Plastic Surgery

BREAST AUGMENTATION

Breast augmentation

Breast augmentation has become one of the most commonly performed cosmetic plastic surgical procedures around the world.Today, for many women beauty is often associated with the shape and size of their breasts. For those women who were not endowed by nature with breasts according to their liking, breast augmentation can majorly improve their self image and thus make them feel better about themselves as well as more confident.

Breast augmentation has become one of the most commonly performed cosmetic plastic surgical procedures around the world. In our clinic you have the possibility to enlarge small breasts and improve the shape of breasts that have changed during pregnancy and breast feeding.

During the consultation with your surgeon you should express all your wishes and expectations. Your surgeon will make an assessment of your breasts and help you determine what is possible and what the outcome will most likely look like. You can also consult before and after pictures and discuss which implant size would satisfy your wishes.

The time after the surgery is a most exciting one as you familiarize yourself with your new fuller breast that improve your overall appearance. It is important that you follow the doctor´s advice after the surgery to avoid possible complications, since everyone has your best interest at heart. The advice usually includes: “rest for the first few days, wear a sports bra during the first few weeks after the surgery, and take antibiotics.”

During the first weeks after the surgery it is normal to feel swelling and tenderness. Your doctor can help you manage pain by prescribing medications. Depending on your normal routines you should be able to return to work soon, if your doctor concurs. Most patients are back to their old schedules after 4-6 weeks.

There is no need to be concerned about the safety of the breast implants. So far studies confirm that the implants are safe and there is absolutely no evidence that they increase the risk for breast cancer in any way. Breast feeding after a pregnancy is also usually possible after a breast augmentation procedure.

INCREASE BUTTOCKS

Increase Buttocks

This procedure removes excess skin in the upper part of the buttocks. A surgical buttock-lift is designed for persons who are unhappy with the volume of their buttocks, or their sagging. This is a very common issue, even in highly fit persons who often complain during consultation that no exercises are able to fix this. In case of dissatisfaction with the size of the buttocks as well, buttock lipofilling may be performed or buttocks may be augmented by implants.

This procedure removes excess skin in the upper part of the buttocks, the incision is made at the transition between the buttocks and the back so it is obscured by underwear, and the whole buttocks are lifted to a new position after the excess skin is removed, which improves their form and overall appearance.

Procedure

The procedure takes 90-120 minutes. The incision is made in the upper region of the buttocks at the transition between the buttocks and the back. The procedure is performed under general anesthesia and must be preceded by laboratory blood tests (CBC, biochemical tests and coagulation test) and urinalysis, as well as an internal examination if required based on your medical history. Like any procedure performed under general anesthesia, it is not allowed to eat or drink for 6 hours before the procedure.

Recovery

The patches are removed after 2-3 weeks. The sutures are normally not removed because the wound is sutured by using an intracutaneous suture which is not visible and is biodegradable. The postoperative treatment includes antibiotics and analgesics and wearing a compression strap for 2-3 weeks and it is also recommended to abstain from any major physical activity for one month following the procedure.

All clients with dermal atrophy problems are recommended noninvasive postoperative treatments such as Alma or Encurve to achieve additional tightening and improve the quality of the remaining skin and subcutaneous tissue.

GYNECOMASTIA

Gynecomastia 
Gynecomastia is a term denoting breast enlargement in males. It is a very common problem in the male population and is often seen as fat accumulation in an isolated place in males. Depending on the degree of gynecomastia, as well as the fact whether the enlarged breasts are a consequence of fat accumulation (pseudogynecomastia) or glandular tissue (gynecomastia), during preoperative consultations, the doctor will assess which type of treatment or procedure would be best for you.

With mild gynecomastia great results can be achieved with non-invasive treatments using Encurve. If there is a need for a surgical treatment, the method of choice is laser lipolysis, a laser-assisted liposuction in case of breast enlargement due to fat alone, and if there is also enlargement due to excessive glandular tissue (very often can be felt discoidally under the nipple) that needs to be removed, the incision is performed next to the lower edge of the nipple.

Thanks to the implementation of laser technology in the liposuction procedure, tissue heating induces neocollagenesis and consequently the tightening of the skin with which in most cases outer incisions on the male breast are avoided. Assistant Professor Žgaljardić, MD, PhD presents his outstanding results across the world in numerous conferences and workshops as invited lecturer (2014, Fort Lauderdale, Florida- 20th Annual Scientific Meeting American Academy of Cosmetic Surgery, Kerala, India 2012- 1st International Cosmetic Surgery Symposium, Milano- Agora- 18th International Congress of Aesthetic Medicine, Kolkhida 10th International Caucasian Congress of Plastic Surgery and Dermato-cosmetology …). He is also the author of a chapter in an international textbook on body sculpting titled Laser assisted liposuction as a method of body sculpting.

