Abdominoplasty
Abdominoplasty, or “tummy tuck” as it is commonly referred to, is utilised for the reduction of skin and fat in the abdominal area. The procedure consists of an incision made in the lower abdominal area, typically ranging from hip to hip with the size of the incision being dependent on the amount of skin and fat to be removed. In order to minimize visible scarring, the wound is sutured after the procedure with dissolving sutures being placed underneath as opposed to above the skin. It is important to note, however, that certain individuals naturally scar either more or less than others which will affect the quality of the resulting scar. The typical scar is usually curved and on level with the pubic hair allowing it to be easily concealed with undergarments.
Once the surgeon makes the incision, the fat and skin of the anterior abdominal wall becomes accessible for removal as far back as the ribs. Cuts are made around the umbilicus, or navel, in order to remove both skin and fat tissue with the umbilicus being left connected to the abdominal wall in order to maintain blood supply. The next step in the procedure is known as keel repair in which sutures are used to draw down the skin around the umbilicus causing a tightening of the abdominal wall. Although this “tightness” can be uncomfortable after the operation, the discomfort lessens over time particularly when overly large meals are avoided.
Using the skin of the upper abdomen, the wound is resurfaced by pulling down the skin and suturing. Typically, the upper abdominal skin is sufficient for this procedure so the lower abdominal skin is able to be removed. Two suction drains are closed into the wound and they remain there for between 3 to 6 days depending on the amount of fluid that needs to be drained. If the drains do not remain in place for the necessary amount of time, a clear fluid caused by the seeping of blood plasma and other fluids may occur. This condition is called seroma and can occur after many types of surgeries and is not typically a serious condition. If seroma occurs, the fluid can usually be drained during an out-patient procedure.
Variations of Abdominoplasty Procedures
There are three variations of the abdominoplasty procedure. These are the mini-abdominoplasty, the extended abdominoplastyand apronectomy. The mini-abdominoplasty consists in the removal of excess skin below the umbilicus with liposuction typically being performed at the same time to remove fat from the area. This procedure usually leaves a smaller scar than standard abdominoplasty. In contrast, the extended abdominoplasty removes fat from the abdominal area as well as the loins and lower back leaving an extended scar that continues onto the back of the patient. The third procedure, the apronectomy, is performed on patients who have a concentration of excess fat and skin along the pubic area. A transverse incision is made to remove the surplus resulting, usually, in a long scar on the level of the pubic hair.
Recovery After Surgery
After the surgery, the patient should typically expect to feel numb in the lower abdominal area. This can last for extended periods of time but in the vast majority of cases, does not result in permanent numbness. During the recuperation process, it is important to ensure that the area is protected from injury such as burns. Due to the numbness, the area can feel no pain thus potentially resulting in significant damage if one is leaning against a hot object for a long period of time without becoming aware of it. Another unavoidable side effect of the procedure is noticeable scarring although surgeons will, to the best of their ability, attempt to limit the scarring to places that can be hidden by underwear and swimwear. However, concealment is not always possible and patients should discuss this with their surgeon before the procedure. Scars will typically be red following the surgery but will fade with time. As is the case with other operations, problems can occur with infection, continued bleeding, and recuperation delays which are particularly seen in patients who have large amounts of fat, are diabetic, or smoke.
As mentioned previously, recovery can be quite uncomfortable due to the stretching of the skin tissue. Patients are typically required to remain in bed for the first 24 hours after their operation and a urinary catheter is utilized for the first three days with the hospitalization for the procedure averaging 4 days. The recuperation process usually lasts for several weeks with patients being able to return to work usually about three to four weeks after the surgery.
Thrombo Embolic Deterrent or TED stockings are utilised during and after the surgery in order to apply calf pressure. This helps to avoid post-surgical risks such as deep vein thrombosis and pulmonary embolus which are rare but can occur after any type of operation.
The Benefits of Abdominoplasty Surgery
The benefits of the operation are many but in order to maintain lasting positive effects, continued exercise of the abdominal muscles and proper diet are crucial. Following the surgery, over exertion can lead to increased likelihood of seroma and to delayed recuperation. However, within 15-20 days light exercise can be resumed with sports being allowed after approximately 6 weeks.
One of the biggest areas of concern for patients is scarring and, although it is difficult to determine how the scar on the abdomen will heal due to each individual’s different healing capacity, it is recommended that the scar be taped for the first 6 weeks after the operation. Continued use of oil such as Bio oil is encouraged for the next six months in order to reduce the appearance of the scar. It is, however, important to note that despite precautions the scar may become red and itch at times.
Our Practices
Mr Fourie practices at Nuffield Health Hospital, Leeds, conveniently situated in the city centre near Leeds General Infirmary and at Barnsley Medical Consulting Rooms in central Barnsley.
Cosmetic Surgery Procedures
Mr LeRoux Fourie offers a wide range of cosmetic surgery and non surgical treatments and below is a brief outline of each
Inverted Nipple Correction
Many women find their nipples to be a great cause of embarrassment as they do not project past the breast and remain inverted. Mr Fourie is able to correct this problem using a quick and reliable treatment that can be done in as little as thirty minutes
Prominent Ear Correction
Although having prominent ears typically causes no physical discomfort as such they can sometimes lead to a lack of self-confidence and be on the receiving end of cruel jokes. Sometimes just one ear is the problem but usually both will be pinned back. It is also possible to perform other types of ear surgery to the lobes depending on the complexity of the case.
Male Breast Reduction
Gynecomastia is the medical term for male breasts and can be a very humiliating condition for men and can make them very self-conscious. Because of this, some individuals decide to undergo a male breast reduction procedure in order to remove the excess tissue and, occasionally, even skin from the area of the breasts.
