Cosmetic Surgery


☰ Category

Cosmetic Surgery


  • How do we age?
  • How can we treat ageing of the face?
  • Ageing of the face can be treated by both surgical and nonsurgical means. Each person ages differently and you need to see a doctor to help you make the right decision regarding which treatment option would be the best option for you. Sometimes they may be combined or they maybe done in different stages.

    Surgical Options for ageing of the face
  • Facelift
  • Necklift
  • Blepharoplasty
  • Browlift
  • Lip lift
  • Earlobe rejuvenation
  • Fat Grafting to the face

  • Non surgical Options
  • Botox
  • Fillers
  • Chemical Peel


  • What is Abdominoplasty?

  • Abdominoplasty is an operation in which the excess skin and fat below the umbilicus is removed to give the abdomen a better shape and make it look nicer.


  • Who will benefit from an abdominoplasty?

  • When people gain and lose weight as following pregnancy and significant weight loss, the lower abdomen is stretched and refuses to go back. No amount of diet and exercise can overcome the laxity of the skin especially if it has stretch marks. In this situation, the excess skin and fat have to be removed by surgery. So those who would benefit from abdominoplasty are

    • a. If you have got excess abdominal tissue which doesn’t go with exercise
    • b. If you can hold a pannus of tissue with both your hands below the belly button and feel it unwanted
    • c. If you are embarrassed with the abundant stretch marks below the umbilicus which you find it unappealing.
    • d. If you are embarrassed as the abdomen overhangs the top of the trouser, skirt or saree and causes a bulge under fitted dresses.

  • Where will the scar be after an abdominoplasty?

  • The scar will be a transverse scar over the lower abdomen extending from one hip to the other hip. This will be hidden while you wear a pant, skirt or a saree and we will try to hide it under the bikini line.


  • What is done during the operation abdominoplasty?

  • The operation abdominoplasty is done under general anaesthesia. It lasts for 2 to 3 hours depending on each patient. During this operation the skin and fat over the abdomen are lifted from the underlying abdominal musculature, redraped and the excess skin and fat are removed. If there is an underlying weakness of the abdominal wall causing divarication of recti, we will repair it and strengthen the abdominal wall musculature. To ensure that there is no excess collection of serous fluid or blood collecting under the flap we will place three surgical drains to drain them. The umbilicus or the belly button is sited at the right place, and the wound is closed.


  • Will Liposuction be done along with abdominoplasty?

  • Some patients are bothered about excess fat around the hips or at the waistline popularly called as the saddlebags and lovehandles respectively. During the operation fat from these areas can be sucked out to give them a good shape to the body. This is done when the skin tone is good. However when the skin tone is not good it will be better to excise it. This will be done by having a longer transverse scar which goes around the side of the body to the back. The scar will still be hidden by the panty line


    Liposuction over the Lovehandle area


    Liposuction of Fat over the Saddlebag area


  • Will I be able to lose a lot of weight with this procedure?

  • This operation is primarily a body contouring operation and not a weight reducing operation. After the operation, you can expect a decrease of about 1-2 kg weight. Some patients may not reduce weight at all. So if reducing weight is your primary goal, this operation is not for you.


  • What is the normal post-operative course?

  • Soon after the operation, the patient may feel slightly tight over the abdomen as the abdominal musculature has been repaired and the excess skin has been removed. This will go away in 2 to 3 weeks. We will give adequate painkillers to control the pain. We will monitor the amount of fluid in the drains daily and will remove them as soon as the amount of fluid in the drain is very less. Depending on how comfortable the patient is we will try to mobilise the patient from the first or second day after surgery. We will discharge the patient as soon as the patient feels comfortable walking to and from the toilet and after the drains have been pulled out. This amounts to approximately 4 to 5 days of hospital stay. Patients who stay near and are happy to monitor the drains may be discharged earlier around the third or fourth day from surgery.


  • What are the complications associated with this procedure?

    • a. Delayed wound healing and skin necrosis :
      A small subgroup of patients may have delayed wound healing and may have minimal skin necrosis ( skin becomes black due to reduced blood supply). If the amount of necrosis is very less, it can be managed with regular dressings. If the amount of skin necrosis is more, then we may take the patient back to the operation theatre, trim it and resuture the area.

    • b. Seroma:-
      Seroma is excess serous fluid in the cavity below the abdominal flap. This usually occurs later than 3 weeks and is usually aspirated out. When it comes repeatedly, we may take the patient to the operation theatre and remove the excess fluid.

    • c. Mild asymmetry or some excess fat over the sides :
      In spite of all our efforts there maybe some mild asymmetry or excess fat over the sides of the abdomen which can be revised by a minor procedure.

    • d. Decreased sensation over the lower abdomen :
      The sensations can be reduced or feel different over the lower abdomen for a while as the abdominal flaps have been raised. This is expected, and the sensations will return in a few months.

    • d. Hypertrophic scarring :
      Each person heals differently and some patients may develop raised large scars called hypertrophic scars. They will get better with techniques like scar massage, silicone sheets and compression.

    • d. Deep Vein Thrombosis (DVT) and Pulmonary Embolism :
      DVT is formation of blood clots in the veins of the legs. This can happen as the surgery is a prolonged surgery. This clot may go on to the lungs causing difficulty in breathing. Fortunately this complication is not common and rare as we will take a lot of efforts to prevent this. We will be giving blood clot thinners before surgery and after surgery. We will also have sequential compression devices which will keep pressing the legs so that the legs are not static and this will help prevent DVT.


  • Facts about the surgery at a glance :
  • ( Each patient can be different. Please consult your doctor regrading the same )


    Surgery time : 2 - 3 hours
    Hospital stay : 4 - 5 nights
    Walk to the Toilet : Next day
    Take a shower : 2 days
    Reasonably mobile : 2 weeks
    Driving : 3 weeks
    Sport & exercise including gym : 8 weeks
    Full recovery : 8 weeks
    Time off work : 2 - 3 weeks
    Bras and garments : Yes Abdominal binder
    Long-term issues : May require scar management

  • What is Blepharoplasty?

  • Blepharoplasty is a type of plastic surgery in which the excess skin and fat over the eyelids are corrected to give a youthful appearance to the eyelids and the face.


  • Why do people opt for upper blepharoplasty?

  • As we age, the skin and ligaments of the eyelids become loose and the fat tends to prolapse over the upper eyelids resulting in the upper eyelids looking droopy, unattractive and may even cause disturbances in the peripheral vision.


  • Why do people opt for lower blepharoplasty?

  • With loss of fat in the face due to ageing, the skin over the lower eyelids become loose. With the ligaments in the lower eyelid losing their strength, the fat tends to prolapse creating baggy lower eyelids. There seems to be a definitive ridge between the lower eyelid and the face called as the “Tear Trough” which simulates ageing


  • How is Upper Blepharoplasty done?

  • Some patients may opt to have Upper blepharoplasty alone. In such cases it can be done under local anaesthesia. If it is combined with lower blepharoplasty or other procedures, it can be done under general anaesthesia. An incision is made few mm above the eyelashes of the upper eyelid and the excess skin is removed. In severe cases there may be prolapse of fat from the upper eyelid which can be removed. With ageing as there is loss of volume of fat, in some cases we may add fat to the upper eyelid to male it look more beautiful.


  • How is Lower Blepharoplasty done?

  • Lower blepharoplasty is done under general anaesthesia. We prefer to make an incision in the conjunctival side of the lower eyelid. The prolapsed fat is removed and the loose ligaments of the lower eyelid are released. The distinction between the lower eyelid and the face known as Tear Trough deformity is removed by injecting fat which can be got from other areas of the body such as in the abdomen and medial thighs. If there is excess skin still remaining in the lower eyelid, a strip of skin can be removed from the lower eyelid close to the eyelash of the lower eyelid.


  • What is the normal post operative course?

