Thursday, 10 May 2018

The Real Reason You're Looking Older

Not all signs of ageing are obvious ones, like lines and wrinkles. If you look in the mirror and feel you’re looking older but can’t put your finger on the reason why, it’s because the change is happening on the inside, not the outside.

The culprit is facial fat. Facial fat is a good indicator of someone’s age as it’s something we gradually lose over our lifetimes. It’s easy to identify a baby or toddler by their chubby cheeks, but as a child grows their face slims down and the “puppy fat” is eventually lost.

Unfortunately this process does not stop after puberty; we continue to lose facial volume. The results of this usually start to be seen in the mid to late 30s. There are subtle changes to the face shape, which might make you feel less youthful.   

How facial volume changes as we age

A youthful face has a smooth covering of fat, giving an overall rounded appearance. The cheeks have a round projection, the lips are full and the forehead and jawline display clean arcs. As soft tissue fullness declines, the skin begins to sag downwards. Starting from the forehead, this leads to a “heavier” brow, droopier skin around the eyes and hollowing of the eyes and cheeks as the fat moves southwards.

The extra weight in the lower half of the face results in the appearance of nasolabial folds (marionette lines) and jowls, which disrupt the smooth line of the jaw. In contrast to the fat loss seen in certain parts of the face, fat cells in other places increase in size. This can result in a double chin, bulging lower cheeks and under eye bags (the appearance of protruding fat around the eyes is exacerbated by the loss of volume from the cheeks beneath).

The impact of facial bone loss

It’s not just fat that diminishes as we age; we lose bone too. Throughout our lives bone is constantly being made and reabsorbed, but ageing slows the process causing more bone to be absorbed than is created. This means facial bones decrease in density and start to recede. The bones of the eye socket gradually widen, the brow bone shrinks back and the jawbone becomes less defined.

In women, changes to the facial skeleton can be seen between 41 and 64, while the most pronounced bone loss happens for men when they are 65 and older. Facial bones are like scaffolding for the tissue and skin, so a reduction in bone volume is another factor responsible for facial sagging.

The widening of the eye sockets causes the skin above the eyes to droop, as it has less to cling onto (sagging is exacerbated by fat loss around the brow). Likewise, a reduction in the angle of the lower jaw contributes to a less well-defined jawline.

Why skin tightening alone won’t make you look younger

In the old days plastic surgeons used to tackle facial ageing by lifting the skin; pulling it taught, removing the excess and reattaching. Now we understand that skin tightening is only one part of facial rejuvenation. Skin tightening alone won’t ever be able to restore a person’s youthful looks, since the loss of facial volume will still be evident.

To achieve true rejuvenation, it’s vital to “make good” the underlying structures - otherwise it’s like trying to paper over unplastered bricks. Volume can be restored using transplanted fat, dermal fillers or, in more advanced cases, facial implants.

Dr. Kai Kaye, Head Surgeon at Ocean Clinic Marbella, combines fat transfer with all his facelift procedures. Fat is taken from a donor site elsewhere on the body and grafted to key areas of the face, such as the cheeks, lips and jawline. The extra volume not only restores youthful contours, it helps to plump out the skin, smoothing away wrinkles and improving skin tone.

What if I’m not ready for a facelift?  

Facial fat loss contributes to the earliest signs of ageing - the subtle differences you start to notices in your 30s, like a decrease in skin tone. Of course, this is far too early for facelift surgery, but you can start fighting volume loss.

Fat transfer to the apples of the cheeks, the lips and hollows of the eyes can have a dramatic effect in rejuvenating the appearance. Meanwhile, grafted fat can also be used to smooth out lines, such as those starting to appear around the mouth.

Fat transfer is a minimally invasive procedure, requiring only local anesthetic for both the removal of the donor fat and the re-injecting. The two procedures can be carried out on the same day.

As living tissue, transferred fat can provide permanent results, unlike dermal fillers that will need to be topped up every 12-18 months. This method also has the benefit of offering a plentiful supply of filler - most of us have pockets of fat on our abdomens or thighs that can provide more than enough for plumping out the face.

On the other hand, hyaluronic acid filler (such as Restylane) must be purchased by 1ml syringe, however, if you have a smaller budget it offers a more affordable way to get started. A single syringe to the lips provides a noticeable difference, while 1ml can also successfully be used to fill in marionette lines around the mouth.

How do I know what areas of my face need treating?

Because of the knock on effect that fat loss can have, it can often be hard for people to understand exactly what treatment it is they need to restore youthfulness to their face. You might actually believe you need a facelift, when in fact you simply require a bit of extra volume here and there. An experienced surgeon, who is familiar with the anatomy of the face, can look at a patient and quickly see where small tweaks could be made to improve the appearance.  

