Exploring Top Plastic Surgery Procedures with Dr. Matteo Vigo & Sarah (EP2)

Exploring Top Plastic Surgery Procedures with Dr. Matteo Vigo & Sarah (EP2)

Hello and welcome to another episode of my podcast series about plastic surgery. I’m Lotto Matteo Vigo. I’m a plastic surgeon working in Dubai since 2013.

I’m here with my assistant Sara. Hello everyone. Welcome.

So today we are gonna discuss about some questions about plastic surgery you receive from our patients and it’s a generic introduction to the plastic surgery world and to see if you have more questions please comment below and give us your feedback. Of course we gonna start by maybe telling us what is the main kind of procedures you actually perform. As a plastic surgeon I perform as you know all the kind of procedures except rhinoplasty.

I was not trained for that and decided not to go deep into that kind of procedure because you know rhinoplasty the nose is the most unforgiving part of the body because it’s made of three different tissues, skin, bone, cartilage and if you don’t know how to do it absolutely properly it’s very easy to make a mistake about that. So I decided not to focus on that but I perform all the other plastic surgery procedures. As you know I am mainly focused in breast surgery but I do liposuction, tummy tuck, body lift, post-bariatric procedures, face lifting, blepharoplasty a lot, otoplasty so I do a variety spectrum of plastic surgery procedures.

I actually always admire how you have a precise surgical plan for each patient that makes me actually wonder maybe audiences and patients wonder how do you actually determine what’s actually right for every single particular patient. Well I think 20 year experience speak for themselves. Definitely.

Because with one look at the patient situation I can already immediate understand what they need and how I can help them to achieve their you know outcome the one the desired outcome. It’s important for me to listen to the patient. I have a very long consultation the first time with the patient you know to listen to them understand what is their goal.

More than one consultation. Yes sometimes more than one yes true and try to understand the personality of the patient because each of us has a different personality, different beauty standards and it’s very important for me to understand this. In this way I can plan the surgery accordingly and I always review a lot of my notes.

I write a lot of my notes in the medical record of the patient because I go through them every now and then and understand if really what I wrote was correct for that patient and I can have a better understanding. You relate to it somehow. Yes.

Of course definitely. So talking about your area of expertise which is breast can you please tell us more about what is the difference between breast lifting, breast augmentation, reconstruction. Can you please give us more insights about it? Absolutely.

So breast has an evolution during the woman life because it’s with puberty where the breast with the hormones are growing can achieve different sizes. Some women develop the breast very early in the puberty some women very late. Women are subject to of course pregnancies and the pregnancy and breastfeeding will change the way the breast looks and most of my procedures are actually a correction of the result after breastfeeding multiple times or one time only because this affects a lot.

Even the length of breastfeeding if it’s too long that affects it even more. Definitely definitely. So the shorter it is the less effect it has on the patient itself but even the pregnancy which last nine months we cannot change that of course sees an increase in the size of the breast and can create like a different outcome after the delivery of the baby itself.

So a breast augmentation is when we add the volume through an implant that can be placed under the gland under the muscle dual plane technique. I will have maybe have a podcast about that in the future. Breast lifting is when the breast has been deflated even for a weight loss for example and the nipple area compass goes down below the sub mammary fold and we need to re-lift and put it in a higher place.

This can be done only with the tissue of the patient or with addition of the implant and then we have some patient who has a overgrown breast tissue which is a breast hypertrophy so the breast is really bigger than what it’s supposed to be and we need to make a reduction. So breast reduction where we do the same time lifting and we remove some tissue. That’s what confuses the patient sometimes they would tell me oh I need a breast reduction they end up with a breast lifting.

Exactly or also they don’t know that when they do a breast reduction the lifting is always included. Exactly. It is very important because the patient needs to understand that to reconstruct the breast and give them a shape I need to reposition the tissue in a higher position.

Okay let’s talk about another topic apart from the body. What are the most common facial procedures that you do for example? We have a lot of requests from our patients. I perform a lot a lot especially recently a blepharoplasty because it’s a very simple procedure with a very short downtime.

