Thursday, 22 March 2018

Correcting Problems with Permanent Lip Fillers

Have you had a lip enhancement with permanent filler? Did it look fine initially but now you’re experiencing problems?

Late-onset complications with permanent filler injections are not uncommon and can be difficult to treat, however an eight-year study by Ocean Clinic Marbella gives fresh hope to those suffering.

The study looked at the best way to remove the filler and reconstruct the lips. It involved 11 patients who had received Aquamid injections between 2-10 years previously (not at Ocean Clinic). It has now been published in the highly respected medical journal, Aesthetic Plastic Surgery.

Common Complications with Permanent Lip Filler

Polyacrylamide hydrogel (branded Aquamid) has been in use as a permanent filler since 2001. It is considered inherently safe, however problems can occur later on after apparently successful implantation.  

Migration - that is filler moving from its original position - is a common complication, which can develop even years after the injection. In the patients treated by Ocean Clinic’s Head Surgeon Dr. Kaye and his team, migration was seen in the mucosa, which is the membrane lining of the lips and also in the facial skin around the lips.

The filler was visible as yellowish accumulations; lumps and bump, leading to general unevenness and asymmetry of the lips. This was exacerbated by fibrosis (excess scar tissue forming around the filler).

These problems resulted in not only an undesirable aesthetic but also pain, tenderness and - in two patients - infection. One patient also suffered with a burning sensation in their upper lip.

Fixing Issues with Permanent Lip Filler

Because it is not possible to aspirate the filler  (remove through suction) in cases where it has diffused different skin layers, surgery is the only option. Dr. Kaye used a lip reduction technique known as the ‘bikini reduction’ - so called because of the shape of the incisions (see below diagram).

Says Dr. Kay: “Through the bikini access, the gel and the surrounding scar tissue were removed by sharp scissor dissection. Complete dissection of muscle and mucosa had to be performed to excise the majority of the polyacrylamide gel.

“Because the product extended in most cases into the mucosa and musculature, leading to volume loss after removal, individual modifications of the described technique had to be performed to give the upper lip the favorable shape of an M and the lower lip the shape of a W, while maintaining a good volume relationship between the lips.”

In order to restore volume to the lips and create the best aesthetic result possible, fat was taken from patients’ abdomens and transplanted into their lips, in eight out of the 11 cases.

The Results

Dr. Kaye and his team removed as much of the Aquamid deposits as possible from all 11 patients, however residues of the gel close to the mucosa had to be left in eight cases to avoid compromising the blood supply.

The majority of the patients declared themselves to be satisfied or very satisfied with the aesthetic result one year after the initial operation.

The shape of the patients’ lips were observed by two independent plastic surgeons after one-year postoperatively and no dynamic asymmetries were detected. The patients who had fat transfer to the lips continued to have satisfactory volume.

Concludes Dr. Kaye: “Volume reduction and restoration of a harmonic relation between the upper and lower lips can be achieved using a modified bikini technique.

“Autologous fat grafting to the lips is a useful tool to correct volume deficits and asymmetries and can often be performed successfully within a single-stage operative session.”

Want your permanent lip filler removed? Contact Ocean Clinic for a consultation on 951 775 518.

Thursday, 15 March 2018

Veneers - Porcelain or Composite?

Heard about dental veneers but unsure about the difference they could make to your teeth? Ocean Clinic’s cosmetic dentistry expert Dr. Paul Arts explains how both types of veneer work...

Veneers are made to make your teeth look better, nothing more and nothing less. They consist of a thin layer of either porcelain or composite that covers the frontal, visible side of your teeth. Colour, shape and, to a certain extent, the position can be changed. Veneers do not weaken your teeth.

Veneers are made of porcelain or composite. Composite can be done in one session, whereas porcelain takes two to four sessions as the porcelain veneers are made in the dental laboratory. Porcelain veneers are more laborious and hence cost more.

Often, before making the veneers, a digital design and/or a simulation of the treatment in wax on study models is required.

