Friday, 15 September 2017

Breast Reduction - Your Questions Answered

While many women dream of having bigger breasts, for others big boobs can be a curse.

If you suffer with back or neck pain, struggle finding clothes that fit or experience discomfort when exercising, then a breast reduction could be the solution you’re looking for.

We understand, however, that having elective surgery is a big decision and you will have lots of questions. The surgeons at Ocean Clinic Marbella have extensive experience of breast surgery and we invite you to make an appointment for a free consultation to have all your questions answered.

In the meantime, here are answers to some commonly asked questions to help you in making your decision to have a breast reduction.

Should you wait until you’ve finished having kids before having a breast reduction?

If your breasts are causing you severe pain or discomfort, a breast reduction can bring you great relief - waiting until after you’ve completed your family will only extend your suffering. It’s worth noting that your breasts will increase in size during pregnancy, further exacerbating your symptoms.

However, because having a breast reduction may impair your ability to breastfeed you must weigh up the benefits of having smaller, more manageable breasts versus possibly having to formula feed your baby.

It’s also possible that you will require secondary breast surgery following pregnancy (if your breasts have significantly increased in size or changed in shape). For this reason, if it is purely for aesthetic reasons you are seeking a breast reduction, then it is better to wait until after having children to avoid revision surgery.

Will I be able to breastfeed following a breast reduction?

There is a risk of reduced ability to breastfeed with breast reduction surgery, however it can be greatly reduced by leaving the nipple and areola area still attached to the breast tissue beneath.

The experience of your surgeon will make a big difference to the amount of nerve damage sustained. Nerves are vital to breastfeeding because they trigger the release of prolactin and oxytocin, two hormones that affect milk production and letdown.

It is advisable to wait at least 18-months after having a breast reduction before becoming pregnant, giving your nerves time to recover and for full sensation to return.

How old do you have to be to have a breast reduction?

It is best to wait until you are at least 18 before having breast reduction surgery to be sure your breasts have finished developing. However, we understand there are many younger teenagers with breasts that are causing them extreme discomfort and psychological distress.

At Ocean Clinic Marbella we assess the suitability of each patient on a case-by-case basis, regardless of age. Breast reduction surgery can be an excellent option for some younger patients. However, it’s important to understand that further surgery may be necessary in the future, if the breasts were to grow in size again.

Can asymmetric breasts be corrected through breast reduction?

The breasts can be made more symmetric as part of breast reduction surgery. This is achieved by reducing each breast by a different amount. The shape of the nipple-areola complex can also be made symmetric at the same time.
However, absolute breast symmetry should not be expected with any type of breast surgery. There are many factors which may contribute to asymmetry, such as your rib cage, which can not be treated with a breast reduction.

Should I lose weight before having a breast reduction?

Ideally you should wait until you reach your goal weight before having breast reduction surgery. This will give you your best aesthetic result, since losing weight after your surgery could leave you with saggy breasts and/or loose breast skin.

That being said, many large breasted women find it too difficult to exercise, which inhibits their ability to lose weight. If you are unable to be properly active because of your chest size, then it makes sense to have a breast reduction sooner rather than later.

Can a breast reduction be done by liposuction alone?

Breast reduction can be carried out via liposuction alone but it is only suitable for a select group of patients. Your suitability for this procedure will depend on the amount of reduction you desire, how much sagging you have and the quality of your skin.

It is ideal for younger patients who only wish to go down one or two cup sizes. Younger people tend to have better skin tone meaning they will enjoy better retraction. Reduction via liposuction can provide these patients with good results without any scarring.

Liposuction will not provide pleasing aesthetic results for patients with a significant amount of ptosis, however it can be useful for reducing weight to alleviate back and neck pain.

What scars will I have following breast reduction?

There are two main techniques for carrying out breast reduction surgery. The Lejour, used for moderately heavy breasts, involves making an incision vertically from the base of the breast, up to and around the nipple (it mimics the shape of a lollypop).

The second technique, Hall-Findlay, is used for very heavy breasts or those with pronounced sagging, and involves an anchor-shaped scar. The incision goes around the nipple, extends from the nipple down to the base of the breast and then in the breast fold itself.

Scarring will be pink for a number of months but should eventually fade to become unnoticeable.

Will my nipples be cut off during breast reduction?

Usually the nipples remain attached to the breast tissue beneath (the pedicle technique) and simply moved to a higher position. Free nipple graft (complete detachment) is only necessary for extremely large breasts or very low nipples.