The result is quite almost guaranteed. I develop a technique that allows me to give a very consistent result to the patient. Of course modifying the technique here and there to adapt to the anatomy of the patient and the desired result that the patient wants.

I do a lot of also face lifting from the mini facelift full facelift and neck lifting. I do eyebrow lifting and I do otoplasty as we said before I don’t do rhinoplasty because it’s not my field of action but what the people are tending to have now it’s something which is minimal invasive. In fact also I perform quite a lot of fat grafting to the face because this is another area where we combine the aesthetic field of the medicine with the regenerative medicine because we remember that fat has stem cells inside so the moment you transfer the fat in the face this can give you also rejuvenation of the tissue itself.

It’s not harmful of course. Exactly exactly so minimal invasive technique up to the more invasive force a full face and neck lifting is a more invasive technique but in some patients it’s needed absolutely so we need to divide what is the patient desire. He can move the fat remove the fat wherever you want he can put it in the breast he can do a fat grafting to the breast fat grafting to the face as well.

Returning to the body procedures how liposuction work and what like how you decide which areas will work effectively on it before you answer that by the way he had a surgery in his shoulder because I have booked him a lot of procedures for liposuction which I have to stop for a while just to minimize it but yeah back to the subject how do you actually think liposuction work so yeah liposuction is a hard work for me okay as you said I had an injury on my shoulder because of that because of me because the movement that you do is uh you know quite important but consistent for a few hours to achieve the result but what is my motto by liposuction liposuction is not a weight loss procedure exactly so it’s very important that the patient understand this if a patient is overweight and wants to reduce their weight I’m not addressing it with liposuction liposuction is to reshape a body to resculpt the body and to remove some stubborn area of fat that could be the flanks the thighs the tummy wherever and what is also very important that Dubai has a strict rule Dubai health authority a few years ago put a strict rule about the maximum amount of fat that we can remove from the um the body of a patient which is five liters so if a patient is too much overweight five liters is not even enough to give the idea of a weight loss.

What happened if you take more than five liters it can be dangerous for the patient itself that’s why they put that some complication here in Dubai so they wanted to protect the patient to put a rule that applies to all the surgeons so it is very important that we respect this rule and to explain to the patient that with five liters in some of them we achieve a certain amount of result the rest is also their effort to do on to go on a diet program to go with a personal trainer physiotherapy in order to activate the body and to reduce the amount of weight that they can lose I recently done a patient she did the liposuction and then she started a serious dieting program she lost 15 kilos after liposuction of course a result of the liposuction even shows more because she has a new shape of the body with less volume so she’s absolutely extremely happy with that thank you for saying the mentioning the DH regulation about the five liters because a lot of patients ask me actually and they wonder why it’s okay outside of UAE but it’s not inside um what are the differences doctor between the liposuction and the tummy tuck a lot of patients actually get confused about it they would tell me I need the liposuction they end up having a tummy tuck and what do you think actually the who’s the ideal candidate for the procedure so uh liposuction is a perfect situation where we have a little bit of fat in the abdominal area and a good quality of the skin.

So there is no stretch skin hanging skin usually the best candidate is a patient didn’t have pregnancies because remember that when a pregnancy one of multiple pregnancies the muscle tend to separate in the midline which is a condition that liposuction cannot fix so in that case when I do a tummy tuck I can suture the muscle together and re-establish the abdominal wall so I need to evaluate the patient there is extra skin the quality of the skin is poor we have different nationalities in Dubai so I see different kind of skins and I’ve seen that the darker the skin is the more prone the patient is to have stretch marks this means that the skin is not a good quality but we can treat it later yeah exactly but if we do liposuction on a stretch mark skin the skin will be even more loose so it will not look nice so it’s a very important understanding balancing what is a possible outcome with the liposuction and if I can avoid the scarlet tummy tuck of course I will always choose the liposuction but sometimes again because of the muscle because of the quality of the skin because of the extra skin that is already present in the body even if the quality is good but the pregnancy stretch too much or the weight loss and gain during the years have done this you know balloon effect up and down up and down the skin remains and remains hanging so in that case we need to go ahead with the tummy tuck which is scary for some patients but I have seen during these years of career that actually the patients are more scared of the idea of the tummy tuck rather than of what really happens and a lot of patients came back to me I was really worried about the pain at the postoperative period and at the end of the day it’s not as bad as I thought it was right we have a phrase that came up.

