Staiano Plastic Surgery

Plastic Surgery Q&A Episode 313 |How long does it take for a scar to fade after having a mole, cyst or lipoma removed and more...

I will be talking about:
-Do we offer Umbilicoplasty?
- How long does it take for a scar to fade after having a mole, cyst or lipoma removed?
-Do we offer encapsulated seroma removal surgery?
- I have a few flat moles that I’ve lasered two times, but I barely see any difference. The doctor told me that if laser doesn’t work for my flat moles, nothing will. But it is possible to get rid of flat moles with excision right?
- Is it possible to breast feed after having a breast lift with implants? And anything else that crops up. #AskJJ

Broadcast on:: 28 Sep 2024
Audio Format:: other

Welcome to the Steiano Plastic Surgery Podcast with plastic surgeon JJ Steiano, the only plastic surgeon in the UK who owns a clinic specializing in breast and body contouring. Yes, Instagram are still doing, you know, they're still playing, trying to suppress me basically, they're trying to suppress me, they're trying to stop me from doing live videos but I will not be repressed by the powers that be. I've still got a lot of support in Facebook and YouTube in the towers of power in YouTube and Facebook so I'm still doing a live Q&A on those platforms and I will continue to strive to be a voice for a reason and for plastic surgery questions but not in a live fashion on Instagram. Goodness knows why but they're saying I can't do it on my account but anyway, I'm on YouTube and Facebook at the Steiano Clinic, if you want your questions answered, I'm doing it now. I'm actually live as we speak so I better go. Something's going off. It's all kicking off here so why don't I just stop that video, can't be posted. Right anyway Q&A is what this is about. Let's just not forget why we're all here. All of you, why you are here and thank you all for being here by the way, each and every last one of you. It really is touching to see so many people here tonight who come along to support me in my Q&A endeavours so really you, the people, are the real heroes, not me. It's not about me this, it's about you, the audience and it really is touching to see so many people here today so thank you all for coming, I know you've all busy and you have taken time out of your busy schedule to join me on this live Q&A. If you've got a question then please ask it but fortunately I've got some questions in the bag so I will go through those at my leisure and I will feel free to be interrupted by one of the crowd, if anyone wants to raise a hand then please do and we can always go off and attend and I'm always open to a tangential discussion but for now it seems it's going to be a linear progress which is absolutely fine so why don't I just answer this question here, do we offer umberlycoplasty, I don't know if this person is asking for something specific in terms of umberlycoplasty, I mean plasti, plastic, plasti basically means changing the shape off and umberlyco is umberlyco's belly button so kind of changing the shape of the belly button covers a wide range of procedures there so it can range from umberlyco reconstruction so for people who are born without a belly button, people who are born with abdominal wall defects and don't have a belly button so that would be an umberlyco you do an umberlycoplasty where you recite the umberlyco's you keep the stalk and you recite it and there's a technique for doing that to get a natural looking umberlyco's but it might be someone who's going to have normally like an LT for instance or an abnormally shaped belly button or a problem with a belly button after a piercing so you can cover a wide range of things but in broad terms yes we do change shapes off belly buttons and we do things to belly buttons and you will be surprised it is a quite a thing the structure of the belly button and there are many papers written about it one of which is mine well actually Mr. Naranjan mainly but me and Mr. Naranjan I wrote that you came up with the idea but anyway both authors on it and when you write a paper on something like that on how my paper was about how you reinsert the umberlyco's at the tummy tuck a technique for doing that but when you write a paper like that you realize how many papers there are out there there's a lot of people who've kind of researched what the ideal shape of the umberlyco's is and how we go about making it look aesthetically pleasing so yeah I guess if you're going to have anyone do things to your belly button plastic surgeon's going to be the one who is sort of who does do umberlyco or unblock a plastic or unblock a reshaping or unblock a reconstruction where you want to call it but sure answer yes we do yeah we do we do unblock a plastic so how long does it take for a scar to fade up having a mole cyst or lipoma removed sometimes we put these clip it clip it's clip it's a word isn't it it's clips of this on instagram just with a not on instagram on youtube just with the the clip and base and tick tock and I did one a while ago say I've done a couple actually how long to dissolve how long do dissolving sutures take to dissolve and what's the cost to mole removal both of them were like this someone's asked that question and then I have to answer it on the live Q&A and then we post it on youtube as a as a as a video saying cost to mole removal or how long do the zol will sutures take or like this