MULTIPLE AESTHETIC OPERATIONS IN ONE SESSION:

According to the patient’s state and necessity, more than one aesthetic
operation could be performed in one session. These operations could complete
each other or they could be independent from each other including various sites
of the body.

The preparations before the operations do not possess any diversities when
compared to the standard routine operations. Any medical problem that could be
inconvenient for the patient to be operated under general anesthesia should be
discarded or the problem should be dominated.

During the increased duration of the operations due to the multiple aesthetic
procedures over various sites of the body, the comfort of the patient during and
after the operation is maintained by the specialized anesthesia doctor who
utilize the most appropriate anesthesia method.

The multiple aesthetic operations to the patients, young or old, could be
performed easily without any risks, by the specialized and experienced aesthetic
surgeon with the specialized anesthesia team and the patient could return to her
normal daily activity early.

Assoc. Prof. Ömer Şensöz has undergone multiple aesthetic operations in a single
session by the specialized aesthetic surgeons who were trained by him. Eye lid (blepharoplasty),
eye brow lifting, face lifting, liposuction to the neck, fat (dermofat)
injection to the depressed areas of the face (liposculpturing), inguinal hernia,
abdominal tightening (abdominoplasty) and diastasis recti repair operations were
accomplished successfully in one session of 7 hours.

There were no problems about the vital functions and the biochemical profile
during and after the operation. No blood replacement was necessitated due to
minimal blood loss. After the operation for the first 48 hours, intense fluid
support was done and no complications were encountered.

VAGINOPLASTY (CONSTITUTION of VAGINA):

The absence or underdevelopment of the vagina is a rare malformation occuring
during the intrauterine life. The external genital organs possess normal
appereance, so the abnormality can only be recognized when the female does not
have menstruations by adolescence or during the first sexual experience.

This is why the patients attend to doctors at the age of 16-20. These patients
can not give births as they do not have uterus or ovaries either. However,
constitution of a vagina appropriate for a normal sexual activity is surgically
possible.

The new vagina is constructed at the region and of the size that is to be under
general anesthesia. The canal is daubed with a skin patch. A mould(stent) is
located inside the canal to occupy a place for 3 months and finally a vagina
appropriate for a normal sexual activity can be established.
 

ABDOMINAL TIGHTENING (ABDOMINOPLASTY):

The abdomen is one of the regions that fat is accumulated mostly, especially in
the obese people. The abdominal wall muscle gets weaker with age, labour and
inactivity and the wall loosens.

The abdomen hangs down with the accumulation of fat and weakness of the muscles.
This unaesthetic appereance can be accompanied by abdominal hernias. For the
treatment of these situations abdominal tightening(abdominoplasty) operations
are performed.

The excess skin and the fat tissue at the abdominal region are excised and the
fascia underneath the fat tissue is supported with permanent sutures so as to
make the waist thinner. The suture line is at the level of the bikini or
underwear so the minimal scar is not visible after the tighten skin is closed
according to the original (anatomical) place.

Good functional and aesthetic results are achieved by tigthening of the skin and
the muscles.The patient is discharged at the 2nd or 3rd day and is not allowed
to return to her normal life for 10 days except some restricted activities.(eg.
The patient is advised to walk in a bent-forward position).

After 10-15 days, the patient can start her normal life avoiding exertions to
the abdomen.(The patient should avoid hard works for 3 months). The sutures are
taken on the 7-12 days after the operation.
 

LIPOSUCTION:

The regions that fat tissue deposites mostly are abdomen, hips, inner thighs,
waist, the part of the neck under the chin, and armpits. The fat tissue of the
obese people increases diffusely, meanwhile depositing at these regions. The
regional increase in the fat tissue can be encountered in slim people. The
patients with regional increase or deposits of fat tissue are candidates for
liposuction.

Liposuctin is not a method of slimming but an art of sculpturing the contour of
the body by removing the regional fat tissue. After general or local anesthesia
and following 0.5cm of an incision of the skin, the fat tissue of desired amount
is aspirated with specialised high volumed injectors or with small canules under
negatice pressure. There are two major techniques: Wet and dry.

