the need to cancel surgery.

Dress appropriately:  do not wear jewelry, hair clips, body piercing, cosmetics.  (If there is something you cannot remove, let the admitting nurse know right away)

Wear comfortable, clean, loose- fitting clothing: Do not wear jeans or any tight fitting bottom; rather have a pair of loose, drawstring sweatpants to wear home. You may wear a robe. Wear slip on, flat shoes with a slip proof sole; no heels. Wear clean cotton socks as the operating room can feel cool.

During the surgery:

·        Appointment for consultation with the surgeon. The discussion will be regarding medical health history as well as the explanation of the course of surgery, recovery period, risk and complications. Don’t hesitate to ask questions for clarification and the technique to be used for SRS.

·        Routine Physical examination

·         Admission to hospital

·         Singing of informed Consent for legal purposes.

·         The operation date and time will be arranged within twenty-four hours after Preoperative consultation.

·        During surgery, your vital signs will be watched closely.

·        Patches containing leads for monitoring your heart will be placed on your chest. .

·        After your surgery, you will be taken to a recovery area where you will stay for about an hour.

·        A nurse will closely monitor you as you wake up from the anesthesia, checking your vital signs frequently.

·        If you feel pain, ask your nurse to give you pain medication.

·        Once you are awake and your vital signs are normal, you will be taken to your own hospital room and your family will be able to visit you there.

·        You will be discharged from the hospital as soon as your surgeon believes that you are ready and are not experiencing any complications from the surgery or anesthesia.

·        Genital electrolysis must be done prior to SRS to prevent hair in and around their new vagina.

·        Please remember that the effects of the anesthesia medications go away very slowly. Do not plan on doing anything important the day of or day after your surgery. You will feel drowsy for hours after your surgery. For these reasons, you MUST NOT drive a car, work with machinery, or sign any important papers for at least 24 hours.

It is important that you follow the written instructions given to you when you are discharged.

For more information about the procedures you may contact International Marketing Coordinator: osias05@hotmail.com or call mobile phone: +66816572522, Tel: (662) 753-9206

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