So let’s say popular and trendy these days since recent honestly last let’s say 10-15 years which is a mom makeover can you please tell us more about a mom makeover so a lot of women after delivering one or more babies they feel that they become only moms they are not women anymore and they lose their feminine part their attractiveness towards the the part of the husband and it’s very important that we can re-establish that self-confidence about that because being a mother is the most beautiful job in the world but you’re still a woman so it’s important that the woman feels confident with herself because I think when a person is confident with herself can transmit his confidence to the kids to the husband to the work environment so a pregnancy a delivery a baby should not put these things down so mommy makeover came up as a solution to have the best rebuild of the self-esteem for the patient and give the possibility to combine a breast surgery with abdominal surgery because of the two areas most affected by the pregnancy and with different techniques we can do a breast reduction breast lifting breast augmentation can do tummy tuck and liposuction.

It depends on the case by case but in this way we can really re-give the patient I’m not saying the body before the pregnancy sometimes it’s not possible but a youthful body an attractive body and a body that she can feel a woman in but you mentioned that the tummy tuck to remove the excess skin how about if we did the liposuction and the skin got saggy what what are the solutions for that very important in the years there are some technologies have been developed to tighten the skin in a non-invasive so not cutting not surgically which is for example renuvion okay was called before j-plasma so people know j-plasma.

But now it’s called renuvion basically is a is a cannula which delivers a plasma energy to the skin and heats the tissue that shrinks in a period of three months after the procedure and give this skin tightening is a kind of the machine and tool that I use in specific area for example like I always use on the neck liposuction I always do an arm liposuction to redefine the skin and to retract the skin in that area.

And I use in the back liposuction can be used of course in different area of the bodies like abdomen thighs knees flanks wherever we want and it’s very important for the patient to understand that this heating is like a controlled burn burn is a disease that when it starts it creates an immediate damage but then over the years the healing process will retract the skin.

If you see the skin of a burn patient is always retracted okay we give the same energy but in a controlled environment so the amount of energy we deliver is not like a burn from a gas explosion or something in this way we can induce this retraction to give the aspect of the skin more tense more tightened and with good results honestly that’s that’s that’s actually impressive.

Honestly speaking that you don’t have to do a tummy tuck to remove a skin which you can do with a liposuction I mean if it’s not a pregnancy but tummy tuck is applicable for for men as well right yes absolutely absolutely tummy tuck is a kind of procedure that applies to everyone usually men comes to me after massive weight loss so they were overweight obese sometimes and they do a bariatric surgery where they cut the stomach they lose like 50 60 70 kilos and they have of course extra skin and in this case we can do a tummy tuck we sometimes need to do a body lift which is a scar that goes around 360 degrees around the body and this allows me to lift the lower part of the body the buttocks area the thighs the outer thighs remove the flanks and remove the extra skin in the abdomen this gives the patient a real shape nice shape the scar is hidden.

For example for a man under any underwear if they go on the beach with any swimwear so it’s it’s a very big push to their confidence we have I just wanted to tell you that lately we’ve having a lot of patients who are coming from different kind of countries having revision surgeries like they want to do revision surgeries that they’ve done the initial procedure somewhere else how do you approach those kind of revision surgeries for the patients who are unhappy with the results of course.

Unfortunately lately there are some countries that are offering you know very affordable prices for patients understand not every patient can afford plastic surgery but the risk is in going to a different country from yours in a non really set center okay I’m not saying that all the centers abroad are bad absolutely far away from what I want to say but choosing the cheapest option is not the best option sometimes especially because when you have a complication you’re already back in your country you don’t have your surgeon to take care of you so some of these patient comes to me for an immediate complication an infection a bleeding hematoma seroma whatever I need to treat the the situation immediately some of the patient come later because their surgery has been botched so they have asymmetric breast they have irregularity after liposuction they have.