Procedure

The procedure lasts 60-90 minutes, depending on whether only lipolysis/liposuction will be performed or also the removal of glandular tissue disc. In case of liposuction, entry incisions are 3-4 mm long, and in case of glandular tissue removal, incision is next to the lower edge of the nipple so it will be almost invisible after it heals. If it is performed as a single procedure, it is possible to perform it using only local anesthesia but it is mostly done as part of a more extensive liposuction so it has to be performed under general anesthesia.

Recovery

Depending on the type of anesthesia used during the procedure, you can go home after the procedure or you will stay at the clinic 5-12 hours in case of general anesthesia. Antibiotics and analgesics are usually prescribed after the surgery. Stitches are removed after 7-14 days. After bandages are removed, there is a possibility of minimal swelling or bruising. All of the aforementioned side effects should resolve within 14 days. After the surgery, the patient should wear a girdle for 3 weeks, throughout the duration of neocollagenesis, i.e. while the skin tightens.

To all patients with skin atrophy problems we recommend non-invasive treatments such as Alma or Encurve after the surgery in order to achieve additional skin tightness and enhance the quality of the remaining skin and subcutaneous tissue.

SPIRAL LIFT

Spiral lift was named after the incision that starts from the inner side of the thigh at the underwear level, goes up the front side through the outer side of the thigh towards the back to above of the buttocks (below the underwear). It continues at the back at the edge of the buttocks and slowly descends over outer and frontal side of opposite thigh and terminates on the inner side of the opposite thigh at the underwear level. It is a surgical method to lift the entire lower half of the body – both thighs and buttocks. It is most commonly performed on people who had a massive weight loss.

Procedure

The procedure lasts 4 -5h. It is performed under general anesthesia so before the surgery the patient has to perform laboratory blood tests (complete blood count, biochemistry and coagulation) as well as urine test, ECG and, if needed, depending on your medical history, an internal medicine specialist checkup. As before all procedures under general anesthesia, the patient is not allowed to eat or drink during the period of 6 hours before the surgery.

Recovery

Bandages should be worn for 3 weeks and then they are removed together with outer stitches although, on most occasions, the wound is stitched using intracutaneous stitches that are not visible from the outside and are self-absorbing. Antibiotics and analgesics are usually prescribed after the surgery and during the period of 3 weeks after the surgery, a compression belt must be worn. Any greater physical activity is strictly forbidden. To all patients with skin atrophy problems we recommend non-invasive treatments such as Alma or Encurve after the surgery in order to achieve additional skin tightness and enhance the quality of the remaining skin and subcutaneous tissue.

SURGICAL TIGHTENING OF THE INNER THIGH

Surgical tightening of the inner thigh

Surgical tightening of the inner thigh medial thigh lift or inguinal lift is a surgical procedure that removes excess skin and fatty tissue from the inner side of the thighs. Medial thigh lift is not a surgical treatment for obesity. Obese patients who plan to lose weight should postpone this type of procedure until they reach their wanted and stabile body weight. There is a number of different techniques that surgeons use for the medial thigh lift. The procedure can be performed in combination with other body sculpting procedures, including liposuction. Thanks to the implementation of laser technology in the liposuction procedure that achieves skin tightening, in majority of cases this procedure will not be necessary. Therefore, preoperative consultations are extremely important for the doctor to assess the degree of excess skin on the inner thigh and consider which type of procedure would be the most beneficial in your case.

Procedure

The procedure lasts for 1-3 hours, depending on the amount of skin that needs to be removed. Also, this procedure is often combined with other procedures. If the amount of skin to be removed is small, the procedure can be performed under local anesthesia. If the amount of skin is greater or the procedure is performed together with another procedure, general or regional anesthesia is required. Depending on the type of anesthesia used during the procedure, you can go home after the procedure or you will stay at the clinic 5-12 hours in case of general anesthesia. Antibiotics and analgesics are usually prescribed after the surgery. The incision is usually located at the inner side of the thigh at the edge of the underwear. In people with massive amount of excessive skin, which happens mostly after significant weight loss, besides the incision at the underwear level, a vertical incision as well needs to be performed on the inner side of the thigh. Depending on the skin excess, it can go down to the knee. Surgically, the aim is to try to adapt the skin edges perfectly so the scar would be less visible. However, every organism has its own mode of healing and there is no guarantee as to the final appearance of the scar, given it depends on individual tissue biology. This is important to stress out in case when vertical incision also needs to be performed along inner the thigh since the underwear does not hide that.

