Surgical Techniques for Improved Results
Abdominoplasty (Tummy Tuck)
We preserve a thin fat layer in the lowest part of the stomach beneath the deep fascia (Scarpa’s fascia). This is technically somewhat more difficult than the usual technique of removing all fat, but it has the advantage of avoiding recurrent unpleasant collections of post-operative blood and fluid (seroma) in the stomach – a frequent problem in most other clinics across the world. It also achieves a smoother transition between the stomach and the pubic area. In all abdominoplasties, we use drains to resorb any post-operative blood and fluid, which makes the post-operation period safer.
In all mastopexis (breast-lifts) and reduction of the breast, we also save a thin tissue layer deep down, preserving blood and lymph vessels and nerves just above the thoracic wall. This is somewhat more difficult than the ordinary technique that takes away all these important structures, but we preserve tissue viability and get improved sensation in the breast. We have never had circulation problems of the nipple area – not even after very large reductions. We have developed our own new technique regarding the very large breasts with a so-called medical pedicle (the blood support of the remaining breast is based on the blood vessels coming from the superior and middle part of the breast and chest wall.) So far we have never had any serious complications using this technique, not even on very large breasts.
For breast augmentation we prefer the small opening, 2,5 – 3 cm, in the hair-bearing part of the axillary skin (called axillary skin incision). We do of course never enter the axilla (armpit). No scar in breast surgery is less visible than this axillary skin incision, which virtually disappears after some months since it follows the furrows of the skin.
The so-called anatomic drop-shaped implants have become softer and are now used in some cases also via an axillary skin incision. However, they are still harder than ordinary breast tissue and do not move in such a natural way as round silicone gel implants.
Blepharoplasties include both upper and lower eyelids. If it is missing, we always reconstruct the global line in the upper eyelids. In the lower eyelids we always stabilise the eyelid (and the shape of the eye) using canthoplasty or canthopexy, securing the eyelid against the orbital wall. We have been especially interested in developing techniques to reconstruct the eyelid in scleral show cases (too much of the white bulb is shown) and manifest ectropion.
We have a unique way of correcting the so-called tear-trough by using the fat pad of the lower eyelid to make a smooth transition between the eyelid and the malar area as well as removing the dark shadows above and below the fat pad. Most clinics remove the whole fat pad and thus they often create an empty eye and miss this golden opportunity to create a smooth transition between the eye and the cheek. Our technique is unique and it has now been used in about 300 cases.
Our reduction of male breasts is usually a combination of liposuction with surgical removal of the central gland tissue. We only place a u-shaped incision in the areola (the pigmented area around the nipple). This type of incision gives the least visible scar.
The forehead lift includes lifting the eyebrows. This is the most important part of the technique, which is performed by endoscopy. We never use screws suspending the forehead, since they can cause problems. We use instead small angled holes in the superficial part of the bone enabling the lifting of the forehead.
The lateral part of the eyebrows frequently falls down and cause sagging of the upper eyelid. The combination of a temporal lift and the reduction of the soft tissue in the upper eyelid (blepharoplasty) is often the optimal reconstruction of the upper periorbital area and this has become very popular.
We combine face-lifting with a new way of suspending SMAS of the mid-face to the malar area. We call this technique Wieslander’s Technique or Vertical SMAS Suspension (VSS face-lift). No other technique is so efficient in face-lifting and gives such a natural and rejuvenating result. See the Photo Gallery. If needed, we put implants in the malar area or, at a later stage we augment the malar area by using autologous fat. We started using these techniques 8-10 years ago.
In laser treatment of the perioral area (around the mouth) we use a combined technique of laser first and then dermabrasio on the deepest wrinkles and furrows. We do this in the same session. We thereby reduce the disadvantages of the deep laser treatment and simultaneously achieve better results and more rapid healing. The same technique is used on scars after acne on the cheeks. So far, we have been alone in using this combined technique.
Protruding Ear Reduction
We shape the cartilage mechanically of anthelices, thereby creating soft contours and efficient correction. Scars only occur on the back of the ear.
Besides removal of excess skin and traditional liposuction of the neck and submandibular area, we also extract any fat pads between the muscles and the chin. The results are improved and long-lasting.
We have twenty years of experience with both open and closed rhinoplasties. Cartilage is often borrowed from the ears, which gives no disadvantage to the ear contour.