Ask The Plastic Surgeon

A question & answer session with DR. Somasundaram Sathappan, Consultant Plastic & Reconstructive Surgeon

Dr. Somasundaram Sathappan - April 2, 05:31 PM

Seeking A Trim Tum
I'm a thirty-year old who’s quite trim. While I’m quite happy with my body, my lower belly bulges. I have a pouch that I can’t seem to get rid of, no matter how much I diet or exercise. What treatments would you recommend for a flatter stomach?
 Beccy, KL
Tummy bulges are a common problem many women face, because this is your camel’s hump. The lower tummy is where fat is stored for a rainy day. Unfortunately, in Malaysia, this rainy day never comes because we’re ‘blessed’ with an abundance of food. Since you have a pouch at the lower end of your tummy, the problem can be solved via two methods. First, and if the skin is taut with minimal stretch marks and can retract back to good positions, then liposuction is a good choice. If your skin still hangs down following liposuction, then it’s best you undergo liposuction in conjunction with a mini tummy tuck. 
Face & neck
Face And Neck Combo
I'm a 60-year-old who's contemplating a facelift. According to online articles and news from the grapevine, a facelift is best paired with a neck lift. Why is this necessary, and will it cost more? 
Mei, Selangor
Facelifts and necklifts normally go hand-in-hand because it’s practically impossible to lift the jowls without lifting parts of the neck as well. Besides, if you’re already lifting the upper portion of the neck, one might as well lift the entire neck, which includes plications of the muscles in the chin area to remove double chins and turkey necks. The next thing is, it looks very incongruous to have a tight face with a loose neck. In short, the package should come as a whole. In addition, patients may even need to combine both lifts with eyebag removals to achieve all-encompassing results. In terms of cost, each procedure will be differently priced because younger patients may need a facelift, but may not require eyebag removals. Other people may only want a necklift because the face looks pretty good. Although it’s quite variable, patients are normally recommended a combination of brow, upper eyelid, lower eyelid, face and neck procedures in one sitting for comprehensive outcomes. 
Breast implants
I had massive implants put in years ago, and now I believe they're too big. I would like them removed and replaced with smaller ones, but I’m afraid the skin has stretched. Will you be able to replace my implants with smaller ones without conducting a lift, too?
Tan, Penang
No, that’s impossible, because the skin has already stretched out. Once surgeons remove the implant, the tissues will hang loose, where one looks like they have too much excess skin. If you would like smaller implants, surgeons will have to conduct some skin resection as well. In addition, we may also use the present skin and fat to create new breast molds. While the procedure allows for smaller breasts and implants, I must warn that you may be left with added scars.
I'm a 28-year-old professional who wants a nose job. Although my nose has a high bridge with a good tip, it’s also very bulbous in the middle. If I do undergo the procedure, what would that entail? 
Preet, OUG
Having read your request, it’s difficult for me to make an assessment based on this description alone. If you have a bulbous tip and middle portion of the nose, you will probably need nasal reduction surgery, which is technically a reduction of the nose’s soft tissues. In other words, you need an open rhinoplasty. According to your description, you say you have a bulbous middle, but have a nice tip. In my opinion, this rarely happens because patients with bulbous mid-sections will also have bulbous tips, except that tips may be more well-defined. Since an open rhinoplasty reduces the nose’s middle portion, we might as well redefine the entire region for optimal results. 

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