We prefer a technique, not wet, not dry but a method in between. The fat tissue
to be aspirated is distended with a moderate amount of liquid(0.5-1litre) The
estimation of the fat tissue to be aspirated is done easily as excessive
distention is avoided. The amount of the fat aspirated should not exceed 2 kg.
The aspirated fat tissue contains blood percentages of 20-30% depending on the
region operated.

At the same session, the fat aspirated can be purified and given to the
necessary regions ( deep folds, depressed areas…etc.) to correct the contour.

After the operation, thigh bandages are used for 48 hours. The patient wearing
tight socks(lycra) or corset, is discharged on the same day. The patient can
return to her normal activity on the 3rd-5th day. The patient is advised to use
a corset for 3 months. The final contour of the body is achieved with massages
starting 1 month after the operation.

The blood vessels of the fat tissue are broken down during the liposuction with
the aspirated fat tissue and the damaged fat tissue that is not aspirated is
absorbed by the body and disappears. The absorbed fat tissue is approximately
same amount as the aspirated.The slimming process will continue at the 4-6 and
9-12 months after liposuction.
 

BREAST REDUCTION:

The women who have an oversized breast problem my face some clinical figures
such as painful menstruation, bra marks on the shoulder skin, backaches, itching
due to the candidiasis like infection under the breasts,

The oversized breast problem can be overcome by using the nipple side path or by
leaving an "upside down T" mark from the nipple to the front breast side.

After draining for 48-72 hour in the post-operation period, patients are let use
their bras and go back to their daily activities.
 

BREAST AUGMENTATION:

It is the breast gland that is the most important symbol of female sexuality and
maternity. The breasts that are shaped in the teenager years may not reach the
expected size due to different reasons. In some ages, in the post-pregnancy
period or because of the reasons such as weight loss in a short time, breasts
can lose their size and volume.

If the Breast Gland is small, at its normal place, and not flabby:
This problem can be solved with the prosthesis that is placed under the space
created on the muscle which is under the breast gland. The prosthesis can be
placed with cuts that can be done from the curve under the breast, the around
areola or the armpits.

The cuts that are done around the nipples are not preferred because they leave
traces around the brown line, just like the armpit cuts because of the
inadequacy in the bleeding control. When the cut is under the breast, since the
cut will stay under the lifted breast, there will not be any significant traces
in 6 months time.

Today, the most commonly used prostheses are made of silicone. They are found in
different groups according to the surface structure (smooth or textured), the
filling of the silicone envelope which gives the volume (Silicone, saline-filled..),
the shapes (round, anatomical). Although there is a common belief that the
textured ones are more advantageous, when the progress of the capsule reaction
is considered, we are rejecting that depending on our clinical experiences.

The Capsule Reaction:
It is seen in the 12% of the cases that use breast prostheses. A thin but,
enlarging pouch appears around the prosthesis when the cumulated blood is not
drained out or if the massage (involves moving the prosthesis in the pouch) is
not applied adequately. This is called "the capsule reaction". This risk is
tried to be reduced by draining in the first 48 hours in order to avoid leaking.
These kinds of breasts show an artificial appearance, are hard and partly
painful although they appear to look proper outside. We do not recommend the
operated patients to lay facedown, however; these kinds of patients can already
not lay facedown because of their pain.

If the breast is not in enough size and is flabby:
In such cases, the above prosthesis technique is applied after lifting up the
breast. (Mastopexy)

The recent beliefs in the prostheses’ causing breast cancer or such immune
diseases are totally speculative and the silicone prostheses have no proved side
effects.

PROMINANT EAR:

Prominant ear is a deformity in which the angle between the head and the ear is
wider and some anatomical folds of the ear are straightened. It can be
encountered in both of the ears and in some instances only in one ear.

Especially the girls pretend not to put their hair together on their head
because of the ashaming appereance.When compared to the adult ear, 80% of the
ear
becomes developped when the child is at 5-6 ages old.

