Gynecomastia, male chest reduction, gland excision, VASER liposuction

Many of my male patients have some form of male breast enlargement.  Not all decide to have that area treated as it does not bother them that much.  However, the patients that seek to have treatment for this particular area frequently ask about the other options available.  If they dont ask it is part of my consultation process to inform them of the other options available that are suitable.
In this day and age most patients opt for the non or minimally invasive procedures as they carry less risk and the down-time is less and recovery is faster.
In some cases though it is not appropriate to perform the non-invasive techniques and the surgical ones are more indicated.  It is then also imperative to inform the patients of the associated risks with the surgical options.  Although you may get a better result, you may also put yourself at more risk in terms of complications and side-effects.  It is thus important to balance the risk to benefit ratio.

We want exactly the opposite of what is depicted in this image.
If the wrong technique is used then the risk of adverse outcome is also higher.




The options are really 1. doing nothing 2. weight loss and losing some fat deposit in the area (if the bulk is glandular tissue then weight loss will not help at all) 3. traditional liposuction 4. VASER tumescent liposuction 5. Micro-cannula tumescent liposuction 6. surgical excision

Any of these can of course also be combined.  The most conservative is obviously 1. and 2. These may certainly not be an option if the situation is causing distress, clothing limitations and self consciousness.
Patients coming to us will have started doing some research on the various techniques available and generally come with some idea of what may be required.

3. is old style technique and usually performed under general anesthesia (completely asleep).  It has its limitations and works well if there is mainly fatty tissue and little breast gland.

4. targets the gland and the fat and can be performed under local anesthesia (only the treatment area is numbed)

5. targets the gland and the fat - suitable with smaller amounts of bulk.

6. suitable for large gland excision and  often skin excision in combination.  This is always performed under general anesthesia (completely asleep).  It comes with a variety of different risk factors and longer recovery period.

The important factor is that not too much of the tissue is removed and leaves fibrotic scar tissue that is visible when the chest muscle contracts.  This may leave you with an indented nipple or nipple that gets sucked in when you contract your chest muscles (see pictures below)

These are patients that have presented to me after surgical excision that have had too much removed.  The scar tissue attached to the underlying muscle now causes the nipple to get sucked in when contracting the chest muscles.
Hence I always leave some tissue behind which can be felt as a small disc of hard tissue just behind the nipple complex.

Seen on the left is a common male chest diagram with representation of enlargement of the gland component (right).  This may appear in  various degrees - some having more fat or some having more gland.  We obviously want to remove as much as possible, but also prevent the nipple retraction.





                                                         www.DrWolf.com

Lipoedema treatment - tumescent liposuction, VASER

I was fortunate enough to attend the Lipoedema conference on the 24th June in Reading this year.  It was well attended and very informative for networking and sharing experiences with other professionals.
It was re-iterated that not much information was available for patients with the condition and still many GP are misdiagnosing the condition as obesity.  The training course offered by Lipoedema.co.uk has however had overwhelming response from GPs in getting the word out.
Many GP are now recognizing the condition and referring patients in the right direction.
Some interesting data were produced by a German clinic on the success of tumescent liposuction including VASER and the treatment of Lipoedema.  It remains the only real way of preventing the condition from worsening especially when caught in the early stages (stage I or II).
Stage III requires more interventional treatments such as skin excision and reconstruction.
The key is to diagnose it in the early stages and manage it appropriately.  This includes MLD and wearing hosiery.

www.Lipoedema.co.uk
www.MLDuk.org.uk
http://www.lipedema-simplified.org
Henrietta@MLDLondon.co.uk

VASER 360 degree legs (circumferential)

We have had a resurgence of requests for the circumferential treatment of legs/ thighs.  Our success rate has been really good.
With the majority of patients also having mild lipoedema we always work hand in hand with MLD therapists.
Some of the excellent practitioners we refer to are Henrietta Cassar from MLDLondon , Julie Bradford and Petra Erving, Kimberley Harrington, Helen Fox
It really is vital to find a good therapist that will see you through the recovery period.

Obviously the more fatty deposit there is the more impressive the results will be.  We can however also make smaller thighs look more shapely by making them more proportionate.

