(upbeat music) - Welcome to the Stiano Plastic Surgery podcast with plastic surgeon JJ Stiano, the only plastic surgeon in the UK who owns a clinic specializing in breast and body contouring. (upbeat music) (upbeat music) - Oh, we're live, sorry. Sorry it was taking a bit of a minute. Are we live? I think we're live, right? Yes, I am completely focused and on board with the task in hand. What is that task I hear you scream? It's answering questions in relation to plastic surgery kind of things. That's what I'm here for. That's what I'm doing. Seven o'clock Tuesday night, I've been doing it for years. Starting on Facebook, moved to Facebook and Instagram and more recently added YouTube on it. For some reason I can't do it on Instagram. I don't know why it's just stop working. It says something like your account's not able to use this facility or something. I don't think I've done anything wrong. Goodness knows I've done wrong things in the past. I hold my hands up. I have been banned at my Facebook. I actually haven't been banned by Instagram, but I have been banned by Facebook in the past for certain photos. Should we just say that I have posted which have deemed deemed to be against their rules? But I don't think I've done anything recently about on Instagram, but it feels like a random thing. Anyway, any who, there's a very, very vibrant and lively community on YouTube and Facebook. Let's face it, just the YouTube and Facebook community will have this room filled with my fans. So I'm not sure where they are at this present time, but they're there. You know, they don't actually literally have to be there. They're out there, you know? So I know you're out there. You know you're out there. You may not be watching this right now, but you know that you're there. So that's what matters. So the actual watching of it is less important really. Anyway, I'm gonna carry on. True professional. So with some questions and answers, and I'll be answering these questions. I'll be asking them and answering them to myself, but you know, that's okay. You know, maybe it's not working. Maybe it's not actually working on Facebook and YouTube, or maybe no one's watching, I don't know. Either way, it doesn't face me. And it's fine, it's absolutely fine. Is having a hiatus hernia an issue to having a tummy tuck with liposuction? No, not. Not. Well, I was saying not at all, but not in the same way recently, I've been talking a lot about hernias and tummy tucks for some reason. But a hiatus hernia is different. A hiatus hernia is not like other sorts of hernia. A hiatus hernia is kind of internal. It's where the esophagus passes through the diaphragm and joins the stomach. And so when you swallow food, your food goes down your esophagus, your food pipe into your stomach. And hiatus hernia is when the stomach kind of herniates or dislocates up through the diaphragm. And that makes that join between the stomach and the esophagus a bit less robust. And so you get reflux, basically. You get heartburn acid reflux. But it's an internal thing. It's inside your abdomen. It's not external. So it's not an external hernia like the sorts of hernias we've been talking about before with tummy tucks. It's inside your abdomen as a hernia through your diaphragm. And so we would completely not see it. And we would have completely nothing to do with it, doing a tummy tuck, although the anesthetists would probably want to know if you suffer from reflux. So it'd be more of an anaesthetic thing than a surgical thing, and it's certainly got no bearing on the surgery at all. So it's actually fine from that point of view, because I say the anestists would want to know. There are tan spots on my scar. Will they be permanent? What measures should I take to remove them? Difficult without seeing your scar, this one. So, well, the first question, always the question where you're dealing with scars, how old is the scar? So if the scar is less than a year, I first will be saying that's less likely it's, you know, there's more room for it to change. But also if it's less than a year and you've got sun on it, that's the one thing that I'm worried about. If you've got sun on it, if it's a kind of relatively fresh scar, then a year would be that sort of benchmark for that. So if it's still quite red and you've got sun on it, then you can get tanning on the scar, pigmentation of the scar, which doesn't fade and can be permanent. So if it's an early scar and you've got tan on it, tan sun on it, to tan it, then that might be permanent. If it's a later scar, if it's a sort of more mature scar, I'm not sure what they are, the tan spots. So they might be just by pigmentation of your skin. And I would advise you don't really take any measures to remove them in your own hands, but kind of see your doctor. Don't go, you know, messing with things is all sorts of things to be able to talk about. But go and see your doctor and just see to see whether it's just tanning of the scar or whether it's pigmentation of the skin, whether it's a mold that's within the scar or you've seen tan spots. I don't know, it sounds a bit odd. It's gonna see your doctor or your surgeon. If I'm your surgeon, come and see me. And it doesn't sound like I need to worry about, but I guess it's a cosmetic thing really, isn't it, in short, tan spots in your scar? Is it hard to remove a tattoo on the spine? No, not, no, no. The spine will not have any effect on it, basically. The thing that has an effect on the tattoo is the laxity of the skin and the shape of the