Recovery

Bandages and stitches are removed after 2-3 weeks. During that time, a girdle should be worn. Antibiotics and analgesics are usually prescribed after the surgery. Postsurgical swelling and bruises usually heal as well during that period. To all patients with skin atrophy problems we recommend non-invasive treatments such as Alma or Encurve after the surgery in order to achieve additional skin tightness and enhance the quality of the remaining skin and subcutaneous tissue.

BUTTOCK ENLARGEMENT WITH IMPLANTS – GLUTEOPLASTY

Buttock enlargement

Buttock enlargement is a procedure that reshapes and enhances the appearance of a gluteal area i.e. buttocks and results in a lifted and rounded buttocks and its profile. In the last ten years, this procedure has become very popular around the world since finely shaped buttocks are often perceived as a symbol of femininity and sensuality.

The procedure includes insertion of silicone gel-filled implants either in or under the gluteal muscle where the implant remains hidden but it gives the wanted shape and form from the outside. This procedure is for people with “flat” and/or sagging buttocks which causes dissatisfaction with the aesthetic appearance of the buttocks.  Gluteal augmentation leads to a greater satisfaction when choosing pants or swimwear. The access incision or incisions are placed in a crease between the two glutei, which makes them maximally hidden and invisible.

The procedure can be performed under general or tumescent anesthesia with sedation. The procedure lasts 1-2h. The postsurgical recovery lasts 3 weeks during which you should wear an appropriate girdle. However, during that time you can continue with your everyday activities given that they comply with the given postsurgical instructions. Please contact us if you feel this procedure is right for you. During consultations we will discuss your wishes, the surgical procedure will be explained to you as well as its options and you will choose the implant most suitable for the desired look of your buttocks!

SURGICAL TIGHTENING OF SAGGING SKIN ON UPPER ARMS – BRACHIOPLASTY

Sagging skin on the upper arm can appear with time, as a consequence of skin elasticity loss but it is more common in people with significant weight loss. Procedure that solves that problem is called brachioplasty or „upper arm lift“.

In case of mild skin sagging, the solution can also be laser lipolysis of the upper arm, which by stimulating the skin and the subcutaneous tissue, also stimulates neocollagenesis. That type of procedure is reserved for younger people with mild sagging problem. Others are candidates for brachioplasty. The procedure includes removal of excessive skin on the upper arms. The procedure includes incision on the upper arm, and the length of the incision depends on the status of the skin. The aim is for the scar to be hidden at the inner side of the arm to get a nicely shaped upper arm with a minimally visible scar.

Brachioplasty can be performed under local or general anesthesia. It lasts 60-90 minutes. Postsurgical recovery lasts 3 weeks but you can continue with your everyday activities without major limitations after 1-2 days provided that you follow the given postsurgical instructions.

BREAST LIFT & REDUCTION

Overly large breast occur due to excess glandular and fatty tissue. Therefore the breasts can become heavier, change shape and tend to sag with a low laying nipple.
This is a process that usually happens during puberty, pregnancy and obesity. After breastfeeding the temporarily enlarged breasts tend to go back to their former size or even become smaller. However they might also stay enlarged.

If the breasts are sagging but have enough tissue we can perform a procedure that is called “Mastopexy “. This is a method which reshapes the breast by removing the excess skin and repositioning the nipple at a higher location.

The breast reduction is a surgical procedure that removes the excess breast tissue and skin and therefore reshapes the breast in proportion with the body. The nipple is relocated in a higher position.

There are different surgical techniques, but today’s trends go towards having minimal scarring. One method that allows for minimal scarring is the vertical mastopexy technique (Lejur) where the scar goes around the nipple and vertically down. Another possibility is an even less invasive periareolar technique where the scar will only be around the nipple.

Very large breasts do not allow for these techniques but call for more conservative methods. The procedure can be done under general, local or locally potentiated anesthesia.

The recovery time can take up to two weeks with greater reductions and as little as three days with smaller breast lifts.

LASER LIPOSUCTION

The major advantage of this body shaping method compared to standard hidromicroliposuction is the use of laser energy which melts the fat cells. The fat cells are trapped within their firm tunica and are removed after the process in an emulsion through a microcannula. This procedure is less traumatic for the tissue and the small vessels are simultaneously coagulated which allows for only minimal blood loss.