Liposuction / Liposculpture / Body-Jet Lipo
You can now experience the latest advancements in cosmetic surgery with the revolutionary Body-Jet Water-jet assisted liposuction procedure. The gentle water jet washes away the fat without damaging the underlying structures such as the blood vessels and nerves which means less recovery time and bruising.
Non Surgical Treatments
Antiwrinkle Injections
It is inevitable that as we age lines and wrinkles will become visible and to some this is of concern. Lines around our eyes can develop as can lines on the forehead. The prescription injection treatment we all know as BOTOX® is now formally approved for cosmetic use and is called a new name which is VISTABEL®. VISTABEL® is a treatment that is used to relax the frown lines that can trouble our forehead as well as crows feet which can develop around the eyes.
Excessive Sweating
Our body uses sweating to help control body temperature and is normal human function however some people suffer from excessive sweating which can lead to severe embarrassment and anxiety. Following a consultation if your suitable we can provide a treatment that will prevent your excessive sweating that involves BOTOX® being injection into your arm pit.
DermaRoller
Genuine Dermaroller™ Therapy™ can offer a significant improvement in appearance for those who suffer from acne scars, sun damaged skin, fine lines and wrinkles and stretch marks. The DermaRoller procedure stimulates your skin to help with the regeneration and repair of itself and is a natural and safe way to create smoother, brighter and healthy skin.
Fillers
Dermal fillers can be used for many different non surgical enhancements and anti ageing treatments. They can be used for lip enhancement to create subtly increase the volume of the lips, smoothing lines around the lips, nose and cheeks as well as many other areas of the face and body to improve the appearance of the skin.
Mole Removal
It is very common for moles, lesions or cysts and can appear in many different places on the face and body. Sometimes they can be in a prominent position which can cause frustration or self awareness. Mr Fourie is able to assist in many different types of these problems and would be happy to perform many of these in the minor theatre or treatment room if he is able.
Mr Fourie
About Mr Le Roux Fourie
Mr Le Roux Fourie is a Cosmetic and Reconstructive Plastic Surgeon based in West Yorkshire. Mr Fourie was born and raised in South Africa and underwent his medical and post graduate training in South Africa, obtaining his basic Medical Degree in 1979. Thereafter he served as a Medical Officer in the South African Defence Force Medical Corp, before starting training as a registrar in Plastic Surgery at the University of Stellenbosch in CapeTown. He qualified as a Plastic Surgeon in 1987 and was appointed a Consultant Plastic Surgeon at Number One Military Hospital in Pretoria, where he served as full-time Consultant for three years reaching the rank of a Lieutenant Colonel.
In 1991 and 1992 he was in full-time Cosmetic Surgery Practice in Pretoria.
In 1993 Mr Fourie joined the Department of Plastic Surgery and Burns at Pinderfields General Hospital as the second consultant to be appointed after the tragic murder of the two previous Plastic Surgeons. He helped establish the current Department of Plastic Surgery from two members to the current seven consultants. During his time in Pinderfields General Hospital he established a Breast Reconstructive Surgery Service, which works mostly with the Breast Surgeons in dealing with primary breast reconstructions and delayed breast reconstructions after breast cancer.
Mr Fourie has been in part-time Private Cosmetic Surgery Practice in Methley Park Hospital, Nr Leeds since 1993.
Since April 2008 Mr Fourie has been in full-time Private Cosmetic Surgery Practice in Methley Park Hospital.
Special Interests
Mr Fourie is an experienced Breast Surgeon dealing with congenital breast problems, acquired breast problems such as breast reconstructions after cancer surgery (both immediate and delayed) and cosmetic breast surgery.
He has published articles regarding nipple areola reconstruction and has developed a tattooing technique which is now used by Cosmetic Tattooists in the UK.
He has been involved with the Allergan Implant Corporation in a ten year follow-up study of the long term effects of silicone breast implants which was published in the International Journal of Plastic and Reconstructive Surgery.
Mr Fourie further specialises in Facial Aesthetic Surgery and is one of the first surgeons to use the MACS (Minimum Access Cranial Suspension) face lift technique in the UK in October 2002. His long term results using the MACS face lift were presented at the Summer Meeting of the British Association of Plastic Surgeons in Dublin in 2005.
Publications and Presentations
Mr Fourie was awarded the BAPRAS prize for the best clinical paper read at the British Association of Plastic and Reconstructive Anaesthetic Surgeons Summer Meeting in Windsor in 2005.
He was awarded the BAAPS prize for the best paper read at the 2007 Conference in London. The Hackett Prize for the best paper at the BAAPS Conference 2007 was awarded to Mr Fourie.
Mr Fourie has lectured on nipple areola reconstruction and tattooing techniques, the treatment of pressure sores, wound infections and wound problems, facial aesthetic surgery and body contour surgery.
Mr Fourie has appeared in the Discovery Channels series on cosmetic surgery. He also featured on BBC's Inside Out in October 2007.
Mr Fourie has published papers in International Peer Review Journals on topics such as Breast Reconstruction, Breast Implants, Cosmetic Breast Surgery, Nipple Reconstruction and Facial Plastic Surgery
Charity Work
Mr Fourie does voluntary charity work in Africa as part of the Facing Africa Team involved in the treatment of noma (www.facingafrica.org). This is based at Yakatit 12 Hospital in Addis Abbaba, Ethiopia where reconstructions are done on patients suffering from Noma
Qualifications
MBCHB.
FCS (SA) PLAST
FRCS
BAPRAS (British Association of Plastic, Reconstructive and Aesthetic Surgeons)
BAAPS (British Association of Aesthetic Plastic Surgeons)
BAHNO (British Association of Head and Neck Oncologists)
GMC Specialist Register - Registered as a Specialist Plastic Surgeon on GMC full registration. The GMC registration is 3633562.
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