New abdominoplasty

A Tummy Tuck is a surgical procedure by means of which we can improve the appearance of the abdomen when there is an excess of fat and skin tissue

In the majority of cases, a tummy tuck is performed on adults over the age of 50 who are feel uncomfortable with an excessive amount of skin and have to wear loose-fitting clothes to conceal it. It can also be related to obesity problems. Generally speaking, it involves skin that has lost its elasticity, whether through several pregnancies or after a weightloss diet, and is no longer smooth and taut over the framework and muscles of the body.

There is an evident aesthetic problem and greater inconvenience with regard to clothes.

For many years, abdominoplasty has been described as a technique to eliminate a large amount of excess skin by means of an incision made from hip to hip, passing across the pubis and the navel. Several types of incisions and scar patterns are described, generally in the form of an inverted “M”. The fact of having to cut a large quantity of skin means the surgeon has to relocate the navel, making an opening higher up and stitching at that level.

During the operation it is possible to take the opportunity to stitch the abdominal muscles in cases of slackening of the stomach wall. In general it is not advisable to have a liposuction followed by an abdominoplasty because the risk of the tissue scarring badly or dying (necrosis) is much higher.

The results of a classic tummy tuck are variable. In the majority of cases patients have been very pleased at being able to dress more easily and with the image of having a new body, when clothed. When the clothes come off, then the results are not quite so satisfactory because the scar is very large and visible, which patients are somewhat embarrassed to show.

“ In the field of abdominoplasty, as in any other procedure of aesthetic plastic surgery, my concerns have always been to reduce the pain, the trauma of the anaesthetic, surgery and recuperation time, as well as the visible aspects of having undergone surgery i.e. the scars…”

My point of view

In the field of abdominoplasty, as in any other procedure of aesthetic plastic surgery, my concerns have always been to reduce the pain, the trauma of the anaesthetic, surgery and recuperation time, as well as the visible aspects of having undergone surgery. i.e. the scars… At the same time to increase the patient’s pre- and post-operatory comfort, the naturalness of the results and the discretion of the surgeon’s intervention to be able to enjoy a new life to the full.

For these reasons, I have never been fully in favour of performing a major tummy tuck, and have always tried to achieve satisfactory results with a minitummy tuck, i.e. by making only one incision at the level of the pubis that goes 2 or 3 centimetres beyond the pubic hair, respecting the original navel, or in other words, removing a crescentshaped section that is 4 or 5 cm wide.

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Upper Abdominoplasty

But of course, the technique of a minitummy tuck is not enough in cases of an excess of skin, and we have to think of something additional. For this there is a new surgical option that can complement what is known as a lower abdominoplasty, and is called specifically the upper abdominoplasty. The technique, always with the aim of reducing the “visibility” of the operation and increasing the naturalness of the results, consists of lifting the skin above the navel and cutting the excess at the level of the inframammary folds. With incisions of 10 to 15 cm long, it is possible, as with the lower abdominoplasty, to remove 2 more crescents of skin of 4 and even 5 centimetres width.

NEW Abdominoplasty

(Tummy Tuck )

“…Many men ask questions, interested in this technique, particularly after the age of 55 or 60, because they do not have inframammary folds, to hide the scars”…

Many advantages The advantages of this technique are numerous : it is a far less invasive technique than the major tummy tuck, it is not necessary to touch or reposition the navel, the scars are almost invisible because they are hidden by the weight of the breast that always falls a little and covers the fold. The recuperation period is much less and more comfortable, with far less risk of skin necrosis, infections and split stitches. While it is true that this technique cannot be used in cases of extreme obesity, many patients, both men and women, are able to enjoy having a flat tummy – not only with no fat, as would be after a liposuction – but also with smoother skin. Many men ask questions, interested in this technique, particularly after the age of 55 or 60, because they do not have inframammary folds to hide the scars. It is the same as in the case of younger women with small breasts. For these cases, the solution would be to make use of a tattoo. Nowadays it is widely accepted and not considered at all strange to wear a tatoo, which can even be discreet and simple, such as a leafy branch, for example, although some people prefer the idea of a snake tattooed all along the scar. In any case, I would tell anyone who is definite about not wanting a scar in that place, that it is far more attractive than a lot of hanging skin or a scar running from one side of the abdomen to the other. It is simply a matter of mentalizing yourself and having a tattoo applied when you had never before thought of having one.

