Plastic surgery in Germany - Calf surgery and more

 

 

 

 

 

 

 

Tummy Tuck | Abdominoplasty

The tummy tuck, or abdominal wall tightening, is also known as abdominal plastic surgery, abdominal wall plastic surgery or, medically, as abdominoplasty. The following types can be differentiated:

• Classical tummy tuck = abdominoplasty with mobilization to the costal arch (lower rib cage) and repositioning of the navel
• Mini tummy tuck = mini abdominoplasty with mobilization only to a little above the navel, which is not repositioned
• Inverted T-incision = large abdominoplasty with an additional vertical incision line. This incision is required in cases of massive skin excess.
• Upper tummy tuck with the incision in the area of the inframammary fold. This surgery is seldom performed because of problematic scar tissue build up.

Related terms: abdominal wall plastic surgery, abdominal skin tightening, mini abdominoplasty, panniculus (fat apron), panniculus reconstruction, panniculectomy (removal of fat apron).

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Breast reduction | reduction mammoplasty

Breast reduction (reduction mammoplasty) is associated with the medical term macromastia, which describes breasts that are too large. Macromastia is considered to be one of the breast deformities.

Many women suffer with breasts that are too large. They often have the feeling that other people gawk at them because of their exorbitant size. This often leads to a subconscious bent-over position of the thoracic spine in an attempt to conceal the breasts. In addition, patients desiring a breast reduction usually report a list of symptoms that result from the excess weight of the breasts. For example, the patients frequently complain of back and neck pain. In this regard, 80% of the women feel relief immediately after the breast reduction. Because of the weight, tightness of the shoulders develops from the bra. Maceration (intertrigo) and fungal infections develop in the fold under the breasts, especially in summer. Poor posture caused by the weight can lead to signs of wear in the thoracic and cervical spines. Sports activities are hardly possible. It's a challenge to find clothes that fit well.

Conservative therapy for large breasts is useless, because the real problem, the heavy weight of the breasts, cannot be corrected through physical measures and psychotherapy. This can only be achieved through breast reduction. In the case of preexisting cervical spine and thoracic spine syndromes, the breast reduction can lessen the weight and thereby alleviate the discomfort and delay further deterioration

In the case of being overweight in general, an attempt should be made to reduce weight before a surgical breast reduction is performed, because, for many women, more than the average amount of weight that is lost comes from the breasts. Sometimes breast reduction becomes unnecessary after weight reduction. However, in many cases, because of resultant excess skin, a breast lift is desired.

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Rhinoplasty / Nasal Surgery

Cosmetic nasal surgery or nasal plastic surgery is known medically as a nasoplasty, or more commonly, as a rhinoplasty. Nasal surgery can correct a nasal deformity and normalize the overall aesthetic image of the face, all the more because the nose plays a central role in the aesthetics of the face.

Typical nasal deformities include the long nose, the hook nose, the nasal hump, the broad nose, among others. A saddle nose occurs most commonly in those with an Asian background, and in Europeans it is usually caused by a broken nose (fracture of the nasal bone). Functional conditions, such as impaired nasal breathing, are frequently present and must be considered during nasal correction.

A deviated nasal septum can lead to impaired nasal breathing, but doesn't necessarily have to. There are a whole host of people with severe malalignment of the nasal septum whose nasal breathing is not impaired. In the forefront of this article is the cosmetic rhinoplasty.

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Nose Tip Rhinoplasty

The nose tip rhinoplasty is, for the most part, only one component of the standard rhinoplasty. However, there are cases, in which malformation of the nose tip exists in an otherwise normal nose.

• In the former, no bony structures are modified. It is a procedure involving cartilage and soft tissues. Therefore a nasal splint in the case of a simple nose tip rhinoplasty does not have to be worn as long. However, it is recommended by many nose surgeons to avoid swelling and hematomas.
• The nose tip rhinoplasty can, it is true, be performed under local anesthesia in principle, with twilight sleep if necessary, but the anesthetic injections are very painful, so that here too, general anesthesia is recommended.
• For a more marked molding of a nasal tip, an open approach is usually necessary. Only in this manner can one recognize and revise the structures perfectly. Therefore, as a rule, an open approach is chosen for a nose tip rhinoplasty.