  • Blepharoplasty is mostly done as a daycase in which the patient comes in the morning and goes in the evening. If needed the patient may stay in the hospital for 1 night. The patient will have mild pain which will be controlled by painkillers. The patient will have bruising and swelling over the face which goes away in 2 to 3 weeks. The swelling of the eyelids may prevent the eyes from closing and cause watering of the eyes. To prevent this we may temporarily suture the upper and lower eyelid partially for 4 days to a week. After a week this suture will be removed. Cold packs can also be applied over the face to reduce the swelling. The patient is advised to keep the head in the upright position to reduce the bruising and swelling over the face. Makeup for the eyelids and contact lenses are to avoided for 2 to 3 weeks till the edema over the eyelids settle. Patients are advised to wear sunglasses to avoid direct sunlight when they go out as this can cause hyperpigmentation over the scar. Patient can take a shower the next day. If only upper blepharoplasty is done the patient can go to work the next day or in two days. If lower blepharoplasty is also done depending on the edema, the patient can go to work in 1 to 3 weeks.


  • What are the risks and complications associated with blepharoplasty?

  • As mentioned earlier blepharoplasty can be associated with pain, bruising of the eyelids causing haematoma of the eyelids, excess swelling of the eyelids which can prevent closing of the eyelids and watering of the eyes.


  • Why do patients want body contouring?

  • Patients can have gross fluctuations of weight after bariatric surgery (weight loss surgery), lifestyle changes due to diet and exercise or after multiple pregnancies. With fluctuation in weight the amount of fat content decreases. However the skin may not contract proportionally with the decrease in fat content as the elasticity of the skin reduces . The damaged elastin in the skin can be seen as the stretch marks which are very commonly visible in the abdomen of women with multiple pregnancies.


  • The excess skin may manifest as deflated folds in the abdomen, chest, breast, arms, face and thighs which do not look nice and can prevent one from wearing many nice dresses of their choice.
  • With multiple folds, there can be some skin excoriation and fungal infection underneath the folds due to the moisture which can be very uncomfortable for the patient.
  • Even though the weight loss would have made them healthier by reducing their high blood pressure and controlling the blood sugar, they appear older and unhealthy due to the weight loss. When people comment that they don’t look good, the patients tend to again start eating more and getting their additional weight on again.
  • Some patients have fat deposits in some parts of the body which do not go away even with strenuous diet and exercise which some people would like to get rid of.

  • Can body contouring be used to reduce weight?

  • Body contouring surgery is not used to reduce weight. This surgery is used to make people look better. By this procedure the patient may reduce only by 0.5 kgs to 2 kgs depending on the amount of tissue that we remove. Weight reduction is better done by maintaining strict diet ,exercises and bariatric surgery where the surgical gastroenterologists decrease the size of the stomach or they prevent the food from getting absorbed.


  • Although I have reduced weight, I have localised excess fat in certain places that I am unable to remove with diet and exercises. What can I do?

  • For localised excess of fat which are resistant to diet and exercises as in the sides of the abdomen or the hips liposuction can be done. Here a small incision of 5 -10 mm is made and the excess fat is sucked out. Liposuction is done only when the skin tone is good as in young people who have not had much fluctuations in their weight. This is because after the fat has been removed we depend upon the good skin tone to contract back to give a good shape. If the skin tone is not good, then we may excise the excess skin and fat to give a better contour.


  • Who are good candidates for body contouring procedures?

  • Patients are considered to be good candidates for body contouring procedures if


  • They have a stable weight for at least 6 months. Patients who put on weight after the procedure may not have a good lasting result and lifestyle changes such as healthy diet and exercises are to be continued after the surgery as well.
  • Patient should be healthy with adequate haemoglobin, proteins and nutrients. Patients who have health problems are asked to get their health problems sorted out before undergoing surgery
  • Patients who have lost a lot of weight and have a BMI( Body Mass Index) of less than 30. Patients who are overweight might need to further decrease the weight before they go for body contouring procedures.

  • Having lost a lot of weight I have multiple folds of skin in my face, chest, breast, arms, abdomen and thighs. How do I correct them and in what order do I correct them?

  • With weight loss there is generalised decrease in the fat content in the body. This results in multiple folds of skin throughout the body such as in the face, neck, chest, breast, arms, abdomen and thighs. This may need multiple surgeries and the order is also important. We would like to do surgeries which addresses many deformities in one time. We examine and talk to the patient about what they are most bothered about and we do the surgeries accordingly. Sometimes patients may want only one part to be corrected. They are free to choose what they want and we will not force them. We will explain the pros and cons of each decision and make the patient choose what they want. Generally the order in which we would like to do the procedures are


    • 1. Lower Body Lift :- Here the excess skin and fat is removed circumferentially around the lower abdomen. This will improve the abdomen both in the front and the back. This will also lift the sagging buttock and the lateral aspect of the thigh. Some folds in the upper back and in the side of the body may also improve with this procedure. As this procedure improves a lot of areas we tend to do this first as we feel that just this procedure will make other procedures easier to do and some patients do not want correction in other areas.
    • 2. Upper Body Lift :- Here the excess folds in the arms, armpits and the sides of the body are removed. The sagging breast is corrected by doing a breast lift.
    • 3. Facelift, necklift ,blepharoplasty and fat injections to the face :- With loss of weight the multiple folds in the skin make the patient look old, tired and unhealthy. In this procedure fat injections are done to the central part of the face to give the youthful look and the excess skin is removed from the cheek, neck and the eyelids. While doing so the muscles in the face and neck are also slightly tightened to give a good youthful look. The excess skin over the eyelids are also removed. Many patients are happy with this because the excess skin over the eyelids can block a part of their vision.
    • 4. Breast lift and Augmentation:- With excess skin over the breast and with loss of fat, the breast is not only sags, but many feel it unattractive. This is corrected in 2 stages.Breast lift is initially done

  • What is Arm Reduction?

  • Arm reduction is a procedure in which the excess fat and skin in the arms are removed to make the arms look nicer.


  • Why do patients seek treatment for this condition?

  • There are two different kinds of patients who seek arm reduction. The first type of patient is the young person with disproportionate excess fat in the arms who would like to reduce their size of their arms. These type of patients are best served with liposuction. The other type of patient is the one who has lost a lot of weight due to weight loss surgery or due to lifestyle modifications like diet and exercise. These patients are extremely uncomfortable with the excess skin sagging when they lift their arms. This makes them unable to wear sleeveless clothes or short sleeves and find going to gym and swimming bothersome


  • How do we assess the patient during the consultation?

  • During the consultation we would get a thorough medical history and perform a directed physical examination. We will assess the amount of excess skin and fat and will then discuss with you whether liposuction would be enough or excision of the skin would also be needed.


  • What is done during the “Armlift” procedure ?

  • The Armlift procedure is done under general anaesthesia. By making 5 mm incisions the excess fat is sucked out by liposuction. After the fat is sucked out the excess skin is then excised and sutured. We may place a drain before closing the wound so that it would remove the excess blood and fluid in the arm. The surgery would approximately take 2 hours.


  • Where will the scar be ?

  • The scar is positioned over the posteromedial aspect of the arm. In simple words it is the place where you will find the seam of your shirt. This is the place which is least noticeable.



  • What is the normal post operative course after this procedure?

  • There maybe minimal bruising and swelling over the operated area which will go away in 7 - 10 days. Patients may have some pain which is usually controlled by painkillers. If we had placed a drain we will review the amount of fluid that is in the drain. When the fluid in the drain is very less we will then remove the drain. Patient can walk to the toilet the next day and can also take a shower. After the drain is removed and when the patient is comfortable walking the patient is discharged home. It would be advisable for the patients to wear compression garments atleast for 3 months so that it reduces edema, swelling, gives a better scar and gives a very good result.


  • What are the possible complications of this procedure?

