Dr. Marouk performs several cosmetic surgery procedures on the body such as liposuction of the tummy, arms, butt and hips. He is also performs the tummy tuck, calf augmentation, thigh lift, body lift, and butt lift.
Liposuction is one of the most common procedures used by cosmetic surgeons to sculpt the body by suctioning unwanted fat from specific areas through a surgical tool called a cannula. It’s effective and versatile in that it can be used to enhance many different parts of the body.
Most Common Areas of Liposuction Treatment
- Bra bulge
- Gynacomastic (Chest)
The best candidates for liposuction are normal-weight people with firm, elastic skin who have pockets of excess fat in certain areas. They should be physically and mentally healthy with realistic expectations. Although age is not a major consideration, older patients tend to have diminished skin elasticity and may not realize the same results as younger patients. Liposuction is not a recommended treatment for obesity.
Liposuction is a procedure in which a narrow tube or canal is inserted through a tiny incision and used to vacuum out localized deposits of fat leading to a re-contouring in the area of focus.
The time required to perform liposuction may vary considerably, depending on the size of the area, the amount of fat being removed, the type of anesthesia and the technique used. Dr. Marouk most commonly uses the Super-Wet technique. Fluid, a mixture of intravenous salt solution, Lidocaine (local anesthetic) and Epinephrine (drug that contracts blood vessels), is injected into the tissue before liposuction to support fat removal, reduce blood loss and provide anesthesia during and after surgery. Fluid injection also helps to reduce the amount of bruising after surgery.
Usually the amount of fluid injected is equal to the amount of fat to be removed. This technique often requires intravenous sedation or general anesthesia and typically takes one to two hours of surgery time. Small areas may be done under local anesthesia only. Liposuction is normally safe. Though they are rare, complications can and do occur. Risks increase if a greater number of areas are treated at the same time, or if the operation sites are larger in size. Removal of a large amount of fat and fluid may require longer operating times than may be required for smaller operations.
Although recovery times vary from patient to patient, pain medication is usually required for the first several days – appropriate should be taken. Patients are encouraged to resume moderate activities such as stationary bike and waking after about a week.
The scars from Liposuction are small and strategically placed to be hidden from view. However, imperfections in the final appearance are not uncommon after liposuction. The skin surface may be irregular, asymmetric or even baggy, especially in the older patient. Numbness and pigmentation changes may occur.
Although most patients notice a difference in the shape of their body soon after surgery, improvements become even more apparent after four to six weeks, when most swelling subsides. After about three months, any residual swelling usually disappears revealing the final contours.
The new shape created by Liposuction remains with the patient under reasonable maintenance of weight through diet and exercise. The normal aging process, however, can still effect changes in body shape.
Commonly referred to as a Tummy Tuck, Abdominoplasty is a major surgical procedure that removes excess skin and fat from the middle and lower abdomen as well as tightens the muscles of the abdominal wall. The procedure can dramatically reduce the appearance of a protruding abdomen.
The best candidates for Abdominoplasty are men and women who are in relatively good shape, but are unable to get rid of large fat deposit or loose abdominal skin through diet or exercise. The surgery is especially useful to women who, through multiple pregnancies, have stretched their abdominal muscles and skin beyond the point where they can return to normal without surgical assistance. Loss of skin elasticity in older patients as a result of slight obesity may also be improved through the skillful application of Abdominoplasty.
Patients who intend to lose a substantial amount of weight should postpone the surgery; along with, those who plan to have more children.
Most-commonly, the surgeon will make a long incision from hipbone to hipbone, just above the pubic area. A second incision is made to free the navel from surrounding tissue. With a partial Abdominoplasty, the incision is much shorter and the navel may not need to be moved.
Next, the surgeon separates the skin from the abdominal wall all the way up to the ribs to reveal the vertical muscles of the abdomen. These muscles are tightened by pulling them close together and stitching them into their new tighter position. This provides a firmer abdominal wall and narrows the waistline.
The skin is then stretched down and the extra skin is removed. A new hole is cut for the navel and then stitched in place. Finally, the incisions will be stitched. Dressings will be applied, and a temporary tube may be inserted to drain the excess fluid from the surgical site.