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Editorial: Dr. Pier Albrecht, Dr. Pierre Albrecht, Dr. Pierjean Albrecht,

Dr. Pier Jean Albrecht, Dr. Pierre F. Albrecht, Dr. Pierre Frank Albrecht,

Dr. P. Frank Albrecht, Dr. Pierjean Frank Albrecht, Marbella Clinic

The seduction of the female breast

It is a demonstrated fact that a woman’s breasts are one of her most important weapons of seduction. They are undoubtedly one of the most basic elements of femininity.

An attractive bustline does not remain perfect indefinitely, only for around ten years in most cases, then after the first pregnancy it usually gives the impression of being empty and drooping. In cases where the breasts are small and underdeveloped, the need to feel completely feminine, confident and seductive begins to arise towards the end of the teens. The pressure created by advertising that bombards young girls daily with images of supermodels only goes to strengthen the belief that there is a real need to resort to surgery to correct the physical injustice of Mother Nature. With maturity the body goes through the unpleasant changes brought about by the passing of time, a woman’s breasts become her greatest concern when trying to delay the effects of ageing.

DIFFERENT OPTIONS FOR HAVING AN ATTRACTIVE BUSTLINE Breast augmentation is a surgical operation that increases volume by inserting breast implants, thus obtaining beautiful and natural-looking breasts in accordance with the characteristics and the expectations of each patient.

As in any kind of aesthetic operation involving surgery, the first consultation with the plastic surgeon is an essential stage, as at this point a relationship of mutual confidence is formed, in which the patient is provided with complete information and all the details and steps of the operation are explained, along with those for the choice of prosthesis. It is also a stage in which we check that the implants will be tolerated and whether the patient’s health and medical history are suitable for this type of operation.

Once these points have been checked then the choice can be made as to which kind of implant is to be used as there are several types, for example, liquid silicone with a smooth or textured surface, of hydrogel, or anatomical implants of cohesive or semicohesive gel. For inserting these implants, there are several techniques by which to gain access: from the armpit, from under the areola, under the breast and the umbilicus, amongst others, which leaves scars that are practically invisible.

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The kind of implant chosen will determine the final result. Anatomical implants are less likely to lose their shape, although they leave a larger scar. It is possible to make use of the edges of the areolas if they are large enough to insert small anatomical implants, and also the fold under the breast to insert larger anatomical implants.

Nowadays the most reliable prostheses are made of silicone soft cohesive gel with a textured surface because they offer the greatest consistency and give a more natural result as regards shape and feel. Within this category there are several different types, which in specific circumstances “reconstruct” the breast, giving it the desired shape. I do not recommend those made of saline solution as they can deflate and do not provide natural shape for the breast. Investigations have proved that women with breast implants do not suffer from cancer or immunological diseases any more than women who do not have them, they can get pregnant and breastfeed their baby in the natural way. It has not been proved that silicone passes to the milk. One problem that can arise is the so-called “capsular contracture”; although fortunately, during the course of my experience, I can say that this only occurs on very rare occasions. Some factors that give rise to a tendency for this hard scarring around the prosthesis: bruising, bacterial contamination, etc, that are treated with oral antibiotic prophylaxis.

At present there are many high-precision techniques to determine the shape and the dimensions of the anatomical implants. In our Clinic our preference is to use local anaesthetic with sedation, although it is possible to use other methods. The operating time varies between one and half and two hours. The operation can take place as outpatient surgery meaning that the patient can leave the clinic on the same day, with a compression bandage, which will be removed the next day. The post-operative followup is carefully monitored in our Clinic.

The results are immediate, during the first 3 or 4 days it is advised to rest; after this period the patient can usually drive a car and return to work. But she must avoid excessive force or lifting heavy weight for the next 15 days. It is evident that this is one of the operations that most contributes to restoring a woman’s self-esteem, helping her to feel more feminine and confident in herself.

In the majority of cases, surgery and breast implants provide a new commodity for women, increasing their confidence in themselves and in their power of seduction.

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Editorial: Dr. Pier Albrecht, Dr. Pierre Albrecht, Dr. Pierjean Albrecht,

Dr. Pier Jean Albrecht, Dr. Pierre F. Albrecht, Dr. Pierre Frank Albrecht,

Dr. P. Frank Albrecht, Dr. Pierjean Frank Albrecht, Marbella Clinic

Pier Albrecht – Beauty and Perfection, two different things.

Beauty and perfection should go together? This is the most mistaken idea that we come across in our speciality of Plastic Surgery and Aesthetic Treatment.

