And this is not surprising as we all know, that the signs of aging are reflected in large measure by the eye/ facial expression and appearance.

Huge effect, quick procedure: The upper eyelid surgery (local or general anesthesia, ½ to 1 hour) implements a removal of excessive skin and – depending on the case – fat tissue.

The result is amazing because: At Aestheticon® only sophisticated plastic/ aesthetic surgeons with many years of surgical aesthetic experience perform this kind of operation!

Further classic Aestheticon® procedures are:

– Laser Hair Removal: from top to toe

– Botulinum toxin and filler treatments

– Skin Care: This month’s highlights are Medical Peels for each and every skin condition

– Skin Surgery: Skin tags, tumor, mole, warts removal, wound treatments, scar removal

– World renowned Face Surgery & Breast Surgery all round!

– All kind of proven plastic/ aesthetic procedures of the body!

– Specials: female genital and perineal reconstruction surgery

– Hand Surgery: Congenital abnormalities, disorders, infections, injuries including sport injuries,
diseases incl. chronic hand diseases, anti-aging treatments of the hand

– Foot Surgery such as bunion, hammer toe

What procedure are you interested in?

Please contact us, ask us any questions, and book your appointment at +971-52-9843498 (also WhatsApp), +971-4-4311863, [email protected] or www.facebook.com/Aestheticon, Saturdays to Thursdays, 10 am – 7 pm and on appointment.

We look forward to welcoming you!

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Surveys show that most people consider the doctor or physician as the most trustworthy person. As much as this fact fills doctors with gratitude and joy it is also a massive obligation to not misuse the patient’s trust.

As an expert in the field of Plastic and Aesthetic Surgery, I have come across all kinds of consultation styles being used or performed by colleagues. Some I have witnessed firsthand, most through patient’s reports. Patients expect from their trusted physicians that those will advise them in regards of best possible options to achieve the best possible treatment results. This is the patients’ right and is any way the obligation of each doctor. The fundamentals of this right are derived from the Hippocratic Oath, which was written in the late 5th century BC.

In reality, it’s not black and white. Aesthetic procedures are not performed to cure a physical disease. They are performed to improve one’s appearance and to boost their self-esteem, thus elevating their spirit. The crux is that there are many ways to approach a problem, some equal in efficacy some not.

How does a surgeon choose what to advise a patient about?

My first rule is to determine if what the patient wants is achievable at all. The second rule is to decide for myself is this is something I am ethically ok with and can see the patient’s point. If both rules are covered I engage in an in-depth consultation with the patient. Here is where approaches between surgeons can differ.

Some surgeons know, that what is asked is not achievable or at least not for them, because they may lack the experience or training. In that case, they should send the patient away or refer them to a colleague who can help. And this is exactly what patients would expect, because they trust the profession, as explained above. If a surgeon now chooses not to send a patient away but to propose a less effective procedure just to convert the business, the patient would not know until after. This is a very common complaint I hear from patients who come to us for correction of outside performed procedures.

Some surgeons don’t understand the patients’ point or know what is asked should not be entertained for ethical reasons. For example, performing a liposuction to replace a much-needed diet with weight loss. By performing ineffective or unnecessary procedures on the patients they break the rule of the Hippocratic Oath “you shall not harm”.

From my experience, it is a matter of course that our patients’ needs can usually be satisfied. However, from time to time it can happen that I have to tell a patient, that her / his perception of the treatment result is not realistic and thus not achievable. This can be due to different reasons e. g. former misinformation regarding the treatment/ surgical options and expected results or for the special condition of the respective patient.

If you need to make a decision, which doesn’t meet the patient’s expectations, the patient will understand the reasons and take gratefully the advice, if they feel that you act out of concern for their wellbeing.

The Patient’s Benefit doesn’t allow compromises

Only rarely it happens, that a patient will consult another doctor to hear what she/ he might like to hear, but I truly believe that professional advice for the benefit of the patient does not allow any compromises. Experience shows that those patients, who underwent a procedure elsewhere against better advice, eventually come back to have things rectified.

Hand Surgery is beside the Aesthetic Surgery I do, one of my favorite surgical fields. It requires a profound knowledge of the anatomy and superior surgical skills as the hand is packed with tendons, nerves and arteries in close proximity.