The procedure does produce a permanent scar, which, depending on the extent of the original problem and the surgery required to correct it, can extent from hip to hip. Post-operative complications such as infection and blood clots are rare but do occur. Infection can be treated with drainage and antibiotics. Blood clots can be minimized by resuming an active lifestyle as soon after the surgery as possible.
Tummy Tuck Recovery
For the first few days, the abdomen will likely be swollen and pain and discomfort will need to be controlled with medication. Depending on the extent of the surgery, patients may be released within a few hours following their surgery. In general, stitches will dissolve without the need to be removed, and the drain tubes will be removed about one week after the surgery.
It may take up to two months to feel back to normal, and those who start out with strong abdominal muscles tend to recover from Abdominoplasty much faster. Some people return to work after two weeks, while others take three or four weeks to rest and recuperate.
Many men and women are dissatisfied with the shape or size of their calf muscles to the point that they avoid wearing garments that expose their legs. Even intensive exercise may not significantly enlarge the calf muscles, particularly in relation to one’s larger thigh muscles. Calf implants can also be used to correct deformities resulting from injury or nerve disease that result in muscle deterioration.
Calf augmentation, or calf implants, is a surgical procedure that uses soft, solid silicone implants to increase the size and enhance the shape of the calves. Reasons for calf augmentation are verified and include cosmetic enhancement and reconstructive necessity. Body builders often use calf augmentation to enhance the fullness, shape and bulk of the calf muscles when exercise falls short on further development. Others choose calf implants to improve proportions, definitions and curves of the lower legs for simple muscular enhancement or to correct the appearance of thin and/or bowed legs.
Calf augmentation with implants uses an incision placed in the natural crease behind the knee that generally heals in an inconspicuous manner over time. A critical element in determining the right size and shape is based on the skill of the surgeon who can assess the proportions correctly, and properly sculpt and place the implant, thereby anticipating any changes after surgery.
It is important to make the pocket just large enough to accommodate the implant to avoid post-operative displacement. The implant is then carefully inserted into this space to insure the implant lies correctly. The same procedure is followed for the additional implant(s). The fascia and skin are closed with dissolving sutures, which are placed under the surface of the skin. Surgery usually takes one to two hours, depending on placement of three or four implants.
Calf Augmentation Recovery
The long-term recovery phase begins two to three weeks after surgery that more normal walking and non-stenuous activities usually start. Strenuous activity such as bicycling, jogging and leg exercises must be avoided for eight weeks to allow more complete healing around the implant, which prevents shifting and displacement. Complete healing takes time and patience; taking up to one year, Follow up appointments will be scheduled periodically up to one year post-operatively, and annually thereafter.
Thigh Lift cosmetic surgery helps to tighten the skin of the thigh, hip and/or buttocks as well as reduce sagging in those areas. It can also be performed in conjunction with other procedures such as body lifts and buttocks lifts.
In a situation where a patient has excess fatty deposits in the thigh area, Liposuction might be employed to first remove as much fat tissue as possible. If after recovery, the skin around the thigh area still sags, a thigh lift is recommended to tighten and contour the area. The procedure tends to produce particularly good results for those who have recently lost a significant amount of weight, and it can also decrease irregularities in the skin surface.
Thigh Lift Recovery
Swelling will be present for up to 3-4 months but a dramatic difference is seen at 7 to 10 days after surgery. Any bruising may take 3-4 weeks to disappear. It will take one week to 10 days to return to work and approximately one month to resume strenuous exercising. The sutures are mostly internal but any external sutures will be removed around 10 days. The final scar will not be fully mature until one to two years after the surgery.
An arm lift, also known as Bracioplasty, is a surgical procedure to remove loose and excess fat deposits in the upper arm. With age, upper arm skin can become loose and flabby. In some cases Liposuction, used in conjunction with an arm lift, helps to remove excess fat making an arm lift even more effective.
The procedure is very common and appropriate for patients who have lost a large amount of weight. In these cases the skin tends to remain loose, instead of snapping back into shape around the now smaller arm. And when these sagging areas don’t respond to diet and exercise, an arm lift may be the best way to remedy the situation.