For that reason there is a risk of people ending up looking like each other. It is sad to see faces with forced curves, noses that are straight but rigid, big lips that look swollen, exaggerated cheekbones, etc. The idea of perfection comes from the fact that many people imagine themselves like a car, with parts that are interchangeable with those from other types of car.

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The case frequently arises when someone comes with one or more magazines and tells the doctor “I want this mouth, doctor, I’d like to have this nose, these breasts,” etc. And in the end what do we have? An image that is fabricated out of identical parts that are used by many others, an image that looks unnatural, in which the human being who is hidden behind it has been lost.

What is left of Michael Jackson on the outside? and what is left of Michael Jackson on the inside?

I always feel that the victims of this kind of image have lost their common sense. Don’t they realize that it is obvious to everyone? Even their best friends laugh when they are with other people, otherwise ask their hairdressers, who are experts in camouflaging so many scars produced by the face-lifts of which there are more and more every day.

We have come to the point of thinking that a pretty face can be the sum of a number of pretty features : lips, nose, eyes, chin, cheekbones… But this is not necessarily so. Nowadays I often hear in my surgery that people prefer perfection rather than beauty, in the same way as people prefer respect rather than love. Perfection can be worked on, in the same way as respect, it can be developed starting with standardized and normal things until it responds to defined scientific rules. I think we could even say that perfection is something that is measured by the immobility of statues. Perfection is rigid and boring, it is not in favour of contrasts.

Beauty, like love, is something that cannot be easily controlled, it is something mysterious that is perceived and is related to the world of art, a world whose rules are unknown to us and that has to be understood with the intellect of the heart rather than with the intellect of the brain. It is also related to intuition. It is possible to be handsome with a long or short nose, with large or small eyes, with irregularly shaped lips. Latin beauty is not the same as Scandinavian beauty, for example. Beauty and perfection should go together. This is the most mistaken idea that we come across in our speciality of Plastic Surgery and Aesthetic Treatment.

Beauty, like love, is something that cannot be easily controlled, it is something mysterious that is perceived and is related to the world of art, a world whose rules are unknown to us and that has to be understood with the intellect of the heart rather than with the intellect of the brain. It is also related to intuition. It is possible to be handsome with a long or short nose, with large or small eyes, with irregularly shaped lips. Latin beauty is not the same as Scandinavian beauty, for example. Beauty is something that is measured by the movement of real life. An expression, a smile, even certain movements that are almost imperceptible in the muscles of the face and body, can give an impression of beauty and seduction…..or the complete opposite. Yes, natural beauty is movement and life, it does not allow room for boredom because it changes with the circumstances.

Not long ago I saw a photo of a wellknown English singer from the 80’s on the cover of a magazine. She must have been around 50. I could see she had undergone a deep phenol skin peel. The truth is that her face had no wrinkles, nor marks nor flabby skin, but I could see that this woman must have been over 45 by looking at her eyes. The upper part of her eyes, just below the eyebrows, was very hollow, you could see perfectly what we call the skeletonization of a face…this is when the bones start to protrude…a sign of aging. Her face looked as if it were made of porcelain. It certainly did not look very inviting to kiss it. This is a typical example of a face that is perfect, but not beautiful, nor young.

In natural beauty a face can be slightly assymetrical, with imperceptible movements of the curves that are a result of human nature. Many people have an idea of ideal beauty as in a sculpture. But a live human face has greater value than a sculpted face.

Beauty, youth and maturity In this aspect there is a difference between men and women. As in the animal kingdom, men want their women to be beautiful because in this way, through a strong sexual attraction, they can reproduce and improve the species. And in most cases, a woman’s beauty in linked to her youth, which is the ideal moment for reproduction. Age, with its wrinkles and flabby skin, relates women to the ravages of time and tiredness, and men do not want the object of their desire to be ravaged and tired.

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The woman turns into a mother, and men are not keen to make love to a mother. These statements are generalities, obviously, but it becomes a global tendency, a more animal and instinctive way of seeing others. The problem is that today’s society is more in favour of this more superficial and physical way of seeing other people than through deeper and more sentimental values. This situation has always existed, but nowadays even more so.

With men it’s a different matter. Women find men to be more attractive when they are older, with wrinkles, showing signs of experience, strength and maturity. This is because women are subconsciously searching for the best father for their children and the maximum security. As in the animal kingdom, men with more experience, wisdom and strength are considered to be the most appropriate. So whilst men consider age to be detrimental with regard to women, women take it as a sign of improvement in the case of men.

