Plastic, Cosmetic & Reconstructive Surgery, Regenerative Medicine

Body Contouring (After Massive Weight Loss/Bariatric Plastic Surgery)

There are more and more people who, under medical supervision, lose weight to a great extent through diet, exercise and / or bariatric operations (sleeve stomach and often lose 30 – over 100 kg or more.

As a result of the severe weight loss through, diet and/or exercise, medication or Bariatric operations there is a significant excess of inelastic skin, with typical formation of deep creases (with chronic skin inflammation) and sagging skin sacs.

Changes in body shape after massive weight loss lead to physical, aesthetic / psychological and / or functional impairments.

In order to help patients suffering from excess skin and fat after massive weight loss quickly and comprehensively, we have set up a special Bariatric Plastic Surgery Consultation.

The body is sculpted gradually. The restoration in the different regions can be done one after the other (about 6 – 12 months apart) or partially at the same time, as part of combination treatments (lower body lift, upper body lift). The the classic sequence is:

Lower Body Lift

• Abdominoplasty (Tummy tuck) (+ mons pubis lift)
•  Lateral thigh lift
• Buttock lift

Upper Body Lift

• Breast lift (Mastopexia)
• Chest lift
• Arm Lift (Brachioplasty)

Head and neck Lift

• Face & neck lift

Burns & Scars

Burns are painful and serious injuries, especially when they occur on the face or mechanically stressed areas such as the hands and feet. In the Department of Plastic, Hand and Reconstructive Surgery & Regenerative Medicine, acute burn injuries are treated and the repair and scar therapy for the consequences of burns (e.g. restrictive scar strands, webbed webs in the folds between the fingers) is carried out. Our medical team has many years of experience in burn injury centers. Our specialized hand therapists are available for scar and occupational therapy.

Acute burn treatment

In order to achieve an optimal functional and cosmetic result, you need professional treatment including intensive wound care and, if necessary, operations. In our department, local burns are treated with intensified wound therapy and the latest surgical and skin grafting techniques - as long as they do not require intensive medical monitoring and therapy in a specialized center due to an onset or impending burn disease. In addition to minimally invasive procedures such as hydrosurgery and enzymatic debridement, modern wound dressings are also used fee microvascular tissue transfer

Treatment of burn sequellae – Burn scars

Even after they have completely healed, burns often lead to significant problems due to scarring – from a conspicuous, cosmetically unsightly appearance to retracted areas with differences in level. Some scars lead to significant limitations in movement and function, which - if they persist over a long period of time - can lead to irreparable joint damage.

In order to avoid permanent functional limitations or even poor growth in children, burn scars should be checked regularly and corrected at an early stage if necessary. We offer the entire spectrum of plastic surgery:

Simple scar corrections (including needle roller therapy and injections)
- Local flaps
- Skin grafts
- Expansion of healthy skin by tissue expanders
- Complex microsurgical tissue transfers
- Techniques of autologous fat transplantation from the body's own fat tissue (to improve the scar quality and level differences)

Aesthetic/Cosmetic Surgery & Procedures

The main motive of Aesthetic or Cosmetic Surgery is to increase and improve one's own appearance and thus one's own well-being. Aesthetic treatments and operations (cosmetic operations) can be carried out in all parts of the body.

Liposuction

With liposuction, fat cells can be permanently sucked out of the deep fat layer under the skin in all body regions (trunk, arms, legs, face and neck). If the skin is sufficiently elastic, there is then a change in shape due to the shrinkage of the overlying skin. With a normal diet, the result will be permanent. If you gain weight again, this will be more “everywhere” and not more in the area of the former fat deposits.