In most cases, little or nothing is taken away from your teeth. The composite veneers are made by laying a thin layer onto your teeth followed by finishing/polishing. For porcelain veneers impressions or a scan of your teeth are made, on which the dental technician can fabricate the veneers.

It takes approximately a week to 10 days before they return from the dental laboratory. In the meantime you might need provisional veneers. When the porcelain veneers are delivered, they will be tried in and placed on your teeth.

The main differences between porcelain and composite are:


-Keep colour life-long
-Life span 15-20 years
-Stronger, less chipping
-Difficult to repair       
-Two, three or four sessions
-€ 500-600 each


-Will gradually become darker
-Life span 6-10 years
-May chip when biting something hard
-Easy to repair
-One session
-€ 175-250 each

It may be difficult to choose between porcelain and composite. There are no fixed rules to choose one above the other. Discuss the pros and cons with your dentist.

You can find out more about cosmetic dentistry on our website. To arrange a consultation with Dr. Paul Arts contact Ocean Clinic Marbella on 951 775 518.

Tuesday, 13 March 2018

Ocean Clinic Facelift Study Published in Top Scientific Journal

Research carried out by plastic surgeons from Ocean Clinic Marbella around new facelift techniques has been published in JPRAS, a highly respected scientific journal.

The study, entitled “The Liquid Facelift” looked at how water jet-assisted liposuction could be applied to the face - this technique had only previously been used on the body.

Head Surgeon Dr. Kai Kaye worked together with Dr. Sonja Kästner and Plastic Surgery Resident Dr. Felix Paprottka on the research project, which involved 25 patients.

They utilised water jet-assisted liposuction (WAL) to enhance three aspects of the facelift surgery they carried out:

  • WAL was used to help separate facial skin from the underlying soft tissue in order that it could be pulled taught and reattached. Using water is gentler than alternative methods and keeps surrounding vessels and nerves largely intact.
  • WAL was used to harvest fat from other areas of the body to be transferred to the face. This method prevents fat cells rupturing during collection and provides better quality fat for transplantation.
  • WAL was used to contour the face, removing excess fat from areas such as the eyes and chin. Gentle removal of facial fat aids better healing, reducing postoperative bruising and swelling.

The Results

To assess the success of the WAL techniques, patients were observed by two independent surgeons and also asked to rate their own satisfaction levels. The patients, who had a median age of 56 years, were graded over a one-week follow-up period for the following criteria:

  • Discomfort during the procedure - no discomfort was experienced by patients, who were treated under intravenous sedation.
  • Intraoperative bleeding - no bleeding was observed during the procedure
  • Postoperative swelling and bruising - only minor swelling and bruising was present after the procedure.
  • Skin necrosis - no skin death was detected post surgery.
  • Requirement for revision surgery - none of the patients had to be operated on again.

In the patient survey, performed to analyse their perception of the esthetic results, respondents indicated a high satisfaction rate.

Dr. Kaye says: “We are delighted with the results of this study. The use of the WAL technique has been proven to offer a number of benefits for facelift patients. Going forward, we will be applying WAL in all our facelift surgeries, delivering Ocean Clinic patients superior results.

“However, myself and the team hope that this technique will also be adopted by other plastic surgeons. We believe knowledge-sharing among peers is vitally important, which is why we sought to have the study published, and will also present the techniques at a number of medical conferences, including our own MIPSS congress in June.”

Visit our website for more information about facelift surgery at Ocean Clinic Marbella or call 951 775 518 to book a consultation.

Thursday, 1 March 2018

Innie or Outie? Why Belly Button Procedures Are On The Up

Did you have your belly button pierced in the 90s? Does it now look a little less appealing? As the women who sported this era’s trend hit their mid-thirties, plastic surgeons are seeing an increase in requests for umbilicoplasty.

Celebrities like Britney Spears and Beyonce drove the craze for navel piercings, but as women age, have babies or gain and lose weight, they might find their piercings have become distorted.  

According to RealSelf, there's been a 21% increase in people asking for navel surgery in the UK compared to last year. The uptick can also be seen in the United States, where 12% more people are expressing interest in umbilicoplasty compared to 2017.