I don’t know a terrible scar from the abdominoplasty etc etc so it’s important that what I give to the patient is also a six months follow-up so the moment you do come and do a surgery for me for six months you’re allowed to come and visit me anytime you want you don’t pay any single dirham extra but I take care of you definitely these abroad surgeries the surgeon cannot take care of you because he is not there and this might be the downside of the so don’t always choose the for the price.

I know Dubai sometimes can be expensive for that but choose the doctor you need to feel confident with the doctor I was about to ask you as well doctor you mentioned a couple of complications and rest the patient might face actually the seroma the bleeding the scar how do you mitigate them so I always tell the patient that I have three main complications that can happen in any kind of surgery not only plastic but also general surgery orthopedic whatever the first one is bleeding and I’m very attentive in coagulating each single vessel when I’m doing the procedure the second one is infection a very strict protocol especially when it comes to an implant take a shower by the way unless after a week they will see the doctor because at the end of the day they’re humans they don’t know how to exactly take care of their bodies you know so yeah she’s very more strict than me actually with the shower yes.

Honestly I don’t like it although you allow them in two three days but I don’t like them because I don’t like it because they might have water sneaking I know we use mostly waterproof dressings right but sometimes the water will sneak in they will not pay attention to it so that’s why I don’t like them to take a shower you’re gonna stay for a week but it’s fine you need to you know take it be taken care of but in any case the infection is very important to prevent the moment we have an implant because an implant is a surface where the bacteria can grow and if the implant got infected we need to remove it so it’s absolutely mandatory that we take care of this with an antibiotic during the surgery antibiotic after the surgery I soak the implant in an antibiotic solution before putting in the in the breast itself and so the protocol is very strict.

Thanks god my rate of infection is not very high so if it happens sometimes happen only on the scar very superficial that just delays the healing of few days but nothing more than that so the recovery actually not only depends on the surgeon depends on the patients as well if we can say right do you have anything to say more about the recovery process.

For example uh it’s very important the patient will follow our instructions uh we try to make them as easy as possible for he wants you to be comfortable as well of course she learned from me so her instruction on my instructions it’s important that the patient will understand each step of the healing process and that any surgery has a very long healing process it’s not that in one week you’re ready to go and you can do whatever you want you need to take care of yourself from the scar I always say to the patient the scar itself is something I can control up to a certain point because I don’t know the reaction of your skin.

So your skin can really react in a very bad way to my perfect surgery and you perfect care so even if you’re a very good patient you take care as I instructed you you can still develop a hypertrophic scar which is not nice to see so that’s very important you need to understand what step you need to take day by day to make the overall situation and overall surgery become better and better also with the gym I always tell the patient you have to listen to your body you are the judge of yourself if you go to the gym after three weeks one month two months.

Whatever is the period that suggests to go to resume your physical activity and you feel that something is wrong don’t force it stop it and in that moment you come back to me we understand what is the risk. Since the last couple of years doctor I have noticed that we had a trend of let’s say Kardashians kind of Brazilian but left the breast but patients now tend to go for more natural results what do you think about that? Well my philosophy is always to give a natural result I strongly believe that my patient is my business card so if I send out patient with this gigantic breast or you know fake lips etc it’s maybe not my best marketing.

I believe and I truly believe that the beauty stays in the natural results so I always try to give the patient subtle changes evident changes because they’re there they pay money to see some results but something that really is not it cannot be defined as horrible with some of the results that we see around so a lot of patients ask me that as well and I’ve seen for example the breast implant size a few years ago I was not going below 300 cc for the implant now they’re all between 215 to 160 because they want this kind of natural result natural appearance and everything goes towards this direction okay the Pamela Anderson look of the year in the 90s is not desired anymore for anyone.

Actually they criticize people who still want that and it’s our responsibility as surgeons to I’m not saying following the trend but to guide the patient towards this process and suggest it from the best to what’s best for them for sure I have honestly as a PA I have a lot of queries from patients on how to solve problems without going to invasive kind of procedure or a surgery do you think the non-invasive kind of treatments had a lot of impact on the field of plastic surgery definitely people now wants the weekend treatment the lunch break treatment and they want something that can fix them in a short period of time.