This technique is avoided where possible because the nipple areolar complex loses its blood supply. This results in loss of sensation and projection as well as loss of pigment. The nipple becomes either deep pink for darker skin types or pale pink for lighter skinned individuals.

Will a breast reduction correct sagging breasts?

A breast reduction alone will not correct sagging breasts. If you are suffering with breast ptosis (sagging) as well as excess breast tissue, it’s likely that your surgeon will recommend you have a breast lift in combination with your reduction.  

The lift moves your breast tissue higher on the chest wall and firms up your breasts, giving them a more youthful look. The breast lift is carried out using the same incisions so there is no additional scarring. Liposuction may also be used as part of your breast surgery to sculpt your breasts into a pleasing final shape.

Are you under local or general anesthetic for a breast reduction?

Breast reduction surgery is performed under general anesthesia. With this type of anesthesia the patient is completely unconscious during the procedure and will stay overnight in the clinic.

A liposuction-only breast reduction can be performed on an outpatient basis, with sedation (twilight sleep) plus local anesthetic.

How painful is breast reduction?

Because breast reduction only deals with skin and fat (not muscle or bone) it is one of the least painful procedures. Most patents have some discomfort for a few days only but rarely true pain.

Women are usually so happy to have the extra weight off their breasts that the minor pain from the incisions is a welcome trade off.

How much does a breast reduction in Spain cost?

The cost of breast reduction surgery in Spain is usually in the region of €5,000 to €6,500.

Ready to learn more about breast reduction? Contact Ocean Clinic Marbella to make an appointment.

Tuesday, 29 August 2017

Gym Not Working? Sculpt Your Body with Implants

It’s incredibly disheartening to dedicate months to working out and not see any results. It’s an unfortunate fact that some people find it much harder to build muscle mass than others.

Fortunately there is a solution. Silicone implants, historically used for female breast enhancement, now come in a range of shapes and sizes suitable for augmenting different areas of the body - for both women and men.

Ocean Clinic Marbella now offers breast, gluteal, pectoral and calf implants, enabling you to create the physique you desire. Read on to discover how implants can give you the broad chest and strong legs you’ve always wanted.

Chest Implants (Pectoral Implants)

Many men wish to have larger, more defined pecs but find they are unable to achieve this through lifting weights. Pectoral implants are designed to change the contours of the chest and are made of a soft but solid silicone that mimics the look and feel of real muscle.

Pec implants can be inserted via a small incision in the armpit, meaning it is not necessary to create scars on the chest itself. The armpit, with its natural folds and hair growth, presents the ideal place to hide the incisions and ensures the procedure is highly discreet.

Just like with breast implants, pectoral implants come in a range of shapes and sizes to suit your body and create the look you desire. Your surgeon will take careful measurements of your chest to help you select the right implant and ensure the end result will be muscular and masculine.

A highly natural appearance is created by inserting the implants between the pectoralis major and pectoralis minor muscles, which hides the outline of the implant. The surgeon will create a carefully sized “pocket” in which to put the implant, symmetrically placed on either side of the chest. This holds the implants firmly in place and ensures they remain above the inframammary fold; important for maintaining a manly appearance.

None of the muscle is damaged after pectoral augmentation, although it will be stretched initially. As the body heals, a “capsule” of collagen will be formed around the implants, which further prevents dislocation.
It is necessary to abstain from exercise for around six weeks post-op but after that light cardiovascular exercise can be resumed. After 12 weeks patients are able to return to body-building exercises. The chest can still be developed naturally through weightlifting, despite the implants being in place.

Pain post-op is well managed with painkillers but it is advisable to factor in a week of downtime. You will also be unable to drive for a week or lift your arms above your shoulders for around 10 days while the incisions are healing.

As well as enhancing underdeveloped muscles, chest implants can also be used to provide aesthetic correction in patients who have asymmetry (uneven chest) or other abnormalities of the chest wall, such as pectus excavatum or Poland Syndrome.

Calf Implants

Skinny legs can be the cause of much embarrassment for men. Often they will be too uncomfortable to wear shorts, preferring instead to suffer in Spain’s heat. Lack of calf development is especially noticeable for men who work out and have achieved upper body bulk, causing them to look top heavy and unbalanced.

Tall men, too, may feel extra conscious about thin, unshapely legs. Lack of calf muscle can be genetic (if your father has skinny legs, you may too) or may be caused by a health condition or injury. In some patients, calves are asymmetric, with one side bigger than the other.