Another factor thought to be fuelling the trend in belly button procedures is the fashion fo gym clothing. The #fitspo (fitness inspiration) brigade on Instagram are forever showing off their toned tummies in lycra sportswear and yoga pants, making the rest of us want to get in on the act.

As such, demand for belly button surgery includes procedures to both repair and reshape, and to improve aesthetics by turning ‘outies’ into ‘innies’. People are also seeking to change the orientation of their navels (horizontal to vertical) to give the illusion of a more toned abdomen.

Whatever your goals, umbilicoplasty is a relatively straightforward procedure to carry out, can be performed under local anesthetic and requires little downtime. Find out more...

Changing the shape and size of your belly button

From a cosmetic perspective, the belly button is an important part of our anatomy. Its shape and size has an effect on the overall appearance of the abdomen. If you feel your belly button is too large and gaping, it can be made smaller by removing extra belly button skin and tightening the bordering abdominal skin around the belly button.

If you think your belly button is too small (perhaps because loose skin is hanging over and covering it), its appearance can be improved by removing some of the surrounding abdominal skin and gently stretching the belly button tissue to reach the enlarged border. This technique can also be used to repair the hangover left by piercings. Meanwhile, scar tissue from piercings can be cut away and stitched to leave just a fine scar.

A belly button that is off centre is another factor that can detract from the appearance of the stomach (sometimes this happens as a result of tummy tuck), but this can also be corrected. Sutures placed underneath can help pull it into optimal position.

Sutures can also be used to create a belly button that is vertically-oriented (stretched from above and below) in order to makes the torso look longer and the abs leaner.

Changing a belly button from an ‘outie’ to an ‘innie’

Got a sticky-out belly button but would prefer to have one that’s concave? Umbilical hernia repair can give you the navel you desire. So-called ‘outie’ belly buttons are caused by tissue, usually fat, protruding through a small hole in the abdominal wall. This makes the belly button bulge outward.

You can have an umbilical hernia from birth or sometimes an 'outie' can appear later in life due to pregnancy or heavy exertion. The procedure to fix it is a little more complicated than an umbilicoplasty, involving repairing the hole in the abdominal wall.

In addition to creating a more aesthetically pleasing midriff, repairing an umbilical hernia can have medical benefits by preventing the small intestine from potentially pushing out of the abdomen.

Although the surgery does not take long to perform, anyone undergoing this procedure must avoid any form of exertion or exercise that could put pressure on the weakened area for a number of weeks.

Dealing with other tummy concerns

If your dissatisfaction with your tummy goes further than the appearance of your navel, you might want to consider a tummy tuck. An abdominoplasty will rid you of excess fat, loose skin and tighten up lax tummy muscles, as well as give you an ideally shaped and sized belly button.

If you have an umbilical hernia or have suffered diastasis rectus abdominus (separation of the abdominal muscles) as a result of pregnancy, these conditions can be corrected at the same time as the tummy tuck is carried out.

If you’d like discuss your suitability for umbilicoplasty or abdominoplasty, contact Ocean Clinic Marbella for a consultation.

Friday, 16 February 2018

Making Waves Together - Dr. Paprottka and Dr. Kaye Present New Facelift Techniques

Dr. Felix Paprottka joined Ocean Clinic last summer as Dr. Kaye’s resident. Since then the pair have been working together on pioneering new facelift techniques.

You’re from Germany, how did you come to be working with Dr. Kaye at Ocean Clinic in Marbella?

“I’d seen Dr. Kaye give keynotes in several congresses and always liked the way he presented his clinic, himself and his ideas. When he was looking for someone to replace Doctor Kaestner´s resident position, he put an announcement on the website of the German Plastic Surgery Society. He said he was looking for a young colleague to join him who was in his final year of training. Someone who had been doing research and taking on various other responsibilities and I was reading it and I was like, ‘Okay, this is me!’

“I was one of three people asked to come for an interview. We met and connected really well. Then I started the adventure of moving from Hamburg, Germany, to Marbella last June. I came just before the last MIPSS Congress, so I went straight into the bright lights. It was a tense time for the team but it helped me to integrate because there were a lot of things to be organised and I could play my part to support them.”

