Wednesday, 14 January 2015

100% patient satisfaction in latest audit for gynecomastia surgery

As part of good clinical practice I regularly audit my work at Riverbanks, including VASER Lipo for gynecomastia or manboobs. An audit is a systematic review of a variety of outcomes, including but not limited to patient satisfaction, complication rates, revision rates and operation duration time.

In 2014, we performed well:

  1. 100% of our gynecomastia patients were satisfied with 43% being VERY satisfied and 57% being satisfied.
  2. The average time it took to perform the surgery was 70 minutes.
  3. We had 1 post-operative bleed occurring 4 days after the surgery.
  4. 4% revision rate - this is low, and means that in 96% of patients, no further surgery is necessary.
  5. 20% of our gynecomastia patients also had their tummies and flanks treated at the same time.

Before and after VASER Lipo for gynecomastia treatment
1 week post VASER - see slight bruising

If you would like to schedule a consultation with me, Dr Ravi Jain, I would be delighted to see you in Central London in my Harley Street office, or at my cosmetic surgery hospital in Harpenden. Please call 01582762877 and my secretary will be happy to arrange that for you.

Thursday, 22 May 2014

Will VASER get rid of the gland in gynecomastia?

I've been successfully treating gynecomastia with VASER Lipo since 2008 now and have change 100's of mens lives for the better. It really is a satisfying treatment to perform as the difference it has made to my patients lives is very rewarding. Many have had such a boost in confidence that it has led to better things such as career changes, business growth, and even better relationships with partners, not to mention feeling more confident in clothes, on holiday, and by the pool!

One of the most frequent questions I get asked by my patients is "will the VASER actually get rid of the gland?"

Well, first of all, in over 95% of the cases I have treated over the years, I have not had to formally cut the gland out to get great results. I use the VASER in a very specific way which dissolves the glandular tissue in the vast majority of my patients. By using the VASER in this way, I can therefore only use a 5mm incision just beneath each nipple, making the whole procedure virtually scarless.  Below you can see a video of how effective this technique is in reducing the volume of breast tissue in the chest.

If after using this technique there is some gland still present, then I will cut it out using the 'pull-through' technique which only requires a very small increase in the size of the scar to about 8-10mm. I will do this at no extra charge to the patient. Sometimes stitches are required and these will be removed at your 1 week check up. If you are unable to attend the 1 week check up, I will use absorbable stitches for you.

Prior to each and every surgery I perform, I carry out an ultrasound scan and video the pinch thickness as above. This allows me to determine the exact technique I need to use during the surgery. I then repeat the ultrasound scan and video afterwards to confirm success.

Post-op recovery is relatively quick with most office workers returning to work within 48 hours and manual workers requiring about a week off work. We then review all patients at 1 week and 8 weeks post op routinely. If all is good then, we discharge you!

Tuesday, 8 October 2013

How much does VASER Lipo cost for Gynecomastia Reduction?

Here are some before and after photos of Gynecomastia reduction with VASER.

These are typical examples of my work.

When quoting for Male breast Reduction with VASER prices start at £2800. Post Op aftercare massages are extra at about £100-150 per session depending on the therapist. Sometimes, in larger cases, the price may increase to £3-4000 as the surgical time will be longer. And finally there may be an additional fee for hi definition of the pectorals and anaesthetic and hospital fees.

Tuesday, 6 August 2013

Costs of VASER liposuction to thighs

Some women are slim around the waistline, but their inner and outer thighs are disproportionately bigger, making it very difficult for them to find clothes to fit properly. Often their waistline can be 1-2 sizes smaller than their hips / thighs. No matter how much they exercise or diet, they struggle to lose the fat from their thighs. I'm afraid that usually, the only solution is fat removal with VASER liposuction and recently good results are possible with Cooltech Fat Freezing.

So what is involved in VASER liposuction to the thighs?

The outer thighs are classed as 1 area, and the inner thighs are classed as another area. So to have both the inner and outer thighs treated, you would need to budget for 2 areas. It is not recommended to treat all the way around the thighs in any single sitting as this could lead to serious lymphatic complications, so I avoid treating the anterior part of the thigh in the same surgery as the other two areas.

On operation day, I agree the areas to be treated with the patient in front of a mirror and then make the surgical markings with the patient's approval.

The surgery is performed under IV Sedation (twilight sedation) by my consultant anaesthetist, for a pain free experience. Don't believe the hype about pure tumescent anaesthesia being painless - it is definitely not. Its tolerable (just) but not pain free. I start with the patient lying on their front and I place a small 5mm incision in the crease below each buttock (so it is hidden), and this allows me to treat the back half or each inner and outer thigh. In fact this is where most of the fat lies anyway, so the majority of the work is done in this position. The patient then rotates onto their back, and I then place another 5mm incision in each groin, being careful to avoid important vessels and nerves such as the femoral structures. These incisions give me access to the front part of each outer and inner thigh, and the scars will heal in the groin which is usually covered up by underwear or bathing costumes.

After the surgery you will be placed into compression leggings designed to minimise swelling and bruising and maximise the smoothness of the contour. I recommend Manual lymphatic drainage and pressure therapy for at least 10-20 sessions over the next 6 weeks to help remove swelling and prevent unevenness.

How much does VASER Lipo cost?

There are 5 components to the fees generally:

  1. The surgeon's fee
  2. The hospital's fee
  3. The anaesthetists fee
  4. The post-op therapists fee
  5. Compression garments
At Riverbanks Clinic, all of the above are packaged into one convenient price for you with no hidden extras. Our current fee for treating inner and outer thighs under IV sedation with 10 aftercare sessions starts from £4800 (as of August 2013) but please check current fees when enquiring.