Calf implants can be used to either create a more proportioned leg (single implant) or a leg that appears more muscular and defined (two differently sized implants in each leg). The implants are made of soft but solid silicone that replicates muscle and are available in a range of shapes and sizes.

Your surgeon will take measurements that will enable them to suggest an appropriate implant for your body and aesthetic goals. The style may be limited by the tightness of your muscle or amount of existing tissue. These factors will also influence the placement - either beneath the calf muscle (submuscular augmentation) or on top of the muscle but beneath the tough fibrous fascia that surrounds it (subfascial augmentation). The fascia is a very tight and strong layer covering the muscle and will both hold the implant in place and camouflage its edges.

For both methods the implants are inserted through a two inch incision in the crease at the back of the knee. While this will be visible at first, the scars should heal to be largely unnoticeable. The results achievable with calfplasty are highly satisfactory, while implants do not inhibit any form of sporting activity.

Patients must, however, wait eight weeks to return to running and 12 weeks before resuming any vigorous leg exercises (lifting weights). For the first couple of days of your recovery, your legs will feel as if they have run a marathon and you may need crutches to help you get around. It is therefore advisable to take a week off work.

Ready to shape your perfect physique? Contact Ocean Clinic Marbella for a free consultation.

Wednesday, 16 August 2017

New VR Tech That Lets You “Try On” Body Modifications Comes to Ocean Clinic

Deciding to have cosmetic surgery can be daunting. Wouldn’t it be great if you could “try on” that new nose or larger breasts before committing to surgery? Thanks to the latest developments in 4D virtual reality, you can.

Ocean Clinic Marbella is one of the first plastic surgery clinics on the Costa del Sol to offer this advanced service. It means that patients can finally have an answer to the question, “What will I look like after surgery?” - simply by popping on a VR headset and looking into a virtual mirror.

How does 4D virtual reality imaging work?

The 4D simulation technology can be used to visualise all sorts of face, breast and body procedures. To see what you would look like after a facelift, with fuller lips or a flatter tummy, all that is required is three normal photographs.

The consultant takes the photos from three different angles (left, centre and right) and then uploads them to the Crisalix software. Within minutes the system generates realistic 3D views, which show how the patient would look post-surgery from various perspectives.

But to really get an idea of what to expect, patients need to “try on” on the body modifications. To enable them to do this, the 3D images can be viewed wearing a virtual reality headset, creating a 4D environment you can interact with.

It appears to the viewer as if they are looking at themselves in a three-way mirror. They are also able to look down at their own virtual body. This means breast augmentation patients can actually “see” the new breasts on their chest. It’s so realistic, most patients reach out to touch them!

What procedures can be visualised in 3D/4D?

Nearly all cosmetic procedures can be simulated, including minimally invasive treatments such as Botox and fillers. Being able to visualise changes to the face is especially valuable for patients, since procedures such as rhinoplasties and chin implants can dramatically alter appearance.

When it comes to breast augmentation planning, the Crisalix system really comes into its own with the ability to simulate almost every implant available on the market (more than 5,000 models). It also lets patients try on a virtual wardrobe of clothes to see how their breasts would look in different outfits.

Here are just a few of the procedures that can be simulated:

  • Buttock implants
  • Tummy tuck
  • Pectoral implants
  • Breast implant revision
  • Eye lift
  • Brow lift
  • Neck lift
  • Thigh lift

How accurate are the results?

It will never be possible to give patients an exact picture of how they will appear after surgery, this is because of all the variables that can affect your outcome, such as the way your body heals. Despite this, it can give you a very good idea.  

Head surgeon at Ocean Clinic Dr. Kai Kaye says the new technology is a useful tool to add to existing consultation techniques: “For patients to achieve realistic expectations prior to surgery it is still necessary, first and foremost, to have good verbal communication with the surgeon. However, this is a wonderful tool for helping patients visualise how they will look after surgery.

“The Crisalix system has been developed in consultation with hundreds of surgeons and is now used at leading clinics around the world. Patients who have viewed 3D simulations prior to surgery have reported higher levels of satisfaction, so we are delighted to be able to offer this service here on the Costa del Sol.”

Interested in a virtual reality consultation? Contact Ocean Clinic Marbella on 951 775 518 or email  

Tuesday, 1 August 2017

Patient Case Study: Breast Implants

What’s it like to undergo breast enlargement surgery? If you’re thinking about having this procedure but unsure about what to expect, read our patient’s first hand account…

Deciding to have breast implants

I became unhappy with my breasts after having my son. Before pregnancy, my bra size was a full 32D and I’d always considered my breasts one of my best assets. However, post-baby they shrank to a small C cup. I’d lost volume from the top of my breasts; they were no longer full and I had to start wearing padded bras to fill out my tops. I just didn’t quite feel like me anymore.