The important factor is the skin texture and elasticity.  If this is not ideal then any removal of tissue may result in loss of skin turgor and resultant laxity.  Then one would need to consider a thigh-lift which is more complex and involves excising skin and pulling the remaining tissue tighter by stitching it back together. 
We would certainly recommend this option if the VASER liposuction is not suitable.
In all cases it is important to maintain realistic expectations.  We are not magicians and cannot create something out of nothing.......
In most cases we can create something more shapely that will fit much more comfortably in clothes especially around the hips and thighs.

The healing process after Vaser lipo or Micro lipo

The healing process can take varying amounts of time. As each person has their own genetic make-up, lifestyle, diet and exercise routine the recovery pathway in each case is different.

Hence it is difficult to give concise time frames. On the whole though it would take 5-6 months. Even after that the last 10-15% of healing is not visualised externally.  This all takes place under the skin and is microscopic. Occasionally one may have certain sensations such as itchiness, pulling sensation, electric shock type sensation, hypersensitivity or even mild lumps that appear and disappear.

Every person is different and that is normal.

If you have any concerns it is best to see your treating doctor.

Exercise after VASER lipo and Microlipo

After your surgical procedure you will need to let your body rest and recover.  In addition your nutrition will need to be balanced to help with the healing process.
Most patients who are active prior to the procedure get really itchy feet in the first week or two after the procedure as they feel lethargic and get the unfit feeling.

Stretching is very important every single day.  You want to get your body out of its comfort zone and break up the scar tissue.  Try touch your toes, flex to the right and the left and try and touch your knees.  If you feel any "knots" massage them with firm pressure.  These may come and go.  The more you stretch and massage the quicker the lumps and knots will disappear.  Remember that you will also feel numerous types of sensation - itchiness, hypersensitivity, numbness - all these are normal and indicate that the healing process is progressing.

Exercises you can start doing immediately after the procedure are hill walking and treadmill low impact, high incline walking.  You will prefer not to do any impact work such as running or jogging.  You can also go swimming after all the incision points have healed - generally a week after the procedure.

Obviously areas that have not been treated can be exercised with caution and if it feels comfortable then continue and build up the levels.  Your body will remind you what can what cant, or should not be done.
If any doubt just speak to your Doc.

I find it really helpful wearing a heart rate monitor as this can give you an idea of how many calories you are burning.  There are various types on the market.  Best to get one that determines the calories from the heart rate.  Ideally you want to get to heart rate ranges of 160bpm.  If you can sustain this for 40 seconds and then have a 10s rest and repeat the process about 4 times, would be good.  Your fitness levels will soon improve.

After 4 weeks you should be able to get back into a fairly normal routine.  Build it up slowly.   Don't jump straight into "Insanity".  Use a week to get back up to speed.

Nutrition after VASER or Microlipo

After having VASER or Microlipo its important to give your body enough energy and strength to fast-track the healing process.  It also helps in strengthening your immune system to fight any infection.

Obviously a well balanced diet is important - this will include vitamins, minerals, fibre, protein, carbohydrates and fat - Yes FAT.
Minerals - Zinc and Iron are important in the healing process and also forming new red blood cells as you will most likely lose a bit of blood. Foods rich in these are red meat, green leavy veg, broccoli and seafood.
Vitamins can be gained from veg or fruit as a daily intake.  Some may be taking vitamin supps which is also ok.


Fibre - in many cases after surgery you will be taking pain relief tabs which can cause constipation.  Drink plenty of fluid - not tea and coffee as this will dehydrate you even more.
Drink at least 1.5 litres of water.  You may be leaking from incision wounds and this needs to be replenished.  Make sure your urine is always very light in colour and that will give you a good idea of your hydration.


Protein - For your body to heal it requires lots of protein, amino acids etc. to manufacture the building blocks of regenerative tissue and scar tissue.  Foods rich in protein for example are chicken, tuna, seafood, nuts, eggs, tofu and certain dairy products.  In addition protein shakes can also be used.

Fats - from nuts, avocado, coconut and olive oil are the best and are required for absorption of certain vitamins and foods.  They also act as a supply of energy.


Carbs - Lots of energy is required during the recovery phase. Carbs in the form of veg, fruit, whole grain (NOT whole wheat) should be taken.  Avoid white bread, pasta, rice and potatoes.  If you crave potatoes then try sweet potato.

As you are most likely not in full exercise routine its best to limit your white refined carbs such as white sugar, fizzy drinks, sweets, chocolate etc.  These will only stimulate your insulin levels and result in fat storage rather than breakdown.