This is the optimum time for the operation. The region to be operated is
anesthetised locally, so the patient does not feel any pain. The cartilage of
the
ear is weakened with some surgical procedures and suturation technique is used.
These are accomplished with very small incisions. The dressing of the region
is kept closed for 3 days and a hair bandage is used for 2 weeks.

FACE LIFTING:

There are some typical changes in the human face such as flabby cheek fats,
significant lining of the cheek-lip path (nasolabial sulcus), flabby necks,
wrinkled eyes and mouth, wrinkled necks, flabby eyebrows, when the glands under
the skin lose their characteristics or change their places due to ageing and
the gravity.

The skin is cut from the temple to the hairy skin of the front of the ear, from
below the ear ladle to the back of the ear, and to the hairy skin. After the
flabby structures under the skin are replaced, the excess skin is removed and
the skin is stitched. In order to avoid leaking in the first 48-72 hours,
drains are applied. When the cut is located in the hairy skin distinction line
and in the curve in front of the ear, the post-operation traces will not be
recognisable.

The patient is let to go back to his daily activities following the 3-5 days of
dressing. Although many methods are used in face lifting, the most effective
and reliable one is SMAS plication and its being fixed to the stable points. By
this way, the complications such as flabby ears and enlarged scar traces are
avoided.

As we have stated above, during the ageing period, eyes and the middle face are
also affected. Beside the standard face lifting operation, these regions are
also to be evaluated and included in the surgical procedure when necessary. We
apply the operation to the middle of the face when the operation for the eyes
is considered. (midface lifting)

LASER RESURFACING:

The laser, that was made to be a weapon, is utilised for the humanity purposes
when its power is controlled. In various diseases of eye, brain and especially
in plastic surgery, it can be used safely with different wavelengths.

The reduction of some sort of scar tissue, the treatment of the vascular
diseases of the skin, the eradication of the unwanted hair and stain of the body
and rejuvenation of the face are some examples of the laser.

The aim of the utilisation of the laser over the face is not only to eradication
of the fine wrinkles and stain of the face that are a result of aging face, but
also rejuveniation of the connective and supportive tissue of the face. Coherent
Ultra Pulse 5000 is the safest and best model among the various models of laser
for the rejuveniation of the skin of the face.

One of the most important properties of this apparatus is to conduct constant
energy to the skin from a distance of 1 to 160 cm. Excellent results can be
achieved because of the property of peeling(ablation) of 100-150 microns(1/10 of
1 mm). The chemical and mechanical peeling techniques are still popular
especially for the deeper scars and wrinkles that could not be eradicated by
laser.

The face of the patient treated with laser, is dressed three times in the
following two days. The patient uses vaseline creams for the following period.
The pink view of the face fades away on the 10th day and the patient can easily
make up as the skin of the face has already healed at this period.

The important point is that the patient should protect her face from the direct
sun rays with protective creams for 1-2 months. The laser operation for the face
is not accomplished in summer as the sun exposure rate is high during July and
Augustos. The increase of the collagen tissue of the dermis after laser
applications is proved microscopically(histologically) so that the young
appereance of the face lasts for a long period. (at least for 5 years)
 

LIP AUGMENTATION:

In addition to the main functions such as feeding and talking, lips are also the
symbols of sexual attraction. Thick lips had always taken attraction in the
society as concepts of beauty and attraction at all times.

In the lip augmentation procedure, materials such a liposuction material,
silicone or collagen. Among these, the silicone injection has been abandoned by
all the plastic surgeons because of its side effects (causing loss of
sensitivity, changing its location in the tissue and its being unable to be
isolated from the gland in case of a reaction). We do not prefer the others
because of their losing their volume after being absorbed and requiring
reapplication.

We use the augmentation technique that requires the vermilion replacement with
the cuts in the mouth or the one that is formed by the dermo-fat graft that is
taken from the curvy parts of the body. On the other hand, we can achieve quite
sufficient aesthetic results by simply injecting new filling materials such as
synthetic polymeres or natural tissue fillers.