Liposuction / VASER Liposelection

Anaesthesia

The procedure can be done under General Anaesthesia or with intravenous sedation.

The procedure may be done in the clinic in selected patients or as a day surgery procedure in the hospital

RECOVERY

You will be able to walk about the same day.

The stitches are taken out after a week.

During recovery, firm pressure garments fitted to you are worn to reshape and re-contour the treated areas. These need to be worn for up to 2 months for optimal results. For optimal results, the liposucked areas are also treated with a course of radiofrequency therapy. This facilitates healing, reduces bruising and swelling and promotes skin tightening. Radiofrequency will be performed by our nurse therapist in the early recovery period.

Deep massaging will also speed recovery and reduce swelling. We treat all areas of the body including:

Neck
Cheek
Arms
Upper back
Abdomen
Flank
Thighs & Hips
Legs

Surgical correction of excessive sweat/smell of the armpits.

Correction of Sweaty Armpits

NATURAL and LASTING FACELIFT

Deep Plane Facelift

As we age, our face tends to lose its shape, often making us look tired and haggard. Today, modern facelifts can help turn back the clock by profoundly restoring the youthful contours of the face for a fresher, more revitalised look without any tell-tale sign of surgery.

Fig 1. Facial soft tissue spaces and retaining ligaments of the face.
WHY DOES TRADITIONAL FACELIFT LOOKS UNNATURAL?
HOW CAN A NATURAL LOOK BE ACHIEVED?
Recent TECHNICAL ADVANCES in the COMPOSITE FACELIFT TECHNIQUES
THROUGH THE FACIAL SOFT TISSUE SPACES APPROACH TO THE DEEP PLANE COMPOSITE FACELIFT
WHAT AREAS OF THE FACE ARE ADDRESSED with THE A DEEP PLANE Composite facelift?

A composite facelift treats the lower face, including the marionette lines and the jawline. A neck lift is also done as part of the composite lift. In patients that also have midcheek descent, a composite facelift can also be used to lift the cheek as well as the nasolabial fold. This extended dissection is called the extended composite facelift or High SMAS composite facelift. Should there be upper face (brow and forehead) aging, a forehead lift or a brow lift can be included with the composite facelift, which will then be known as a complete facelift.

Dr. Wong has published his Deep Plane / Composite facelift technique in the journal Plastic Reconstructive Surgery. You may review this paper here.

The Composite Facelift
THE BASIS OF A SAFE PROCEDURE

Breast lift

What breast lift surgery can't do

Breast lift surgery does not significantly change the size of your breasts or round out the upper part of your breast. If you want your breasts to look fuller, consider breast lift with breast augmentation surgery. If you want smaller breasts, consider combining breast lift and breast reduction surgery. 

How is the surgery done? Are there any scars?

Your breast lift procedure can be achieved through a variety of incision patterns and techniques.

The appropriate technique for you will be determined based on: 

  • Breast size and shape
  • The size and position of your areolas
  • The degree of breast sagging
  • Skin quality and elasticity as well as the amount of extra skin

Generally, incisions will be made around the nipple and areola and down each breast to remove excess breast skin. The nipple / areolar complex with be reshaped and repositioned to a higher position and the skin envelop of the breasts tighten to lift the breasts. The size of the areola also might be made smaller.

The incision/ scars will fade over time and becomes quite inconspicuous, but they will not completely go away.

The surgery will take 2 to 4 hours depending on amount of reduction and associated ancillary procedures that may be required. This procedure is done under general anaesthesia in the hospital. 

Recovery

Immediately after surgery, the breasts are covered with bandages and supported with a surgical bra to hold them in place. There will be some swelling and bruising of the breasts. A surgical bra that closes in front is worn to support the breasts.

Limit physical activity for 4 to 6 weeks while the breasts heal. Wear a surgical bra at all times to allow the breasts to heal and reduce swelling
Scarring fades over time. You will need a regular follow-up visits to check on your recovery.

Results

Successful breast reduction surgery can relieve pain in the upper back, neck and shoulders. It might also increase the ability to take part in physical activities and promote a better self-image.

Results will show right away, but it can take months for the swelling to completely go down and the surgical scars to fade. The final result generally lasts a long time. But aging, changes in weight, pregnancy and other factors can change breast shape and size.

Breast Reduction

When the breast is excessively large and causing discomfort, Breast reduction surgery, also known as reduction mammaplasty may be indicated. This procedure removes fat, breast tissue and skin from the breasts and reposition the nipples. It can predictably relieves the discomfort from the weight of the breasts and improve appearance.

Breast reduction surgery might also help improve self-image and the ability to take part in physical activities.

What are the symptoms of excessively large or heavy breasts?

Breast reduction surgery is meant for people who have large breasts that cause the following:

  • Chronic back, neck, and shoulder pain
  • Shoulder grooves from bra straps
  • Chronic rash or skin irritation under the breasts
  • Nerve pain
  • Not being able to take part in some physical activities
  • Poor self-image due to large breasts
  • Trouble fitting into bras and clothing 
How is the surgery done? Are there any scars?