Central fat is worse than being fat all over

Scientists have now determined that central or visceral fat is more unhealthy than being fat all over.  See this article
Although this is nothing new there is a little more scientific evidence on the topic now.  We have always known that central fat is more harmful, but there has never been much evidence.  Clever Docs at the Mayo Clinic have now found out that the risk of early death is far higher when having a "belly" than being generally obese.  Now, this does not mean that its ok to be obese.  Central obesity is often associated with metabolic disease or syndromes and thus carries with it relatively more risk of early death.
It shows thus that it is important where you carry your fat.  Visceral is also rather difficult to target.  It only responds to exercise and dietary change.  Lipo is not an option here......

Expectations after Lipo

The challenge for any medical practitioner in the aesthetics industry is to make an accurate assessment with regards to the suitability of a patient.  After thorough medical history taking and short psychological profiling the mainstay of suitability is not only physical examination, but also what the expectations are.
Every patient needs to be seen as a new canvass and no two patients can be compared. The variables of any patient pathway is different to the next patients'.
The human body is complex structure and thus we can broadly describe a recovery processes, however, each individual will have his/her unique recovery path.  Thus we can only give guidelines and estimate time scales, or give broad time frame ranges.
Expectations need to be very realistic.  We as Doctors are not magicians and are governed and restricted by anatomical features and physiological processes that we have no hold over.
Yes we can improve features, yes we can subtly change shapes or alter contours - there are however limitations.

If you are striving for perfection then having aesthetic/cosmetic surgery or treatments is not the right solution.  You need to have very realistic expectations.
If anyone promises you perfection or picture perfect results you should also be alarmed.

Realistic results will include slight imperfections and slight asymmetries.
The human body is not a perfect symmetrical structure and anything the resembles that is most likely photoshopped or fake.......

Fat Freezing, 3D lipo, Strawberry lipo......VASER lipo

I often see patients that have tried numerous other promising techniques to reduce some stubborn areas of fat before they end up in my consulting rooms. These range from fat freezing, infra-red, ultrasound, external laser therapy etc. Don't get me wrong - these can have a purpose in treating certain small pockets. However, in the majority of cases the areas are substantial and often require some form of contouring too. Remember that shrinking the respective areas is not always enough and that sometime one needs to create some shape too. In this instance the external devices and techniques are not really useful. The only method that really is suitable is some form of aspiration or suction. Most of the external devices rely on the immune system to remove the injured or damaged tissue and this subsequently can take 6-12 months before one sees any changes. This often results in demotivation and patients will often fall into their same routine lifestyle with no change in diet and exercise routine. Occasionally patients will deny having had any intervention such as external treatments. They may also have forgotten as it was long ago or they didn't really see it as a treatment as it was not successful. I will notice this in the texture of the tissue when I commence my VASER treatment as the fat layer is very fibrous and scarred. This can make the VASER treatment more technical and also the results a little less predictable. Essentially, if you are considering external treatments for larger areas, then understand that these will cause significant scar-tissue under the skin (not visible) and make any subsequent treatments a little less successful. The risk of irregularities and dimples is also more likely. Best research all the treatments and go for consultations for all the treatments so you are well informed....

2 hour surgery time slots are a No,No - alarm bells should ring

I've had a few patients see me recently for a consultations for various treatments that have had consultations at other clinics.
A common question I get asked is how many 2 hours slots will be required, or if we work in other time limited surgery slots.
I am amazed that doctors actually try and work and perform treatments limited to time slots.
A procedure should be performed to its completion regardless of how long it takes.  If the doctor is limited by time then there is a good chance that the procedure is either rushed or incomplete.  This will results in poor results or complications.
Remember that you are not paying for the time, but for the complete procedure and result.  The doctor should not be limited by a 2 hour time slot.

I thus advise that any clinic that performs surgery in limited time slots should be avoided.

Have a look at my YouTube channel DrWolf.com for some really informative videos.

VASER, traditional liposuction and MLD

In my practise I see many patients that do their homework and attend 1-3 consultations to gather information on treatments.  It gives the patient the opportunity to get to know the doctor and determine whether they like/get on with them.
Remember that having any cosmetic procedure means you are going to have a patient-Dr relationship for 6-12 months, if not more.  You need to "like" your doctor....!!
Seeing more than one doctor also allows you to gather more information about procedures and appreciate different approaches of doctors.
Its much more likely that you will all your questions answered by seeing more than one doctor.
I often get asked why some doctors are still practicing traditional liposuction and have not converted to VASER.  The answer to this is multifactorial - some patients still warrant having traditional liposuction for massive bulk reduction.  When removing large volumes (5 litres upwards) it is advisable to stay overnight to monitor your fluid balances.
Some doctors prefer to stick with what they know works; others are not keen to progress on to newer treatments.  The machines are very expensive and not every doctor can afford to purchase these machines.