The length and location of the incisions depend on the amount of extra skin. The fatty tissue is removed and the sagging skin is trimmed. Then the skin is sutured into place leaving smooth appearance when stretched over the arm that is now devoid of excess fat.
Arm Lift Recovery
TED Hose (tight compression socks) will be placed on the arms to help reduce swelling and provide support. No heavy lifting or straining for three weeks. Patients may shower the next day after the follow-up appointment with Dr. Marouk. Patients generally return to work in four to five days.
As with any procedure, patients can expect to experience some swelling, bruising, pain and discomfort which can be managed by regularly taking pain medication, along with other practices that Dr. Marouk will recommend. As the swelling begins to subside after 2-3 weeks, most patients resume work; however, patient should still avoid strenuous exercise and heavy lifting for another couple weeks.
As the years go by, a person’s mid-section, including the abdomen, thighs, buttocks and hips, may begin to accumulate excess fat causing the surrounding skin to stretch, lose its elasticity and sag accordingly. To surgically address this reality, Dr. Marouk employs a technique known as Lipectomy to remove the excess fat and restore the sagging skin to a tighter, more youthful state.
In some cases Liposuction is used to remove the excess fat and in others, the patient loses the fat through diet and exercise. Either way, they are still left with sagging skin that, due to a loss in elasticity, fails to snap back into shape around the now smaller area that it covers.
Although the exact protocol varies with each patient, depending on desired outcome and body type, generally, the body-lift procedure calls for an incision along the upper and/or inner thigh, to the waistline. In more aggressive cases, the incision circles completely around the waist and lower back.
After the excess skin and underlying fat is removed, the skin is sutured into a tighter position. The procedure can last anywhere from 3 to 7 hours under general anesthesia. As an extension of the full tummy tuck, the incision goes completely around the body lifting the skin from the underlying tissues.
Mid Body Lift Recovery
Sleeping propped up tends to provide patients with the most comfort at night, with prescription pain medication helping to minimize any residual discomfort. Patients return the day after surgery to remove all bandages and the abdominal binder is replaced to help control swelling and give support to the abdomen. Patients are providing with instructions regarding the drains on each side of hip bone area. Walking around the house to aide circulation is highly recommended. The sooner one stands straight up and without fear of “pulling or hurting something” the faster healing process begins. Most patients are comfortable talking two weeks off for a mid body lift.
A labiaplasty (or labial reduction) is the most common vaginal surgery women receive. The procedure reduces the labial tissues (size and shape) giving a more symmetrical appearance. The most common cause of labial enlargement is multiple child birth, particularly if the babies were larger. Labial enlargement may also occur with age and to a lessor extent may be hereditary.
There are several reasons many women choose to have a labiaplasty (or labial reduction). These may include pain or chafing during sexual relations or physical activity such as sports. Others may feel self conscious when wearing tight fitting clothing or swimsuits, or just want to improve their appearance.
Labiaplasty is a relatively short procedure, usually taking 60 to 90 minutes. It may be performed under local anesthetic or local anesthetic with sedation. The labia are first marked in order to determine the size and shape desired by the patient. Once the desired anesthetic effect is achieved, special surgical instruments are used to remove the tissue precisely as marked.
Usually there is no bleeding at the time of surgery. Extremely small dissolvable sutures are placed, which dissolve in 8-10 days. These sutures are placed in such a manner that no visible scar is apparent. The patient is discharged to home and should be pain free for 2 – 3 hours. A mild antibiotic will be prescribed as well as medication for pain and swelling.
A cool pack to the groin area will help with the initial swelling and discomfort. This is in addition to prescribed pain and anti inflammatory medicines. Patients are seen the day after surgery and the site is cleaned. Showering may begin the day after surgery with an antibacterial soap. Patients are also encouraged to wear loose fitting clothing for the first 2 – 3 weeks. The time off from work is usually 3 days, however it may be longer if work involves strong physical activity.
Normal activity is usually achieved in 10 – 14 days. More strenuous activity such as bicycling and horseback riding is allowed after 6 weeks. Secual activity may occur after 3 weeks.