  • Just like any other procedure this procedure can also be associated with bleeding producing haematoma, seroma and infection. The most common problem that patients can have is the scar that is seen over the inner arm. After 10 days we would then teach various techniques to improve the scar like scar massage, wear compression garments, silicone sheets and if necessary give steroid injections to improve the scar.


  • What is Botox?

  • Botox is a natural purified protein which is derived from bacteria. When small quantities of botox are injected into target muscles, it temporarily relaxes the muscles which are responsible for producing wrinkles on the face


  • How does the treatment work?

  • Botox acts on chemical mediators at the junction between the muscle and the nerve and prevents the muscle from contracting.


  • Why do people want botox treatment?

  • As we all age, the skin gets thinner and loses volume over time as the collagen, elastin and hyaluronic acid in the skin gradually diminish. When the underlying musculature contracts harder in some individuals, this is manifested as wrinking over the face while performing certain facial expressions like frowning, laughing or smiling. These lines are called dynamic lines. For example while some people laugh, they can have wrinkles over the side of their eyes or their nose. Over a period of time these lines are seen not only while performing the facial expressions, they are also seen at rest. Botox helps to relax the muscles which are overacting and helps to prevent the dynamic lines. Few examples where botox is commonly used are


    • a. Horizontal Forehead Lines
    • b. Frown lines between the eyebrows which makes people look that they are always angry
    • c. Crows feet :- Lines around the sides of the eyes which makes people look very old
    • d. Bunny Lines :- Lines over the nose
    • e. Gummy smile :- When people smile they may show their gums a lot which doesn’t make the smile look good
    • f. Marionette Lines :- Lines below the corners of the mouth which makes people look very sad

  • What happens during botox treatment ?

  • Botox injections are done in the clinic. Very fine needles are used to used to inject Botox in specified target muscles over the face.


  • Does botox treatment take effect immediately?

  • No. For Botox to take effect it takes approximately 3 days and is best seen after 1 week.


  • How long will the botox treatment last?

  • Since the Botox is a purified protein it acts only for a short time of approximately 4 to 6 months. After that if the patient wishes, another botox injection can be got.


  • What are the side effects of botox treatment ?

  • There can be bruising and swelling over the face while injecting Botox as the face is a very vascular area. If the botox diffuses into a muscle nearby that was not planned to be paralysed, the effects of relaxation of that muscle can be seen.


  • Facts at a glance

  • Procedure time : 20 - 30 minutes
    Hospital stay : Out patient
    Anaesthetic assessment : No
    Pre admission tests : No
    Reasonably mobile : Immediate
    Washing : Immediate
    Driving : Immediate
    Sport & exercise including gym : Avoid for 24 hours
    Full recovery : Immediate
    Time off work : None
    Long-term issues : Takes 7-10 days to see results and these will last between 4-6 months

  • How common is breast asymmetry?

  • Breast asymmetry is very common. In a study done in USA, it has been found that 88% of women had some form of asymmetry of the breast and 65% of women had asymmetry in more than one parameter of the breast.*


  • Who need treatment for breast asymmetry?

  • All women need not be treated for breast asymmetry as many variations are minor. There can be some situations in which there is gross asymmetry of the breasts which can even be noticed externally and this can bother many women.


  • How are patients with breast asymmetry managed?

  • Patients with breast asymmetry need to be evaluated and have to be discussed with the patient. The breast asymmetry could be due to asymmetry in volume, projection or due to the position of the nipple. The exact problem has to be found out and then tackled.


    If there is asymmetry due to volume, we can either reduce the size of one breast or increase the size of the other breast. Reducing the size of one breast would need breast reduction and increasing the size of the other breast would need breast augmentation with implant or fat grafting or use tissues from another place such as the abdomen (DIEP flap) or the inner thigh (TUG flap) or the back (Latissmus dorsi flap) .


    Some breasts may have adequate volume. However, one breast may hang more than the other breast. This can be corrected by a breast lift operation where the volume of the breast is not disturbed and the excess ptosis or hanging of the breast is corrected.


    The nipple size, shape and position can also be corrected. The final aim of the operation is to have breasts which are as symmetrical as possible.



    1. For whom is breast lift done?

    2. Breasts become larger in size after pregnancy and lactation. After lactation is stopped, the breasts become smaller in size. This process continues with multiple pregnancies. With gravity the breasts also continue to sag with age. The result is that the skin over the breasts become lax, stretch marks appear and the breasts droop and sag which many women don’t like and want to get their original shape of the breasts back. In addition the upper part of the breast becomes hollow due to loss of volume and becomes unattractive. Breast lift is done for women to regain the shape of the breasts.


    3. What is breast lift?

    4. Breast Lift or mastopexy is a surgical procedure which involves removal of excess slack skin and repositioning of the breast tissue and the nipple to give a more youthful appearance to the breast.


    5. What is done when I consult the doctor?

    6. We would like to meet you before the surgery to talk to you in detail about what exactly you want, how we can fulfil your expectations, what the surgery would entail, the postoperative recovery, the risks and complications associated with this procedure. We would also ask some questions regarding your general health to ascertain that you are fit enough to undergo the procedure. We believe in being very transparent, and we also do not pressurise anyone in going through the procedure as we feel that the decision to undergo the procedure should only be the patient’s decision. We are only there to help you make the decision and help you achieve your expectations. We may take photographs so that we can compare the result before and after surgery. We may take few blood tests and any other test that would be necessary for fitness during surgery.


    7. Where would the incision be made during the operation and will there be a scar after the surgery?

    8. The final scar will be around the areola of the breast which will not be noticed. It will continue perpendicularly down from the areola of the breast to the inframammary fold where there will be another scar below the breast. This is the best place to have a scar, and we will take all measures to produce a good scar


    9. Facts at a glance about the operation and postoperative instructions : ( May change person to person as each person is different. Please confirm with the doctor)

    10. Type of Anaesthesia : General Anaesthesia
      Surgery Time : 2 hours
      Hospital Stay : 1 - 2 days
      Sleeping position : On back for 2 weeks
      Walking to toilet : The next day
      Mobilising within house : From the second day
      Taking a shower : The next day
      Driving : 2 weeks
      Sports and Exercise including gym : 6 weeks
      Time off work : 2 weeks
      Full recovery : 6 - 8 weeks
      Special Bra : 2 weeks

    11. How is the post-operative period managed?

    12. Patients may feel mild discomfort with the operation which will be adequately controlled by painkillers. The patient will be mobilised the next day. If they feel comfortable, they can walk to the toilet and may take a shower. We may place a drain during the operation if we feel that he patient may have bleeding. The amount of fluid and blood collection in the drain is noted everyday. When the amount of drain output is less, we will then remove the drain which is usually painless. For a few days after the operation, the breasts may look swollen due to oedema which will settle down in a few weeks. After the patient can comfortably walk to the toilet and after the drain is removed the patient is discharged.


    13. Will this surgery interfere with lactation or sensation over the breast?

    14. The surgery is unlikely to interfere with sensations to the nipple or with lactation.


    15. What are the postoperative complications from this procedure?

    16. Just like any other procedure, breast reduction has its complications namely


      Bleeding :


      We will take all our efforts to restrict the bleeding during the operation. Rarely the blood vessel which was closed during the operation may open up later. This is one among the reasons for placing a drain after the operation which will help us to know whether there is bleeding. Usually it stops on its own.


      Skin necrosis :


      In large droopy breasts, the blood supply to the tip of the skin flaps may not be enough resulting in blackening of the tip of the skin flaps. This will usually settle on its own, or the patient is taken to theatre to revise this if necessary.


      Infection :


      As in any operation, there is a small chance of infection which we will deal with antibiotics and dressings


      Minor Asymmetry of the breasts :


      There may be minor asymmetry of the breasts as each breast may heal differently. Even before the operation, asymmetry of the breasts is seen in around 85 % of women.


      We will go through the risks and complications in detail when we see the patient in the clinic.