Over the years the progress that has been made in terms of aftercare has been phenomenal.  I still battle to understand though why old-school surgeons have not adopted the train of thought that MLD post-op is firstly very effective to reduce swelling, secondly, expedite recovery, thirdly, reduce bruising, fourthly, reduce the incidence of irregularities and lastly, also afford a continuity of care.
I work hand in hand with many MLD practitioners and many of them are now well experienced in treating post-op VASER patients.  Reassuringly, many comment on how much faster VASER patients recover compared to traditional liposuction patients.

see below a video

Come see our website www.DrWolf.com 

Lipoedema, lipedema

Once again I have seen numerous patients in the last few weeks that have mild to moderate cases of lipoedema and have been seen by several GP's and plastic surgeons who fail to recognise the condition.
This is very frustrating for patients as they are continuously asked to lose weight.  LIPOEDEMA does not respond to dietary weight loss or exercise.

Patients find it such a relief when they are told of the condition and informed on what they have and why they themselves cannot change their shape.  They find it a relief that they have not failed in attempting to change their body-shape, but that they have this condition which prevents this.

I can only hope that the awareness and acceptance of Lipoedema improves in the medical circles.

Some help forums -
www.Lipoedemaladies.com      Facebook - Lipoedema ladies webpage
www.Lipoedema.co.uk

 I cannot strongly recommend you do as much research as possible and also get in contact with a MLD therapist in your area   www.MLDuk.org.uk





Below is a video of one of the options to improve the appearance of Lipoedema

Come see our website www.DrWolf.com 

Recovery - VASER male chest reduction

Once you are the road to recovery you will notice that the chest will feel a little firm, the tissue will feel spongy.  This is completely normal.

Occasionally patients will experience various types of sensation:
1. Itchiness
2. Hypersensitivity of the nipple
3. Numbness of the skin
4. Tingling sensation

These are all normal parts of the healing process and indicate that healing is still taking place.  Remember that you may experience these on both sides or only on one side, or at different time intervals.  This is normal.

With progress you will notice some small nodules (almost like a "string of pearls") on the margin of your pectoral muscle especially when you stretch your arm upwards like reaching for the stars.  This is completely normal again.
I recommend that you stretch regularly (2-3 times a day) and massage these areas very firmly and they will soften up.  MLD helps tremendously for this.
The other action I recommend is to hang off the door frame suspending your weight partially and with the other hand massage the "string of pearls".  Within a few days this will soften up.

Remember that none of these times frames are exact and every person will heal at a different pace.

Have a look at my YoutTube channel DrWolf.com for some informative videos on the procedure and recovery.....

Male chest reduction - gynecomastia

Many guys find this is a real issue.  Often they are very apprehensive about looking into treatments, and find it embarrassing asking what can be done about it.
The good thing is that there is a solution, and one which is very effective and fairly straight forward in terms of procedure and recovery.
The majority of males will have a certain amount of muscle, fat and glandular component forming the chest prominence.  When you tighten your pec muscles - everything you can pinch in between your fingers that is mobile is generally something that can potentially be removed.
In many cases we have asymmetrical bulk which means that one side is slightly larger than the other - this is normal anatomical variation.  The human body is not a symmetrical structure.

There are various options to reduce the chest bulk:
1. Traditional liposuction
2. Surgical excision
3. VASER Liposuction

1+2 have been around for many years and are still appropriate for the right candidates- usually when there is large amount of excess gland and excess skin.
For the moderate gynecomastia patient VASER is a perfect alternative.

The procedure is performed under local anaesthesia (awake) and takes approximately 1.5 hrs.  You can go home straight away. I recommend wearing a compression vest for 2 weeks to minimise swelling and bruising.  Majority of patients will only require painkillers for 24hrs.

Come see our website www.DrWolf.com 

Hyperhidrosis - excessive sweating

Excessive sweating of the underarms or palms of the hands can be a terribly embarrassing condition.  Many patients will find that their social life suffers due to this.
Unfortunately many also done realise that this condition can be treated very successfully with Botox.
There are certainly also other treatment modalities available, although these can be more invasive.