The temperatures that develop during this procedure lie between 38° and 41° C. The heat induces the stimulation of collagen which enables the tightening of flaccid skin. Thus the skin surface becomes more smoothly and the possibility for developing skin irregularities is kept minimal.

If there is only a smaller amount of fat tissue, lipolysis is performed. The laser energy with its photothermic effect allows the doctors to melt the fat cells directly beneath the skin and it can therefore be applied in facial areas. This procedure can be done with local tumescent anesthesia or with general anesthesia.

Postop: Afterwards it is important to wear a corset which helps to achieve additional skin tightening. The incision marks are kept minimal and we try to place them in hidden areas whenever this is possible.

Additional skin tightening, shaping and maintenance are done postoperatively with the RF Velasmooth laser (syneron) and the Accent laser (Alma). These procedures depend on the clinical status before the treatment, the amount of lipodysthrophy and the flaccidity status of the skin.

TIGHTENING THE FACE AND NECK

The face lifting procedures can be of interest to people as young as 40. Nowadays you have the option to say “no” to ageing and show that you are young at heart.

At our clinic we offer you a combination of laser treatments (Smartlipo 1064 NdZag and Lasermar 1500 nm), we do skin tightening procedures around the neck area, we help reduce double chins and define jaw lines with S-lift short scar incision and vertical lifting and we correct all kinds of dermatological aging abnormalities.
Older generations also combine the face lifting procedures with nose corrections, as the nose is getting longer with age and the apex tends to be drooping. The expectations in connection with face lifting should always stay realistic and it is important to remember that often “less is more”. The procedures generally take between 1,5 and 2 hours under local or general anesthesia.

Another very common procedure is the blepharoplasty-eyelid correction as well as chin implants for more defined jaw lines.

Procedure

There are many advantages to the S-lifting procedures:

  • you will accomplish a natural younger and refreshed look
  • you will benefit from a quicker recovery time than the standard face lifting procedures
  • the risk for complications is minimal
  • scarring will be minimal and hidden
  • you will experience no hair loss.

Recovery period and tips

You may go home as well as stay in our recovery rooms for 5 to 12 hours. During the first 24 hours you should rest at home. In that period you should forego regular food and use liquid nutrition. There may be some minor bruising and swelling during the first few days but generally there is no pain. You will have to wear a small bandage for 5 days and the suture will be removed after 7 days.

Results

After this surgical rejuvenation procedure and recovery you will have a natural younger look. By no means is this procedure to be mistaken for a transforming operation.

TEMPORAL LIFT

emporal lift is an ideal procedure for people who notice signs of ageing around the outer part of the eye and eyebrow – lowering of the outer eyebrow, pronounced wrinkles in the outer part of the eye.  People often describe that condition by saying “I used to have such beautiful eyes and now they appear small and hidden”. Therefore this procedure is commonly performed together with upper and lower blepharoplasty.

Procedure

The procedure lasts 1 hour. As a single procedure, it can be performed under local anesthesia or if combined with other procedures, we recommend general anesthesia. If the procedure is performed under general anesthesia, before the surgery the patient has to perform laboratory blood tests (complete blood count, biochemistry and coagulation) as well as urine test, ECG and, if needed, depending on your medical history, an internal medicine specialist checkup. As before all procedures under general anesthesia, the patient is not allowed to eat or drink during the period of 6 hours before the surgery. Incision is performed along the hairline so it is almost invisible after the stitches are removed.

Recovery

Bandages and stitches are removed after 7 days. Antibiotics and analgesics are usually prescribed after the surgery. We recommend staying out of the sun and warmth, as well as avoiding warm food and drinks that evaporate to the face in order to avoid postoperative swelling and for you to be able to go back to your everyday activities after several days already.

FACIAL BONE AUGMENTATION WITH AN IMPLANT

In the last few years this procedure has become more popular especially among women but more and more men also want their cheekbones to be more pronounced. This can be achieved using dermal fillers and lipofilling. Dermal fillers are resorptive so the procedure has to be repeated, due to fat resorption. The same goes for lipofilling as well. Cheekbone augmentation with an implant gives a stable and permanent result. Facial implants, therefore, zygomatic implants as well are specially formed, firm, biocompatible materials designed to enhance or enlarge the physical structure of the face. They come in multiple sizes but can also be custom-made.

