Offering quality treatment protocols today, is a matter of combination between excellent clinical skills and abilities, deep knowledge of Plastic Surgery and finally proper selection and use of equipment and materials:
Non Invasive Aesthetic Procedures
Sutures’ Face Lift
Aging changes and gravity cause early jowls or laxity of the face and the neck. Minimal invasive procedures with sutures can provide lifting of the tissues. They are an excellent option for patients in their 40’s to early 50’s who need a well defined cervico-mental angle and patients with early neck laxity or platysmal bands who wish to avoid major invasive procedures. They are suitable for heavy necked male patients or patients who have residual neck laxity following a previous face lift who require a further adjustment.
The procedure takes about 45 minutes and is carried out in the out-patient setting. Minimal discomfort is expected during the treatment and minimal bruising may occur, which will usually resolve after 1 week. The effects of the sutures are long lasting but adjustments may be needed.
This ancient Asian beautification practice has gained popularity around the world. Micropigmentation-sometimes referred to as "permanent make-up"- is a technique in which, metabolically inert pigment granules are implanted below the epidermis for aesthetic or reconstructive enhancement. Needles penetrate the skin a few millimeters, in what is basically a tattooing process.
Micropigmentation is used to enhance facial features like eyebrows, lashes and lips; to improve conditions like scarring and vitiligo (uneven pigmentation); or to reconstruct the areola at the breast area. Typically, two treatments are needed, one or more weeks apart.
Botox Cosmetic® is a purified protein produced by the Clostridium Botulinum bacteria. It has been used for wrinkle therapy since the early 1990's with no serious side effects documented. A small amount of Botulinum toxin is injected right into the muscles that are responsible for creating wrinkles or undesirable facial muscle effects. This treatment is quick and results usually last for 3-4 months (It may stay longer if it's combined with tablets of zinc).
The toxin temporarily inactivates the muscles that produce wrinkles, thereby causing lines to disappear or diminish dramatically. It usually takes a few days after the injection to notice the wrinkle smoothing effect.
Some of the common areas treated with “Botox” include crow's feet, frown lines, laugh lines, and forehead wrinkles. The toxin can also be injected to weaken the muscles responsible for a "gummy smile", which can improve this appearance dramatically. Injections into muscles that lower the eyebrow or corners of the mouth can produce a form of temporary brow lift or lip lift. Last years, “microBotox” injections can be addressed immediately under the skin decreasing the sebaceous glands’ secretion and eliminating the tiny wrinkles around the face. They smooth the skin surface and stretch the neck and the jaws resulting in a fresher look.
After the first treatment, you may return for follow-up injections after 2 weeks. Some doctors report that after several treatments, the effect of Botox Cosmetic® appears to last longer, often up to several months.
Complications from Botox injections to the upper eyelid include occasional bruising from the injection, and a temporary drooping of the eyelid, which rarely occurs after frown line injection. The injected medication is used in extremely small amounts and does not spread throughout the body so you can return to full activity immediately.
Botox Cosmetic® can be used by almost anyone; however, patients who are pregnant, breastfeeding or who have a neurologic disease should not use it. New uses for Botulinum toxin include reduction in sweating of hands (hyperhydrosis) and relief of headaches.
Wrinkles can be smoothed out by fillers. Some are permanent and occasionally can be rejected, exposed or infected. Others like hyaluronic acid are absorbable and provide a temporary fill. It is widely used because it is tolerated well. It can be used to fill wrinkles or to add volume to depressed areas at the face and the body. It also hydrates the skin by bringing water to the surface which gives a more youngful appearance. The augmentation needs nothing but anesthetic cream before injection and lasts 6-18 months depending on the body chemistry. It has minor complications such as pain and redness and if there is an overcorrection can be smoothened by hyaluronidase or better by 5FU and triamicinolone injections. Rarely inflammation may be occurred and will be released by cortisone creams and antibiotics.