In conclusion, for women we associate beauty with youth, while for men, beauty is associated with maturity.

Dr. P. Albrecht M.D. Ph. D. – 952 816 981

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Editorial: Dr. Pier Albrecht, Dr. Pierre Albrecht, Dr. Pierjean Albrecht,

Dr. Pier Jean Albrecht, Dr. Pierre F. Albrecht, Dr. Pierre Frank Albrecht,

Dr. P. Frank Albrecht, Dr. Pierjean Frank Albrecht, Marbella Clinic

Pier (pierre) Albrecht – Aesthetic surgery – Legal requisite

Aesthetic surgery legal requisites h a n d s o m e When you decide to have any treatment carried out on the face or body, you must make sure that you are dealing with an adequately qualified professional. The ONLY legal requisite for being a doctor of aesthetic medicine – surgery was to be a general practitioner (from 6 to 8 years of study in Europe) with a non-official training imparted by colleagues or through conventions or workshops. Things are changing.

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Spanish legislation has recently introduced changes to the effect that a Doctor who practices aesthetic medicine or “Cosmetic” surgery, may only handle skin and fat down to the level of the muscles. This means he can carry out all kind of injections, exfoliation treatments, laser treatments, diets, anti-aging programmes and limited liposuctions.

The surgical training of these doctors is probably incomplete, to ensure safer conditions for anything that goes beyond those treatments. Generally speaking, “cosmetic” basically means superficial. For this reason we gradually come to an international standardization of vocabulary, using the term Aesthetic Plastic Surgery, instead of Cosmetic Surgery, only for real specialists. A surgeon is entitled to the qualification of Specialist in Plastic, Aesthetic and Reconstructive Surgery if he has received training for techniques in plastic surgery for a minimum of three years, or more, and with an average of between five and seven years of hospital practice (if he has studied the reconstruction of the face or hands after burning), and he must also have received training in plastic surgery, carried out in a hospital.

The fact of a surgeon belonging, or not, to a Scientific Association, is not a legal requisite. He MUST be registered in a Professional Doctors’ Association (for Malaga, El Ilustre Colegio de Medicos de Malaga).

The security provided by this aspect means that patients are guaranteed that the treatment is going to be carried out by a real specialist in a clinic that is registered. The European Community has set out a series of safety regulations and requisites that must be complied with for clinics to be able to obtain the licence required for aesthetic surgery to be performed within their facilities.

Aesthetic Plastic Surgery in this new millenium is undoubtedly based on technological progress. Photos are taken with a digital camera of full face, profile, etc, then these photos are stored on a computer using ultrapotent software that will evaluate the best strategic options for rejuvenation or the changes necessary for obtaining the face or body that is closest to the established standards of beauty.

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Then orders pass from the computer to mechanical “arms” to perform the operation under the supervision of the surgeon, but in a way that is more mechanized. This is not a dream, it is reality. It already exists in some fields of surgery, where operations are performed long-distance. Nevertheless, nowadays, surgery is still carried out for the most part completely manually (with two hands and ten fingers). The surgeon is the key element of the operation. He measures, draws, cuts and stitches. In short, he decides which is the most appropriate option and technique for his patient, according to his training, his experience and his own technical and artistic preferences.

Dr. P. Albrecht M.D. Ph. D. – 952 816 981

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Editorial: Dr. Pier Albrecht, Dr. Pierre Albrecht, Dr. Pierjean Albrecht,

Dr. Pier Jean Albrecht, Dr. Pierre F. Albrecht, Dr. Pierre Frank Albrecht,

Dr. P. Frank Albrecht, Dr. Pierjean Frank Albrecht, Marbella Clinic

Dr. Pier ALBRECHT – Biography

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Dr. Pier (pierjean) Albrecht , French, born in 1962 is a  Surgeon, specialising in Plastic, Reconstructive and Aesthetic Surgery, registered at the General Medical Council of Malaga (Ilustre Colegio Oficial de medicos de Malaga) under number 29/07945. He also is an Expert Witness to the Court. He arrived after 16 years training, during which he has been studying medicine and surgery, and working in Europe in the fields of Plastic-Aesthetic Surgery, Laser and Anti-Aging Pharmaceutical Research.

Dr. Pier (pierjean) Albrecht was trained in France in the Medical Schools of the Louis Pasteur University in Strasbourg, Montpellier, Paris V and VI, and in Spain in the Department of Surgery in the School of Medicine of Salamanca University.