Procedure

The procedure lasts 1 hour and it can be performed under local anesthesia with sedation or under general anesthesia. If the procedure is performed under general anesthesia, before the surgery the patient has to perform laboratory blood tests (complete blood count, biochemistry and coagulation) as well as urine test, ECG and, if needed, depending on your medical history, an internal medicine specialist checkup. As before all procedures under general anesthesia, the patient is not allowed to eat or drink during the period of 6 hours before the surgery. The access incision is intraoral i.e. through the oral cavity so there are no visible scars on the outside.

Recovery

Depending on the type of anesthesia used during the procedure, you can go home after the procedure or you will stay at the clinic 5-12 hours in case of general anesthesia. Antibiotics and analgesics are usually prescribed after the surgery. We recommend liquid diet i.e. softer food that does not require much chewing. We also recommend that you sleep on your back with your head elevated to reduce the swelling. Due to the same reason, we recommend staying out of the sun and warmth, as well as avoiding warm food and drinks that evaporate to the face. Bandages are worn for 5-7 days. Stitches are removed after 7-14 days. After bandages are removed, there is a possibility of minimal swelling or bruising. All of the aforementioned side effects should resolve within 14 days.

Result

The result is visible immediately after the procedure, but to see the final result, you must wait for the postoperative swelling to completely disappear.

FACIAL LIPOLISIS

“Chubby” face is a common problem often affecting even those who are not overweight. The introduction of laser technology into liposuction has enabled reaching smaller localized fatty tissue clusters placed at the very top of subcutaneous tissue and thus enabling reaching fatty deposits in the face. The application of laser energy to the tissue leads to its heating and skin tightening which enables us to remove excessive fatty tissue without the fear of skin leftover.

We are proud of our Assistant Professor Zoran Žgaljardić, MD, PhD, who is one of the pioneers of laser lipolysis/liposuction in the world. Because of his results, he was invited to speak on a number of conferences and workshops worldwide (2014, Fort Lauderdale, Florida- 20th Annual Scientific Meeting American Academy of Cosmetic Surgery, Kerala, India 2012- 1st International Cosmetic Surgery Symposium, Milano- Agora- 18. International Congress of Aesthetic Medicine, Kolkhida 10th International Caucasian Congress of Plastic Surgery and dermato-cosmetology…). He is also the author of a chapter in an international textbook on body sculpting titled Laser assisted liposuction as a method of body sculpting.

Procedure

As a single procedure, it can be performed under local anesthesia. It is commonly performed as part of bigger liposuctions or as part of a lift so then it is performed under general anesthesia. If the procedure is performed under general anesthesia, before the surgery the patient has to perform laboratory blood tests (complete blood count, biochemistry and coagulation) as well as urine test, ECG and, if needed, depending on your medical history, an internal medicine specialist checkup. As before all procedures under general anesthesia, the patient is not allowed to eat or drink during the period of 6 hours before the surgery. Treatment areas are approached by incisions of a few millimeters that we try to position into natural creases to make them maximally hidden and invisible.

Recovery

Depending on the type of anesthesia used during the procedure, you can go home after the procedure or you will stay at the clinic 5-12 hours in case of general anesthesia. Antibiotics and analgesics are usually prescribed after the surgery. We recommend sleeping on your back and staying out of the sun and warmth. Bandages are removed after 7 days, and in case this was a single procedure, getting back to your usual daily activities is possible already after several days. There is a possibility of minimal postoperative swelling or some bruising that usually resolve within 14 days.

Result

The result is visible immediately after the procedure, but the final result is visible 3 weeks after the disappearance of possible postoperative swelling and after the process of skin tightening induced during the procedure by laser energy has finished.

FRONTAL LIFT

Frontal lift or forehead skin lift is a procedure that corrects signs of ageing on the forehead, eyebrows and partially upper eyelids.

Depending on your physio-anatomical characteristics of the forehead and your wishes, the access incision is made at the hairline or on the scalp. The excess skin is removed, thus correcting the excess skin on the forehead, lifting the eyebrows, partially tightening the wrinkles on the forehead and between the eyebrows and giving an overall youthful look in the upper third of the face in people for whom this procedure is indicated.

Procedure

The procedure lasts around 1 hour. It can be performed under local anesthesia as a single procedure or under general anesthesia, depending on the patient’s wishes or whether it is combined with other procedures. If the procedure is performed under general anesthesia, before the surgery the patient has to perform laboratory blood tests (complete blood count, biochemistry and coagulation) as well as urine test, ECG and, if needed, depending on your medical history, an internal medicine specialist checkup. As before all procedures under general anesthesia, the patient is not allowed to eat or drink during the period of 6 hours before the surgery.