    1. Why do patients get ears pierced in the hospital?

    2. The idea of getting ears pierced can be frightening for a lot of people as it is painful. As many children are frightened and anxious due to the pain, they keep turning their heads which make it difficult to pierce in the right spot. Many people are also worried about the sterility of the procedure done as it may become infected if it is not done well in a sterile manner.


    3. What would we do?

    4. We would give one intravenous injection through which we will sedate the patient. After getting the patient to sleep under sterile aseptic conditions, we will pierce the ear and insert the ear ring.


    5. How long will I need to be in the hospital?

    6. Although we give short sedation, many people sleep for a while after the procedure due to the effect of the drug. After they get up and feel comfortable the patient goes home the same day.


    7. I would like to get the ear piercing done on an auspicious day at a particular time. Can we get this done?

    8. We can surely do this in the day and time of your choice. We would like to meet you at an earlier date and fix the date and timing of the procedure.


    9. Can my family members come in and watch the procedure?

    10. As we would like to get it done with all strict aseptic precautions, it is done in an operation theatre where we would not like people around. Hence we do not encourage people around while piercing the ear.



    1. For whom is breast reduction done?

    2. Many women have large breasts due to hereditary, weight gain and hormonal changes. They find it uncomfortable as their large breasts attract unwanted attention from people making them self-conscious both in their workplace and while participating in leisure activities such as shopping and going to the gym. The large breasts may also produce shoulder pain, neck pain and back pain making them uncomfortable. The undue weight of the breasts may produce deep furrows over the shoulder. Excessive sweating under the breasts may result in irritation of the skin and fungal infections. Getting into normal clothes for many is not possible, and they may need to buy costlier and special clothing. These reasons may dent the confidence of the patient as well as prevent them from pursuing many activities.


    3. What is breast reduction?

    4. Breast reduction is a surgical procedure in which the excess breast tissue is removed from the breast to give back a good size and shape.


    5. What is done when I consult the doctor?

    6. We would like to meet you before the surgery to talk to you in detail about what exactly you want, how we can fulfil your expectations, what the surgery would entail, the postoperative recovery, the risks and complications associated with this procedure. We would also ask some questions regarding your general health to ascertain that you are fit enough to undergo the procedure. We believe in being very transparent, and we also do not pressurise anyone in going through the procedure as we feel that the decision to undergo the procedure should only be the patient’s decision. We are only there to help you make the decision and help you achieve your expectations. We may take photographs so that we can compare the result before and after surgery. We may take few blood tests and any other test that would be necessary for fitness during surgery.


    7. Where would the incision be made during the operation and will there be a scar after the surgery?

    8. The final scar will be around the areola of the breast which will not be noticed. It will continue perpendicularly down from the areola of the breast to the inframammary fold where there will be another scar below the breast. This is the best place to have a scar, and we will take all measures to produce a good scar.


    9. What is done during the operation?

    10. The breast reduction operation is done under general anaesthesia. The nipple, areola and part of the breast tissue are conserved. The rest of the breast tissue are excised to reduce the size of the breast and the breast is then closed. There will be a drain tube coming out through the chest to remove any excess blood or serous fluid.


    11. Facts at a glance about the operation and postoperative instructions:- ( May change person to person as each person is different. Please confirm with the doctor)

    12. Type of Anaesthesia : General Anaesthesia
      Surgery Time : 3 hours
      Hospital Stay : 2 - 3 days
      Sleeping position : On back for 2 weeks
      Walking to toilet : The next day
      Mobilising within house : From the second day
      Taking a shower : The next day
      Driving : 2 - 3 weeks
      Sports and Exercise including gym : 6 weeks
      Time off work : 2 weeks
      Full recovery : 6 - 8 weeks
      Special Bra : 2 weeks

    13. How is the post-operative period managed?

    14. Patients may feel mild discomfort with the operation which will be adequately controlled by painkillers. The patient will be mobilised the next day. If they feel comfortable, they can walk to the toilet and may take a shower. The amount of fluid and blood collection in the drain is noted everyday. When the amount of drain output is less, we will then remove the drain which is usually painless. For a few days after the operation, the breasts may look swollen due to oedema which will settle down in a few weeks. After the patient can comfortably walk to the toilet and after the drain is removed the patient is discharged.


    15. Will this surgery interfere with lactation or sensation over the breast?

    16. As a part of the breast is removed, there is a considerable amount of milk ducts that are removed along with a part of the nerve supply to the nipple. However, in most of our cases, women do breastfeed and have some nipple sensations after the operation.


    17. What are the postoperative complications from this procedure?

    18. Just like any other procedure, breast reduction has its complications namely


      Bleeding

      We will take all our efforts to restrict the bleeding during the operation. Rarely the blood vessel which was closed during the operation may open up later. This is one among the reasons for placing a drain after the operation which will help us to know whether there is bleeding. Usually it stops on its own.


      Skin necrosis

      In large droopy breasts, the blood supply to the tip of the skin flaps may not be enough resulting in blackening of the tip of the skin flaps. This will usually settle on its own, or the patient is taken to theatre to revise this if necessary.


      Reduction in the sensations of the nipple

      The sensations to the nipple may be reduced even before the operation in large breasts. The sensations may reduce even further after the operation in a small group of people although this is uncommon.


      Necrosis of the nipple and areola

      In large drooping breasts the blood supply to the nipple may be decreased, and this may result in blackening of the nipple and areola although this is not common.


      Infection

      As in any operation, there is a small chance of infection which we will deal with antibiotics and dressings


      Minor Asymmetry of the breasts

      There maybe minor asymmetry of the breasts as each breast may heal differently. Even before the operation, asymmetry of the breasts is seen in around 85 % of women.


      We will go through the risks and complications in detail when we see the patient in the clinic.

    19. How satisfied are women after this procedure?

    20. Most women are very satisfied after the procedure. Among all cosmetic surgery procedures, breast reduction is the procedure with maximum satisfaction levels as this not only makes them look better but also reduces their shoulder pain, neck pain, back pain, the chance of fungal infection below the breasts and allows them to go out with lot more confidence.



    1. When and for whom is breast augmentation done?

    2. Feeling good about oneself is very important. Women like to have a youthful good looking breast of the right size and shape which is in harmony with the rest of the body. Women like to choose breast augmentation when


      • They feel that their breasts are small
      • The breasts are not of the same size, and they would like to increase the size of the breast
      • After breastfeeding, the breasts may have lost volume and women like to have their youthful shape back
      • More medial cleavage of the breast

    3. What is breast augmentation?

    4. Breast augmentation is a surgical procedure in which an implant is inserted behind the breast to give the breast a larger look and a better shape.


    5. What is done when I consult the doctor?

    6. We would like to meet you before the surgery to talk to you in detail about what exactly you want, how we can fulfil your expectations, what the surgery would entail, the postoperative recovery, the risks and complications associated with this procedure. We would discuss with you regarding the size of the implant that you would like to have. We would also ask some questions regarding your general health to ascertain that you are fit enough to undergo the procedure. We believe in being very transparent, and we also do not pressurise anyone in going through the procedure as we feel that the decision to undergo the procedure should only be the patient’s decision. We are only there to help you make the decision and help you achieve your expectations. We may take photographs so that we can compare the result before and after surgery. We may take few blood tests and any other test that would be necessary for fitness during surgery.


    7. Where would the incision be made during the operation and will there be a scar after the surgery?

    8. A 5 cm incision is made underneath the breast. This is the best place to make an incision as this incision heals the best. We will take a lot of effort in making the scar look very good. But there are no means by which a scarless surgery can be done. We can only make the scar as good as possible.


    9. What is done during the operation?

    10. The operation is done under general anaesthesia. After the incision is made underneath the breast, the breast is lifted off the underlying muscle, and the breast implant is placed in the pocket created. In some cases, we may lift a part of the muscle so that the breast implant partially lies underneath the muscle and partially under the breast. In certain cases, we may aspirate some fat from another area, and we will add it in certain areas of the breast that we feel are necessary to it a better result.