Incisions will be made around the nipple and areola and down each breast to remove excess breast tissue, fat and skin to reduce the size of each breast. The breast and nipple areolar complex with be reshaped and reset. The size of the breasts will be tailored to make them more evenly sized. The size of the areola also might be made smaller.

The incision/ scars will fade over time and becomes quite inconspicuous, but they will not completely go away.

The surgery will take 2 to 4 hours depending on amount of reduction and associated ancillary procedures that may be required. This procedure is done under general anaesthesia in the hospital.

Recovery

Immediately after surgery, the breasts are covered with bandages and supported with a surgical bra to hold them in place. There will be some swelling and bruising of the breasts. A surgical bra that closes in front is worn to support the breasts.

Limit physical activity for 4 to 6 weeks while the breasts heal. Wear a surgical bra at all times to allow the breasts to heal and reduce swelling.

Scarring fades over time. You will need a regular follow-up visits to check on your recovery.

Results

Successful breast reduction surgery can relieve pain in the upper back, neck and shoulders. It might also increase the ability to take part in physical activities and promote a better self-image.

Results will show right away, but it can take months for the swelling to completely go down and the surgical scars to fade. The final result generally lasts a long time. But aging, changes in weight, pregnancy and other factors can change breast shape and size.

INDICATION

BREAST AUGMENTATION with FAT GRAFTING

For patients who want bigger breast but are not keen to have an implant in their breast, FAT GRAFTING offers an alternative for breast augmentation.

THE PROCEDURE

In this procedure, fat is harvested from the abdomen and/or the thighs, processed and meticulously re-injected into the breast to enlarge the breast. Typically 200 to 400 cc of processed fat is injected into each breast. Importantly, the fat is not injected directly into the breast but into the soft tissues around and behind the breast tissues. This minimized the effect of the procedure on the breast tissues. Fat grafting to the breast, when done properly therefore do not interfere with screening mammograms for the breast and an experienced radiologist with be able to accurately read the mammogram.

WHAT is the EXPECTED OUTCOME of FAT GRAFTING to the BREASTS?

The survival rate of the transferred fat, using our current refined technique for grafting the breast is about 60-80%. Fat grating is a highly technique / operator dependent procedure. That is to say, the survival rate varies greatly depending on the technique of the surgeon performing the procedure. 

The advantage of this technique is that, as the fat is part of your own tissues, once the transfer or grafting is successful, the results are permanent. As the fat tissues are your own tissues, hardening or capsular contractures that may occur with implant, is not a problem with fat grafting of the breast. The amount of fat that can be injected into the breast depends on several factors including the size of your breast and the availability of fat in the abdomen and thighs for harvesting. Very thin patients may need to put on some weight before the procedure.

Procedure

Breast Augmentation with Breast Implants

Breast augmentation involves placement of implants behind the breast to enlarge the breast. This procedure is the most established method of enlarging the breast and is reliable and predictable in achieving the desired goals of breast augmentations. In the consultation process, several key decisions need to be made jointly between the patient and the surgeon.

Type of Implants

Breast implants are filled with either Silicone or Saline. Silicone implants are safe and have recently been FDA approved for use in breast augmentations. Silicone IMPLANTS are very popular because it feels more natural than saline implants. The new generation silicone implants are safer and last longer. Dr. Wong uses a full range of breast implants catered to the needs and specific requirements of patients including the MOTIVA and MENTOR range of textured, smooth or nanotextured implants.

Shape of the implants

Breast augmentation can be done with round or tear shaped implants. The round implants are popular with patients who want more fullness in the upper part of the breast (more fullness in the cleavage or the decolletage area). The tear shape implants, so named because it looks like a tear drop from the sides, are popular for patients who are looking for a more natural looking breast. Because of its shape, more of the implant volume is distributed in the lower part of the breast and less in the upper part, giving a more natural and softer look to the breast.

Incisions for Breast Augmentations

An incision needs to be made to place the implant under the breast. The incision are carefully designed and precisely made so that they are as inconspicuous as possible, hidden in natural creases of the body so that its visibility is minimized. The incision can be placed in the lower fold of the breast (called the inframammary fold incision), around the nipple (called periaereolar incision) or in the armpit. Each of these incisions has their advantages and disadvantages and the selection of the incision placement is made together with the patient.

Location or Plane to Place the Implant

The Implant can be place either under the breast or under the chest wall muscle (the pectoralis major). The location in which to site the implant is selected based on the patient’s unique tissue characteristics, the degree of droopiness (if present) of the breast and the amount of breast tissue available to cover the implant. This is because the implant needs to be covered with adequate chest wall and breast soft tissues to feel and look natural. In patients with adequate amount of breast tissues, the implant can be placed under the breast. Called the SUBFASCIAL plane, placement here is also more effective in correcting minor drooping of the breast, gives patients a more natural result and allows the implant to move more naturally with different body postures such as when she is lying down. In patients with very little breast tissues in contrast, the implant may be placed under the pectoralis major, to provide more soft tissues to cover the implant so that the breast will look softer and feel more natural. This is called the SUBMISCULAR plane. The decision as to where to site implant will be made together with the patients at the consultation.