I deliberated long and hard about the surgery - my son was five by the time I finally decided to take the plunge. I was worried about my boobs looking fake or too top heavy. I also feared losing sensitivity and complications. What persuaded me was looking at the before and after photos from Ocean Clinic and seeing how amazingly natural implants could look. I also researched the risks and was reassured that - with an experienced surgeon - these would be minimal.

I discussed my aesthetic goals with Dr. Kaye, telling him that I simply wished to restore my breasts to the size and shape they were previously and that I hoped they would appear as natural as possible.

Initially, I had thought about having anatomical “teardrop” shaped implants or saline implants that are not completely full so that they act like a natural breast when you lie down, rather than staying static on the chest.

However, after examining me, Dr. Kaye advised that these would not be the best option, since it was upper pole fullness that I wanted to restore - both of these implant types would place more fullness in the lower pole. Instead, he suggested round, silicone implants. He measured my chest to ascertain the correct size for my torso and suggested 300 cc. I tried sizers on under my top to get an idea.

Marked up for surgery 

Another important decision was which implantation method I should have. There are three types -
inframammary incision (under the breast crease), periareolar incision (around the nipple) and transaxillary incision (in the armpit). I was interested in the transaxillary approach as I didn’t like the idea of scars on my breasts, since I have very pale skin. Dr. Kaye said this would be a good choice for me because I also have small nipples, so a periareolar incision wouldn’t be the best option.

The incisions made in a transaxillary breast augmentation are made in the natural creases of the armpits, so are as good as hidden. I had heard that the implants could be harder to place via the armpit as the surgeon does not have direct access to the breast like they do with an inframammary incision and therefore the risk of malposition is higher. However, I learned that by inserting the implants endoscopically, the surgeon gets a clear picture of the entire pocket on a TV monitor making it easy to place the implants correctly.

Meanwhile, using round implants eradicates the risk of breasts becoming misshapen should implant rotation occurs (if a round implant rotates the shape of the breast stays the same, unlike with a teardrop shaped implant).

I told Dr. Kaye that I would like placement under the muscle (submuscular), as opposed to subglandular so that there was no chance the implant could be seen beneath the skin (also there’s a lower risk of capsular contracture with this placement). He agreed this would be suitable for me.

With all the details decided I just had to wait a month for my surgery!

The day of surgery

During the wait for my surgery I started to have second thoughts about how big I wanted to go. I am a keen horse rider and started to worry that implants might be uncomfortable when riding. I also didn’t want my boobs to be the first thing people noticed about me, so I decided to discuss the possibility of having smaller implants.

The doctor carrying out my surgery was Dr. Benito Ruiz and he came to meet with me in the morning. I shared my worries with him and he took various measurements before agreeing I could have 270 cc. This would fill out the empty bit of my breasts at the top, while not making them overly large - I would go up by roughly one cup size. I was happy and reassured by this and stopped worrying about waking up to find a huge pair of knockers on my chest!

The surgery was over in a flash. All I remember is lying down on the bed in the operating theatre, feeling a small scrape on my hand and then nothing. The next thing I knew, I was waking up in the recovery room. I was taken by wheelchair to my room and helped into bed. I had bandages wrapped around my chest and two drains (plastic tubes with a container on the end) coming out of each armpit to drain away any blood from around the implants.

I learned that Dr. Ruiz used a “Keller funnel” to insert the implants. This advanced technique means the implants do not get touched, which decreases the chance of skin bacteria being drawn into the breast implant pocket. This is something which can lead to a capsular contracture.

In terms of pain, the meds coming through the IV line were doing a good job but I did have great difficulty in trying to sit up. You don’t realise how much you use your chest muscles until they’re out of action. Getting out of bed to go to the loo, bringing the drip and drains with me, was quite a challenge. The worst thing about the recovery immediately after surgery was the nausea I felt. I felt very sick and wasn’t able to enjoy the lovely meal that was ordered for me. I let the nurse know and she explained it was probably the anti inflammatories that were making me feel ill. She gave me some anti-sickness medicine which really helped.

I slept overnight at the clinic and in the morning Dr. Kaye’s resident Dr. Paprottka came to check me so I could be discharged. He had to remove the drains which was pretty painful but over very quickly. He helped squeeze me into a special surgical support bra, which he told me I should wear constantly for a month. I was then able to go home.

