General

Where can I see Mr Sabbagh

Mr. Sabbagh has clinics in four leading hospitals located in London and the south east:

Berkshire:                  Princess Margaret Hospital, Windsor

Surrey:                       The Runnymede Hospital, Chertsey, Surrey

London:                     Bupa Cromwell Hospital, London

North London:          Kings Oak Hospital, Enfield, North London

What to expect at the consultation

You will always be seen by Mr. Sabbagh. Your consultation is never rushed and although 30 minutes are allocated, some cases may take longer and this is always accommodated. A second consultation may be necessary for some cosmetic procedures to finalize the surgical plan and clarify any points prior to surgery.

Is there a consultation fee

There is a consultation fee after the first consultation. This is invoiced following your consultation. No further fees are charged for a second visit and any follow up appointments following surgery.

Where will the surgery be performed

Surgery is performed at all the hospitals where Mr. Sabbagh consults. These include the following BMI Hospitals: Kings Oak Hospital (Enfield), Princess Margaret Hospital (Windsor), and The Runnymede Hospital (Chertsey, Surrey).

In Central London surgery is performed at Bupa Cromwell Hospital (Cromwell Road, Kensington).

How is post surgical care provided

You are always reviewed by Mr Sabbagh on the Ward after your operation. For all procedures you will be seen at one or two weeks after surgery. Following this, patients are usually seen at 6 weeks, 6 months, 1 year and as necessary thereafter. Patients can call Mr. Sabbagh’s office until 8pm if there are any concerns in the early period following surgery. After 8pm patients can call the hospital ward who will contact Mr Sabbagh without delay.

Breast Augmentation

What make of implant is used

Mr Sabbagh uses cohesive gel silicone implants manufactured by Allergan (Natarelle gel) which offers one of the widest ranges of implants. Allergan are leaders in the medical aesthetic industry and offer a lifetime guarantee for rupture.

What shape of implant is used

Both round and teardrop implants are used. The chosen implant will depend on accurate assessment of the breast. Generally teardrop implants produce less fullness in the upper pole to simulate a more natural breast contour.

Where is the incision made

The incision for breast enlargement is positioned in the inframammary crease, the crease under the breast. The scar is well hidden and once fully healed (after several months) will be almost invisible.

Where is the implant placed

The implant is positioned either behind the breast or behind the pectoral muscle. Generally in slim women it is preferable to place the implant under the muscle as this provides better soft tissue cover and produces a more natural shape.

Will I have drains

In most cases drains are not necessary.

What dressing will I have

Following surgery a small waterproof dressing is placed over the incision. In addition to this the patient will need to wear a sport type or post-surgical brassiere for support for a period of 6 weeks.

What am I allowed to do following surgery

There will be some minor discomfort of the breasts following the surgery. In addition elevation of the arms may also be uncomfortable in the first week. Small non- vigorous tasks can be performed following discharge from hospital, however, the degree varies between patients. It is advisable patient avoids carrying heavy objects or engaging in strenuous physical activity for 2 weeks following surgery. Upper body gym exercises should be avoided for 6 weeks.

Breast Uplift

How is breast uplift performed

Breast uplift is performed under general anesthetic. Effective breast uplift alters the shape of the breast gland as well as tightening the skin. This is done by first separating the skin from the breast tissue. The breast gland is then converted into a more rounded, firmer shape by using special sutures. The excess skin is then removed. To do this there will be surgical scars around the areola, a vertical scar and a small horizontal scar in the crease under the breast.

What are the scars like

In the majority of patients the scars heal extremely well leaving fine faded scars which are only visible on close inspection. This could take up to a year. In a very small number of patients scars can become ‘hypertrophic’. This means the scar is a little red and raised. This can be treated to improve their appearance.

Will it change the breast cup size

Although in breast uplift no breast tissue is removed the breast cup size usually decreases as essentially the breast has been squeezed into a smaller firmer breast.

Rhinoplasty

Open or Closed rhinoplasty

Mr Sabbagh uses both the open and closed approach in rhinoplasty. For most cases which only require a hump reduction and minor adjustments a closed approach is utilized. In those cases that are complex, require changes to the tip or/and the septum then an open approach is selected.

Will I have packs

Nasal packs are usually placed in the nostrils after surgery. In most cases the packs are removed one day after surgery. Cases that involve correction of the septum may require packs for 3 days.

Will I have a splint

An external splint will be used in the majority of cases. This will help to stabilize the new position of the nasal bones and also helps to minimize swelling. The swelling will be removed at one week following the surgery.

Can I breath from my nose after surgery

There will be a degree of blockage in the first week after surgery. This is because some blood and mucous dries up and prevents smooth flow of air. Steam can be helpful to loosen any blockage.

How long will the bruising last

Bruising around the eyes is variable and usually occurs if the nasal bones need to be broken to narrow the nasal bridge. Most of the bruising subsides one week following the surgery.