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Lip reduction

Lip reduction is an intervention that is clearly performed less often than lip augmentation. However, very large lips are also found. This affects the lower lip more commonly than the upper lip. In Down Syndrome (trisomy 21) and other syndromes, oversized lips are commonly encountered. However, the cause is very often the ethnic background of the affected person. Especially people with an African background frequently complain about their large lips and seek out the plastic surgeon with a desire for a lip reduction.

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Ear reduction

Oversized ears can be corrected by means of ear reduction (or auricle reduction). The medical technical term for a developmentally large ear is macrotia. The definition is not fixed; the relative size depends on body and head size. The approximate normal value for the ear axis length for women lies between 58 and 62 mm and for men between 62 and 66 mm. In general, the psychological distress of the affected person, often strengthened by wisecracks and teasing, is critical for the indication for ear reduction.

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Calf surgery - General Information

Patients may want calf surgery for calves which are genetically too small or too large. They may also be experiencing changes in the muscles or build up of fat. Calf deformity can also be caused by various diseases. Calf deformity can take on extreme forms, particularly in the case of disease, and may also be connected with obvious asymmetry. The following diseases are among those that can cause muscular changes in the calves:

• Clubfoot
• Spastic Paralysis
• Polio (Poliomyelitis)
• Osteomyelitis
• Injuries such as burns, extensive contusions, broken bones, and nerve injuries connected with muscle wasting (muscular atrophy).

Localized fat deposits can often cause the calf/lower leg area to be perceived by the patient as being too bulky:

• Localized Obesity
• General Obesity
• Lipedema (Type of Lipomatosis)

In many cases patients undergo calf surgery for purely aesthetic reasons. They perceive the calf as being much too small or too large. If the finding is indeed plausible (the calf could be perceived as too large or too small) and the condition is combined with psychological strain and, depending on the case, limits social activities, then calf surgery can result in significant improvements to the patients quality of life. There are currently various procedures which produce good or very good results with little risk of complications, provided they are carried out by a practiced hand ...

 

 

Calf reduction surgery

Calf reduction has a subordinate role in plastic surgery, particularly in comparison with breast augmentation, breast reduction, abdominoplasty (tummy tuck), etc. However, there are many people (mostly women) who, due to their large calves, suffer psychological strain that is at least as intense as that of women who undergo breast augmentation because their breasts are too small, or women who decide on breast reduction surgery due to overly large breasts. This article should serve as information on the options available to you. In the end, whether you undergo calf reduction, and which method you decide on, depends on the subjective amount of psychological strain you are experiencing.

The choice of calf reduction technique depends on what caused the calf to become too robust. Often bulky calves (also known as “radish calves" or "radish legs”) are caused by simple accumulation of fatty tissue; in this case, liposuction is the best method for calf reduction.

In many cases, however, the calf muscle is also excessively thick. Liposuction has no effect in these cases. Extreme growth of the calf area can be observed in patients with muscular dystrophy. Muscular dystrophy is a hereditary disease which takes many different forms. Aesthetic concerns are not the main issue for patients with muscular dystrophy, making surgical calf reduction pointless.

Internal factors that create 'fat calves', such as water retention (edema) or lymphostasis (lymphedema), also require treatment for the cause of the problem, not cosmetic surgery. ...

 

 

Reasons for Calf Augmentation

Calf enlargement (the medical term is calf augmentation) is often considered by patients whose calves are excessively narrow (in extreme cases they may be described as 'stork legs') due to illness. The diagnosis can apply to only one side of the body. Calf augmentation for aesthetic reasons has also become more and more popular in the last few years.