Dr. Pier (pierjean) Albrecht has been an Adviser at The Laser Clinic , Harley Street – London, and other places in Europe, dedicating special attention to Rhinoplasty (nose surgery) in Guadalajara-Mexico with Professor Armando Gonzalez

Dr. Pier (pierjean) Albrecht obtained the Superior Medical Degree for “Lasers and Plastic Surgery” from the Specialties Department of the School of Medicine RENE DESCARTES, of the Paris V University.

After Dr. Pier (pierjean) Albrecht has been awarded a specialized studies title in “Advanced Surgery” by the “Department of Surgery” of the University of Salamanca, he published his six years research about “The Use of Lasers in Cutaneous Therapy and Plastic Aesthetic Surgery”.

Dr. Pier (pierjean) Albrecht has been awarded the Ph.D. degree “Doctor in Medicine and Surgery” – Cum Laude – by the same University, that allowes him to teach and to carry out research programs.

Publications :

Dr. Pier (pierjean) Albrecht has published articles about Plastic Surgery and about the relationship between anti-aging, antioxidants and the immune system, in French and international publications.Communications: Comparative use of Lasers in Cutaneous Therapy and Plastic-Aesthetic Surgery, These. Doc. Univ., Salamanca. 2001.· Alloplastic Malar Implants for Aesthtetic Purposes in zone 1. The transconjunctival route. (in press)span> Gliadin Films. I : Preparation in vitro evaluation as a carrier for controlled drug release. Internationnal Journal of Pharmaceutics. 117 – 121 .1995. Elsevier Mise en évidence des propriétés antioxydantes d’un L. M.F. dans des dermocosmétiques . Journ.de Pharm.Clinique. 1995· “Aesthetic and Reconstructive Surgery of the eyes and of the look” Plastic Surgery Symposium. Birkenwerder- Berlin. 2004· COngress of the French Society for Plastic, Reconstructive and Aesthetic Surgery: Closed Blepharoplasty, the U suture before incision. 2002· Chirurgie Plastique-Esthétique Faciale et Laser. Ecole de Chirugie de Guadalajara. 2001 · Alloplastic Malar Implants for Aesthtetic purposes in zone 1. The transconjunctival route. IMCAS. Paris 2002· Congress of the Rio de Janeiro Society for Aesthetic Medicine, and in more than 200 workshops, conferences and congresses about health, anti-aging, Lasers and Plastic-Aesthetic Surgery in Europe, USA, Canada and the Middle East:

Utilisation des immuncomplexes dans le vieillissement de la peau. Congrès de la Société de Chirurgie Esthétique de Rio De Janeiro, Brésil 1994

·Intérêt du L.M.F en clinique. Salon de Dermatologie Pratique.Paris 1995

Teaching:

.He was an Invited. Profesor for the E.N.T. Specialists Academic Program in the Civil Hospital of Guadalajara in Mexico.

Scientific Societies:

He is an active member of the following Scientific Societies:

Former member of French Society for Aesthetic Plastic Surgery (SOFCEP)

(AREDEP)Association for the Research in Aesthetic Dermatology and Plastic Surgery

(ESLAS). European SOciety for Laser Aesthetic Surgery.

(SEMAL). Spanish SOciety For Anti-ageing Medicine and Longevity.

(NYAS)New York Academy of Sciences

 For other scientific publication of Pierjean (Pier) Albrecht, see also :

Pierjean (pier) Albrecht: congress in Rio de Janeiro

Pierjean (pier) Albrecht en bigsight.org:

Pierjean (pier) Albrecht, co.autor in Journal de Pharmacie Clinic

Pierjean (pier) Albrecht: co – autor en el International Journal of Pharmaceutics

Pierjean Albrecht - Gliadin films - Internationnal Journal of Pharmacuetics

Pierjean (pier) Albrecht, Doctorate – Plastic Aesthetic Surgery Thesis 

Pierjean (pier)  Albrecht, Patent Lactoserum multifermented

Pierjean (pier) Albrecht: National Congress  of the SOFCPRE (Société Française de Chirurgie Plastique Réparatrice et Ésthétique

Pierjean (pier) Albrecht publication in Aesthetic Surgery Journal

 

Publication 

Transform Magazine, Pierjean Albrecht editor

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Editorial: Dr. Pier Albrecht, Dr. Pierre Albrecht, Dr. Pierjean Albrecht,

Dr. Pier Jean Albrecht, Dr. Pierre F. Albrecht, Dr. Pierre Frank Albrecht,

Dr. P. Frank Albrecht, Dr. Pierjean Frank Albrecht, Marbella Clinic

Essential Marbella Award 2008 Marbella Clinic business of Excellence in Beauty/Aesthetic category

Once more Marbella Clinic has been granted the “Essential Marbella Awards”. Marbella Clinic was chosen among 4 other clinics specialized in beauty and aesthetics by thousands of votes as the centre of excellence. This award confirms us 12 years of hard work and satisfied patients, offering the best techniques and treatments, with the famous artistic touch combined with passion for Plastic-Aesthetic surgery.