Eyelid Surgery

How is the operation performed

For upper eyelids surgery is primarily to deal with the excess skin that has gathered above the lid. In some patients there are some fat bulges in the upper lid especially on the inner part of the upper lid. The excess skin is removed and the wound directly closed. One buried continuous pull through suture is used to close the wound which is removed at 1 week.

For lower eyelids, surgery is primarily to deal with the abnormal fat that has gathered causing bulges under the eye. The operation type will depend on the exact problem. An incision is made just under the eyelashes to get access to the fat. The excess fat can then either be removed or repositioned depending on the appearance of the area under the eye. The incision is closed with one continuous suture.

What type of anesthetic is used

For Lower eyelids surgery (with or without upper lids) a general anesthetic is necessary. For upper eyelids in isolation surgery can be performed under general anesthetic or local anesthetic with some sedation.

What type of dressing is used

Very thin steristrips are applied to the wounds which will need to stay on for 1 week.

What to expect during recovery

There is always some bruising and swelling associated with eyelid surgery. Most of this usually resolves after 1 week. However this variable and occasionally bruising can take 2-3 weeks to fully resolve. It is recommended that you take 7-10 days of work to recover from the surgery. During this period there may be some discomfort around the eyes and patients may experience some watering of their eyes.

Will the scars be visible

Scars heal extremely well and are almost invisible after 3-6 months. In the early period they will be visible and may appear a little red

Are there any risks

Very rare complications include haematoma (collection of blood) requiring removal of some sutures and infection.

There may be some irritation to the eye after the surgery (eye watering, redness) which can take several weeks to resolve. In rare cases the irritation results in a clear film of fluid on the eye (Chemosis) which may require some eye drops.

With lower eyelids there is a small risk of the eyelid drooping 1-2 mm. This usually improves as the swelling subsides. On occasions this may require a small operation.

Prominent Ear Correction

How is the operation performed

Surgery is performed from behind the ear. A small ellipse of skin is removed to gain access to the ear cartilage. The fold of the cartilage visible on the front of the ear (antihelix) is recreated with several non-dissolving sutures. In some ears the conchal bowl (the deep concavity of the ear) is excessively prominent. This is repositioned with sutures or, if very stiff, some of the conchal cartilage is removed. The skin is then closed behind the ear with dissolvable sutures.

What age can the surgery be performed

Correction of prominent ears can be performed at any age after 5 years. Although it is possible to perform the surgery before the age of 5 it is not advisable as the operation requires understanding and co-operation from the patient.

Will there be scars

There will be a surgical scar behind the ear which will not be visible.

Will I need to wear a bandage

A head bandage covering the ears and forehead only will be placed at surgery. The aim of the bandage is to make healing more comfortable and minimize minor bleeding that may occur. The bandage is kept on for 3-5 days; however it can be removed earlier if uncomfortable. The patient will be advised to wear a headband at night and during sport activities for 6 weeks.

Is the operation painful

There will be some discomfort of the ears and this is alleviated by basic painkillers such as paracetamol. This usually settles after 1 week; however the ears can remain slightly tender to touch for 6 months following the surgery

Are there any risks

This is a procedure with a very high level of satisfaction. Complications are very rare and minor. There may be some bleeding from the wound which is of no consequence. Infection rate is very low at 1{82ef48bd981dc220f81c4f72e9c3866ba645e010f63c46dce235c6109bc60eef}. In the majority scars heal very well and are almost invisible. In a small group of the population thicker (hypertrophic) scars may form which may need further treatment.

There is a small risk (5{82ef48bd981dc220f81c4f72e9c3866ba645e010f63c46dce235c6109bc60eef}) of partial recurrence of the ear prominence. This is most likely to occur in the first six months and can be corrected if necessary.

EarFold FAQs

Section

Earfold is an implant created to correct prominent ears by reshaping the anti-helix. It is introduced through a small incision under the skin of the ear and grips the ear cartilage and immediately adopts a pre-set shape. The earfold is made from Nitinol alloy (titanium and nickel). The implant consists of a thin strip of metal plated with 24 carat gold to limit its visibility through the skin. No dressings are needed following correction and return to most activities is possible after one week.

How are earfolds inserted

Insertion of earfold implant is a quick and easy procedure performed under local anesthetic. A small incision (5mm) is made within the rim of the ear and the implant (which is pre-mounted on an introducer) is released to correct the prominence. One or two dissolvable sutures are needed to close the incision.

Can earfolds be used on all protruding ears

The earfold implant is designed to re-shape the antihelix. If the prominence of the ear is primarily as a result of conchal bowl prominence then the earfold will not correct this and a different surgical procedure will be required.

How long is the recovery period

No bandage is necessary following earfold insertion. There will be minor bruising and swelling following its insertion which will subside over a period of 2 weeks.

Do they have any risks

The implant itself has no associated health risks. The implant can be felt under the skin and is almost invisible.