Recovery

Depending on the type of anesthesia used during the procedure, you can go home after the procedure or you will stay at the clinic 5-12 hours in case of general anesthesia. Antibiotics and analgesics are usually prescribed after the surgery. Bandages and stitches are removed after 7-14 days. You can resume with your normal activities after 7 days. After bandages are removed, there is a possibility of minimal swelling or bruising. All of the aforementioned side effects should resolve within 14 days.

CHIN CORRECTION BY OSTEOTOMY AND BONE TRANSPLANT

Chin deficiency that is corrected using osteotomy and bone implant is analyzed in lateral and frontal picture. In profile, the chin should be aligned to the philtrum (connection between the nose and upper lip), while in frontal picture, the lower third of the face (from the philtrum to the edge of the chin) should be equal to the remaining two thirds of the face. The chin can be smaller than the above-mentioned criteria which we refer to as microgenia, or it may be larger than the above-mentioned criteria which we refer to as macrogenia. The procedure that corrects microgenia is called augmentation genioplasty (mentoplasty), and procedure that corrects macrogenia is called reduction genioplasty (mentoplasty).

Who is a candidate for the procedure?

Preoperative consultations are extremely important since during that visit you and your surgeon analyze your photos and the previously taken MSCT scan of the face to determine if there is bone disbalance and make a plan for the correction. If you are not satisfied with the size or shape of your chin, please consult us and find out which procedure would be the best to correct your condition.

Procedure

The procedure is performed via the so-called intraoral approach where the access incision is hidden inside the oral cavity in front of the front teeth of the lower jaw. If reduction genioplasty is performed, we have to trim a wedge from the chin bone and position the 1chin to the new place thus correcting its vertical and profile position. If augmentation genioplasty is performed, we have to insert a bone that is usually taken from the iliac crest. In both cases, we fixate the bone in the new position using mini titanium plates and screws that don not need removal. The procedure lasts approximately 90-120min and is performed under general anesthesia.

Recovery

After the procedure you will stay at the clinic for next 5 – 12 hours. Antibiotics and analgesics are usually prescribed after the surgery. We recommend liquid diet i.e. softer food that does not require much chewing. We also recommend that you sleep on your back with your head elevated to reduce the swelling. Due to the same reason, we recommend staying out of the sun and warmth, as well as avoiding warm food and drinks that evaporate to the face. Bandages are worn for 5-7 days. Stitches are removed after 7-14 days. After bandages are removed, there is a possibility of minimal swelling or bruising. All of the aforementioned side effects should resolve within 14 days.

Result

The result is visible immediately after the procedure.
At our clinic, we perform numerous jaw surgical procedures to harmonize the facial appearance so chin correction with an implant or a bone transplant is often performed with rhinoplasty, in order to harmonize the profile, the so-called prophiloplasty, and this procedure is also often combined with face lift surgery because people with a small chin often face early loosening of facial structures.

NOSE CORRECTION

Today aesthetic nose corrections are usually offered in combination with any functional surgery done for difficulties with breathing.

A beautiful nose is defined by certain aesthetic rules which have been set by Michelangelo. There are natural differences between male and female noses. Women are considered the gentler sex and therefore the angle between the upper lip and the nose ideally is obtuse. The male nose on the other hand is supposed to be shaped at a right angle.

Procedure

Aesthetic surgery reshapes the cartilage-bone framework in order to improve the appearance of the nose. It is possible to shorten a long nose by shortening the septum and remove cartilage from the tip of the nose. A functional operation corrects the deviated septum and reduces the hypertrophic nasal cochlea. This helps with common problems such as breathing difficulties, snoring and apnea.

It is possible to correct the nose according to individual requirements; however a thorough consultation takes physiological and anatomical limitations into consideration. Beauty is in the eye of the beholder and everyone has different opinions on this very personal matter, thus the clients wishes are highly respected.

Postoperative biodynamic of the nose is to be expected during the six months following surgery. The healing process can be accompanied by swellings and irritations. There is also the risk that the tip of the nose will sag which is why the surgeon has to take some preventative measures in order to lower this risk.

This operation is not exclusive to the younger generations but popular among all age groups. Frequently a nose correction is performed together with face lifting procedures. The aging process causes the nose to change because ligamentary support is losing its tension which causes the nose to droop and appear longer.