You have been working on some exciting projects over the last eight months. Tell us more...

“Dr. Kaye and I have been working together on several research projects. One of those was using water jet-assisted liposuction to improve facelift results. We finished up the liquid facelift paper in October and it was accepted in the JPRAS Journal, one of the best plastic surgery journals.

“Since then, we’ve put a major focus on other new techniques we are developing right now, called PERF (Posterior Earlobe Rotation Flap) and CMSS (Concha Mastoid Suspension Suture). Sometimes after facelifting there’s a lot of tension on the skin and the underlying fascia structures. This may lead to a distortion of the earlobe. You can see it as the “pixie ear” deformity - where the earlobe is pulled downwards and forwards.

“It’s a stigma for patients who have had facial surgery because people can see that something is not right. Dr. Kaye has developed a technique where you have a rotation flap, which you harvest from the backside of the earlobe and insert it into the earlobe. With this novel method a free earlobe tailoring is possible. If you combine this with a suture you place in the concha and connect to the mastoid, which is the bony part behind the ear, then the ear is fixed in position and stays there. With this new method you do not have a pull on the earlobe, which avoids deformity.”

You are about to have a paper published on this technique, is that right?

“Yes. We have now performed this on over 100 patients and the treatment has been well received. We are the first ones in the world publishing this new technique and right now it looks likely to be accepted in the most well-known aesthetic surgery journal. We are still in the process of pleasing the editors, but so far everything looks really good.”

Is facelift an area of special interest for you?

Face surgery in general is something I find really interesting, in combination with body contouring and breast surgery. Dr. Kaye and I share the same surgical interests. You have a lot of different methods you can apply to achieve beauty, or what you consider to be beautiful.

Your background also includes reconstructive surgery, hand surgery, and burns surgery. How does this experience help you?

“I was lucky to get a residency back in Germany that included training in all four elements which make up plastic surgery - aesthetic, reconstructive, hand and burns surgery. I also received further training concerning burn surgery and intensive care in the university clinic in Hannover where I was in charge of the burn surgery unit.

“I had six severely ill, burned patients on my ward that I had to take care of. It was quite challenging but I think the experience complements my work now, as I prepare to become a specialist performing plastic and aesthetic surgery at a very high standard at Ocean Clinic.”

Is there any area in particular you want to focus on at Ocean Clinic?

“I really like doing research and developing new things. I will present our new PERF and CMSS techniques at a congress in Madrid this May. Then we have the MIPPS congress coming up in June.

“We have a couple of well-known, international surgeons coming to present new neck, facelift and abdominoplasty techniques. Right now we’re testing all the different camera systems, with for example a surgeon´s head-on camera - so we can offer a very good view to those in the auditorium. Really exciting!”

The 3rd Marbella Plastic Surgery Summer School (MIPPS) takes place from June 21-23. For more information visit

Monday, 5 February 2018

The "Mommy Makeover" Leads Trend for Combined Plastic Surgeries

Offering optimal results, with decreased costs and downtime, combined surgeries (getting more than one procedure done at once) have risen in popularity.

The trend is being led by the so-called “mommy makeover” - a suite of treatments, which include a tummy tuck, breast augmentation/ breast lift and liposuction.

Becoming a mother brings great joy, but it can also bring unwanted changes to a woman’s body. Our patients typically complain of sagging breasts, loss of volume in the breasts, flabby tummies and lax, crêpey skin.

Unfortunately, the skin and muscle of the abdomen become stretched during pregnancy and tonacity often does not completely return. Because of this, it can be impossible to regain your pre-pregnancy shape regardless of the amount of exercise you do.

As well as a combination of surgeries, the mommy makeover may also include some non-surgical treatments. These treatments, such as Venus Legacy radiofrequency or LPG Endermologie, are designed to further tighten skin, improve tonacity and reduced the appearance of cellulite and stretch marks. Your surgeon will tailor the procedures in your mommy makeover package to address your specific aesthetic concerns.      

