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PATIENT SERVICES / Aesthetics Center

Frequently Asked Questions About Aesthetics

aesthetics

FAQs on Aesthetic Surgery

How do I know if an aesthetic/plastic surgeon is board certified?

The Medical City has strict qualifications in accepting doctors. All doctors have to undergo formal training in their respective fields. They have to submit the requirements needed for the approval of the Joint Commission International, the world’s leader in accreditation, and the board certification from their respective Specialties. You can check the PAPRAS website or contact the Philippine College of Surgeons for their list of surgeons with good standing.


How long will the surgery take?

The length of surgery usually depends on the kind of anesthesia administered, the anatomy of the patient (size, droopiness, previous surgeries), and the technique of the operation. This means that the length of surgery not only differs from one surgeon to another but also from one patient to another.


How long will the healing take?

Most stitches will usually be out in three to seven days.

It will take approximately three weeks for most swelling to subside and six weeks for the scars to tighten. Depending on your doctor, most strenuous activities will be allowed after six weeks.

Improvement in the scarring will continue for one to two years.


How long should I take a leave from work?

It is recommended that you take seven to 10 days leave from work, depending on the surgery and your doctor’s advise.


How long should I book my “vacation” if I travel to the Philippines to have my surgery? Can I do a sight seeing tour of the Philippines after I have my surgery?

It is safest to book your stay for three weeks. You will be able to go sight-seeing depending on the extent of your surgery.


What are the preparations or required laboratories before surgery?

Blood tests (CBC, Clotting time, bleeding time, protime) are usually required for surgeries under local anesthesia. Additional blood tests are needed for patients with other problems like diabetes, etc. Those taking blood thinners and certain medications like Vitamin E and oral contraceptive pills will be required to stop the medications one to two weeks before your procedure. ECG and chest X-rays will be required for those who will require general anesthesia and a medical/cardiopulmonary clearance is often requested for patients with co-morbidity factors or those above 40 years old.


Where will my procedures be performed?

All aesthetic surgery procedures, whether under local or general anesthesia, will be performed in the Aesthetic Surgery Suite located at the Wellness Center. This Operating room is dedicated solely to Plastic surgery patients offering a relaxing waiting area to avoiding mingling with the Main hospital patients. The Center is supplied with laminar airflow, reducing the risk for airborne contamination and has a separate set of elevators from the Main and Clinic buildings ensuring better privacy.


Where will I be admitted if my surgeon requires me to stay in the hospital for a few days?

You will be admitted in The Medical City Hospital where doctors of all specialties are available 24/7. You can also choose to be admitted at the Aesthetic/Wellness Unit located in the Wellness Center.


FAQs on Weight Loss Surgery

What is weight loss surgery?

Weight loss surgery (also known as “bariatric surgery”) is a surgical procedure performed on the gastrointestinal tract to induce weight loss and treat metabolic disorders particularly Type 2 Diabetes.


What are the aims of weight loss surgery?

  • To reduce the size of the stomach

  • To delay food digestion and absorption

  • To control hunger


Who are the best candidates for weight loss surgery? (based on Asian guidelines)

Severely obese individuals (BMI ≥35 kg/m2) who have failed conventional treatment.

* The BMI or Body Mass Index is the most widely used formula to measure the amount of body fat. It is calculated by dividing the weight (in kilograms) by the height in meters2 (square meters).

Those with BMI ≥30 to 34.9 kg/m2) who have obesity-related medical conditions or uncontrolled Type 2 diabetes.

Selected individuals with BMI ≥ 27 to 29.9 kg/m2) who have obesity-related medical conditions or uncontrolled Type 2 diabetes.

Serious weight-related health problem, such as Type 2 Diabetes, high blood pressure, and severe sleep apnea.


What are the other important criteria considered for this procedure?

  • Healthy individuals, with ages ranging from 18 to 60.  Patients outside this age range may be considered in select cases.

  • Individuals who are serious about losing weight and have tried to lose weight in the past.

  • Persons who are prepared to make the necessary lifestyle changes following surgery.

  • Persons who are not heavy alcoholics and are not illicit drug users.

  • Persons without untreated mental illness (may impair ability to understand the surgery or the required lifestyle changes).

  • Not indicated for pregnant women.

  • Individuals with no other medical conditions that can cause weight gain such as thyroid problems as well as untreated cancer or liver disease.


What are the bariatric procedures commonly done in the Philippines?

  • Sleeve Gastrectomy – involves surgery that removes the greater portion of the fundus (upper portion of the stomach) and body of the stomach.

  • Roux-en Y Gastric Bypass-a combination of procedures that involves creating a small stomach pouch to restrict food intake and repositioning of the small intestines.


How is it done?

Most of the above-mentioned procedures are done through small holes in the abdomen known as keyhole surgery or laparoscopy which is the preferred method as patients recover more quickly.


How long does the procedure take?

Duration of the procedures can range from 1 to 2 hours for the sleeve gastrectomy up to 3 hours for the gastric bypass.