Fat Transfer (Lipofilling)

Lipofilling describes the method in which the body's own fat is used for tissue injection. The chances of success that transplanted fat cells will permanently grow in are very high. The result of the lipotransfer is long-lasting and can be corrected over the years

- Face
- Hand
- Breast(Natural Breast Augmentation)
- Genital
- Buttock (Brazilian Butt Lift)

Cosmetic (Aesthetic) Surgery

Head & Neck

- Face Lift/Neck Lift
- Midface lift
- Brow and forehead lift
- Blepharoplasty/Eyelid Lift Surgery
- Prominent Ears Correction (Otoplasty)
- Buccal fat pad fat Removal (Face slimming)
- Cheek and Chin Implant
- Rhinoplasty
- Genioplasty / Chin Augmentation

Upper Limb

- Arm Lift / Brachioplasty
- Hand Lift (→Link Hand Surgery & Hand Medicine)

 Trunc

- Breast
- Abdominoplasty (Tummy Tuck/ Abdominoplasty)
- Back Lift

 Buttocks

- Lifting
- Implants
- Fat transfer (Brazilian Butt Lift)

 Lower Limb

- Liposuction (saddle bag deformity)
- Thigh Lift
- Calf implant / Fat Transfer

Breast Surgery

An appealing breast shape is very important for both women and men.

Female Breast

The female breast is the most important problem area for women. Disturbances in the aesthetic image of the female breast can be caused by the following conditions:

Congenital malformations

Affect the number of breasts and the shape and structure of the individual breast

- Resection of the accessory gland/breast
- Correction of tubular breast deformity

Too small Breasts

Represent a great psychological burden for many women. Breast enlargement (augmentation) is the most common cosmetic surgery for women.

- Breast augmentation with autologous fat injection/lipofilling.
- Breast augmentation with silicone implants.
- Combination of lipofilling and silicone implant (so-called “hybrid technique”)

Too big Breasts

Can lead to physical (back pain, poor posture, chronic inflammation below the breasts) functional (impairments in everyday life, in sports, when choosing clothing) and psychological impairments (lack of self-confidence)

- Liposuction.
- Breast reduction (There are numerous surgical techniques available for breast reduction/mammary reduction, which enable scar-saving volume reduction).
- Liposuction and Breast Reduction.

Unequally sized Breasts

Disturb the basic harmony and make the breasts appear less attractive.

- Autologous fat injection/lipofilling.
- Breast augmentation with breast implants.
- Breast shaping on the smaller side or an equal reduction on the larger side.

Sagging Breasts

Develop in the course of tissue aging. Empty and/or sagging female breasts often disturb a positive body feeling”

- Autologous fat injection/lipofilling lipofilling.
- Breast augmentation with breast implants.
- Breast shaping/Mastopexia.
- Breast shaping/Mastopexia with additional implant.

Breast Cancer

Breast Cancer is the commonest malignancy in female patients. 1 in 8 women in the U.S. will have had a diagnosis of invasive breast cancer in their lifetime. There are about 1500 new cases in women per year in the UAE. Women diagnosed with early-stage breast cancer often have a choice of surgical treatments, Removing the breast cancer (Lumpectomy, Breast-Conserving Surgery/BCS) and Removing of the entire breast (Mastectomy).

Breast Reconstruction, using tissue from the patient`s body (Autologous Tissue Reconstruction)
- Single-stage Breast Reconstruction with autologous tissue (flap reconstruction).
- Multiple-stage Breast Reconstruction with autologous fat tissue according to KHOURI.

Breast Reconstruction using Silicon implant
- Single-stage Breast Reconstruction using Silicon implant.
- Multiple-stage Breast Reconstruction using Silicon expander according to BECKER.

Reconstruction of Areola and Nipple
Matching Contralateral Mammoplasty

Male Breast

The male breast is one of the male problem areas. Disturbances in the aesthetic image of the female breast can be caused by the following conditions.

Congenital malformations
Affect the number of breasts and the shape and structure of the individual breast

• Resection of the accessory gland/breast

Reconstruction of Areola and Nipple
Is most often cause by deformities after nipple piercing

Male Boobs (Gynecomastia)
In men is often felt to be embarrassing by the patient and can lead to a considerable loss of self-confidence.