    11. Facts at a glance about the operation:- ( May change person to person. Please confirm with the doctor)

    12. Type of Anaesthesia : General Anaesthesia
      Operating Time : 1 - 2 hours
      Hospital Stay : Daycare or 1 night
      Taking bath : Can shower the next day
      Walking : Can walk the next day within the house. Advised to take rest in the house for a week and avoid lifting any heavy objects for 6 weeks
      Gym : Can go to the gym after 8 weeks

    13. What are the other postoperative instructions?

    14. We don’t expect the patient to have much pain after the operation and we would be giving painkillers after the operation to take if there is pain. As we would be using dissolvable sutures, it would not be necessary to remove sutures. We would call you to the clinic in 1 week and 2 weeks to look at the wound to review if the wound is healing well. The patient is advised to wear a fitted bra for 5 days, and sports bra for another 3 weeks. No wired bras are to be worn for 6 weeks.


    15. Will this surgery interfere with lactation or sensation over the breast?

    16. No. The implant is inserted behind the breast, and hence lactation and sensation over the breast will not be affected.


    17. Do breast implants cause breast cancer?

    18. No. Breast cancer arises from the ducts and lobules in the breast. As on date breast implants have not found to cause breast cancer.


    19. Will breast cancer be difficult to detect with an implant if ever I get one?

    20. A recent study done in America shows that breast cancers are more easily palpable after breast augmentation as the implant behind makes it easily palpable. This makes breast cancers detectable even when they are smaller in size. Detection by mammography may need some special views, and MRI is taken if in doubt. Patients are advised to undergo regular screening by palpation and mammography just as they would if they did not have a breast augmentation


    21. What type of breast implant will be put inside?

    22. As the breast implant stays with the patient for a long time, we at Ganga Hospital put only good implants which are approved by the FDA (Food and Drug Administration) which is a regulatory body in the United States of America. As textured implants have been recently associated with ALCL ( Anaplastic Large Cell Lymphoma), a type of cancer of the lymph nodes we do not use such implants. We use only smooth breast implants. We also use only round implants as the anatomical or teardrop shaped implants have been associated with rotation in the breast pocket and studies have shown comparable results between round implants and anatomical implants


    23. What are the complications associated with this surgery?

    24. The risks with this surgery can be divided into early complications and late complications


      Early complications ( within 5 days)
      • Bleeding
      • Infection

      A lot of effort would be taken to avoid these complications are are not common

      Late complications
      • Asymmetry :

        Studies have shown that in women who have not had a breast augmentation, 88% of women have asymmetrical breasts and 65% of women have asymmetry in more than 1 parameter . So breasts which are very similar and as symmetrical as possible is what we plan to achieve and exact symmetry of both breasts are difficult to achieve.

      • Implant rupture :

        Implant ruptures are uncommon. If they do happen the company allows you to change the implant free of cost as the implants have lifelong warranty.

      • Capsular Contracture :

        Patients tend to form a scar around the breast implant that has been inserted. In some people, the scar formed around the implant may contract and become smaller in size. This tends to make the implant appear more spherical with time. This may be palpable in some and rarely may cause pain after few years. If it becomes very troublesome, then the implants need to get replaced.

      • ALCL( Anaplastic Large Cell Lymphoma) :

        Anaplastic Large Cell Lymphoma is a rare cancer of the lymph nodes associated with textured breast implants. It occurs in 1 to 3 women among 10,00,000 women with breasts. Even though it is very rare, we do not use textured implants, and we use only smooth implants. The ALCL presents with serous fluid collection around the breast implant or with small masses mostly around 8 to 10 years from implanting the breast implant.


    25. Will my breast implant need to be changed?

    26. Generally, it is told that breast implants need to be changed every 10 years. This is due to ruptures or capsular contractures. Each person reacts differently to the effects of surgery. Some may get their breast implants replaced earlier, some they may replace it longer than 10 years and some may not need any replacement at all.



    1. What does Gynaecomastia mean?

    2. Some men may have breasts which are larger than the size most men have and this is called as Gynaecomastia


    3. Why does it occur?

    4. The most common cause of Gynaecomastia is idiopathic (Meaning that there is no obvious reason behind this) . It can also occur due to the intake of various medications or from hormonal changes


    5. Is this condition common?

    6. Gynaecomastia is fairly common and studies have shown that it can be as high as 40% among the age group 18 -26*


    7. Why do men seek treatment for this procedure?

    8. Men find it embarresing removing their shirts during religious functions, going to the gym, swimming and changing shirts in the locker room. They also don’t like wearing tight outfits and this can prevent many men from going to the gym and participating in many outdoor activities. This can also dent their confidence.


    9. How is this procedure treated?

    10. Surgery for gynaecomastia is done under general anaesthesia. A small incision of about 5 mm is made in the chest and the excess fat in the breast is sucked out by a procedure called liposuction. Another incision is made just around the areola and the excess breast bud tissue is removed.


    11. What is the post operative course?

    12. After the surgery the patient may have swelling and bruising over the chest which will go away in six weeks.There may not be an appreciable change in the size of the breast immediately after surgery due to the swelling and the final result maybe evident only 6 weeks after surgery when the swelling subsides. Patient may have minimal pain which will be controlled by painkillers. Most patients are discharged home the next day. Men are then advised to wear a tight compression garment after surgery which will reduce the swelling faster and will give a good result.


    13. What are the complications that can happen with this procedure?

    14. Complications for this procedure are not very common. It can however be associated with

      • Haematoma

        which may settle by itself or may need evacuation

      • Seroma

        Serous fluid can get collected under the skin which can be aspirated with a needle and a syringe

      • Change in the sensations over the nipple

        There can be minimal change in the sensations of the nipple due to the surgery which will come back after a few months

      • Mild Asymmetry

        Inspite of all our efforts there may be a mild asymmetry of bothe the breasts


    15. How satisfied are patients with this procedure?

    16. Patients are usually very satisfied with this procedure because they have an appreciable change in the size of their breasts which allows them to go to gym, swimming, wear tight clothes and approach life with more confidence.


    17. Facts of Gynaecomastia surgery at a glance ( Needs confirmation with the doctor as this can vary from person to person)


    18. Type of Anaesthesia : General Anaesthesia
      Surgery Time : 2 hours
      Hospital Stay : 1 - 2 nights
      Taking bath : Next day after surgery
      Driving : 2 weeks
      Time off work : 1 week
      Full recovery : 6 weeks
      Sports and Gym : 6 weeks
      Garments : Need to wear compression garments


    1. Why do people want a lip lift?

    2. As we get older the upper lip loses its youthful pout and slowly droops downwards. This group in results in increased vertical height of the lip. The lip line viewed from the side shifts from the forward pout to straight down and then backwards. When in repose with the lips slightly parted with the jaws relaxed there should be mild teeth show. When the lip droops down the teeth are not seen when the person smiles which may not be very aesthetic.


    3. How is the procedure lip lift done?

    4. The procedure is done under local anaesthesia. Skin is excised from the upper part of the upper lip, just below the nose and sutured which helps to shorten and lift the upper lip. So this brings back the youthful pot of the upper lip and the teeth of the person is seen while smiling after the procedure.


    5. What do I need to expect during recovery?

    6. There may be swelling and pain after the procedure. Although the pain may not be much we will give pain killers to reduce the pain. To reduce the edema and swelling after the procedure we will be closing the incision done with non absorbable sutures. The sutures would need to be removed in 5-6 days from the date of operation. This procedure is done as a daycare procedure and the patient need not stay in the hospital for the night.


    7. What re the risks and complications associated with lip lift?

    8. Although most surgical procedures go smoothly, it is important to make patients aware of the risks and complications that can occur with a lip lift. There can be mild asymmetry due to healing issues during surgery. Numbness may be felt for some time following the procedure. Scarring can also be more prominent than intended. If so we will advise you as to how to make the scar look better. But generally it is hid by the nose. Infection is rare, but a possibility.