one how long does it take for a scar to fade and then everyone berates me because I don't give an answer you know they're like well he hasn't told us how long it takes to zol will sutures he hasn't told us what the cost to mole removal he hasn't told us what this is like because the fact matter is most of these things the answer is it depends which is very unsatisfactory I do know but it does depend it depends on the sight of the body where it is so around your ankle heels very slowly and it's got a poor blood supply your face heals very well and will heal more quickly and and scar the scar will fade more quickly it depends on your age you heal more quickly there is a young person than you do as an old person but the scar phase better as an old person than a young person it depends on how much tensions on the wound so how big it is so moles are skin lesions so we take out skin system lipomas are subcutaneous lesions so we don't take out much skin so hopefully as a sister lipoma the closure wouldn't be too tight but a mole you might have tight closure which might make the scar a bit more red for a bit longer it depends on how the healing goes if you have delayed healing for whatever reason but if infection it might take longer it depends on your skin type if you have a very pale skin you might from scars are a bit more red and take a bit bit longer to fade some people do make worse scars than other people there are people who do scar well and people who don't have good scars so there's a variety of factors which will will come into it but what I normally say is a kind of ballpark answer for these sorts of questions is that the skin is healed in a week and that doesn't matter if you're having a mole removes or having a tummy tuck or you're having a face lift or you're having a whatever operation you're having basically the hope is that the skin is healed in a week pretty much I mean obviously you can get problems with delayed wound healing but the idea is that the skin should be healed in a week but it's not very strong so you can leave it a few months before you do anything to it and often if you look at it a week it actually doesn't look bad and you look at it at six weeks and it looks more red so they often go more red before they go less red so if you look at it a week oh that's a good scar happy with that and in six weeks oh my god it's all red and hard because as the scar gets stronger it gets more red and a bit more lumpy and then it fades so I normally say three months is the sort of time scale I give for three months when things start to fade that's when things start to start getting better we talk about scar management massaging the scar and what have you we'll talk about the clinic but basically three months is where it starts to fade and then it's six to twelve eighteen months for it to properly fade so again broadly speaking a year is kind of like the time that most people would say is when you're you know you're fully faded but it's sometimes eighteen months you know sometimes it's still a bit ready a year so you can't 100% say that about everybody but broadly speaking a year is kind of what you're looking at in terms of the fading and what have you and so yeah three months later start to fade twelve months later properly fade is the is the is the short answer so hopefully if this does go to YouTube or TikTok or something like that it won't require you know won't have loads of people berating me having said that I think it helps having comments so bit of a win win really but that that no no because that will be clickbait wouldn't it people say oh it's clickbait I might stop clickbait someone's asked me a question what's the you know what's how long the dissolver suits take and I'm attempting to answer it there's loads of dissolver sutures so I can't give an answer depends on the time you know so it's not that it's just me trying to answer these questions I think they think I've posted a video of that and I've like instigated this myself you know which is like not in my defense do we offer encapsulated seroma removal surgery now instantly well I think I can say this is probably not our patient I do remember I did have one with the patient who had one behind her knee surprising enough an encapsulated seroma which I had to remove but it's a very rare problem in encapsulated seroma and I'm thinking just by the nature of the question I'm thinking it's probably a tummy tuck because that's kind of like the normal area where I would you know where you would get this sort of thing and so the answer the question is yes we do offer encapsulated seroma removal but the preface to that is we would not offer it if it's someone else's we don't treat other people's patients so you if you've had your surgery somewhere else the advice is always to go to that other person and to have treatment with them so we wouldn't really take on a person who has a post-op complication like that because it would be classed as a post-op complication and there would be a vested interest for your surgeon to do it and often we would do it maybe with no cost or certainly reduce fees if it was your case but if you went someone else they'd probably charge you for a whack so we wouldn't do it if you had surgery with someone else but if you've had surgery with us and you got encapsulated from absolutely yes we would do it but as I say it's an extremely rare problem that you hardly ever