• Liposuction
• Resection of the breast gland (subcutaneous mastectomy)
• Liposuction and Resection of the breast gland
• Liposuction and Resection of breast gland and concentric skin resection
• Breast Reduction in men

Sagging breasts after massive weight loss

• Breast reduction and chest lift

Breast Cancer
Most breast tumors in men are benign. However, men get breast cancer, too (1 – 2 %): Since there are no early breast cancer detection programs for men, the disease is usually diagnosed in men at a later stage than in women.

Reconstructive Surgery & Regenerative Medicine

Even ín the reconstruction of disfiguring tumors or life-threatening large defects, the plastic surgeon always strive for the best available aesthetic result in addition to restoring the function.

Reconstructive Surgery

Reconstructive surgery stands for the restoration of body shape and body function. This includes the restoration of defects after congenital malformations, large skin, soft tissue and bone defects, e.g. due to tumor removal, accidents, inflammation or chronic diseases.

Microsurgery

Microsurgery is a technique within Plastic Surgery in which the tissue is no longer visualized with the naked eye, but is operated on under the microscope. Above all, microsurgery has become an essential part of reconstructive surgery and hand surgery. Today, microsurgical operations allow us to sew up vessels and nerves that are 1 to 2 mm in diameter.

- Perforator flaps
- Fee microvascular tissue transfer
- Peripheral nerve surgery
- Lymphatice microsurgery

Regenerative Medicine

Is the youngest subspecialty of Plastic surgery, dealing with slowing down the aging process and regenerating tissues as opposed to repairing tissues with scar tissue.

- Stem Cell Therapy

Pediatric Plastic Surgery

Plastic surgery in childhood is intended to correct functional limitations or disfiguring physical deformities so that the child is not excluded or tormented by other children and can develop physically and psychologically in line with their age.
Plastic surgery in children poses a special challenge for the Plastic Surgeon, who must have appropriate training and experience.
For a child-friedly environment and treatment close cooperation with Pediatrics is mandatory.

The typical Plastic Surgeries in childhood concerns

Congenital Malformations

- Red Birthmarks and brown Nevi (giant nevus syndrome)

- Head & Neck

• Ear deformities (Darwin nodule)
• Protruding ears

- Hand

• Congenital trigger finger
• Too many fingers (Polydactylia)
• Webbed fingers (Syndactylia)

- Breast

- Accessory nipple or breast
- Abdomen
- Incomplete abdominal wall closure (Gastrochisis)

Trauma

- Acute trauma & Burns
- Obstetrical Brachial Plexus lesions (OPBL)
- Extravasation injuries

Tumor

-Defect Reconstruction after tumor removal (multidisciploinary tumor board)
- Complication Management after tumor treatment
- Extravasation of chemotherapy

Aesthetic

- Protrouding ears
- Gynecomastia (Boys)
- Gigantomastia (Girls)

Wound Care

There are a multitude of different chronic and problem wounds. They present a great challenge because they

Occur at any age, from newborns to the elderly are constantly increasing in medical and economic importance affection of the patient by

- Pain
- Bad smell (odor)
- Functional impairment
- Mental impairment
- Affection of people around the patient (physical and mental stress)

Due to the improved medical care and above all the increase in the proportion of older patients, chronic wounds and problem wounds are constantly increasing in medical and economic importance.

Chronic Wounds

There are 3 classic chronic wounds, which accounts for more than 90% of all chronic wounds

- Diabetic foot syndrome
- Pressure sores
- Lower leg ulcer

Problem Wounds

Are defined as wounds due to a specific cause that therefore require a specific form of therapy

- Decollement injuries
- Extravasation injuries
- Scars
- Osteomyelitis (Sternum, Limb…)
- Radiation (actinic) damage
- Calciphylaxis

Tumor Wounds

The adequate care is important for the overall quality of life

- Defects from the tumor itself (exulceration, tumor necrosis)
- Extravasation of chemotherapy
- Defects after radiation therapy (radiation/actinic damage)