While a mommy makeover is not a substitute for proper diet and exercise, it does offer a solution to women who have been left with irreversible changes to their bodies following pregnancy. These changes, while entirely naturally, can take their toll psychologically, resulting in a loss of self esteem. Surgery can help restore your confidence, giving you back your pre-pregnancy figure, or even improving on it!


Having a mommy makeover is a big decision, so it’s important to choose the right time in your life to undergo surgery. Factors to consider include your health, lifestyle and family plans.

Ideal Candidates

The most important thing to remember when considering a mommy makeover is that getting back into shape after having a baby takes time - this surgery is not for recent mothers. From the images that appear on social media, it’s easy to think celebrities just pop back into shape after giving birth, but they have the benefit of an army of trainers and dietitians behind them (not to mention nannies to help with childcare while they workout).

It is advisable to wait at least a year postpartum to give yourself enough time to lose any baby weight and undertake exercises to strengthen your tummy muscles. The exception to this is if you’ve suffered a condition called diastasis rectus abdominus during pregnancy. This is where the left and right side of the muscle that covers the front surface of the belly separates. It cannot be corrected with exercise and requires surgical repair (this can be done as part of an abdominoplasty).

Mommy Makeovers also offer a way to address scarring and skin sagging incurred as a result of a caesarian. Additionally, if you have suffered a hernia around your naval, common after giving birth to twins or triplets, this damage can be repaired as part of the procedure.

Another factor to consider with regards to timing, is how long you might be breastfeeding for following the birth of your baby. While breastfeeding, your breasts will be enlarged with milk. When you stop, it can take between three to six months for them to fully shrink. It’s important to wait to see your breasts’ final shape and size before planning enhancement surgery.

Finally, if you plan on having more children, it’s best to wait to have surgery. While having a mommy makeover will not endanger any future pregnancies, the effects of the surgery could be reversed by carrying a baby to term.

Want to know more about having a mommy makeover? Book a free consultation at Ocean Clinic Marbella on 951 775 518.

Monday, 29 January 2018

4 Ways to Get Rid of Cellulite

Cellulite is incredibly common (more than 80% of women will develop it) but that doesn't stop us wishing we didn’t.

If you dislike the “orange peel” appearance on your thighs, buttocks or around your knees, you’re not alone; one study found that women with cellulite consider themselves overall less attractive than those who don’t have it.

Although cellulite can be stubborn to treat, there do now exist a number of procedures to tackle its characteristic lumps and bumps and achieve smoother skin. Below, we profile four options, all available at Ocean Clinic Marbella.

What Causes Cellulite?

Cellulite is more than skin deep; it occurs below the derma, when fat cells enlarge and start to push through the connective tissue into the skin. This happens as women age and start producing less estrogen and storing more fat (generally from around 25 to 35).

In women, the connective tissue (formed mainly by fibroblasts and collagen fibers) is arranged in free-standing chambers filled with fat cells. These are separated by vertical walls of fibrous bands called septa. In men however, subcutaneous fat is stored in smaller chambers with septa that form a criss-cross structure.

This criss-crossing of men’s septa means the chambers are stronger and more able to contain the fat within, thus preventing it from protruding out. Meanwhile, men are also less inclined to store fat on their buttocks and thighs - the areas most prone to cellulite. This explains why men are far less likely to have cellulite than women.

Types of Cellulite

A cellulite severity scale, published in 2009, ranks the condition using three grades:

Grade 1 (mild): There is an "orange-peel" appearance, with between 1-4 superficial depressions, and a slightly "draped" or sagging appearance to the skin.

Grade 2 (moderate): There is a "cottage cheese" appearance, with between 5-9 medium-depth depressions, and the skin appears moderately draped.

Grade 3 (severe): There is a "mattress" appearance, with 10 or more deep depressions, and the skin is severely draped.

The severity of your cellulite will affect the results that can be achieved with treatment, however the appearance of all grades should be improved. Your doctor or therapist will advise you what kind of results you can expect.