see or I hardly ever see anyway certainly a tummy tuck I don't think I've ever had one other tummy tuck but you know it's out there in the world so I'm not saying it's like a kind of like really rare but it's not like it's not like a common thing um so yeah I've had a few flat moles that I've lasered two times two times I've lasered two times but I barely see any difference the doctor told me that if laser doesn't work for my flat moles nothing will but is but it is possible to get rid of flat moles with excision right yes right I'm not sure I would necessarily 100% agree with that doctor actually probably 0% agree with that doctor you know saying that if laser doesn't work nothing will that's not true the thing about doing things like laser for moles is that you are using thermal energy to burn the mole basically and if you do too much you're going to get too much scarring if you do too little you get a residual mole so that's the problem if you don't do enough you can obviously get less scarring because you're damaging less skin but you will then when the skin heals the the pigment cells will still be there you need to destroy all the pigment cells somehow so I would yeah so a flat mole can always be removed by excision and going back to the cost of mole removal question it depends on the size and location because you can get very big moles but most moles are kind of small moles let's be honest with ourselves most moles are small moles but you know any any size mole we can certainly talk about removal if a very big mole you might be saying the risks of outweigh the benefits but that's kind of occupation really but generally speaking any flat mole can be removed by excision and I would say excision is the best way to remove it I would I would I do well I wouldn't I would say that I do say that um and I'm not just saying that because we do it because I don't mind who does it you can have anyone do it I'm saying that because I think it is the best way to remove to remove them you can be very um it depends on the type of moles sometimes we do shave excisions and stuff like that but a flat one you can't really do a shave excision a flat mole a flat pigmented lesion probably is best to be sent for histology and number one so we can be sure that it's nothing sinister and number two you can be absolutely sure that you're removing it there's no kind of question that we might come back or anything like that it's a it's a guaranteed really result so I think and you can be clear about how much skin you're removing you do a very minimal margin usually for a benign mole and so you get the minimum scarring whatever you do there's going to be some scarring and I think anyone who says there's no scarring it's like well this scarring might be so good you can't see it but you can't really say there's no scarring there is a kind of especially if there's a full thickness injury whether that be with acid or laser or a knife or spoon you know scraping or whatever there's a full thickness injury that's going to be a scar um oh Lynn Lynn's in look we have got there is life Lynn what you got can you have loose skin if you lose weight after tummy tuck yes hold a minute can you have loose skin if you lose weight after tummy tuck yes you can Lynn and that is why ideally and I know it's not an ideal world but ideally if you're going to have a tummy tuck you would not lose weight afterwards so I always say to people you don't want to have weight fluctuations either way for a tummy tuck so sometimes people say I've got you know I know I'm overweight but I find it very hard to lose weight because of this abdominal apron and I'm like you're better off not having a tummy tum so I want to have the tummy tuck because then I can exercise better and all that stuff and I completely understand that but if you have a tummy tuck and then you exercise and then you lose weight you're going to have redundant skin you're going to get loose skin because we make it as tight as we possibly can when we do a tummy tuck but if you then lost weight after the tummy tuck that would cause the the loose you know to have more loose skin which we could have removed if you'd lost the weight first so you're 100% better to lose the weight prior to your tummy tuck because you can get an annoying you know a bit of loose skin there so so yeah weight fluctuations are a real problem after the tummy tuck. Either way so if you put on weight again if you put on weight you're going to put on weight yeah doesn't the tummy tuck doesn't say oh I spent all this money on my tummy tuck my abdomen is going to be great you're going to put on weight and you know the worst thing you can do is putting on a losing weight because that will stretch that skin again and cause a recurrence of the problem but certainly if you're not happy with your weight at the moment and you're thinking you might lose weight after the tummy tuck you might my advice is very much that you should try and do that before the tummy tuck because you're going to get a better result you're going to have less risks because your complication rate is higher with a higher weight but also you're going to get a better result because we're going to get a maximum out of spare skin out and a lot of people will say what a lot of people say so yeah so you get a mass in our skinner so yeah if you do it at the time you'll get more skin out that's right I know what I was going to