Mechanism of action
Botox has an affinity for the receptors of the sweat gland.  Once it attaches to these receptors the nerve impulse that stimulates sweating is blocked. The hand and armpit this remain dry.

Majority of patients will choose to have the underarm treatment at the beginning of spring.
The palm treatment so common throughout the year as it is not so season dependent.
The effect of the treatment lasts about 6-9 months, but can vary in patients. 

Treatment
I generally use topical anesthetic cream, but one can also use nerve blocks for the palm.  This stays on for about 45min.  This depends on the threshold of the patient.
For the underarm (axilla) I dont use anaesthesia as it is well tolerated without.
The treatment takes about 15min.  The effect will be noticed at about day 4 and will reach its maximum intensity at about 2 weeks.

Iodine test
This test can be performed to confirm the exact area of sweating.  I don't routinely undertake this.

This treatment changes peoples lives as they can resume normal social activities without feeling self-conscious or embarrassed.
Some have said that "its the best thing they have ever had done......."

Non-surgical Facelift -Thread lift, Suture Lift facial rejuvenation

On my consultation days I see many patients that come in for facial rejuvenation advice.
Granted, many come for Botox, fillers, lasers and IPL rejuvenation.
There is, however, the group of patients that are not interested in those sort of treatments, but sit in front of me and move certain parts of their face to a position it once was.  They tell me that they are not interested in a FACELIFT, but would like something of the sort that takes a few years off your perceived age.
I think we've all done that in front of the mirror- elevating the hair just above your ear to remove the nasolabial lines and jowls. This can have a very dramatic, although, subtle effect.

Threadlifts have been around for years and basically involve thin threads that are placed under the skin and anchor or reposition certain parts of your face.

We can split the face into zones - upper, mid and lower face and neck
Upper - brow and temple
Mid - cheeks
Lower - jowls and jaw line
Neck

As we age we typically lose volume as some of the fat in our deeper skin layer atrophies.  This can leave us looking fairly gaunt.  Signs of this are loss of cheek volume, temple volume and sunken eyes.
Unfortunately our elastin fibres also deteriorate and thus we get the sagging of skin with the effect of gravity.
Our cheeks drop leaving us with nasolabial lines, and jowls will form on the jawline leaving us with marionette lines.  The aim is thus to reposition these areas to their original position.

So, by placing some thin threads into positions that lift the areas that have dropped we can give the face a rejuvenated look which makes you look fresher.

The procedure is performed under local aneasthetic and everything is done through tiny needle holes thus leaving you with no scars.
The threads eventually dissolve over a period of 18-24 months.
I often perform this in combination with something called Serdev suture lifts which are a little stronger.  These are also performed under local anesthetic and through tiny puncture holes.
The majority of patients will have no bruising and may require some pain relief for the pulling sensation experienced.
It is important to treat your face very gently over the first 4 weeks to prevent the threads from losing their hold.

VASER post op aftercare

I get asked time and again about the aftercare following a VASER procedure.  I thought it was thus time to write something about it.  Ideally you should be reading this before the procedure so you know what to expect.

The recovery period is the most important part besides the actual procedure itself.  Although I go through the aftercare at the consultation period and again immediately after the procedure, I suppose it cant be stressed enough.  In most cases it is your first procedure and you are not really sure what to expect.  Every patient will also retain and remember different points of the conversation.
I have actually made a video on this topic this passed weekend and hopefully, once edited, will add this to the post.
Immediately after the procedure you will be really padded up to absorb all the leakage.  This will stay in place for the first 24hours.
If there is any leakage beyond the padding then its just necessary to add some more.

DO NOT REMOVE THE GARMENT in the first 24 hours.

I advise my patients to make sure they sleep on old towels and mattress protectors- this will prevent soiling of your bedlinen in case there is some leakage while you are sleeping.
We generally give you ample padding to take home, but it is worthwhile to have some more sanitary towel available.