The recovery

My pain levels were easily manageable at home with the painkillers I had been instructed to get (I had a course of antibiotics to take too), I just found myself a bit tired. It didn’t help that the weather was extremely hot and the big surgical bra was making me extra warm. At least I was free to take a shower. Although I had dressings under my armpits, I could get these wet and then dry them with the hairdryer.

I had a peek at my new boobs when I took the bra off to shower. They felt full and sore, similar to after I’d given birth and my milk came in, but I couldn’t believe how good they looked already! Although they were still swollen and sitting a little high (it takes a while for the muscle to stretch and for them to drop), there was next to no bruising and the placement looked great. I showed my husband and he was suitably impressed!

One month post-surgery

The first night, I realised I’d have to get used to sleeping on my back for a while (something I hadn’t thought about), but I was able to get comfortable enough by propping myself up on cushions. I also had to ask my husband for help taking my top off and reaching up for things in the kitchen cupboards. I’d been told I couldn’t drive for a week, so he had to do that too. Plus he had to take responsibility for walking the dogs because they pull on the lead. Luckily my son understood that I couldn’t pick him up.

I had my surgery on a Friday and because I have a desk job working from home, I was able to return to work on Monday. Downtime was pretty minimal - I even had a night out on the tiles for my friend’s birthday just one week later. I’d been a bit worried that it was too much too soon, but I was fine.

I did end up swapping the surgical bra for a maternity bra after a few days because it was simply too hot and uncomfortable. Dr. Kaye approved the bra when I attended the clinic for a dressing change but gave me a elastic strap to wear over the top to keep the implants pushed downwards.

My stitches were removed after 10 days and I could already see the scars were healing really well. I returned to the clinic once a week to have ultrasound therapy and lymphatic drainage, which helped to speed up healing and reduce swelling. After four weeks, swelling was almost gone, the implants had dropped a little and my breasts were starting to feel softer. My scars were already fading to white and I was able to swap to normal non-underwired bras and sleeveless tops (I could get back on my horse again too).

It’s now been five weeks and my new boobs no longer feel alien, they just feel like part of me. I know it could be up to a year until they have totally bedded in and softened up, but I’m already thrilled with them. I now fill out all my old tops, dresses and bikinis again and feel more confident. Despite all my fears and reservations, having the surgery was definitely the right choice for me.

Considering a breast enlargement? Book a free consultation at Ocean Clinic Marbella to discuss your options. Contact us today.

Friday, 14 July 2017

Second Marbella Meeting for Plastic and Aesthetic Surgeons Doubles Attendance

Marbella’s assets proved a big draw for plastic and aesthetic surgeons, attracting 110 specialists from around the world to attend the second edition of the Marbella International Plastic Surgery Summer School (MIPSS).

The number is more than double the amount of delegates that attended last year. The medical meeting, organised by Ocean Clinic Marbella, mixes high-level knowledge sharing with a vibrant social programme.

It took place from June 22-24 at the H10 Andalucia Plaza Hotel, with live surgeries broadcasted into the auditorium from Ocean Clinic’s in-house operating theatre, located on Av Ramon y Cajal.

Ocean Clinic's Medical Director, Dr. Kai Kaye says: “We have been blown away by the success of the summer school, which, after one year, has doubled in size and attracted participants from over 20 countries. Some travelled from as far away as America.

“The meeting has also been endorsed by five separate professional associations, including the International Society of Aesthetic Plastic Surgery, which is testament to the high scientific level of the education.”

MIPSS’ education track included 35 lectures and three live surgeries from an international panel of speakers representing more than 10 countries. Topics included new concepts in facial rejuvenation, body contouring, breast augmentation, reconstructive and transgender surgery.

Because the meeting was sold out, it was necessary to move from previous venue Hotel Fuerte to a new larger venue. H10 Andalucia Plaza Hotel played host to the conference sessions as well as a poolside drinks reception and gala dinner. Other social activities included partying at Pangea Club in Puerto Banus to celebrate San Juan.

Says Dr. Kaye: “Everyone had a wonderful time; experiencing the fireworks and bonfires of San Juan was a particular highlight.

“We already have lots of interest in next year’s MIPSS, although we are limiting places to 125 to maintain the intimate atmosphere, that we believe best facilitates collaboration between peers.”

MIPSS 2018 will take place from June 21 to 23. For further information about next year’s programme and to register visit