Congenital causes of narrow calves (calf hypotrophy) are:

• Clubfoot
• Spastic Paralysis
• Spina bifida (developmental defect of the spinal cord)

Acquired causes of narrow calves:

• Polio = Poliomyelitis
• Osteomyelitis
• Can occur after injuries such as burns, extensive contusions or broken bones, and nerve injuries connected with muscle wasting.

Every now and then, members of the bodybuilding scene also express an interest in calf implants. It can simply become too frustrating if, after intensive training, the calves are not shaped like the rest of the body, resulting in an imbalance. This is why some athletes decide to face the problem using surgical calf augmentation ...

 

 

Silicone Calf Implants

Image: Cigar shaped calf implant filled with silicone gel. On the right side of the implant you can see a u-shaped loop shining lightly through the implant. The loop is used to anchor the guide wire when placing the implant.

 

 

Breast augmentation using breast implants has become a common procedure for plastic surgeons. There are, however, far fewer requests for Calf Augmentation (see also Calf surgery) using calf implants. However, advances in breast implant technology have also improved the quality of calf implants.

As with breast implants, solid silicone, not liquid silicone, is now the standard material for calf implants. The term cohesive silicone gel is often used. The stability of the outer shell has increased significantly; the chance of the implant breaking is small, even in the event of severe contusions and impacts. Calf implants can easily withstand the burden placed on the calves. Calf implants do not have textured surfaces, as the implant is placed in the gastrocnemius muscle's compartment, where capsular fibrosis (hardening of the implant capsule) is extremely rare. In addition, the implant has to be pushed through a very small incision (4cm) to a depth of 30cm. A textured surface would make this task next to impossible.

We should mention that the calf implants described here are the most common implants and consist of a hard shell filled with silicone gel. There are, however, also solid (firm, rubber like) implants which are described further on ...

 

 

Calf Muscles

The calf (sural region) is the rear upper muscular region of the lower leg. Not all muscles in the calf are calf muscles, however. The calf is defined largely as the three headed calf muscle (triceps surae muscle). In anatomy, we actually talk about the lower leg muscles and divide them into the following categories:

• Deep Layer
• Superficial Layer

• Anterior Compartment
• Posterior Compartment
• Lateral Compartment

You can find more details under the headings superficial lower leg muscles and deep lower leg muscles.

There are, however, only two muscles called calf muscles:

• two headed calf muscle = Gastrocnemius muscle
• soleus muscle

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Indications for ear reduction

Oversized ears can be corrected by means of ear reduction (or auricle reduction). The medical technical term for a developmentally large ear is macrotia. The definition is not fixed; the relative size depends on body and head size. The approximate normal value for the ear axis length for women lies between 58 and 62 mm and for men between 62 and 66 mm. In general, the psychological distress of the affected person, often strengthened by wisecracks and teasing, is critical for the indication for ear reduction.

 

The difference between nose tip rhinoplasty and rhinoplasty

The nose tip rhinoplasty is, for the most part, only one component of the standard rhinoplasty. However, there are cases, in which malformation of the nose tip exists in an otherwise normal nose.

• In the former, no bony structures are modified. It is a procedure involving cartilage and soft tissues. Therefore a nasal splint in the case of a simple nose tip rhinoplasty does not have to be worn as long. However, it is recommended by many nose surgeons to avoid swelling and hematomas.
• The nose tip rhinoplasty can, it is true, be performed under local anesthesia in principle, with twilight sleep if necessary, but the anesthetic injections are very painful, so that here too, general anesthesia is recommended.
• For a more marked molding of a nasal tip, an open approach is usually necessary. Only in this manner can one recognize and revise the structures perfectly. Therefore, as a rule, an open approach is chosen for a nose tip rhinoplasty.

 

Lip reduction for lips that are too large

Lip reduction is an intervention that is clearly performed less often than lip augmentation. However, very large lips are also found. This affects the lower lip more commonly than the upper lip. In Down Syndrome (trisomy 21) and other syndromes, oversized lips are commonly encountered. However, the cause is very often the ethnic background of the affected person. Especially people with an African background frequently complain about their large lips and seek out the plastic surgeon with a desire for a lip reduction.