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.....
Tuesday, 8 July 2014
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.
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
Tuesday, 24 June 2014
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......."
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.
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.....
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.....
Tuesday, 11 March 2014
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.....
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.....
Tuesday, 24 September 2013
Exercise after VASER, Microlipo - how often, how intense, what type?
I often get asked what type of exercise my patients should undertake, especially as most patients that I do see are fairly active, but become frustrated as they don't get to see proportionate results after putting in a decent amount of 'work' at the gym. The classical scenario is the PT instructing you to do endless sets of crunches to get rid of lower abs fat.
Doing crunches will certainly build your abs, but if you have a few kilos of fat hiding the abs then these will not be visible. It is thus imperative to get rid of this first and this means lowering your overall body fat percentage.
There have been many theories on what exercise provides the best 'fat-busting' results and there has been a significant shift in trains of thought.
Much of the scientific evidence now points to a combination of intermediate length aerobic exercise and high intensity interval training (HIIT).
Many personal trainers will promote doing 'cardio' to extremes to get rid of stubborn pockets of fat. This is largely a myth.
The long traditional aerobic workouts have less impact on fat metabolism and also on maximal oxygen consumption (VO2 max) compared to HIIT. High intensity interval training has been shown to burn fat more effectively. Partly this has to do with improving glucose tolerance and lowering insulin resistance. Compare endurance runners and 100m sprinters - the sprinters tend to have a better muscular physique.
HIIT increases the resting metabolic rate (RMR) for the following 24 hours due to excess post-exercise oxygen consumption (EPOC). After intense sessions of exercise the body goes into a state of oxygen 'deficit'. To replenish this lack and return the body back to a resting state there is an increased state of oxygen intake. Various processes take place: hormone balancing, replenishment of fuel stores, cellular repair (esp. muscle), innervation and anabolism (muscle buildup). This repair cycle is accompanied by an elevated consumption of energy. Fat stores are thus released and broken down to release fuel stores. One study result found a greater loss in subcutaneous fat.
Examples of HIIT:
- 2minutes of gentle pedaling followed by 20 seconds of intense rapid bursts at maximal effort for three sets
- 20 seconds of ultra-intense exercise followed by 10 seconds of rest, repeated continuously for 4 minutes (8 cycles)
There are numerous regimens around (Peter Coe regimen, Tabata regimen, Gibala regimen, Timmons regimen) and its best to choose one that incorporates the exercise you prefer.
So, extended sessions of cardio are useful, however, combined with HIIT one can achieve better results in a shorter space of time over fewer days a week, leaving you with more time to socialise and see family.
Doing crunches will certainly build your abs, but if you have a few kilos of fat hiding the abs then these will not be visible. It is thus imperative to get rid of this first and this means lowering your overall body fat percentage.
There have been many theories on what exercise provides the best 'fat-busting' results and there has been a significant shift in trains of thought.
Much of the scientific evidence now points to a combination of intermediate length aerobic exercise and high intensity interval training (HIIT).
Many personal trainers will promote doing 'cardio' to extremes to get rid of stubborn pockets of fat. This is largely a myth.
The long traditional aerobic workouts have less impact on fat metabolism and also on maximal oxygen consumption (VO2 max) compared to HIIT. High intensity interval training has been shown to burn fat more effectively. Partly this has to do with improving glucose tolerance and lowering insulin resistance. Compare endurance runners and 100m sprinters - the sprinters tend to have a better muscular physique.
HIIT increases the resting metabolic rate (RMR) for the following 24 hours due to excess post-exercise oxygen consumption (EPOC). After intense sessions of exercise the body goes into a state of oxygen 'deficit'. To replenish this lack and return the body back to a resting state there is an increased state of oxygen intake. Various processes take place: hormone balancing, replenishment of fuel stores, cellular repair (esp. muscle), innervation and anabolism (muscle buildup). This repair cycle is accompanied by an elevated consumption of energy. Fat stores are thus released and broken down to release fuel stores. One study result found a greater loss in subcutaneous fat.
Examples of HIIT:
- 2minutes of gentle pedaling followed by 20 seconds of intense rapid bursts at maximal effort for three sets
- 20 seconds of ultra-intense exercise followed by 10 seconds of rest, repeated continuously for 4 minutes (8 cycles)
There are numerous regimens around (Peter Coe regimen, Tabata regimen, Gibala regimen, Timmons regimen) and its best to choose one that incorporates the exercise you prefer.
So, extended sessions of cardio are useful, however, combined with HIIT one can achieve better results in a shorter space of time over fewer days a week, leaving you with more time to socialise and see family.
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