Recovery

Postoperative recovery lasts seven days during which the patient is required to wear a plastic immobilization device over the nose and cotton wool plugs are placed in the nose. Breathing difficulties due to the nasal congestion and the plugs are the only discomfort during the postoperative period. This might feel like a common cold.

Hematomas are usually minimal and disappear within seven days. The recovery is painless. The procedure is done under local or general anesthesia.

EYELID LIFT (BLEPHAROPLASTY)

Beautiful eyes and their fresh appearance reflect our youth. Unfortunately, eyelids and the skin around the eyes are the first places to show the signs of ageing. With time, the skin of the eyelids stretches, the muscles and the supportive tissue weakens and there is protrusion of fatty deposits around the eyeballs which adds weight to the upper eyelids and the appearance of bags under eyes.

So it does not surprise us that eyelid lift, blepharoplasty, is one of the most common procedures in aesthetic surgery. The procedure itself, lifting of upper and lower eyelids, is performed as a clinical procedure, mostly under local anesthesia but it is also possible to perform it under general anesthesia. The procedure lasts around 90 minutes. Upper eyelid surgery starts with the incision in the groove of the upper lid and includes the removal of excess skin and fatty tissue, all from the same incision. Postoperative bandages are worn for 6 days. Lower lid surgery starts with the incision directly below the lower eyelashes line and excess skin and fatty deposits are removed or those fatty deposits are repositioned. Postoperative bandages are worn for 6 days.

The patient is discharged home almost immediately after the procedure. You can contact us after the discharge at any point if you have any problems or questions. Antibiotics and analgesics are usually prescribed after the surgery, however, postoperative pain is rare and so is the need for analgesics. We recommend that the patient avoids warmth at home and sleeps with the head elevated to reduce postoperative dilatation of the blood vessels, swelling and, therefore, hematoma.

Cold compresses are used for the same purpose. There is a possibility of hematoma that usually resolves within 7-14 days. Patients can resume with their everyday activities after the removal of bandages. Postoperative scars are barely visible already after the removal of bandages. Therefore, patients can get back to their daily activities.

The procedure is commonly performed in combination with a face lift since the eyes are only one unit on the face or with a chemical peeling or laser treatments of the periocular region which enhances the quality of the skin surface and treats hyperpigmentation and fine lines.

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Please review some pictures before and after the eyelid lift.

CORRECTION OF JAW SIDES WITH AN IMPLANT

People who want to emphasize the sides of their jawline have implants inserted. Facial implants, therefore, jaw implants as well are specially formed, firm, biocompatible materials designed to enhance or enlarge the physical structure of the face. They come in multiple sizes and can also be custom-made.

Procedure

The procedure lasts 90 min and is performed under general anesthesia. Before the surgery the patient has to perform laboratory blood tests (complete blood count, biochemistry and coagulation) as well as urine test, ECG and, if needed, depending on your medical history, an internal medicine specialist checkup and MSCT of the face if needed after consultations with the surgeon. As before all procedures under general anesthesia, the patient is not allowed to eat or drink during the period of 6 hours before the surgery. Access to the sides of the jaw is intraoral, i.e. through the oral cavity, which means there are no visible scars on the outside.

Recovery

After the procedure you will stay at the clinic for next 5 – 12 hours. Antibiotics and analgesics are usually prescribed after the surgery. We recommend liquid diet i.e. softer food that does not require much chewing. We also recommend that you sleep on your back with your head elevated to reduce the swelling. Due to the same reason, we recommend staying out of the sun and warmth, as well as avoiding warm food and drinks that evaporate to the face. Bandages are worn for 5-7 days. Stitches are removed after 7-14 days. After bandages are removed, there is a possibility of swelling or bruising. All of the aforementioned side effects should resolve within 14 days, however, with this procedure, swelling can be present for longer.

Result

Result is visible immediately after the procedure, but the final result is visible after postsurgical swelling completely disappears and immediately after the procedure jawline seems more pronounced then planned due to tissue swelling.

REJUVENATION

Non-surgical rejuvenation

Radio frequency skin tightening lasers Accent XL i Syneron.

Sublative = rejuvenation

Sublative – Fraxel – RF

DOUBLE CHIN REMOVAL

Double chin is a common problem often affecting even those who are not overweight. Introduction of laser technology into liposuction procedure has enabled significantly better results and increased patient satisfaction. Thanks to laser technology, incisions are minimal and laser can melt fatty tissue subcutaneously while the application of laser energy to the tissue leads to its heating and skin tightening which enables us to remove excess fatty tissue without the fear of leftover skin.