What is Dupytren’s Contracture?

The Dupytren’s contracture is a disease of the connective tissue of the hand mainly the palmar aponeurosis which lies right under the skin of the palm and fingers. In patients suffering from this disease, the fibers of the palmar aponeurosis start growing, thickening and contracting. This leads to the fingers being bent in the base joints.  Extending the fingers is not possible, but flexion into the fist still works. The disease usually starts on fingers 3 to 5 (middle to little finger), but can also be seen at the index finger or thumb. In very severe cases all fingers can be involved.

We know four stages with stage 1 being the beginning of the disease with the Dupuytrens cord just being visible to stage 4 being the most severe stage with flexion of the fingers into the fist making them literally unusable. The exact cause is still unclear but linked to genes more spread in Europe and North America.

How Dupytren’s contracture is treated?

In the beginning, the disease can be treated by physiotherapy or application of night splints to keep the fingers stretched. If it progresses to stage 2 and beyond invasive measures have to be taken. In recent years a minimal invasive treatment has been quite popular which uses percutaneous needles to cut the chords and straighten the finger. However, it cannot replace the surgery as recurrences are high. If a surgery is necessary, all affected connective tissue chords will be removed and the underlying nerves, vessels and tendons will be spared. Depending on the severity of the case and in recurrent cases it can be a demanding and time consuming surgery which should be left for the very experienced and trained hand surgeons.  

Do you need physiotherapy after the surgery?

After the surgery usually a splint is applied to keep the fingers straight for 7 to 14 days. The skin sutures can be removed on the 12th to 14th day. After that physiotherapy will help in regaining full function quicker. Most patients can resume their normal daily activity 2 weeks after the surgery.

As a matter of fact, the surgical treatment of Dupuytrens disease was a routine procedure during my time in Germany. Almost every day we would treat patients with this condition. Having operated on more than 1000 of patients the outcome in my hands in reliably positive.

This is of particular importance as the recurrence rate of a Dupuytren is reported to be very high in the literature especially if a non-experienced surgeon performs the surgery.

Whoever suffers from this condition should, therefore, seek for hand specialist with a proven track record of successful surgical treatments of Dupuytren’s disease and sufficient experience in the field.

Last but not least surgeons who operate on this disease should also be versed in the repair of vessels and nerves to be able to reconstruct these structures if during the surgery damage to them happens.

“Can you avoid a rejuvenation surgery of face and eyes by undergoing repeatedly filler and/ or botulinumtoxin procedures?”

This topic is discussed quite controversially and the answer is not that simple.

Patients, who are looking for rejuvenation treatments of face and eye area, have the option to consult medical practitioners with different backgrounds, thus there can be more than one medical specialization engaged. According to their specializations, the practitioners will give their professional advice for a treatment, which can turn out very differently.

For instance, if a doctor does not perform surgeries at all, she or he will most probably advise to avoid surgeries and opt for non-invasive treatments for as long as possible. Does this work for a patient in his or her late 30’s? Yes, definitely, but maybe not that well for someone older than 45 years.

The crux is, that if you wait for too long before you opt for a surgery, the skin may have relaxed to an extend that an optimum result is difficult or not at all to achieve. Very often I need to tell patients, who are in their 60’s, and ask for my advice in my clinic, that it would have been better, if they had visited me a few years earlier. The majority of them tell me, that they have spent ten thousands of dollars over the past 2 decades for non-surgical treatments and that these procedures have not delivered the desired results after a certain age.

So what is the best solution? Every treatment has its rightful place for the right patient at the right time. A medical practitioner, who is able to offer both, non-surgical and surgical treatments of a broad spectrum, like a Plastic Surgeon, is the best person to seek advice regarding the right time/ age to opt for a surgery.

It has been shown over the last decades, that in order to achieve the best and longest lasting results with lifting procedures of face and eyes, the best average age bracket is between 45 and 55 years. In this age group you already see clear signs of ageing, but tissue quality and elasticity of the skin are still good enough to achieve an optimal lifting effect. On top of that, it plays an important role which surgical principals your surgeon follows and which technique is used, but that will be the topic of my next blog.