    9. Facts at a glance


    10. Type of Anaesthesia : Local Anaesthesia
      Surgery Time : 30 - 45 minutes
      Hospital Stay : Day case
      Walking : Same day
      Sports & Exercise : Next day
      Time off work : The day of operation


    1. What is Lipofilling?

    2. Fat is harvested from one part of the body and is then injected into another part of the body to augment contour defects or improve ageing. Since fat is part of one’s own tissues, unlike implants, there is not much reaction to tissues.


    3. Why is Lipofilling done?

    4. Lipofilling is done to correct


      • Contour defects over the face and the rest of the body
      • Correct contour defects due to trauma or breast reconstruction or previous surgery
      • Correct deflation of tissues due to ageing

    5. What is done during the operation “Lipofilling”?

    6. The operation Lipofilling is usually done under general anaesthesia. A small incision of about 5 mm is made, and fat is harvested. The harvested fat is then injected into the contour defect to increase the volume of tissue and correct the contour defect.


    7. How effective is the operation Lipofilling?

    8. The injected fat can reabsorb, and hence fat retention may differ from person to person and also from each area. Various studies have been done to find out how much fat is retained. A recent study looked into the amount of fat retention reported in various studies*. They reported that the amount of fat retention was between 39 -77%. Hence to correct the deformity fully we may have to do the Lipofilling procedure multiple times


    9. What is the normal post-operative care for the patient?

    10. There may be some mild bruising and swelling both from the place from where we took the grafts from and also where we injected. This procedure will be done as daycare or may stay for 1 night in the hospital. A compression garment is usually worn to reduce the swelling.


    11. What are the complications of Lipofilling?

    12. The main complication of fat grafting is the absorption of fat and hence the procedure needs to be repeated multiple times. There can be asymmetries due to this. The other complications such as bleeding and infection are rare.


    13. Facts at a glance


    14. Surgery Time : Dependent on area treated
      Hospital Stay : Day case or 1 night stay
      Can Shower : Next day after operation
      Driving : 1 week
      Sports & Gym : 4 - 6 weeks
      Time off work : Dependent on area treated


    1. What is Liposuction?

    2. Liposuction is a surgical procedure in which small incisions are made, and the excess fat is sucked out.


    3. Why do patients seek Liposuction?

    4. Having a good body shape is everyone’s dream. The fat that is deposited in the body due to weight gain is usually lost by exercise or weight gain. However, there are some areas of the body such as the outer thighs, inner thighs, buttocks, flanks and abdomen which do not respond to exercise or diet. These fat deposits are called as lipodystrophy and have to be treated by liposuction provided that the skin has good elasticity of tissues. Patients often seek liposuction because


      • They have unsightly bulges in fitted skirts and trousers
      • Their inner thighs rub each other in the middle especially during hot weather
      • Lower abdomen and flanks bulge and are visible above and below the waistline
      • Diet resistant fat over the buttocks, saddlebags ( near the hips), lovehandles ( lateral aspect of the lower abdomen), male breast

    5. What does the procedure involve?

    6. The procedure is usually done under general anaesthesia. Fluid is injected in called tumescence to reduce bleeding while doing this procedure. Then a small incision of about 5 mm is made over the skin, and the excess fat is sucked out.


    7. Can this procedure be used to reduce weight?

    8. This procedure is for providing a good shape to the body. It does not reduce the weight of the individual. If losing weight is your main aim this procedure is not for you.


    9. Can this procure be an alternative to diet and exercise?

    10. This procedure is best appreciated when the patient is on a good diet and exercise programme. Liposuction is complementary to diet and exercise wherein it helps remove fat deposits that are resistant to exercise. Hence patients are advised to continue diet and exercise. Liposuction is not an alternative to diet and exercise, and this has to be continued.


    11. What is the normal postoperative course?

    12. Patients may have mild discomfort in the areas that underwent liposuction which is controlled well by painkillers. There will be swelling and bruising in the areas that underwent liposuction, and the final result can not be appreciated until 6 to 12 weeks after surgery. To reduce the swelling and to get a good result compression garments are worn for at least three months. The stitches applied can be removed in 7 -10 days. We usually discharge the patient in the first or second day after the operation.


    13. How much time do I need off work?

    14. It would depend on the amount of fat that was sucked out. If it involves a small area, usually patients go back to work in 2-3 days. However when the amount of fat that is to be sucked out is large, then the recovery may take longer, and they may go back to work in 2-3 weeks.


    15. What are the complications associated with this procedure?

    16. Complications associated with this procedure are fortunately less. There can be mild asymmetry, rippling effect and stretch marks over the treated area. Very rarely do patients need revision procedures for the same. Usually, patients are very happy with this procedure as the fat deposits which were not going with diet and exercise go away.


    17. Facts at a glance


    18. Surgery Time : Dependent on area treated
      Hospital Stay : 1-2 nights
      Anaesthesia : General Anaesthesia
      Taking a Shower : Next day after operation
      Driving : 3 - 4 days if the area was small; 1-2 weeks if the area was large
      Sports & Gym : 2 weeks if the area is small and 4 - 6 weeks if the area was large
      Time off work : 3 - 4 days if the area was small; 2 - 4 weeks if the area was large
      Garments : To wear compression garments atleast for 3 months


    1. What is Lower Body lift?

    2. Lower Body lift is an operation in which the excess skin and fat below the umbilicus and the lower back is removed to give the abdomen a better shape and make it look nicer


    3. Who will benefit from a Lower Body lift?

    4. When people gain and lose weight as following bariatric surgery ( weight loss surgery) and significant weight loss with diet and exercise, the lower abdomen is stretched and refuses to go back. No amount of diet and exercise can overcome the laxity of the skin especially if it has stretch marks. In this situation, the excess skin and fat have to be removed by surgery. When the skin and fat are excessive in the front of the abdomen, the excess is removed from the front and this is called as abdominoplasty. When the excess skin and fat are in the front and sides of the lower abdomen it is called as extended abdominoplasty. When the excess skin and fat are removed in the front, sides and the back of the lower abdomen it is called as lower body lift.


    5. Where will the scar be after an Lower Body lift?

    6. The scar will be a transverse scar over the lower abdomen extending circumferentially across the lower abdomen and back. This will be hidden while you wear a pant, skirt or a saree and we will try to hide it under the bikini line.


    7. What is done during the operation Lower Body lift?

    8. The operation Lower Body lift is done under general anaesthesia. It lasts for 3 to 5 hours depending on each patient. During this operation the skin and fat over the abdomen are lifted from the underlying abdominal musculature, redraped and the excess skin and fat are removed. If there is an underlying weakness of the abdominal wall causing divarication of recti, we will repair it and strengthen the abdominal wall musculature. To ensure that there is no excess collection of serous fluid or blood collecting under the flap we will place three surgical drains to drain them. The umbilicus or the belly button is sited at the right place, and the wound is closed


    9. Will I be able to lose a lot of weight with this procedure?

    10. This operation is primarily a body contouring operation and not a weight reducing operation. After the operation, you can expect a decrease of about 1-3 kg weight. Some patients may not reduce weight at all. So if reducing weight is your primary goal, this operation is not for you.


    11. What is the normal post-operative course?

    12. Soon after the operation, the patient may feel slightly tight over the abdomen as the abdominal musculature has been repaired and the excess skin has been removed. This will go away in 2 to 3 weeks. We will give adequate painkillers to control the pain. We will monitor the amount of fluid in the drains daily and will remove them as soon as the amount of fluid in the drain is very less. Depending on how comfortable the patient is we will try to mobilise the patient from the first or second day after surgery. We will discharge the patient as soon as the patient feels comfortable walking to and from the toilet and after the drains have been pulled out. This amounts to approximately 5 to 7 days of hospital stay. Patients who stay near and are happy to monitor the drains may be discharged earlier around the third or fourth day from surgery.