To book an assessment for fat transfer or dermal fillers contact Ocean Clinic Marbella on 951 775 518 or contact us via our website.

Wednesday, 25 April 2018

10 Myths About Buttock Augmentation Surgery

Big booties are big news, with a more voluptuous female figure back in vogue. The trend has led to an increased interest in buttock augmentation surgery.

Often referred to in the media as the Brazilian butt lift (BBL), there are many misconceptions about this procedure. Here, we endeavour to bust the myths and present the facts.

1) You have to have implants in your buttocks

While implants can be used, Brazilian butt lifts are more commonly carried out using only a patient’s own fat. Using liposuction, fat is removed from elsewhere on the body; usually the abdomen, love handles, back, or from the outer and inner thighs. The fat is transplanted into the buttocks in order to give them a fuller shape. Meanwhile, removing fat from around the outside of buttocks and from the waist gives the illusion of a more accentuated backside. As such, great results are achievable with no implants.

2) Thin women can’t have a BBL

Because Brazilian butt lifts are primarily carried out with fat, you might think lean women would be unable to have this surgery. However, in these cases, silicone implants can be used to supplement the lack of available fat. Even in thinner individuals, some donor fat can usually be found and this can be used to smooth over the implant and add shape. Furthermore, simply sculpting with liposuction around the buttocks can make your bottom appear bigger and give you a more desirable figure.

3) A buttock augmentation just gives you a bigger butt

Actually, butt lift surgery is about so much more than simply gaining a bigger bum. BBL aims to resculpt your entire silhouette, this includes your waist, hips and thighs, to achieve a classic hourglass figure. The changes should be visible from both the front and back. In addition to gaining volume in your buttocks, they will be reshaped to achieve the look you desire - whether that’s a curvier, peachier bum or one that appears to have a higher profile from the side. Issues with asymmetry can also be addressed.

On the plastic surgery review site, most people rate their buttock augmentation surgeries very highly. In fact, 88% of people give their butt augmentation surgeries a “worth it” rating.

4) Buttock augmentation is always a high risk surgery

You have probably seen negative stories in the press about Brazilian butt lift surgery. It can indeed be risky when carried out by inexperienced surgeons. This is because the fat must be very carefully transplanted to ensure it does not enter any veins, which could potentially lead to fat embolism (fat entering the heart and lungs, which could result in death). If a surgeon is not properly trained there is a risk they could inject the fat too deeply, consequently it is essential to choose a surgeon with a high level of skill in fat grafting. If carried out properly, risk of complication is low. Ocean Clinic’s Head Surgeon Dr. Kai Kaye has performed many buttock augmentations, is a specialist in fat transfer, and lectures on the topic to peers around the world.

5) Recovery from a butt lift is very painful and you can’t sit down

A BBL carried out with fat alone is in fact categorised as a minimally invasive procedure, since it can be performed with very tiny incisions. At Ocean Clinic Marbella we use water jet-assisted liposuction which is extremely gentle and reduces swelling and bruising. Pain and recovery time is minimal and you will be able to sit using the special pillow we provide (although long periods of sitting are to be avoided). You are likely to feel fatigued for a few days but after that you will be able to return to work (unless you have a very physical job). Buttock augmentation with implants is more invasive and has a longer recovery time, with at least two weeks off work required.

6) You’ll ruin your results if you gain/lose weight

Some people are deterred from getting a Brazilian butt lift because they feel the results will be temporary and will be easily lost should you gain or lose weight. Actually, once additional fat cells have been transplanted to your bottom, that’s where they will remain. These fat cells can increase or decrease in size according to your diet and exercise but they won’t disappear. One of the great things about a butt lift with fat transfer is that the fat in your backside behaves normally. It means that your buttocks will grow or decrease consistent with changes in your overall body weight, keeping you in proportion.

7) Having liposuction will make your skin sag

Patients often worry that removing fat from one part of their body to transfer to their buttocks will leave them with sagging skin. However, the amount of fat taken from any one location is not usually enough to leave loose skin. Fat will often be taken from multiple sites across the body via tiny incisions, so the fat loss is very even. The skin in these areas will snap back into place during the recovery process, over the following few weeks. If you have lost a fair amount of elasticity in a certain area, such as your tummy following pregnancy, your surgeon will advise not to have liposuction there. Alternatively, you might want to consider combining your BBL with another procedure like a tummy tuck.