There is a very small risk of infection and in the majority this settles with antibiotics. In rare situations (<1{82ef48bd981dc220f81c4f72e9c3866ba645e010f63c46dce235c6109bc60eef}) the implant may come through the skin. If this happens then the implant has to be removed and the skin heals without any problems. The ear prominence may re-occur after this, especially if this happens within 6 months of insertion, and thus a further procedure may be required.

Are there any risks

This is a procedure with a very high level of satisfaction. Complications are very rare and minor. There may be some bleeding from the wound which is of no consequence. Infection rate is very low at 1{82ef48bd981dc220f81c4f72e9c3866ba645e010f63c46dce235c6109bc60eef}. In the majority scars heal very well and are almost invisible. In a small group of the population thicker (hypertrophic) scars may form which may need further treatment.

There is a small risk (5{82ef48bd981dc220f81c4f72e9c3866ba645e010f63c46dce235c6109bc60eef}) of partial recurrence of the ear prominence. This is most likely to occur in the first six months and can be corrected if necessary.

Abdominoplasty (Tummy Tuck)

What is the difference between full and mini-abdominoplasty

In a mini abdominplasty only the lower part of the abdomen is tightened. The umbilicus (belly button) is not moved and no skin above the naval is tightened. In a full abdominoplasty all the skin between the naval and the pubic area is removed thus tightening the whole abdomen as well as the muscles underneath. The belly button will need to be detached and brought through the tight abdomen.

Can liposuction be performed at the same time

Limited liposuction can be performed when combined with a full abdominoplasty. This will be confined to the sides (love handles) and central part of the abdomen. Liposuction in the remaining part of the abdomen is avoided as this can interfere with the blood supply and healing.

With mini-abdominoplasty liposuction can be performed to the whole abdomen at the same time.

What type of anesthetic

A general anesthetic is necessary for abdomninoplasty.

How is the operation performed

An incision is made above the pubic area within the bikini line. The skin and fat of the abdomen are then lifted away from the abdominal muscles all the way to the level of the rib cage, preserving the umbilicus (naval) attachment to the abdomen. The abdominal muscles are then tightened with sutures. The abdominal flap is then pulled down and excess skin and fat are removed. A small incision is carried out centrally through which the umbilicus is retrieved and sutured.

How long will I be in hospital

Following an abdominoplasty you will stay in hospital between 1 and 2 nights.

Is it painful

Some pain is experienced following an abdominoplasty which is primarily noticed on movement. With adequate pain killers most patients are able to mobilize the day after surgery. Most of the discomfort subsides after one week.

What am I allowed to do following surgery

A surgical garment will be provided after surgery which should be worn for 4 weeks to limit the swelling. You will be encouraged to gently mobilize the day after the operation. For the first few days it is better to walk slightly bent forwards to ease the tension on the suture line.

All activities should be gentle for the first 2 weeks. Although you are encouraged to walk to help the circulation during this period you will need to avoid sudden movements, lifting and fast pace walking as well as driving. More strenuous activities such as jogging and heavy lifting should be avoided for 6 weeks.

Liposuction

What type of liposuction is used

Tumescent Liposuction is the preferred technique used by Mr. Sabbagh. This involves injecting a salt based solution (to which local anesthetic and adrenaline are added) into the fatty tissue. This enables easy breakdown and removal of fat with an analgesic effect as well as minimal bleeding. For areas close to the skin, finer cannulas are used, a technique that has been termed liposculpture. Mr Sabbagh also uses ultrasound assisted liposuction for areas with significant fibrous tissue such as in gynecomastia (male breast)

How is the operation performed

The operation is usually performed under general anesthetic. Small incisions (5mm) are made close to the area to be treated through which the liposuction solution is injected. The liposuction cannulas connected to a suction machine are then inserted through the same incisions. The fat is broken down physically by moving the cannulas back and fro (or by ultrasound in ultrasound assisted liposuction) and is automatically sucked by the machine.

How quickly will I recover

As a result of liposuction there will be a variable degree of bruising, swelling and numbness. Although the area will be uncomfortable, there is no significant pain. You will be encouraged to start gentle walking on the same day following your surgery. Usually a period of 7-10 days is needed before returning to most of the daily activities. Heavy activities such as sport may require up to 4 weeks recovery. For a period of 6 weeks it is advisable to wear an elasticated garment to help reduce the swelling as well as aiding the skin to contract following the liposuction.

What are the risks of liposuction

Liposuction is highly effective in removing concentrated areas of fat. The duration of bruising is variable but in the majority of cases subsides by 4 weeks. There will be partial numbness of the area treated which will persist for several months. In some cases minor areas of irregularities can result.  If these persist they can be corrected after the healing is complete.

There is a very small risk of deep venous thrombosis (DVT) and Mr Sabbagh takes all the appropriate precautions to prevent its occurrence.

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