Effective Cellulite Treatments 1. Venus Legacy (Radiofrequency)

Venus Legacy is an exciting new device that combines multi-polar radiofrequency and pulsed electromagnetic fields to stimulate the tissue deep down. It works by heating the tissue to shrink fat cells and trigger the production of collagen. Collagen strengthens the connective tissue that holds the fat cells in place, therefore tightening skin and reducing the appearance of cellulite.

In addition, Venus Legacy encourages the release of trapped fluid and stimulates drainage of fluids and toxins through the lymphatic system. Poor circulation of the lymphatic system is thought to be a significant contributor to cellulite formation.

As well as working on cellulite, the treatment addresses sagging skin and can also have a slimming effect. It can be used to lift and tone buttocks and contour thighs, offering the opportunity to enhance the silhouette at the same time as improving the skin tone.

Venus Legacy is completely non invasive, 100% safe (FDA approved) and painless. Treatments can be customised to target cellulite at any stage, for all skin types and requires no downtime. A course of 5-10 sessions is advised, depending on the severity of your cellulite.

2. LPG Endermologie

LPG Endermologie is a revolutionary connective tissue treatment from France that involves gently rollering and suctioning the skin to reactivate dormant cellular activity. It offers a number of benefits, including the reduction of cellulite. Using the patented "Alliance" treatment head, skin and fatty tissue are stimulated to soften them and make them less fibrous. At the same time, this stimulation helps to release fat and activate lymphatic circulation, giving skin back its tonicity.

The treatment’s efficacy has been proven by 85 scientific studies, which have shown LPG Endermologie can dramatically boost production of collagen, elastin and hyaluronic acid. These rejuvenating substances aid all-natural repair.

The system is also used as a non-invasive alternative to liposuction. Applied on the areas where cellulite typically appears (legs and buttocks), it will both smooth and slim. Inner thigh or knee skin sagging can also be tackled, all at the same time.
LPG Endermologie is absolutely pain-free, safe and does not traumatise skin, meaning no redness. The treatment is suitable for men and women of all ages and all skin types. A course of 6-8 sessions is recommended for optimum results.

3. Ultrasound Cavitation

Ultrasound Cavitation is a non invasive treatment, which uses pulsed ultrasound energy to destroy fat cells. The high-frequency sound waves disrupt the fat cell walls, causing the contents to be released. Meanwhile, the surrounding tissue, nerves and muscles are left completely unharmed by the procedure.

The process stimulates the lymph system, which works to naturally eliminate the fat. Reducing the subcutaneous fat (fat that forms under the surface of your skin) helps to eliminate cellulite. What’s more, you can experience a significant reduction in the circumference of your thighs or bottom (average circumferential loss per area treated with ultrasound is 4.5 cms).

Ultrasound cavitation is safe, quick and painless - it is a gentle and soothing experience, much like a hot stone massage. Treatments take an hour or less and patients can return to work immediately afterwards. Between 3-6 treatments, scheduled two weeks apart are recommended for each treatment area.

4. Thigh lift

If you’re looking for a surgical solution to your cellulite and have additional aesthetic concerns you wish to address, a thigh lift can deliver a total thigh makeover. A thigh lift (also called a crural lift) literally involves lifting the sagging skin and fatty tissue on the upper and outer thigh towards the groin. Excess skin and tissue is removed and deep support sutures are placed in the underlying tissues to help create a tight and toned thigh.

The procedure is combined with liposuction in order to remove larger amounts of fat and further shape and contour the thighs. The removal of fat reduces the appearance of cellulite, while surgical skin tightening leads to improvements in dimpling and other irregularities.

Although a thigh lift can be performed on an outpatient basis (meaning you don’t have to stay overnight in the clinic), it does require at least two weeks of downtime (up to one month if you have a physical job). You will also have scars - they are usually hidden in the groin crease, but can sometimes extend along the inner thigh.

Because of this, a thigh lift is a good choice if you have significant loose skin and excess fat in addition to cellulite. If you are only seeking to tighten and tone, then a non-surgical treatment can provide pleasing results.

To find out which of the above treatments would be best suited to you, book a consultation at Ocean Clinic Marbella on 951 775 518 or email