say so a lot a lot of but sometimes especially massive weight loss people they lose weight and they have such a huge area of redundant skin they feel really uncomfortable with the skin hanging off them and they put on weight to kind of take up the slack a bit which you can understand but if you're having if you're going to have surgery you kind of want to get to a maximal loose skin situation so you might find it uncomfortable having all that loose skin and you might be more comfortable having a bit more weight which is fine if that's you know that's your life but if you're going to have surgery you're much better off maximally losing weight making it kind of look as bad as it can really sort of much loose skin as possible because then we'll get rid of all that loose skin make it tight and then you can kind of move on from there rather than thinking on that I lose weight loss I've had the surgery so that is that carries carries in the life jacket how easy to remove a lipoma from forehead when you need for a bathtub um well Theresa I don't want to make out as if this serves it easy all right I don't want to make that out because otherwise everyone I'll do it all right but usually a lipoma from a forehead is a relatively simple I would say procedure the problem with lipomas is they can be at any depth so certain areas you can worry about lipomas being quite deep now on the forehead there's not that much between the skin and the skull so even if it's kind of just on top of the skull it's not that far away so you know you can get rid of a lipoma so like when we talk about scans and stuff like that a lipoma on forehead but it's not always just not like there sometimes lumps there we worry about some lumps if it could be something else other than a lipoma but certainly you wouldn't worry about the depth of the lipoma on a forehead because you know it's not going to be that deep um so in that respect they are easier to remove than maybe in a lipoma on the abdomen or on the back which could be deep to muscles and what have you the thing about the lipoma on a forehead a couple of things we have to be aware of is it's going to leave you a scar um sometimes you have laughter lines on your forehead or people do so if you've got some laughter lines on your forehead great we can make it look like one of those laughter lines if you haven't we'll put it in a place where there will be a laughter line um in the future but that's you know that's one thing you're trading your your lump in for a for a scar but they usually fade really well to be honest with you when we when we do put it in the line and the other thing to be aware of is there's a couple of nerves coming up here they're called super old tool and super trochlear nerves they come up here and they supply the scalp sensation of the scalp they don't supply any movement so if it's in that kind of area if it's between the sort of medial part of the eyebrow going back if it's in that part of the forehead there's a risk those nerves could be damaged and there's a risk that the uh um sensation of your scalp might be altered which is a bit of not it's not not massive deal but it's a bit annoying when you comb your hair it feels a bit weird so that is a potential if it's kind of in that in kind of that area um but that's something we kind of taught you about but it yeah in time in times of the doing it it's not really particularly difficult um we do have to see and treat thing to raise so you can send us a photo so you get an idea what would be involved come and have it done and then you wouldn't necessarily need to be seen after as we do like to follow people up we always send them off the histology uh and we want to make sure the scar is okay but we can do that with phone calls emails uh video calls and stuff like that so you wouldn't necessarily have to come back between it for a follow up unless there was a problem we could do the follow-ups kind of remotely in terms of the um phone calls and videos and stuff like that so uh because it's just making sure oh you oh actually sorry having said that you wouldn't need the stitches removed sorry that would be which would be a week later so if you do live far away and you're not able to come back then you might be at a GGP to do it obviously we'd happily do it but um that would be the only follow-up if you need stitches removed because on the forehead personally I would prefer to use non-desorbable sutures because that's going to give you a better scar than desirable sutures obviously desirable sutures wouldn't have to be removed but it does not give quite as nice a scar and I prefer to use um non-desorbable sutures which do need to be removed and they normally we normally remove them a week later so that would be something you would need to um have ideally have followed up with us but if you have a um if you're unable to then sometimes we can um uh you can ask a GP to do that if you need different rates for a linn thank you linn thank you for the input it's on my husband's forehead he also he's also in the live chat next to me oh there you go yeah look at that well thanks uh nice to meet you both and uh yes oh well if it's on your husband's forehead who cares don't care about a scar and it's not your forehead no anyway the same thing applies uh to raise about the you know the kind of line in the increase and what have you so um so yeah thank you to raise so is it possible