Dr. Pier Albrecht and his world-class staff will welcome you to the Marbella Clinic and make your time here educational and comfortable. Whatever your interest is, we will thoroughly detail the procedure, recovery time, risks and options to be sure that your expectations are realistic and desired results can be achieved. Thank you for all the votes

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Editorial: Dr. Pier Albrecht, Dr. Pierre Albrecht, Dr. Pierjean Albrecht,

Dr. Pier Jean Albrecht, Dr. Pierre F. Albrecht, Dr. Pierre Frank Albrecht,

Dr. P. Frank Albrecht, Dr. Pierjean Frank Albrecht, Marbella Clinic

Pier Albrecht – Antiaging: Exomask

By Dr. Pier Albrecht

The art of skin rejuvenation

Our facial skin is a magnificent organ being thick enough to protect our face from a lifetime of sun, wind and rain while in the meanwhile being flexible and delicate enough to express emotions and mimics in the unique way only a human being is able to do. After having undergone the changes of many seasons and the sum of emotions of a full life our skin starts to show the inevitable signs of ageing: Wrinkles, age spots, a thinning of the skin and an overall loss of elasticity.

Not long ago, any correction of these ageing effects was only accessible by more or less invasive plastic surgery procedures. But since a couple of years new treatments called Peelings are available which consist of a chemical or mechanical removal of the upper layers of the skin (Epidermis) followed by an assisted healing phase which allows for a regeneration of a new, immaculate skin.

It is very important to know that the exfoliative effect of a chemical peeling only is responsible for a part of its results, while the other part is the effects in the deeper layer of the skin (Dermis), where a deep chemical peel induces a hypertrophy and a retraction of the elastic fibres which results in the remarkable lifting effect of such a deep chemical peeling. Furthermore this lifting effect can be as well achieved in zones which are difficult to treat with classical surgical face lifting procedures (e.g. the area around the mouth and the lower eye lid area).

There are other peelings available which are targeted only on the exfoliative effect, that means they provide only the removal of old skin cells to enhance the appearance of the skin but have no lifting effect which can remove deeper creases and wrinkles. These superficial or medial depth peelings are for example the Fruit Acids peelings or the glycolic acid peelings which can not be considered as an alternative for surgical lifting procedures.

An alternative to deep chemical peeling is the EXOmask which is only available at a few selected centres in Europe. Based on a special chemical formula which has been developed over 30 years through extensive testing on human tissue samples in the laboratory, EXOmask provides a deep lifting effect on the dermis without any destruction of the underlying pigment cells (Melanocytes), which are responsible for the skin colour and the natural sun protection through the tanning effect. Most of the other deep peelings currently available have an immanent risk of permanent depigmentation of the treated area, which results in an unsatisfying skin colour and the mandatory use of permanent sun protection.

The EXOmask treatment is carried out in only one session, mostly as an out-patient procedure, under local anaesthesia and in some case including a light sedation. After the peeling lotion has been applied, an elastic silicone mask seals the face for 24 hours allowing the solution to penetrate into the deeper part of the skin. This process is painless, the patient can in most cases go home with the mask and sleep normally. After 24 h the mask is removed and a special powder is applied on the skin. This powder enhances the regeneration process and serves as a dressing for 7 days until the new skin has grown completely.

After 7 days the results are instantaneous, the patient has a smooth and spotless skin and the lifting effect through the skin retraction is completed. Due to the ongoing regeneration process of the deep elastic fibres the new skin is widely vascularized and therefore shows a redness which will slowly fade during the next 8-10 weeks but can be covered up completely with make up.

In conclusion the EXOmask peeling is an attractive alternative for patients who have an overall ageing of the facial skin and want effective facial rejuvenation without undergoing classical surgery procedures.

The EXOmask treatment is carried out in only one session, mostly as an out-patient procedure, under local anaesthesia and in some case including a light sedation.