What does the patient undergo before, during, and after weight loss surgery?

Before Surgery:
- Blood Tests
- Supervised Diet

During Surgery:
- Patient will be sedated under general anesthesia

After Surgery (depend on his recovery)
- Regular follow-up with the healthcare team
- Diet: Liquid to Soft until tolerated
- Maintain on a healthy and balanced diet
- Be active in physical activities
- Assist in maintaining weight loss


What are the benefits of the procedure?

- Weight loss
- Controls blood glucose, cholesterol levels and blood pressure.
- Prevents obesity-related medical conditions, disability, and death


What is a realistic weight loss after surgery?

A steady weight loss is reached around 12-24 months after surgery depending on the type of the procedure.  Overall, the average weight loss is around 50 to 65 % of excess weight.  


What are the risks of the procedure?

Risks of surgery increase with a person’s age, weight, and medical conditions.  

Early complications:
- Stomach perforation
- Bleeding
- Pneumonia
- Infection
- Blood clots in the lung

Late complications (occurring after 30 days from surgery):
- Malnutrition
- Gallstone formation
- Gastroesophageal reflux
- Gastric pouch ulcers
- Low blood sugar or Hypoglycemia


FAQs on Hair Transplantation

For men and women suffering from hair loss, hair transplantation can be a life-changing procedure. Hair transplant surgery restores naturally growing hair to areas that had been thinning or bald. In addition to scalp hair restoration, hair transplants can be used to restore eyelashes, eyebrows, facial hair, and hair lost due to trauma on the scalp and on the body, as well.


Follicular Unit Hair Transplantation  (FUT), represents the end refinement of surgical hair transplant. In a properly performed follicular unit transplant, the result will mimic the way hair grows in nature and will be undetectable as a hair transplant . The effect of the procedure is not only aesthetic, but also emotional, granting many patients increased confidence and self-assurance


Hair Transplant is considered a minor surgery, which usually takes  6 -12 hours. Patient will be under local anesthesia and mild oral  sedation.


The length of the procedure  depends on the scalp characteristics, how patient is prepared for the procedure  and the  number of grafts to place in one session.


At the end of the procedure, a light dressing will be applied accompanied with a clean  surgical cap or bandana or patient’s  preferred cap to protect the grafts from harm.


Some patients require only one session  but other individuals with  progressive and severe pattern of  hair loss might  require more  than one session . In  addition since  donor supply is limited ,  especially in young patients, proper  scalp assessment and   careful  planning  are important to reach the beneficial aesthetic result.


There are two techniques to perform Follicular Unit Transplantation (FUT) namely, STRIP FUT and Follicular Unit Extraction FUE) . They are both acceptable techniques for harvesting donor grafts. Each technique has advantages and disadvantages


STRIP FUT

The donor hair is harvested by excising a narrow strip of scalp from the back donor , the size of which is planned by the physician.


The excised area is then closed using surgical stitches. The stitched area can be covered immediately after surgery by your existing hairs at the back or sides of your head, if worn long enough. These stitches are removed after 1 week to allow the skin to heal.


Strip and FUE procedures are sometimes combined for more grafts production especially in patients with tight scalp.


Donor Area Scar:10 months after STRIP FUT

A technique called Trichophytic closure is done by the surgeon to minimize the scar from the donor area. This technique enables the scar to be less visible, camouflaging it by allowing the hairs to pass through the scar tissue upon healing. A thin, less visible, white scar will form after several months over the areas harvested.


Right after placing of all 2,791 grafts in this patient, The hair transplant surgeon herself must be proficient with each step of the procedure in order to train surgical assistants in stereo-microscopic dissection and placing of high quality grafts.


Other applications of Hair Transplant

  • Camouflage of scalp scars from surgery,trauma or scalp conditions

  • Camouflage scar from cleft palette reconstructed

  • Camouflage of scar in any hair bearing areas

  • Restoration /augmentation of sideburns after Face-Lift Procedures

  • Restoration/ augmentation  of eyebrows

  • Restoration /augmentation of eyelash

  • Restoration/augmentation of other areas: mustache, beard, temporal peak, armpits, chest and pubic hair


FOLLICULAR UNIT EXTRACTION (FUE)

The latest and more popular technique in hair transplant surgery is Follicular Unit Extraction (FUE). Physician performs FUE procedure with his /her choice of device. As FUE evolved, so did the development of instruments for harvesting follicular units (FUs). Technical evolution from the original manual instruments, motorised device to a more technically sophisticated, mechanically or electronically-assisted instruments, to the latest development of a robotic FUE device.

Physician’s efficiency and speed of proper individual graft dissection with her choice of FUE device and a good surgical team are important to harvest individual physiologically healthy and anatomically intact follicular hair grafts from the back donor area


Recipient Area

The intact follicular units are removed from a donor site and transplanted to a recipient sites which are more likely to thrive and produce hair at the transplant recipient site.