to breastfeed after having a breast lift within plants again another one I'm going to get braided for probably because I'm going to say maybe what can I do the answers these questions often isn't straightforward the reason that breastfeeding is potentially in jeopardy when you have a breast lift and it's the breast lift part of it that's doing it not the breast implants so if you're just having breast implants on their own then yes you can breastfeed assuming you can breastfeed already having implants is not going to alter your ability to be at a breastfeed some people can't breastfeed so you know you might not be at a breastfeed but it won't be the implants is doing that it will be so implants will not affect your ability to breastfeed because they kind of go behind the breast but it's the breast lift aspect of it so a breast lift or worse a breast reduction both those operations involve moving the nipple so we have to kind of move the nipple to a higher position the nipple sitting too low that's basically the problem with a with a breast that requires a breast lift so the nipples set say it's sitting a bit too low so you can lift the nipple um but that means you kind of have to isolate the nipple so you're isolating the blood supply you're isolating the nerve supply and you're isolating the milk ducts when you're doing that part of the surgery you can't see the blood supply or the nerve supply or the milk ducts in the piece of tissue that's going to the nipple so you don't know if there's enough certainly enough nerve supply and milk ducts you can get an idea of the enough blood supply because you can see the nipple the nipple is looking pink you know it's fine because the nipple is looking sort of blue then you're thinking all cranky i've taken away too much tissue and there's not been a strain it's getting a bit engorged so but you can't really tell by looking if there's blood if there's nerve supply or or milk ducts in that piece of tissue that you're isolating the nipple on so you have to kind of hope now in a breast reduction there's more of a dissection is done around that nipple in order to remove all the tissues so in a breast reduction some breast issues removed in the breast lift no breast issues removed you only remove skin so in a breast lift there is less isolation of the nipple so there is more likelihood that those ducts will be intact going to the nipple so there is more likelihood of you'll be in a breastfeed following a breast lift than there would be after breast reduction having said that you still have to isolate nipple to a certain degree and it kind of depends on the group we look at the nipple to sternal notch distance so the distance from your nipple to your to your sternal notch here and we look at how far we're going to have to move it so the further you're going to have to move it the more you're going to have to sort of isolate that nipple to release it and bring it up and the more risk of problems with the blood supply and nerve supply and the milk ducts so that you know if it's often with people with breast lift and implants often you're not moving a nipple much often it's just a small transposition you need and so there's less likely to have problems with breast feeding but you know you can never be 100% so the main thing that I'm not going to say alarm bells but rings sort of like makes me kind of think when someone asks that question is I'm thinking well hold on a minute you're telling me you're thinking you're hearing children because if you think you have any children I wouldn't have a breast lift with implants because the breast lift with an implant is quite expensive operation and a bit like what Lynn was saying earlier about or if I lose way after a tummy tuck you I'm not going to say you undo the work but you know you can have loose skin again same with the breast lift with implants your breast lift implants fantastic happy days and then you have a child well that's the reason people need breast lift with implants because children because meths is things are you you know breast getting gorgeous they get bigger then when you finish breastfeeding they often get smaller sometimes they stay big sometimes they get smaller they can change is the point they can change after having children so ideally you wouldn't have any kind of breast reshaping surgery until you've finished your family ideally now you might say I'm not going to finish my family for 10 years or something like that so I want to get it done now fine as long as you're aware that if you did have children you might have your breast might change shape and you might not be as happy with them as you were plus you might not be at a breast feed so ideally you would finish a family before having this sort of surgery but it's you know if you didn't want to that's fine but you'd have to you know usually we have a consent form and on the consent form inability to breastfeed or at least in the you know we tell you that there is a risk that you may not be able to breastfeed although as I say if the transposition is small you might be fine but we couldn't give you 100% on that and you really got 100% is to have a you know have a child in the sea because they say some people can't breastfeed and you know even without any surgery so yeah it's raised a lot of things will be in touch good look forward to hearing from you to raise so um all I can say is thank god for linens