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Editorial: Dr. Pier Albrecht, Dr. Pierre Albrecht, Dr. Pierjean Albrecht,

Dr. Pier Jean Albrecht, Dr. Pierre F. Albrecht, Dr. Pierre Frank Albrecht,

Dr. P. Frank Albrecht, Dr. Pierjean Frank Albrecht, Marbella Clinic

Reduction and Breast Lift

Having been since ancient times an outstanding symbol for femininity and fertility the female breast has always been a central part of the visual image of any woman, and despite the many historical changes that image underwent during the last centuries, there was at any given cultural period a quite well defined image of the ideal breast which inspired artists, fashion and society.When we take in consideration western society’s actual idea of an ideal breast, we experience the recreation of a more female look and style. A full breast is considered as sensual and beautiful and fashion and media are competing to visualize this image day by day.

Therefore, breast augmentation is more and more sought after, especially by young women, to approach their individual image of the perfect breast. But something which is not covered in most features covering aesthetic surgery of the breast is the fact that there are even more women suffering from very big or very saggy breasts who are searching for the possibility to get a smaller and beautiful shaped breast.

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This misinformation about the possibilities of modern plastic surgery combined sometimes with the perception of the unfavourable results of some ancient techniques still keeps many women suffering their whole life from their big breasts; with this article we want to provide this missing information by explaining modern techniques of breast lifting and breast reduction and to offer you solutions to this common problem.

From a plastic surgeons view, there are distinctive measurements which define a perfect breast, but aside from those more academic definitions a woman’s feeling regarding her breast size and shape should always be our individual guideline. A breast which may be perfect for a woman looking for a more female and seductive appearance can be much too large for a small-framed woman who loves to do sports and has a more girl-like image of herself.

So the surgeon will consider your personal feeling regarding the size and the form before talking with you about any reduction or lift. After this has been thoroughly discussed the surgeon can evaluate if the adequate technique is a lift which removes only excess skin to achieve a firm and uplifted breast or if a removal of glandular tissue is necessary to meet the patient’s expectations.

A breast lift, sometimes also called a mastopexy, is a procedure which consists of removing excess skin without any removal of glandular tissue to lift up a sagged breast while keeping its original volume. If the sagging and the loose skin are less important the so called Benelli Lifting Technique can be performed removing skin only around the areola. In this case the resulting scar will be only around the areola and is barely perceptible after one year because it is placed exactly on the border of the pigmented areola. If the sagging and consequently the excess of skin are more important, a skin resection of the lower breast pole combined with a resection around the areola is necessary to achieve the desired lift. The result is the circular scar described above and a vertical scar descending to the fold under the breast.

If a patient is suffering not only from an excess of skin but from an excess of glandular breast tissue (Macromastia) the patient’s expectations can mostly only be met by a so called breast reduction procedure. There are multiple factors which can be responsible for Macromastia, in most cases it is a combination of a genetic predisposition together with hormonal changes which can be induced by onset of puberty, pregnancy or menopause. Even without considering the aesthetical aspect, very large breasts are often the origin of serious functional problems like chronic back and neck pain, arthritis of the neck, chronic eczema of the breast fold and others.

Therefore already 2 centuries ago very large breasts represented a serious problem for many women, so the plastic surgeon’s quest for aesthetically and functionally satisfying procedures started in 1882, with the first described breast reduction by the English surgeon Thomas. In the attempt to develop techniques which provide minimal scarring combined with a safe surgical procedure at least 15 different procedures where described during the last century.

Some of those ancient techniques are still frequently used and widely accepted, others have been replaced by more modern procedures, but the basic principle of all breast reduction techniques still remains the same: a circular incision around the areola which allows for skin removal and uplifting of the nipple-areola-complex combined with a vertical incision descending toward the lower breast fold which allows for breast tissue removal in the lower quadrants of the breast. This vertical incision is necessary because any removal of glandular tissue requires a reduction of the skin envelope as well, so by tugging the remaining skin into this vertical oriented scar for suturing the surgeon can rearrange the remaining breast tissue to recreate the natural round breast mound.

Depending on the technique used the scar descending from the areola can have the form of an L, of an inverted T or just be a vertical line. The L or the inverted T shaped vertical scar techniques are the more ancient procedures, but they still have their justification in very large reductions where the single vertical scar technique can not cope with the associated excess of skin.

The more recent technique based on a single vertical scar in combination with the circular scar around the areola was described 1998 by the Belgian surgeon Madeleine Lejour. This surgical approach is based on the ability of the skin to shrink once it has been freed from the glandular breast tissue, so that large amounts of excess skin which would normally need an L or inverted T shaped skin excision can be rearranged in just one vertical scar by using a special purstring suture technique.