    13. What are the complications associated with this procedure?

      • Delayed wound healing and skin necrosis :

        A small subgroup of patients may have delayed wound healing and may have minimal skin necrosis ( skin becomes black due to reduced blood supply). If the amount of necrosis is very less, it can be managed with regular dressings. If the amount of skin necrosis is more, then we may take the patient back to the operation theatre, trim it and resuture the area.

      • Seroma :

        Seroma is excess serous fluid in the cavity below the abdominal flap. This usually occurs later than 3 weeks and is usually aspirated out. When it comes repeatedly, we may take the patient to the operation theatre and remove the excess fluid.

      • Mild asymmetry or some excess fat over the sides :

        In spite of all our efforts there maybe some mild asymmetry or excess fat over the sides of the abdomen which can be revised by a minor procedure.

      • Decreased sensation over the lower abdomen :

        The sensations can be reduced or feel different over the lower abdomen for a while as the abdominal flaps have been raised. This is expected, and the sensations will return in a few months.

      • Hypertrophic scarring :

        Each person heals differently and some patients may develop raised large scars called hypertrophic scars. They will get better with techniques like scar massage, silicone sheets and compression

      • Deep Vein Thrombosis (DVT) and Pulmonary Embolism :

        DVT is formation of blood clots in the veins of the legs. This can happen as the surgery is a prolonged surgery. This clot may go on to the lungs causing difficulty in breathing. Fortunately this complication is not common and rare as we will take a lot of efforts to prevent this. We will be giving blood clot thinners before surgery and after surgery. We will also have sequential compression devices which will keep pressing the legs so that the legs are not static and this will help prevent DVT.


    14. Facts at a glance


    15. Surgery Time : 3 to 5 hours
      Hospital Stay : 3 - 5 nights
      Walk to the Toilet : Next day
      Take a shower : 2 days
      Reasonably mobile : 2 weeks
      Driving : 3 weeks
      Sport & exercise including gym : 8 weeks
      Full recovery : 8 weeks
      Time off work : 2-3 weeks
      Bras and garments : Yes Abdominal binder
      Long-term issues : May require scar management


    1. Why is earlobe rejuvenation done?

    2. In young people, the ear lobes are plump and perky. With time and age, there is a loss of elastin, collagen and hyaluronic acid which make the earlobes thin and weak which may limit women from wearing the ear-rings of their choice.


    3. What can be done to rejuvenate the earlobe?

    4. The earlobes can be rejuvenated by injecting fillers in the ear or fat injections in the ear.


    5. What are these fillers?

    6. Fillers contain hyaluronic acid and little anaesthetic solution. They come as one cc syringes. When the filler is injected in the earlobe they can give additional volume and bulk to the earlobe making it more attractive and stronger. As hyaluronic acid is a natural product, it is absorbed over a period of one to two years. Hence this injection may need to be repeated after 1 to 2 years. This procedure can be done quickly as a lunchtime procedure.


    7. What are fat injections?

    8. Fat injection is a surgical procedure, and we would prefer to do this in an operation theatre. We would give short sedation or general anaesthesia and harvest fat from abdomen or thighs by making a 3 mm small stab incision. We would then inject it into the earlobe.Around 20 to 30% of the fat that is injected may get absorbed. Rest of the fat remains permanently. When we age, we not only lose fat in the earlobe, we also lose fat in many other areas of the face. We will then use this opportunity to inject fat that was harvested in the rest of the face. The areas and the need for injections would be discussed with your doctor during your consultation with him.


    9. How long do I need to stay in the hospital for fat injections?

    10. This procedure can be done as a daycare procedure which means you come to the hospital and go back home the same day. However, when patients come from far, some prefer to stay in the hospital for a day.



    1. What is a tuberous breast?

    2. Tuberous breast or constricted breast is a congenital abnormality in the breast wherein the base of the breast is smaller leading to the lower part of the breast higher than the other breast. The breasts are smaller in size. However, the size of the areola surrounding the nipple is much bigger.


      Fig 1.1 Normal Breast Fig 1.2 Tuberous breast in which the base of the breast is constricted and the position of the infra mammary fold is higher. The size of the areola is larger as it herniates through the constricted envelope.


    3. Why do tuberous breasts develop?

    4. Tuberous breasts develop because there are abnormal fibrous adhesions between the breast and the tissues surrounding the breasts. These abnormal fibrous adhesions surrounding the breasts prevent the breasts from growing into a fuller and rounder shape. As the fibrous adhesions are mostly present in the lower pole, constricted breasts are more common in the lower portion of the breast.


    5. Why do women want treatment for tuberous breasts?

    6. Women like to get the tuberous breasts treated because of the abnormal size and shape of the breast. The breast is much smaller in size, and the breast can be long and narrow. Many women also do not like the size of the big areola in the breast in the small long and narrow breast.


    7. How can tuberous breasts be treated?

    8. We would examine the patient and discuss with the patient as to what she is bothering her and what she would like to get changed. Women can either want their size or shape of their breast changed, or they may be bothered about the bigger size of the areola surrounding the nipple. Most women are bothered about the shape of their breast. We would need surgery to correct these breast deformities. The incision is made around the areola of the nipple, and the constricting fibres around the breast are scored. As the breast is in a higher position, we would lower the inframammary fold or the lower pole of the breast. This would give a good shape to the breast. If the patient would also like to have a larger breast, then a breast implant is placed beneath the breast to make the breast larger. If the size of the areola is large, then this would need a reduction in the size of the areola. This procedure could be done in one stage or two stages few months apart.



    1. Why do they happen?

    2. 1 in every 20 persons has a prominent ear. It is said to be an autosomal dominant condition which means that if one parent has a prominent ear, each child has a 50 % risk of getting this kind of ear. The normal ear has many convolutions or folds which give this the shape of the ear. These folds may not be well developed in some ears resulting in the ears appearing prominent


    3. Why do people get their prominent ears corrected?

    4. Prominent ear correction is mainly done in children as some of them get teased in schools. With nice and attractive ear rings being worn, the ears get a lot more attention, and many adults also would like to have this prominent ear corrected


    5. How early can they get corrected?

    6. The ears reach the maximum size that they can grow by seven years in boys and by six years in girls. We would like to operate on them after that. We operate on children mainly during school holidays so that they would not miss school.


    7. What is done during the surgery?

    8. We would put the patient to sleep by general anaesthesia so that the patient has no pain during the procedure. We would then make an incision behind the ear, correct the underdeveloped folds in the ear and correct the prominence of the ear. After the procedure is done, the patient will have a dressing around both the ears and his head which will remain for four days after which they can be removed.


    9. Will the incision mark be noticeable?

    10. As the incision is made behind the ear and as the prominence of the ear is corrected, the incision will be hardly noticed.


    11. How long would the patient need to stay in the hospital?

    12. The surgery can be done as a daycare in which you can come in the morning and go in the evening. Patients who come from far and for those who like to take rest in the hospital on the day of the operation usually stay for a day in the hospital.


    13. What are the complications or unfavourable results that can happen after this procedure?

    14. Some patients may not heal well and can have hypertrophic scars or keloids which may need massaging and steroid injections later. Although we suture the folds of the cartilage to get it to the right shape, in a very small percentage they may come back again. In that case, we may need to redo again. There is a small chance of infection. If there are any redness, swelling and pain, we recommend our patients to come back again and give them antibiotics to tide over the situation.



    1. What is Labiaplasty?

    2. Labia Minora is the inner lip of the vaginal opening . Some patients may find their labia minora very large, physically uncomfortable and aesthetically displeasing. Labiaplasty is a surgical procedure in which the labia minora are reshaped to the appropriate size to make it look better.