8) A BBL will always look fake

Surgeons work with their patients to achieve the result they desire; some women want a natural look, while others favour a more extreme contrast. A very authentic appearance can be achieved by solely using a patient’s own fat, since it behaves with a natural jiggle. Furthermore, it will not only look real, it will feel real. However, to obtain the best looking results, it remains important to select a skilful surgeon in order to avoid unwanted side effects such as as lumps, bumps and asymmetry.

9) Buttock augmentation is just for celebrities

While BBL is a current favourite with celebrities, the procedure’s popularity goes way beyond the rich and famous. Last year in the USA, more than 20,000 people had a buttock augmentation with fat grafting - 10% up on the previous year (according to ASPS figures). A further 6,000 had a different buttock procedure (such as implants). These figures show that buttock augmentation is now more mainstream than treatments such as hair transplants, thigh lifts and upper arm lifts.

10) BBL is a very high cost procedure

Because of their association with celebrities, people often think Brazilian butt lifts must be extremely expensive, however, the surgery actually costs around the same as a breast augmentation. The exact cost will depend on the scope and complexity of your procedure as well as the skill and experience of your chosen surgeon. It goes without saying that you should get the best you can afford and don’t be tempted to go for cut price surgery abroad where clinical standards may be lower.  

Wondering if you’re a good candidate for a Brazilian butt lift? Book a consultation on 951 775 518.

Thursday, 19 April 2018

Get the Low-Down on All-Natural Penis Enhancement

Would you like a bigger penis? According to research, nearly half of men would. If you’re one of them, the good news is you can get one - without any invasive surgery.

All-natural penis enhancement can be carried out using a patient’s own body fat, in the same way it is now being used to enhance women’s breasts and fill wrinkles. It is a minimally invasive procedure, requiring only tiny incisions to remove the donor fat. The fat is then injected into the penis to provide significant extra girth. Read on to find out more.

How does all-natural penis enhancement work?

All-natural penis enhancement primarily offers patients the opportunity to increase the girth of their penis through transplantation of their own fat. Fat is taken from another part of the body, such as the abdomen, inner thigh or love handles. It is removed via water jet-assisted liposuction; a gentle method which results in minimal trauma to the donor site and only requires very tiny incisions.

The fat is processed before being injected directly into the shaft of the penis, under the skin, to provide added thickness and bulk. Fat can also be injected into the head of penis (glans penis) to make it appear fuller and harder.

Injections in the penis might sound painful, but a local anesthetic is used. Additionally, the fluid used as part of the liposuction process contains the anesthetic lidocaine, which ensures minimal discomfort. Both procedures are carried out in a single appointment and you will be able to return home afterwards. Your penis will be initially swollen but this will subside over the next week to 10 days.

How much width can you gain?

The surgeon will be able to advise you how much extra girth you can expect following examination. It depends on your anatomical endowment and how much fat can be injected, but this will usually be between 20-50 ml.

Typically, a penis enhancement carried out with fat will result in a long term gain of around 20% in circumference - around one to two centimetres. Patients may also experience a small increase in length due to the weight of the fat, but the primary aim of penis enhancement with fat is circumference growth.

Is an all-natural penis enhancement safe? What are the drawbacks?

The procedure is totally safe providing it is carried out by a skilled surgeon. Using your own fat means there are no issues with your body rejecting it. The main downside to transferring fat to the penis is that not all of the fat will gain a blood supply and survive (vascularise). Consequently, there is a risk that fat distribution might be uneven or that hard fat nodules will form.

To avoid this, it is essential to only transfer high quality, intact fat cells. We achieve this by using water jet-assisted liposuction, which does not damage fat cells as it removes them. Careful processing of the fat makes sure it is free of contaminants and ensures the highest level of cell survival.   

The other consideration when opting for penis enhancement with fat is that the texture and tone of the penis will be softer, however this is less noticeable when the penis is erect.

How long will an all-natural penis enhancement last?

Penis enhancement with fat can provide a permanent change, since the fat which gains a blood supply becomes permanent tissue. However, it is important to understand that the result you see immediately after the procedure will change. Not only will there be initial swelling, not all fat will survive. In general, around 50% of the fat injected into the penis will go on to become permanent tissue. It is possible to have subsequent top-up procedures, building on and maintaining the results for a lifetime.

Is all-natural penis enhancement worthwhile?

You will certainly be able to see the results of your procedure, which may make you feel more confident with your clothes off. The added girth may also increase your ability to pleasure sexual partners. According to research, the majority of women report receiving more pleasure from a man’s penis width and not length.

A further study found women preferred an erect penis of 6.3 inches in length and 4.8 inches in circumference for a long term partner.

