Here some of the most current Questions & Answers about plastic and aesthetic surgery, answered by Dr. Kai O. Kaye from Ocean Clinic Aesthetic and Plastic Surgery Center, Marbella

Q: I have very fair skin, but scar very easily which leaves red marks. These red marks and scars are exactly what I want to get rid of, so that is why I am concerned about any surgical procedure that potentially could leave further scarring.

What do you think would be the best option for me?

Can you tell me more about the possible side effects of scarring after a surgical peel or laser resurfacing?

A: Before any peeling treatment, the skin of each patient needs to be assessed in physical examination, because some skin types are not suitable for deep peeling procedures. The fact that you simply have a fair skin type does not mean automatically that you can’t have a deep peel, but in some cases the application procedure and the concentration of the peel must be adapted to your skin. Any kind of deep peeling procedure has a potential risk of scaring if the peeling reaches deep dermal structures, so it is paramount that the treating doctor evaluates your skin to minimize that risk. Taking this in account, a peeling can provide a safe alternative to surgical rejuvenation procedures.

Q: I am well over sixty but reasonably fit, I go to the gym three times a week and keep myself very busy. I had children quite late in life and it has left me with unwanted skin and stretch marks around the waist, would I be a good candidate for a tummy tuck or any other plastic surgery procedure to shape my body, or am I too old?

A: If you are physically fit, and you have no chronic diseases which forbid you having general anaesthesia, a tummy tuck procedure can be safely performed at your age. In the initial consultation, a thorough physical exam and a health questionnaire help us to determine if you are able to undergo surgery, furthermore a exhaustive blood analysis is performed to determine any possible health issues. Aesthetic surgery is very often performed on older patients, and under the conditions named above they have no more risk and an equivalent aesthetic result as younger patients.

Q: Just recently I heard about how Botox can be used for preventing over-productive sweat glands. How long does it last and does it have different reactions to men and women? Also, how long does it really stay in your system, even after the treatment has worn off?

A: The treatment of Hyperhidrosis (excessive sweating) with Botox is an effective and non-invasive alternative to surgical interventions, which leave scars and have associated risks. The treatment can be performed under the arms (Axilla) and in the palms of the hand, reducing the excessive sweating almost immediately for a period of 6-7 months.

Afterwards the Botox is processed and disintegrated; therefore it does not persist as a toxin in your system. International studies with yearlong follow-up did not show evidence of long term complications, in some selective cases the Botox just loses effectiveness due to antibodies produced by some patients.

Q: I have been researching Plastic Surgery procedures looking for an easier way to get rid of some fat on my thighs and came across something called ultrasonic liposuction. It is noted as one of the latest ways to remove unwanted fat with a faster recovery time and a lot less bruising. Do you conduct this form of treatment at your clinic?

A: We use ultrasonic liposuction in patients with extreme fibrotic (hard) fat, which is often the case after a long history of losing and gaining fat in a certain area; the body produces in those patients more connective fibres to fill out existing voids. Additionally patients who already had liposuction tend to have much more fibrotic subcutaneous fat, for those cases it can be useful as well. Generally, bruising depends more on your individual tendency than on the extraction technique, which can be Ultrasound assisted, Vibration assisted or even Laser assisted. I work with all systems and do get good results with either of those techniques, due to this fact I personally contribute a short recovery time and little bruising more to a efficient technique of injection with a solution containing adrenaline and to the fact that I work with very fine cannulas (2-3mm), which allows me to limit the destruction of blood vessels and subsequent hematoma (bruising). This takes a little more time, but results are much smoother and recovery is faster.

Q: There are a lot of different clinics Because Plastic surgery is becoming more and more popular, so it can be very difficult to choose a surgeon. I understand that some Cosmetic Surgery Centers are actually not clinics run by a head surgeon who is reputed for his individual work, but more like managed companies which are hiring different surgeons, and here the decision to hire one can be based more on salary requirements compared to individual skills and personal experience of the Plastic surgeon who will actually perform my procedure. How can I be assured that the surgeon I choose is not only legally qualified and licensed to perform the surgery but also that he or she has enough experience in the special treatment I am looking for?

A: The increasing demand for cosmetic procedures opens the market as well for companies more interested of making big, fast money without offering on the other hand forcefully the best surgeons or sometimes even at minimum qualified ones. The problem is that in many big cosmetic surgery companies or clinics you often don’t even meet the surgeon for your first consultation; in fact this very important first meeting is often enough performed by a senior nurse or a so-called patient coordinator. This practice is not Advisable for me personally. The surgeon actually performing the procedure often comes in only a couple of days per month, you meet him just before, and you can’t really assess if you trust him or not. Qualification and personal experience maybe an issue, and meeting your surgeon just before your actual procedure does not give enough time to assess him personally or to check his experience and qualification level with former patients or regulating bodies.

Q: Are there any particular organizations that I can check with the legal qualifications of the surgeon of my choice?

A: Any patient should check the surgeon’s Legal qualifications to perform the kind of Procedure they would like to have, in most countries this can be checked with the regulating body or authority. For example, any surgeon who is qualified and registered with the UK Board of specialists can be checked at www.gmc-uk.org

I personally decided founding my own, Plastic surgeon led clinic , a concept to stand apart from this concept, to provide extraordinary patient care out of one hand, therefore I personally attend all my patients at the first consultation, I operate all of my patients myself and I check on them personally during the postoperative period.