Second Session

The motorized device make possible also, BODY HAIR TRANSPLANT ( BHT) which allows harvest of grafts from other hairy areas such as the beard, chest, abdomen, thighs and legs . BHT is an option especially for patients who have limited or exhausted scalp donor sites to add density after scalp hair transplantation. BHT also gives new hope to patients  who are not or no longer candidates for traditional hair transplant . Please call for consultation appointment to learn more about this updated and advance technology in hair restoration.


Applications of FUE procedure:

  • Combines with strip procedure to harvest more grafts

  • Patients who want to wear their hair very short

  • Patients who do not want a linear scar on the back

  • Patients who tend to heal with thickened and wide linear scars despite good surgery

  • Patients who is discouraged to undergo another strip because of unacceptable ugly scarring from previous strip poor surgery

  • Patients with old scars from scalp infection , accident or surgery  trauma and do not want further scar formation

  • Patients who require small session i.e eyebrow retouch , small scars.

  • Patients with tight scalp

  • Patients who need to resume high level of activity soon after the procedure.

  • Patients who have significant dislike to after surgery pain

  • Patients with extremely thick hair shafts  and who require  finer hairs from the supra-auricular or low neck regions  to place


FAQs on Breast Reconstruction

Breast Reconstruction: Your Questions Answered

Introduction

One of the most difficult challenges that a woman can face is being diagnosed with breast cancer.

Fortunately, most women who need to undergo a mastectomy to treat breast cancer can opt for reconstruction. Breast reconstruction can help restore the body image of a woman.


What is breast reconstruction?

It is a surgical procedure that creates a new breast mound which is aesthetically pleasing and symmetrical to the other breast.


Who may undergo breast reconstruction?

Candidates for breast reconstruction include women:

  • diagnosed with breast cancer, who had or will have either a mastectomy (surgical removal of the breast), partial mastectomy or lumpectomy (surgical removal of the tumor and surrounding breast tissues),

  • with breast cancer family history (i.e. genetic mutation) and will have a prophylactic mastectomy (removal of non-cancerous breast to prevent cancer)


How is it done? What are the methods of breast reconstruction?

The breast can be reconstructed either by using an implant or a woman’s own tissues. Deciding which reconstruction method is best for you will be discussed during your consultation with the plastic surgeon, who will consider your personal preferences, as well as body and breast shape, prior surgeries, current medical condition and cancer treatment needs. All reconstructive options have both risks and benefits.


  • Implants

A breast implant filled with saline or silicone is placed on the chest wall under the pectoralis muscle and skin.


There are cases wherein the skin may be deficient mainly because the reconstruction is performed months or years after the initial breast surgery. In this case, a temporary tissue expander can be inserted under the chest muscle to allow progressive stretching of the skin and muscle before a permanent breast implant is placed. A combination tissue expander and implant is now also available for single stage breast reconstruction which can take place immediately after the mastectomy.


  • Own tissue

A skin flap or using your own tissue for reconstruction may be the procedure of choice for some women. This procedure can utilize tissues from two areas -

Skin, fat and muscle from the abdomen

This procedure involves taking skin and fat from the lower abdomen and transferring them to the chest wall to create the new breast mound.

Skin, fat and muscle from the back

A piece of skin and muscle can also be taken from the back and moved to the chest wall to create the new breast mound. Depending on the desired size of the new breast, an implant may or may not be added to the tissue from the back.


When can breast reconstruction be performed?

Depending on the patient and her desired goals, breast reconstruction can be performed immediately after the mastectomy or may be delayed.

Breast reconstruction immediately after a mastectomy can minimize the emotional trauma from the loss of a breast, and allows for a better aesthetic outcome as the breast skin can be preserved.

Reconstruction can also be delayed to a few months if the patient desires.


  • Nipple reconstruction

The nipple and areola are usually reconstructed a few months after the breast reconstruction surgery. This is to allow the new breast mound to settle into its position so that the nipple and areola complex may be placed at its optimum location.

The nipple is created from local skin by use of small skin flaps or part of the nipple from the other breast. The areola or dark skin around the nipple can also be created from a small skin graft taken from the groin, or tattooed.


Does breast reconstruction affect my treatment and recovery from breast cancer?

Studies have shown that breast reconstruction does not increase the risk of the cancer recurring nor does it make it harder to detect if the cancer does return. More importantly, it does not affect breast cancer survival rates.

Breast reconstruction does not delay or interfere with chemotherapy or radiotherapy should either be required.

Breast reconstruction can enhance women’s quality of life, sexuality and overall confidence.


Recovery after surgery

Hospital stay is normally between 3 days to a week depending on the type of reconstruction and the patient’s condition or preference.

One can return to their day to day activities such as household chores, sports and leisure, driving and sexual activity 4-6 weeks after the surgery.

Scars will be present initially, but will lighten over time.


The Medical City offers a roster of competent, board-certified plastic and reconstructive surgeons who will evaluate you and perform your breast reconstruction.

Note: This information is not intended to be used as a substitute for professional medical advice, diagnosis or treatment. For any questions please contact any of our accredited physicians or The Medical City trunkline at 8988-1000/8988-7000.