To find out more about all-natural penis enhancement or surgical penis lengthening procedures, contact Ocean Clinic Marbella.

Friday, 13 April 2018

Will A Nose Job Change Your Life?

People who dislike their noses often spend years debating whether they should have rhinoplasty surgery. There are various considerations; from the cost of the procedure, perceived pain and necessary downtime, to whether you’ll be happy with the end result.

Do you believe a nose job would make you feel better about your appearance but at the same time worry about something going wrong? This is totally normal. Because the nose is centre of the face, the thought of altering it can induce the biggest fears. You might think, “What if the new nose doesn’t suit me?”. However, as the dominating facial feature, rhinoplasty also offers the biggest potential for positive transformation - of both a patient’s looks and their confidence.   

To assess the impact rhinoplasty surgery could have on your life, it’s helpful to look at the data. There have been a number of studies looking at patient satisfaction, as well as research into other people’s perceptions of those who have undergone surgery.

How satisfied are nose job patients?

In 2015, a group of researchers analysed 2,326 reviews posted by people who had undergone rhinoplasty on the website RealSelf. Past research into patient satisfaction had been based upon data and opinions from surgeons.

Study author Ibrahim Khansa MD, said: “The website allows patients who have undergone a plastic surgical procedure to rate their experience as “worth it” or “not worth it”, and to provide reasons for their rating. Since patient entries on the website are not surgeon-initiated, and can be anonymous if the patient desires; they do not carry the inherent bias of surgeon-initiated questionnaires.”

The results of the study, which involved reviews from 2,032 females and 294 males, found the overall satisfaction rate was 83.6% (although females were more likely to be satisfied then males).

The top reasons for satisfaction among females were: the nose feels more natural (29.7%), nose is smaller (18.3%) and surgeon was honest (18.2%). For men, they reported being satisfied that the nose feels more natural (36.5%), surgeon was honest (22%) and tip rotation is good (12.1%).

What do other people think of nose job patients?

You might think you’ll look dramatically different after a nose job, but will other people even notice? A recent study set out to measure how perceptions about a person changed following Rhinoplasty surgery.

Through a web-based survey, 473 participants were asked to view pictures of patients before and after rhinoplasty. The survey participants, who were unaware of the 13 patients' surgery status, were instructed to rate the person in each photo for attractiveness, perceived overall health and perceived success (a scale of 0-100 was used).

The images of patients post-rhinoplasty were better perceived on all fronts. They were rated to be on average:

  • 14 points more attractive
  • 10 points healthier 
  • 9 points more successful

Study author Lisa Ishii MD said: "These findings propose that patients experience an improvement in social interactions stemming from the positive effect of rhinoplasty surgery on observer perceptions.”

It’s not just health and success that can be inferred from our appearance; we make many different judgements about a person’s attributes within seconds of seeing their face. Research we have previously written about demonstrated how we unconsciously assess people for traits like trustworthiness, intelligence and friendliness.

As such, changing facial features actually can have a positive effect on a patient’s social interactions. Furthermore, people considered to be attractive receive significant social benefits, such as finding it easier to get jobs and promotions and even getting more lenient court judgments.

How will the surgeon know what nose will best suit my face?

If you’d like a nose job but worry the surgeon will make it too small or too curved, making it look out of proportion, it’s helpful to understand how surgeons plan a rhinoplasty procedure. First and foremost, they listen to your aesthetic desires, then they assess you physically to see what’s possible.

Additional to this, they are guided by mathematical formulas, which help them ascertain the perfect proportions for your nose in relation to your face. Measurements taken into consideration include the width of your nose, the length and projection of your nose, the shape of the septum, how much columella at the end of your nose is on show, as well as the size and rotation of the nasal tip (the amount the nose is turned up). Learn more here.

All of this ensures your new nose will blend seamlessly with your face and enhance your other features. The aim with rhinoplasty is always subtlety, and small tweaks can make a big difference. If you don’t tell people you’ve had rhinoplasty, people are often unable to put their finger on why you look better.

Because it’s not always obvious, patients often opt to keep their surgery a secret, but Ocean Clinic Marbella patient Kara Caradas (pictured below) spoke out to Society Magazine about her experience.

“I felt absolute confidence in my surgeon and his team and honestly couldn’t fault anything,” she said. “It was better than I could have imagined and I was thrilled with the results.

“People worry about plastic surgery, as there’s so much that could go wrong, but choosing Dr. Kaye was the best decision I’ve ever made.”

To book a rhinoplasty consultation, contact Ocean Clinic Marbella via our contact form or call 951 775 518.

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.