Finally, permanent and safer filling can be done by fat transfer from one part of the body to another known as fat grafting or lipofilling. The fat used is liposuctioned from the abdomen or the thighs and usually is performed in an outpatient basis. Lipofilling can be used to recontour the face and provide fullness to brows, cheeks, chin, lips and lower eyes. It lasts longer in areas with no movement and can also improve atrophic aging of the hands. The procedure may need to be repeated until the desired correction has been achieved. Swelling, bruising or discomfort following the procedure can be easily controlled.
Dr Pistor of Paris and his colleague Dr Le Coz in 1952 were the first to perform mesotherapy in order to treat tendonitis, scars and other various skin conditions. Mesotherapy involves multiple injections under the skin (mesoderm) of a special prepared mixtured of vitamines and aminoacids.
Mesotherapy at the face includes vitamins (mainly C and B complex), hyaluronic acid (non cross linked), glutathione and DMAE. It hydrates the skin, remodells the collagen and rejuvenates of the face.
Lipolysis at the body includes phosphatidylocholine/deoxycholate and other chemicals like organic silicium and L-carnitine that primarily dissolve fat. It improves the cellulite and reduces the fat deposits. The best candidates are those with localized fat at the abdomen, the "saddle bags", the "love hundles", the inner or the outer thighs, the knees or the buttocks.
New revolutionary mesotherapy protocols with autologous tissue have already been introduced. They contain blood's PDGF and can be used either to the face or the body with fair good results.
Each treatment takes 10-20 minutes to perform and generally is not painful. The initial course should be 1-2 treatments. There is no recovery time needed and you can return to your daily activities immediately after.
Invasive Aesthetic Procedures
By the age of 50, about 50% of men and a substantial number of women are affected by hair loss, much of which is hereditary.
Flap surgery requires general anesthesia and is performed in a surgical setting. FUE (Follicular Unit Extraction) has no scars but requires more time and sessions.
Micro-hair transplantation (FIT or Follicular Isolation Tecnique) uses local anesthesia and is performed on an outpatient basis.
It requires hundreds of micro-grafts, each of which will generally contain 1-3 hairs mini grafted from a donor site on the back of the head. The donor site leaves a thin scar 1mm of width. It will be obvious only when shaving the hair and even then we can make a medical tattoo to remove it.
The grafts will be randomly implanted in the bald or "thinning area" of the head. 1-1.5 months after, the transplanted hair will fall out. They will be replaced 3-6 months after, when new hair grows in. After the procedure the patient will have 50% density than before: type 1- 3 (Lockwood scale) hair loss patients generally need 2000-3000 grafts to cover the area densely and type 4 -7 hair loss patients about 3500-5500 grafts to fulfill the defect. The procedure lasts 6-9 hours depending on the area we want to replace.
Mr Ioannis Liapakis, Consultant Plastic Surgeon
Dr Ioannis Liapakis, MD, PhD is a Plastic Surgeon. He graduated from the "University of Athens Medical School" in 1999. In 2004 he was awarded his Phd Thesis from the "University of Crete Medical School". In 2008 he completed his specialization in Plastic Surgery at “St Savvas” Anticancer Hospital of Athens and immediately after he obtained a "Facial Plastic Surgery Fellowship" under the auspices of the "Dutch Association of Facial Plastic and Reconstructive Surgery" in the Netherlands and Belgium. In 2009 he worked as a Plastic Surgeon at the "Centre Chirurgical Des Princes" in Paris, France collaborating with Dr Marchac. In 2010 he was awarded with the certificate of the European Boards of Plastic, Reconstructive and Aesthetic Surgery (EBOPRAS) at Bern, Switzerland. During his specialization, he visited several famous Plastic Surgery centres in New York, Toronto, Paris, Stockholm, and Sao Paolo and he also attended several courses in Austria, Great Britain, Germany, the Netherlands, Belgium, Romania and Egypt as well.