My daughter was born with congenital harelip. She is also experiencing sagging on the right side of her face. She is currently 6 years old. At what age should I consider taking her to a plastic surgeon?
Thank you for your question.
Congenital harelip or cleft lip is a condition that is usually corrected surgically very early on in life, typically within the first year.
If she hasn’t had that repaired yet then I’d suggest you consult a plastic surgeon for the repair at your soonest convenience.
With regards to facial sagging, that is not a typical feature of cleft patients, it is usually seen in patients with facial nerve palsy or a soft tissue issue.
If she does not have a diagnosis yet, then she should consult a doctor to diagnose the issue.
My sister is a breast cancer survivor. She underwent partial mastectomy two years ago. However, I can tell she has lost her confidence with her post-surgery breast. Are there any requirements when it comes to breast cancer survivors getting breast implants?
Thank you for your question.
Breast reconstruction is something that I have a lot of experience in and something that I really love doing because it helps patients so much with their self confidence.
There are many different options when it comes to breast reconstruction. A patient’s own tissues can be used for a more natural result, however this requires taking the tissue from another part of the body.
When a patient has had a full mastectomy I usually use excess tummy skin and fat and transfer it to reconstruct the breast. Another option is from the thigh.
When a patient has only had a partial mastectomy, the remaining breast may be distorted and this can actually be a bit trickier to restore than a full mastectomy. One option would be fat grafting to the breast, another option would be implants.
The only requirement for an implant is that there needs to be sufficient skin and the opposite breast should be a good match for the implant.
Breast reconstruction procedures are best performed either at the same time as the mastectomy or very early after the mastectomy. There’s no need to wait.
Hope this answers your question.
I am thinking of having liposuction done for my thighs and belly. I understand I have to be within acceptable BMI in order to go ahead with the surgery. If I am slightly past my BMI limits, is there a possibility I can still go ahead with the liposuction?
Thank you for your question.
BMI limits for liposuction are more guidelines than absolute limits. You would still be able to have liposuction but you must be aware that liposuction is not a weight loss tool. It’s much better if you can get to a healthy BMI first then treat any unwanted stubborn areas with liposuction.
In Singapore, liposuction in a patient with a BMI > 28 must be done as an inpatient in a hospital setting.
I had a fall from a bicycle ride in September last year leaving me with an open wound in my chin. While the wound has healed, there is an unsightly scar. I want to remove the scar with plastic surgery. At the same time, when I move my jaw or swallow food, I experience pain. Should I treat the pain first before fixing the scar? Please give me your opinion.
Thank you for your question.
Scar revision can be performed which would improve the scar externally as well as repair and release anything that is tethered internally.
It sounds like your scar may be tethered which is causing you pain on certain movements.
A scar revision may improve both the scar as well as the pain
I read about non-surgical body contouring on some medical blogs. Is that effective? And are there any requirements prior to the procedure? What are the possible side effects of this method?
Thank you for your question.
Non-surgical body contouring machines use either heat or cold to destroy the fat cells. Typically the maximum decrease in volume is about 20%.
Liposuction is much more effective, but it is a surgical procedure with its own risks and downtime.
Possible side effects that I have seen with these procedures are hard lumps and paradoxical adipose hyperplasia (PAH). PAH is when the fat cells increase in size rather than decrease.
I feel like my cheekbones which used to be quite prominent are now sagging. I am 47 years old this year. Is there any procedure that can help lift my cheekbones? How long would the recovery be?
Thank you for your question.
There aren’t any surgical procedures to lift the bones themselves, but as we age, our cheek fat pads do descend with gravity.
Facelift procedures help to restore your youthful appearance by elevating sagging facial tissues.
The type of facelift can range from a minimally invasive endoscopic facelift or a more invasive deep plane facelift. You would need to speak to a plastic surgeon to see which was more suitable for you.
The recovery is around 2 to 4 weeks depending on what type of facelift is needed.
Hello, Dr Chui. My eldest son has burns on his right shoulder. He described the burnt area as feeling numb. We are considering plastic surgery to repair the skin, but are worried if there is possible nerve damage in that area. Should we see an orthopaedic doctor first to confirm the condition or is nerve examination also a part of plastic surgery if we go ahead with it?
Burns can generally be handled by a plastic surgeon alone in most cases. The only reason to see an orthopaedic surgeon is if there is a suspicion of a fractured bone, but this would only happen if there was some type of mechanical trauma such as explosion or car accident.
A burn that is numb could indicate that the burn so deep that the nerve endings have been destroyed. In these cases, surgery to remove the burned skin and replace it with a skin graft is indicated.
To answer your question, please go and see a plastic surgeon directly.
I had rhinoplasty done two years ago. These two months I can feel there is a lump inside my nose. I am planning to go to an ENT to examine this. But what I want to know is, if it turns out I have to undergo surgery to remove the lump, would there be any issues with my current nose form?
Thank you for your question. Most likely if the lump is felt internally, removal of the lump would not affect your external appearance.
However, it really depends on what is causing the lump.
I want to fix my chin. It is too long for my liking and I feel like I have an overbite. At the same time, I also want to consider liposuction of my chin so I can have a more defined jawline. Which one should I do first? Or can it be done at the same time?
Thank you for your question.
It sounds like you would be a candidate for orthognathic surgery. In Singapore, this type of surgery is most commonly done by maxillofacial surgeons. Some plastic surgeons do perform orthognathic surgery as well.
It is safe to perform liposuction of the chin at the same time, but maxillofacial surgeons don’t perform liposuction. If you wanted to do them together you could ask your surgeons to arrange to work together.
The other option is to have it done separately, in this case I would suggest doing the jaw surgery first. Liposuction of the chin can actually be done under local anaesthesia as a day surgery procedure.
I have a scar on the left side of my stomach from my previous c-section. I am thinking of undergoing plastic surgery after giving birth to remove the scar. I am currently 6 months pregnant and the second birth will probably be a c-section again. How long should I wait after the delivery before I can undergo the surgery?
Thank you for your question. If you are going to have another c-section, your gynae would most likely use the same incision as last time. You could ask a plastic surgeon to help you close the wound at the time of surgery. This may avoid you having another surgery to remove the scar. Although plastic surgeons are very diligent in their closure, it doesn’t guarantee that the scar will heal nicely. If you are going for another surgery after your delivery, the timing will depend on what type of surgery you want or need. If it’s just a simple scar revision, you could do it anytime after the delivery. If you wanted a tummy tuck, you should wait until your uterus shrinks back to normal and you should also not be planning to have any more children. If no more kids are coming, you could have a tummy tuck about 3 months after the birth of your child.