Offering the big advantage of minimal scarring, this technique can be used in almost all reductions except for breasts which are extremely big and sagged. Because of the reduced incisions, healing is fast and most patients can get back to normal life activities after 2 weeks. Due to the fact that this technique is based on the postoperative shrinking of the skin, the reduced breasts require 3-6 months after the operation to achieve their final position and the desired aesthetic result; during this early stage the lower half of the breasts will show some small skin folds which will smooth out gradually.

By using all the techniques available after more than hundred years of modern plastic surgery research, the modern breast lift and breast reduction procedures provide excellent aesthetic results combined with an invaluable effect on the functional problems mentioned above resulting in an important improvement of life quality.

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Editorial: Dr. Pier Albrecht, Dr. Pierre Albrecht, Dr. Pierjean Albrecht,

Dr. Pier Jean Albrecht, Dr. Pierre F. Albrecht, Dr. Pierre Frank Albrecht,

Dr. P. Frank Albrecht, Dr. Pierjean Frank Albrecht, Marbella Clinic

Pier Albrecht – More than just a Face-Lift

By Dr. Pier Albrecht, Director de Marbella Clinic

The most recent advances in lifting involve various techniques and work on the different layers of the skin, achieving results with a more natural effect For several decades now, and even as far back as the nineteenth century, surgeons have attempted to correct the effects of ageing by lifting the skin on the face. All kinds of techniques have been employed, with early attempts resulting in visible scars right in the middle of the forehead or the temples, and later attempts more successfully hiding the scars in the hair or in front of the ears.

The idea was to re-stretch the skin which progressively loses its elasticity, not from top to bottom in line with gravity, but at an angle from the chin to the ears, and from the eyes to the temples, dividing the face into three horizontal segments: The neck and jaw, the cheeks and eyes, and the temples and forehead.

THE REJUVENATING EFFECTS OF THESE FACE-LIFTS UNFORTUNATELY DID NOT YIELD LONG LASTING RESULTS, WHICH MEANT that surgeons had to operate three or four times on the same patients over a period of twenty years. The Surgical look or cat look, in other words the expressionless masklike appearance that resulted from these operations, was indeed free from wrinkles and taut, but was rather unattractive and unnatural looking.

It wasn’t until 1992 that surgeons in France hit upon the idea of associating the skin’s elasticity with the tension of fat and tissue, which cover facial muscles.

Whilst this produced more durable results, surgery was still carried out at an angle, so that after the second or third face-lift, the effect was increasingly less natural.

We have to thank a few plastic surgeons for a new approach, which consists in recognising that the skin loses its elasticity in line with gravity, i.e. vertically, and that it is therefore preferable to divide the face into three vertical rather than horizontal segments. You can observe how the central segment of the nose and chin, and the outer segment close to the ears, wrinkles but does not sag. Only the skin on the cheeks and lower cheeks drops, in a similar way to the breast area. The new technique consists in lifting vertically the whole lower cheek-cheek-eyelid-eyebrow-forehead area, which enables these parts of the face to be repositioned where they were twenty years earlier. The position of and distance between each facial element is respected, which enables a totally natural look to be achieved.

To complement this new approach, I also offer patients the option of stretching the neck and jaw tissues, replacing the cut, which is visible in front of the ear lobe and is hidden behind the outer ear. Nowadays we are therefore able to offer a natural looking remodelling of the face, as long as the first face-lift is not left until too late to be performed, before the skin loses its elasticity.

Finally, it is important to point out that face-lifts affect the skin and the muscles, but do not change the quality of the skin or the volume. In order to obtain better results, it is advisable to use a gentle facemask called microdermabrasion and to restructure the skin by fat injection in the areas, which lack flesh, and/or semipermanent or permanent products to smooth out wrinkles. In short, the new approach to face-lifts provides natural results, by combining techniques, and by working on several levels of tissue – the surface of the skin, the skin and the hypodermic levels of the skin – as well as by focussing on tissues and muscles.

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Editorial: Dr. Pier Albrecht, Dr. Pierre Albrecht, Dr. Pierjean Albrecht,

Dr. Pier Jean Albrecht, Dr. Pierre F. Albrecht, Dr. Pierre Frank Albrecht,

Dr. P. Frank Albrecht, Dr. Pierjean Frank Albrecht, Marbella Clinic