Arm lifts reduce the skin along the upper arm that can create a hammock or ‘bingo wing’ type appearance. Mr Saleh typically liposuctions additional fat around the area that we all have and then removes the excess skin. He uses special skin glue to avoid using drains. The aim is to restore the natural contour of the arms whilst hiding the scar on the inner surface of the arm. Mr Saleh insists on the use of post-surgery compression garments following this procedure to expedite the reduction in surgical swelling and to flatten the scars.

Most arm lift scars lie along the inside of the arm, but less commonly the scar can all be hidden in the armpit region.

A thigh lift is often done together with arm lifts. The loose skin between the knee and groin is removed. Typically a vertical scar running down from the inner thigh gives the most optimal results in tightening the skin and reducing the size of the thigh. In certain cases the scar can be vertical with a curved portion adjacent to the groin crease. Post procedure compression is key to expedite the reduction in swelling and flatten the scars.

Liposuction is a well-developed technique to remove fat in a minimally invasive way. It can be very useful is reducing fat in stubborn regions like the love handles, buttocks, abdomen and flanks (sides). It has limitations, in that, depending on your skin type, the reduction in fat needs the overlying skin to tighten to give an appropriate contour of the body. In many cases, liposuction is combined with skin removal to give the optimal result.

For patients that have had MWL the excess skin also develops in the lower back and an abdominoplasty type procedure isn’t sufficient to remove the skin. Lower body lifts remove the excess skin around the back too, creating an even contour.

Mr Saleh does not use buttock implants or perform ‘Brazilian Butt Lifts’ / BBL. There are safety issues with both of these procedures. To lift the buttocks your own tissue can be recycled above the buttocks and specific incisions are made to lift the skin upwards rejuvenating the appearance of the buttock.

Mr Saleh is one of the few plastic and cosmetic surgeons in the UK that carries the Royal College of Surgeons certification for surgery following ‘Massive weight loss’ (MWL surgery). The excess skin that patients can be left with following significant weight loss can have a detrimental effect on quality of life and function, whether it be through dieting or bariatric surgery.

A major side effect of this weight loss is the lack of skin shrinkage leaving cumbersome skin all around the body. Modified versions of the techniques we use in other forms of body contouring are very useful in restoring the body shape with removal of the excess skin. Procedures can be done in combination, but specific attention has to be made to YOUR priorities and nutritional status.

Procedures Mr Saleh typically performs for patients following MWL are:

Face and Neck lifts

Arm lifts +/- lateral chest reduction

Breast lifts (mastopexy) / Augmentation mastopexy

Abdominoplasty

Upper/Lower body lift

Back reduction

Thigh lift

Mr Saleh does not do all procedures together. It is important to consider that skin excess removal after MWL is a surgical journey that, for some patients, takes many months. There are some very important considerations before you embark on MWL surgery.

1. Your new stable weight has to plateau for at least 12 months. Going through this surgery, to then have another period of major weight loss can mean new skin excess appears, in effect meaning the benefits of surgery may have been lost.

2. All patients have to have a high protein diet for a specific period pre-surgery. There is good science that indicates this improves wound healing and reduces the risk of wound problems.

3. In many patients the skin excess creates stretch marks all across the body and thins the skin. This decrease in skin quality does not really change after the main areas of skin excess are removed so not all stretch marks will disappear.

Labiaplasty is not a ‘cosmetic’ procedure in Mr Saleh’s practice. It is a procedure to improve function. There has been a distressing increase in the number of women seeking labiaplasty. Sadly, the perception of what labia should look like has been distorted and the ease of access pornographic material, means some women are at risk of having a warped perception of what is real anatomy.  This sadly can be amplified by unrealistic perceptions of male partners.