We are proud of our Assistant Professor Zoran Žgaljardić, MD, PhD, who is one of the pioneers of laser lipolysis/liposuction in the world. Because of his results he was invited to speak on a number of conferences and workshops worldwide (2014, Fort Lauderdale, Florida- 20th Annual Scientific Meeting American Academy of Cosmetic Surgery, Kerala, India 2012- 1st International Cosmetic Surgery Symposium, Milano- Agora- 18. International Congress of Aesthetic Medicine, Kolkhida 10th International Caucasian Congress of Plastic Surgery and dermato-cosmetology…). He is also the author of a chapter in an international textbook on body sculpting titled Laser assisted liposuction as a method of body sculpting.

Procedure

As a single procedure, it can be performed under local anesthesia. It is commonly performed as part of bigger liposuctions or as part of a lift so then it is performed under general anesthesia. If the procedure is performed under general anesthesia, before the surgery the patient has to perform laboratory blood tests (complete blood count, biochemistry and coagulation) as well as urine test, ECG and, if needed, depending on your medical history, an internal medicine specialist checkup. As before all procedures under general anesthesia, the patient is not allowed to eat or drink during the period of 6 hours before the surgery. Incisions of a few millimeters are made on each side of the double chin. Access incisions become almost invisible after 10 days.

Recovery

Depending on the type of anesthesia used during the procedure, you can go home after the procedure or you will stay at the clinic 5-12 hours in case of general anesthesia. Antibiotics and analgesics are usually prescribed after the surgery. We recommend sleeping on your back and staying out of the sun and warmth. Bandages are removed after 7 days, and in case this was a single procedure, getting back to your usual daily activities is possible already after several days. There is a possibility of minimal postoperative swelling or some bruising that usually resolve within 14 days.

Result

The result is visible immediately after the procedure, but the final result is visible 3 weeks after the disappearance of possible postoperative swelling and after the process of skin tightening induced during the procedure by laser energy has finished.

CHIN CORRECTION WITH AN IMPLANT

Chin deficiency that needs correction with an implant can be best seen from the profile where the chin should be in line with the philtrum (connection between the nose and the upper lip). Facial implants, therefore, chin implants as well, are specially formed, firm, biocompatible materials designed to enhance or enlarge the physical structure of the face. They come in multiple sizes and can also be custom-made.

Who is a candidate for the procedure?

An ideal candidate for chin augmentation with and implant is a person who has “small” posteriorly placed chin in profile but normal vertical height of the chin itself.

Procedure

The procedure lasts 1 hour and it can be performed under local anesthesia with sedation or under general anesthesia. If the procedure is performed under general anesthesia, before the surgery the patient has to perform laboratory blood tests (complete blood count, biochemistry and coagulation) as well as urine test, ECG and, if needed, depending on your medical history, an internal medicine specialist checkup. As before all procedures under general anesthesia, the patient is not allowed to eat or drink during the period of 6 hours before the surgery. The chin can be accessed from two incisions – one through the groove beneath the chin (so called submental approach) or through the mouth (so called intraoral approach).

Recovery

Depending on the type of anesthesia used during the procedure, you can go home after the procedure or you will stay at the clinic 5-12 hours in case of general anesthesia. Antibiotics and analgesics are usually prescribed after the surgery. We recommend liquid diet i.e. softer food that does not require much chewing. We also recommend that you sleep on your back with your head elevated to reduce the swelling. Due to the same reason, we recommend staying out of the sun and warmth, as well as avoiding warm food and drinks that evaporate to the face. Bandages are worn for 5-7 days. Stitches are removed after 7-14 days. After bandages are removed, there is a possibility of minimal swelling or bruising. All of the aforementioned side effects should resolve within 14 days. After stitches are removed, the scar is barely visible and it could be covered by makeup and in time it becomes nearly invisible. If the approach is intraoral then there will be no scars on the outside.

Result

The result is visible immediately after the procedure.

At our clinic, we perform numerous jaw surgical procedures to harmonize the facial appearance so chin correction with an implant or a bone transplant is often performed with rhinoplasty, in order to harmonize the profile, the so-called prophiloplasty, and this procedure is also often combined with face lift surgery because people with a small chin often face early loosening of facial structures.

CORRECTION OF FACIAL BONES

With surgical techniques it’s possible to shrink excessively large jaws.
Too small jaws can be enlarged with implants. Similarly, a change in the cheek bone with implants is possible.