The following morning I insist that you prepare for a shower.  In preparation to remove the garment I advise that you lie on the bed or on the floor.  Slowly open the clasps and remain in that position for a few minutes.  This allows your blood pressure to normalise and prevent you from fainting and injuring yourself.
Remove all the soaked padding and discard it.  Keep some gauze at hand so that any drips don't soil your carpet.  Get yourself into the shower and have a gentle wash.  Try not to rub any soap into the access points.
Once done, gently pat yourself dry.  You may notice some leaking from the lower access points (pink stained fluid) which is normal.  It is best to resume the lying position again.  Place some small padding (size of the palm of your hand) onto the access points and close the garment again.  During the day it will be necessary to replace the padding.  The is will vary between patients, but a guide is really just when it gets soaked then replace it.

During the following days you will notice that the leakage will reduce to just a trickle and thus you can reduce the padding and the number of times it will need replacing.

Remain vigilant and keep a close eye on the access points.  If you are worried, best to just call your treating surgeon for some advice.

READ THIS AGAIN so you know what to expect.

Have a look at this video for further clarification.....

CELLULITE update - long awaited.........

Apologies for the long delay and absence....
Since the last post we have had a little boy - 7 weeks old now and he has taken priority...

I will get my typing fingers out again and make this a regular occurance.

If you look back at one of my last posts about CELLULITE then you will remember that I was looking into a new anti-CELLULITE treatment.
I can gladly report that I have now performed a few of these treatments and they are very encouraging.  It is still early days but the dimples have remained absent.  I intend to perform a few more on "models" to assess the consistence of the treatment.  I want to make sure that every treatment results in some success before launching this.

I will keep you updated on progress and make an announcement when I'm happy that this is a successful treatment.

Here is a taster.....

Scar treatment post VASER (for incision points)

In most cases the tiny incision points will heal very well and remain pink for a couple of months post-procedure.
I try and place my VASER access points in fairly inconspicuous areas so they are not that obvious.  Unfortunately some areas that I treat require incisions that are a little more visible.  The placement of the incision points is something you need to discuss with your surgeon beforehand if this if going to be of concern to you.

Points to remember are that they may become:
1.  Keloid- slightly raised and bulky (more common on the chest and back in individuals of darker skin colour)

2. Hypertrophied - slightly stretched.

3. Underlying fibrotic tissue - the underlying tissue feels a little lumpy - this usually resolves with time.
4. Hyperpigmentation - the scar becomes slightly darker compared to the surrounding skin

5. Scar retraction - the scar becomes a little indented


What can you do to prevent this?
Unfortunately genetics play an important role in this and if your skin has those specific qualities then there is not much one can do to prevent this.  Make sure there is not too much tension on the scar (this prevents hypertrophy).
Keloids can be treated with low does steroid injection to flatten them out.

Use bio-oil or even better, a Silicon gel.  There are various types available and they are non-prescription.  Apply the gel 2-3 times a day for about 2-3 months and you will see a vast improvement of the scar.

PRP - Platelet Rich Plasma

This topic has been making the rounds on the cosmetic and aesthetic circuit.  Its an exciting newish treatment for skin rejuvenation and also complementary for fat transfer.

PRP - platelet rich plasma - also known as Vampire Facelift, or Dracula lift - uses your own blood to rejuvenate your skin.  It also achieves slight volumisation and gives the skin a fresher look.
I use the  Tropocells™ (Estar Medical) kit as it has a filter in it which ensures purity of any unwanted matter.

What is involved?
10 ml of blood is withdrawn from your arm -similar to having a blood test.  The sample is then centrifuged and this separates the red blood cells from the platelets and plasma.  The latter is the "good stuff".  This plasma is then injected into the superficial part of the skin most commonly in the cheeks, lower lid, around the mouth and naso-labial folds.  It can also be used on the forehead and temples.

How does it work?
When platelets are activated they release many types of growth factors.  These substances start a cascade of many processes.  Fibroblasts are recruited to manufacture collagen.  Vessel growth factors manufacture more tiny blood vessels.  Keratinocyte growth factor stimulates healing, skin cell proliferation and tissue remodeling.
Its evident that all these processes are useful in creating a rejuvenated skin texture.

What is the recovery period like?
A mild stinging sensation is felt during the treatment.  Initially the skin looks sun-burnt for the first 12 hours.  Occasional bruising occurs. The next day the skin should look slightly red, but otherwise back to normal.

How safe is PRP?
The beauty is that it is all your own tissue.  Therefore you cannot have an allergic reaction to the treatment.  Adverse effects are related to the injection procedure itself and not to the PRP content of the injection. 

How many sessions are required?
Usually 3 sessions 6 weeks apart and then top up treatments every year. 

Come see our website www.DrWolf.com