THE CONSULTATION & SELECTION OF THE IMPLANTS

During the consultation, a detailed history will be taken. The patient will be examined to determine her tissue characteristics. The decisions as to the type of implants / brand of implants, shape, placement of the implant as well as the location of the incisions are then made jointly with the patient. To select the size of the implant desired, the patient can try on sizer implants available in the clinic and this important decision made. A second consult can be scheduled if the patient wishes to do so.

THE PROCEDURE

Surgery is usually done under general anesthesia. The procedure takes about 1 hour. The incisions are then meticulously closed and a firm dressings applied.

Recovery

The procedure can be performed as a day surgery procedure for most patients. Of course, if patient wishes, she may stay overnight in the hospital. A tight dressing would be applied to the breast for comfort and this can be removed after 1 day. Gentle range of motion and stretching exercises will be started after the surgery and this speeds recovery and minimizes pain from the procedure. Patients need a comfortable soft bra for gentle support after the operation and generally can start light exercises after 2 weeks, and be back to their usual exercises after about 3 – 4 weeks. Regular check ups are important after the procedures and these will accordingly be scheduled.

Please note that Silicone Breast Implants do not increase the risk of Breast Cancer or autoimmune diseases. Mammogram can and should still be done. Please inform the radiologist that breast implants are present so that specialized views maybe taken, specifically for patients with breast implants.

Whats New?

A new development recently is called the COMPOSITE breast augmentation. This technique is ideal for very thin and flat-chested patients who desire a significant breast enlargement. This technique combines the use of both breast implants with structural fat grafting. Before, the use of large implants with these thin patients would inevitably result in suboptimal result because the thin soft tissues of the breast would result in visibility around the implants, particularly in the cleavage area. With the COMPOSITE technique then, fat is injected around the implant, particularly in the upper part around the cleavage, this gives an overall softer look and more natural result.

Eye Bag Removal

Changes of the lower eyelid with ageing

With aging, the eye bags becomes more prominent. The area below the eye bags develop a deep groove, called the tear trough deformity. Also as importantly, the cheeks loses its fullness / deflates with ageing. This causes the cheek to loose projection and sag. To achieve true rejuvenation of the lower eyelid therefore, all these aspects of the aging lower eyelid needs to be addressed.

Surgical approach for eye bag removal

In general 2 approaches may be used. The traditional approach involve making an incision below the eye lashes. This is call the subciliary approach. An alternative approach involved making an incision behind the eyelid. This is called the transconjuctival approach. 

The Extended transconjunctival Lower Blepharoplasty

The transconjunctival approach (also known as the scarless eye bag removal technique) is beneficial for its effectiveness, quick recovery and safety. Compared with the traditional subciliary approach, it is advantageous because no incision is placed on the external eyelid skin, recovery is much quicker and complications such as prolonged swelling, lower eyelid eversion and retraction occurs much less frequently.

Recent advances in the understanding of surgical anatomy of the lower eyelid has enable all aspects of the aging lower eyelid to be predictably and reliably treated via the transconjunctival approach.

Called the extended transconjuctival lower blepharoplasty, this procedure addresses not only the eye bags, but also correct the tear trough and the loss of volume of the mid cheek. This is Dr. Wong’s preferred approach to treating the eye bags.

Dr. Wong has published his experience with this technique in the journal Plastic and Reconstructive Surgery.

The Procedure

The procedure may be done under moderate intravenous sedation or under local anaesthesia in the clinic. The procedures takes about 1 hour. Depending on your condition, this procedure may be combined with mid cheek fat grafting, to correct mode significant loss of facial volume or fat with more advanced aging to achieve a better aesthetic results.

Recovery and Down Time

Recovery generally takes 1 to 2 weeks. There may be some bruising and swelling after the surgery. Most patients may return to work or social activities after 1 week. Complete resolution of swelling will take 1 to 2 months.

Reconstructive Surgery

Burns

Sorry this page is still under construction, will be available very soon.

Reconstructive Surgery

Corrective Eyelid Surgery

The mechanism that opens the eyelids is called the levator of the upper eyelids. This delicate mechanism opens and closes the eyes several thousand times every day. When the eyes are unable to open fully or effectively, ptosis (latin: to fall) of the upper eyelids is said to be present.

In general, 2 groups of patients present with ptosis. Young patients with congenital ptosis and older patients with senile ptosis.

Congenital ptosis results from congenital deficiency of the muscle that opens the eyes, resulting in inability to fully open the eyes. It can be surgically corrected by tightening and shortening of the levator of the upper eyelid and this can be done with the same incision that would be used for double eyelid creation.

Figure 2: Senile Ptosis results in inability to completely open the eyes, resulting in blocked vision as well as straining of muscles around the eyes.
Senile Ptosis
Figure 3: Ectropion of the right lower eyelid as a complication from a previous lower eyelid surgery.
ECTROPION / LOWER EYELID MALPOSITION CORRECTION