We know down time less visible results etc there is a stage for everything I think so some of these machines products and technologies that came out lately are beautiful I use them a lot and I can deliver good result in specific cases patients need to understand that there is also some cases where a surgery is needed I cannot always give them the easy solution but I need to go a little bit more drastic to give them the result they want especially sometimes they make me laugh whenever patient of 65 70 years old you know with a lot of wrinkles a lot of aging signs come to me and said I just want one two injection and I want to look like I’m 20 I’m not a magician they didn’t give me a magic stick with a degree so I cannot help them in this situation so I need to explain this to them.

I need to tell them that this is what I can do for them okay that’s very important can you share doctor your insights on emerging technologies that you know change the landscape of plastic surgery.

For example I know what you’re gonna answer but I’m happy to let the patient know about it as well well of course I always try to look for the best latest devices latest technology latest technique to deliver the best result to the patient and I’m happily announcing that I’m one of the first plastic surgeon the UAE be licensed for the MIA procedure which is a very minimally invasive procedure to address a breast issue the patient has to basically remove the padded brand the push-up bras on the patient and with a like seven minutes procedure because it takes me literally seven minutes to me.

We can insert an implant to be true yes to be true but we will have an episode about that we talk about these in the details I have already a video on my channel that the patient can look to understand what I’m talking about it’s called MIA femtech but this is the sign that the technology is going towards the less invasive possible how do you manage doctor the expectations of the outcome as you said you’re not a magician you don’t have a kind of a stake that you let the patient be 20 again well how do you actually manage the outcome.

It’s very important again as I said before I talk a lot with the patient I discuss you know all the points and try to understand what they want to achieve and then I show them before and after cases to let them see similar cases of them what can be the possible outcome and I’m very honest with them I don’t promise the moon and then I cannot maintain the promise so I’m very straightforward I said you can achieve this if this is enough for you let’s go ahead if you don’t think it’s enough for you I’m not a surgeon for you I prefer to lose a patient because they have two crazy expectations but sometimes I cannot make them happy and I know that and that’s why I I’m happy to say no to a if I see that I’m not the person for them okay my idea is beauty in one their beauty is different and we cannot have the same concept and we cannot have achieved the same result that we want again because you deserve the best exactly.

I’m going to conclude with one last question that I have how do you actually like what kind of advice is key factors that you advise the patient to do before undergoing a plastic surgery very important you make a research about the surgeon you are consulting with actually I’m very keen to suggest the patient to have different consultation with different doctors because you need to understand different point of view and then make your own one and feel the vibe with the doctor but before consulting with a doctor go online nowadays you can find information about the doctor you can see before and after pictures of the of the doctor itself and you can understand if this person is the right no the google is about the side effects of the surgery because this might mislead the patient but google the doctor try to find information about the doctor try to see the reviews of the patient for this doctor because this is very important check the credential of the doctors there is a board certified doctor which kind of studies did which kind of courses if he’s a teacher in some courses because this adds credibility to the doctor when you find the trust in the doctor go and see different two or three of them if you want and select the one who really inspire you the most and you feel safe and confident with that’s the most important thing don’t research too much on the surgery itself come prepared with million question technical question because you are the patient need to trust that if i call a plumber i don’t ask him which kind of tube he’s using okay he’s doing his job and i had to trust his experience to do that so some question from the patients that come said oh but you do this kind of thing because i heard is the best one don’t do that okay trust the doctor need to find the good feeling with the doctor and then you trust him.

Well thank you so much doctor of course if you want to know more about the procedures and the treatments that dr mateo does please uh check his instagram youtube linkedin check them first of course anytime um last words i’m happy to have done another episode with you um i hope i’ve answered a few questions for the patients for the patient curiosity was very informative and uh yeah stay tuned because more and more detailed videos are coming on the way with some other professional figures that can give their insight in plastic surgery me talking about specific procedure itself so stay tuned i think you will like the content that we will provide soon thank you so much doctor thank you because you deserve the best.

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