Before and after pictures of VASER Liposuction to thighs

Here are some examples of my work at Riverbanks:

© Dr Ravi Jain 2013

© Dr Ravi Jain 2013

© Dr Ravi Jain 2013

© Dr Ravi Jain 2013

© Dr Ravi Jain 2013

© Dr Ravi Jain 2013

© Dr Ravi Jain 2013

© Dr Ravi Jain 2013

© Dr Ravi Jain 2013
If you would like to make an appointment with me to find out if VASER Lipo is an option for you, I am available in Harley Street and Harpenden on 01582762877.

Thursday, 13 June 2013

Is CoolSculpting an alternative to VASER Lipo?

Coolsculpting by Zeltiq, is a relatively new treatment where it is possible to reduce fat in localised areas by 25-40% according to clinical research. This is done without any surgery or any incisions, but simply by freezing the fat cells via a vaccum cup. The Coolsculpt system has gained popularity world wide and has been widely accepted by clinicians due to the good research and results achieved. But is it better than VASER Liposuction?

What is Coolsculpting?

Top dermatologist Dr Rox Anderson from the USA conducted a clinical study on the effects of Coolsculpting on fat cells and identified that up to 40% of fat cells which were frozen would die and would eventually disappear from the patient after about 3 months. This ground breaking study paved the way forward for cryolipolysis (fat freezing).

Coolsculpting works by applying a vaccuum cup to the fatty area (eg stomach, love handles, inner thighs) and then gently freezing the fat. This process is initially mildly uncomfortable due to the suction. Then once the tissue is frozen, the area goes numb. About 60-70 mins are needed to have an adeuqate effect. Then the cup is released and the frozen tissue is massaged til flat. This can be a bit sore for some people, but it only lasts a few minutes.

Over the next few weeks, you may experience numbness over the treated area or some mild discomfort. Occasionally there is some minor bruising, like a big love bite!
Results tend to start to show at about 4-6 weeks with end results at 3-6 months. Naturally it is important to maintain a healthy diet and lifestyle for best results and often. Often, combining fat freezing with radiofrequency treatments or Ultrasound and lymphatic massages helps gets even better results.

What is CoolTech?

CoolSculpt is a first generation system for fat freezing, and like most other first generation systems, is quickly superceded by later generations with modifications which improve the whole system. One of the biggest limitations of CoolSculpt is that it only has 1 cup and so can only treat 1 area per hour. This makes it very time consuming and also costly for patients. Another limitation of Coolsculpt is that the cup size and shape lends itself to creating pockets of fat removal with sharp borders, so that it is possible to see possible indentations after coolsculpting.
4 weeks after 1 Cooltech treatment

4 weeks after 1 Cooltech treatment
Cooltech is a second generation cryolipolysis system which offers significant advantages over its predecessor Coolsculpt. First of all it has TWO cups instead of one, allowing two areas to be treated at the same time, saving the patient a significant amount of money and time. When typical prices per cup with Coolsculpt are £800, you can see how much money can be saved with Cooltech where prices are typically £800 for up to 2 cups!

Secondly, the shape of the Cooltech cup is more graduated, and this allows better blending with the untreated tissues, and therefore giving more natural looking results with no obvious indentation as is possible with the Coolsculpt.

How does Coolsculpting compare with VASER Lipo?

I think Coolsculpting can be as good as a very mildly performed VASER Lipo, but not as good as total body contouring with VASER Lipo. It also depends on the area treated. Lower abdomens probably respond best. But I think if you are considering a totally new torso / waistline speak to your surgeon about the possible results with either system. You may be surprised!

Sunday, 24 March 2013

Not all six pack abs look the same

Four Pack Abs
Many men who dream of a six pack often trawl through fitness magazines or search through the internet, looking for the ideal looking six pack that they would like to achieve. However, even if they reach the desired body fat % and muscular physique to reveal their six pack. they may not be happy with their results because of their very individual anatomy.

You see, we are all very different and have our own muscle shapes and sizes and these are genetically predetermined. This is what I have to explain to all my VASER 4D liposuction patients, because I am only going to be able reveal their natural anatomy and not create a 'perfect six pack' if they don't have one.

If your surgeon disregards your own natural anatomy and gives you a 'perfect' shaped sixpack, when you naturally have a 4-pack or an 8-pack, then the results are going to look extremely unnatural. This is no more than the outdated method of abdominal etching and not the highly advanced Vaser 4D Sculpt technique.

Not all sixpacks look the same
6 pack absFor sure, most male patients have a six pack, but the exact layout is very different. Some lie above the umbilicus, while other start below the umbilicus as seen above. Some men have 10-pack while others
have only a 4-pack.

In patients whose muscular anatomy is very obvious during their consultation, I perform an ultrasound scan to help locate their muscles, so that their VASER 4D liposuction surgery provides the most natural looking results possible.

Monday, 11 March 2013

Before and after pictures female VASER 4D

Here are some examples of results at 8 weeks after VASER 4D Lipo in females. Final results tend to show at about 6 months.

This lady is very slim but has some stubborn pockets of fat in her lower belly and on her love handles (flanks) as well as her outer thighs. Because of her excellent skin tone and no stretch marks, she was suitable for VASER 4D, technique to create the most feminine shape with VASER Liposuction

New body by Dr Ravi Jain

As you can see, amazing results can be achieved very quickly and she has a brand new shape. Results will continue to improve up to 6 months after surgery, when the real definition will start to reveal itself.