raise thank you thank god for lin to raise and larena um for a bit of audience participation thank you much appreciated uh to say uh you the fans out there are the real heroes of this so thank you for being there uh and um I'm gonna go now so I will um oh I hope you're right arena by the way get well soon uh Thorson and uh and uh well maybe many many many thoughts really thought so I'll with you and hope everything's okay and I will um yeah check out basically uh and I'll almost certainly be in next week for more scintillating conversation uh similar to this so um see you then have a good evening oh Jackie Croft is here Jackie you've defected Jackie I'm sorry the instagram's not working I've just tried it a minute ago it didn't work but you know what I know I know my instagram people are crying out for me um you know they are uh I think the instagram people are feeling it to be honest with you Jackie they really are uh and I can I can only say that um you know the ITT working tirelessly to try and get instagram to work um Lin what you got you don't have surgery in London do you no I don't Lin I used to uh I used to do a clinic in London I never did surgery in London because um you you well well because you got to be close to home when you do surgery and so I didn't really want to stay there and things like that although I cooked my brothers in London but anyway I didn't want it um and now no but you know what in no I'm gonna say no especially tummy tucks it's a no because you're talking about tummy tucks aren't you no um no simple answer and I'll see it I'm not messing around the bush no Lin we don't have surgery in London um do you know what Lin and again you're gonna say I'm just saying this I went to Harley Street got a clinic in Harley Street and you kind of think Harley's just brilliant and all that sort of stuff and you know certainly got the name but it's not as you know I think my clinic in age baster is nicer we're certainly more peaceful we've got parking we've got more space got loads of space we don't need we've got a doubt quite like a basement we've got a top floor we don't use um and it's a bit pokey the parking's a nightmare if you've got a chauffeur driven car fire enough because they can just drop you off and then the heat god knows what the chauffeur does but you know if you haven't got a chauffeur you in car it's an absolute nightmare um and can you imagine I mean surgery in Princess Grace or one of the you know one of the London hospitals it's just a nightmare I think but that's me isn't it I'm not but anyway the answer is no I'm not trying to I'm not but yeah if you're in London there's lots of good people in London but no I don't do surgery in London you know what Lin I don't do surgery in Birmingham either I've given up the tummy tasks and stuff I in Birmingham so um but um but yeah but yeah loads of good people in London yeah clinic yeah no I don't don't have the clinic anymore I used to have the clinic in 152 Harley Street um and there was a guy there called Paul Harris Paul Tully and well I went there for a bit and did clinics down in down there and then I thought oh this is a bit too much uh and I know Paul um plastic surgeons quite small world um so Paul regularly did clinics there so I said oh Paul why don't you see the patients in the London patients and he said yeah great fine and then we had the CQ I don't know much you know this you want to know me but anyway we had the CQC come and visit us in Birmingham and they said oh what are you clinic in London asking us all the sort of processes and things and I said well I don't know that's the person who owns the clinic in London it's a plastic certain other plastic surgeon who owns clinic in London I said well I said well then I don't know whether they've got you know safe guarding and all these things um and it was a bit like well you know it's kind of your responsibility and things are all cranky so that was uh that put the kibosh on that Lynne I'll be honest with you so I said sorry Paul it's not worth the grief that we have to sort of have based on too it's like anything you know if you have a big scale if you've got 20 clinics it's probably easy but if you've got one clinic going to two clinics it's like double the work but going from 20 clinics to 21 clinics probably not a big deal because you've got all the processes and all the things but you know we've got everything for the one clinic but going to another one is like but um yeah so that that's that's the London story Lynne um where are you based each bastard and each bastard in Birmingham near the you know Birmingham I'm guessing if you're in London you don't know you never know Birmingham anyway in Birmingham near sort of quite central five ways roundabout anyway we're in Birmingham so yeah that's a good flurry there Lynne all the comments good for the good for the was it you know sort of reach I think um yeah thanks Lynne thanks for participating thank you all and without further ado I'm about to go and it's probably burnt so I better go and rescue it and I will see you in the new new week yeah next week um so yeah looking forward to it already uh see you then thanks Lynne, Jackie, Lorena, to raise thank you all and all my other fans out there thank you all have a question not covered in today's show then send it over to info@styanoplasticsurgery.co.uk using the hashtag #askjj we'd love to hear from you [BLANK_AUDIO]