    3. Why do patients request labial reduction?

    4. In some patients the labia maybe too large and patients desire labial reduction because


    5. It can cause discomfort while wearing undergarments and fitted jeans
    6. Maybe difficult to maintain hygiene during menstruation
    7. May cause pain during and after intercourse
    8. The two labia maybe very different and cause embarrassment

    9. What is done during this surgery?

    10. This surgery is done under general anaesthesia as a daycase. Surgery involves careful trimming of the excess skin and suturing back with absorbable sutures. Patients can be discharged the same day or the next day.


    11. What is the normal post operative course?

    12. Patients may experience mild swelling and bruising of the area. The swelling may reduce by lying down and elevating the pelvis by placing a pillow underneath the pelvis. This swelling will reduce by 2 to 3 weeks. Ice packs over that area may give some comfort after the operation.


    13. When can the patient return to work ?

    14. Depending upon the work done, some women go back to work by 2 days and some go back to work within a week.


    15. When can the patient start having intercourse?

    16. The patient can have intercourse 6 weeks after the operation. At this time the swelling and bruising is expected to have settled.


      Facts at a glance


    Surgery Time : 45 minutes to 1 hour
    Hospital Stay : Daycase or 1 day
    Anaesthesia : General Anaesthesia
    Walking : Same day or next day
    Working : 2 days to 1 week
    Sports and Gym : 6 weeks
    Full recovery : 6 weeks
    Resume intercourse : 6 weeks


    1. What is rhinoplasty?

    2. Rhinoplasty is a surgical procedure that alters the nose's size or shape, making the nose and face look better and helps correct breathing problems.


    3. Why is rhinoplasty done?

    4. The nose's shape and size can be commonly altered after an accident, congenital disabilities such as cleft lip and palate, or can be simply done for cosmetic reasons. A rhinoplasty commonly corrects the following problems.

      • Dorsal hump of the nose
      • The collapse of the dorsum of the nose
      • Boxy or bulbous tip of the nose
      • Deviated (Tilted) noses that are not straight
      • Irregular nostril sizes
      • Breathing difficulties due to deviated nasal septum

    5. What is done when the patient consults the doctor before surgery?

    6. We would like to meet the patient before surgery to precisely understand the patient's desires, how we can fulfil the patient's expectations, what the surgery would entail, the postoperative recovery and the risks and complications associated with this procedure. We would also ask some questions regarding the patients general health to ascertain the fitness to undergo the procedure. We believe in being very transparent. We also do not pressurise anyone to undergo the procedure as we feel that the decision to undergo the procedure should only be the patient's decision. We are only there to help you make the decision and help you achieve your expectations. We may take photographs so that we can compare the results before and after surgery. We may take few blood tests and any other test that would be necessary for fitness during surgery.


    7. How is rhinoplasty done?

    8. Rhinoplasty is done under general anaesthesia. The patient will not have any pain during the procedure and will not be aware of what is happening during the procedure as they will be sedated. A small incision is made in the base of the nose. This incision mark is usually not visible as it is not easily seen. The other incisions are made within the nose. The soft tissue enveloping the nose is lifted, revealing the bones and cartilages of the nose. Necessary changes are made in the bones and cartilage to give a straight dorsum of appropriate length, correct any deviations in the septum and the nose's tip. In some instances, extra cartilage may be required to correct the deformities in the nose. In that case, we may have to harvest cartilage from the rib. A horizontal incision is made in the chest just below the breast, and the rib cartilage is harvested. After the necessary changes are made in the bones and cartilages of the nose, the skin is sutured back in place. To prevent any bleeding, the nostrils in the nose may be packed. We usually leave the packs within the nose for two days and later remove them. We protect the nose with a splint over the nose.


    9. Who is a good candidate for rhinoplasty?

    10. A person is a good candidate for rhinoplasty if he/she knows exactly what they want to be improved. When we clearly understand what the patient wants, it is easy to address the problem. This is the reason why we feel that consultation with the doctor before surgery is very important. We will discuss what we can achieve after surgery during the consultation and what we may not achieve after surgery to have realistic expectations. If we believe that we may not achieve the patient's expectations after surgery, we might not do the surgery. Besides, rhinoplasty is to be done for healthy, stable patients. If the patient has any comorbidities, we should correct them before surgery. Rhinoplasty is to be done for patients after 17 years so that their facial development is complete. It is also essential that the patients stop smoking before surgery.


    11. How does one recover after rhinoplasty?

    12. After rhinoplasty, we encourage the patient to breathe through the mouth as the nose's nostrils will be packed. Painkillers will be given to reduce the pain and keep the patient comfortable. The patient can take semisolid diet in the evening and the next day. Once the patient is comfortable, the patient can take solid food by the second day after surgery. The packs in the nose will be removed in 48 hours. Patients can go home as soon as they are comfortable. Most of our patients prefer to go home after 48 hours once their packs in the nose are removed.


    13. What advice is given to patients after rhinoplasty?

      • Keep the head elevated with two pillows. This will reduce oedema and swelling in the face.
      • Patients may have swelling of the face and the nose initially. The swelling generally reaches its peak in 48 to 72 hours and then reduces. Most of the swelling goes away by 2 to 3 weeks after surgery. There can be mild oedema in the tip of the nose in some people for as long as one year after surgery.
      • Avoid strenuous activity and lifting heavy weights for three weeks
      • Avoid any form of trauma or injury to the nose for four weeks.
      • The tip of the nose and the front of the teeth may feel different initially for a few weeks in some people. The sensations will come back within a few weeks, so one needs not to be stressed about it.
      • Avoid wearing heavy glasses on the nose for at least four weeks after surgery. If one needs to wear glasses, one should temporarily tape the glasses to the forehead. Contact glasses can be worn as soon as the patient is comfortable.
      • There can be mild bleeding from the nose and is usually collected blood, and one need not be concerned if the dressing shows mild soakage. However, if the bleeding is continuous, then it is better to inform the doctor. As we generally pack the nostrils after surgery and as we take care to stop the bleeding before surgery, the chances of bleeding after surgery are very less.

    14. What are the risks and complications after a rhinoplasty?

    15. We take a lot of effort to reduce the complications or undesired effects after surgery. But still, with all our efforts, there can still be some side effects like

      • Persistent Edema :
        After rhinoplasty, most of oedema and swelling of the face reduces by 2 to 3 weeks. The oedema continues to reduce with time. This happens in about 95% of people. In some patients, they may continue to have swelling, especially in the tip of the nose, for as long as one year after surgery. In such cases, we may give steroid injections to reduce oedema and swelling.

      • Not satisfied with the result
        Achieving a good result in rhinoplasty involves understanding the patient's expectations, the surgical procedure, and healing the patient's wounds. We try to get good results by speaking to our patients elaborately and understanding their needs and expectations. We plan what we would need to do to meet the expectations and try to fulfil them to the best of our ability. However, in some cases, the cartilage grafts that we place may change shape or may even get absorbed. In some cases, the scar's contraction while healing may change the way the nasal bones and the cartilage are aligned. We usually allow the nose to heal well. We assess the nose only after six months. We again discuss with the patient and try to understand what they like and what they didn't like. We then can go ahead and do another rhinoplasty procedure. Although not common, we can still correct any problem that the patient is not satisfied with.

      • Bleeding
        The nose is a very vascular structure. We undertake many steps to reduce and control bleeding like injecting medicines to reduce the bleeding, cauterising bleeding points, and packing the nose after surgery, which controls bleeding even if it does bleed. The chances of bleeding is significantly less. There can be some minor soakage of dressings after surgery. This is not of major concern. However, if it does bleed profusely, the doctor should be informed. As the hospital is covered by full-time anaesthetists and senior plastic surgeons 24x7, we will pack the nose again and control the bleeding. This is the advantage of being treated at a hospital.

      • Septal Perforation
        There can be a hole in the septum of the nose which separates both the nostrils. Most septal perforations do not need any treatment unless they produce any symptoms.