tattoo. Those are the things that have effect. There is a bit of skin, laxity in the spine. So if you've got a favorable, if you've got one like going down the down your spine, you're kind of quite thin, probably in. There's no problems. If you're kind of thinking spine and spinal cord and all that sort of stuff, we don't go anywhere deep. We don't go anywhere near the bones, anywhere near the nerves. So there's no problem with removing a tattoo that's over the spine, because we're not going anywhere near the spine. We're just cutting skin out. Aside from the fact that it'll be tight and when you bend over, it might be tight and all those kind of things. But I think this question's alluding to the fact that the spinal cord is there, but we're miles from it. So we're not worried about the spine at all. So we're just cutting a bit of skin out. Ready? Shouldn't make it sound so belittle. It's clearly quite a major undertaking. Should you remove all moles if you suspect of the symptoms? Oh, that's a different one. I'm gonna say no. I'm gonna come down one way or another. I'm gonna say no. I think if you suspect symptoms, or if you have symptoms, you should get them checked out. I think that's what I would say. You for sure need to get them checked out. But the problem is if you start removing every mole that gives you some symptoms that maybe changes slightly or starts to cause some problems, then you might end up trying to remove all of your moles, which is a not great situation to be in and come in a rendering 'cause you might get new moles. So I wouldn't recommend kind of removing all moles of the drop of the hat. I would recommend having a low threshold to remove a mole if there are concerns about it. But what we normally tell patients is the things to look out for to seek help if you have those things bleeding, itching, change in size, change either way a bit or a smaller change in color, darker or lighter, indistinct edges, halo areas around the side, satellite lesions, there's certain things that we would tell people to look out for. But if you get one of those things, it doesn't necessarily mean it's malignant and it doesn't necessarily mean it needs to be removed. So you don't necessarily have to have every symptomatic mole removed, particularly if it's a cosmetically sensitive area and you kind of like the mole. If you don't like the mole and if it's not in a very cosmetically sensitive area and it's just kind of one or two, we're talking about it's probably better to err on the side of caution and to remove it. But if you do, if you don't like the mole and it's in a place where it's not really, you're not gonna be too concerned about scar, you best err on the side of caution, have it removed, but I don't think necessarily need to remove them all if there are symptoms. How long have I been a lesion move before I can go into a swimming pool? So, I mean, a lesion covers quite a lot of things in terms of size. So the bottom line is you wanna have the wound healed. And we normally hope the wound's healed in a week. So I would say on the side of caution, two weeks. The C is a bit different. If you're going in the C, you can go in a bit sooner, but the swimming pool, you probably won't probably healed. So there's no XUD or anything like that. So you've got no dressing. You can wear clothes, you know, you can wear a linen white shirt over the top of the scar and there's no stuff on the shirt. If there's any stuff on the shirt, then I'll be thinking you better not go in swimming pool. Basically, that's kind of like a rule of thumb. If there's any kind of ooze or if there's any war surfaces, but if it's completely dry and just a healed scar, this should be after a week. So I would say two weeks to be safe. You could, you can start going in a swimming pool. The other thing to be aware of is you're gonna put twice tension on the wound with a lot of like crazy swimming. So just be aware of that if you are going swimming, but in actual process of getting the wound or the scar immersed in a swimming pool, I would say a week to, well, two weeks to be safe, a week's two weeks, but two weeks to be safe. It might be okay. We normally see you at a week or catch up with you at a week, so we can always discuss it then, but two weeks is probably kind of like a safe time scale to give you. Can I have a model mood and then gone holiday after two weeks? You can. I think I had, yeah, this patient was in a community today, and I think what I would say to you and what I say to them is you can if you really want to, if there's a pressing reason you need to have it done now, you can. It'll probably be fine, but there's that word probably. It might not be fine. There might be a bit of wound infection. We might say, come in, we'll have a look at it, give you the clean, put in your dressing on it, give you some antibiotics, whatever. It's not common to need those things. Usually you don't need anything, but if you do need any help like that, it's just a bit difficult if you're on holiday. So I would say if it's not a big deal, which it normally isn't, in terms of mole removal, there's normally no kind of time sensitive nature to it. So if you haven't got any pressing need to have it done now, I would say you're probably better off waiting till after your holiday. And I normally say kind of six weeks is kind of normal before you want to think about going on holiday stuff like that. So say, if you have to go on holiday, you can, and it'll probably actually fine. But every now and then you get a little bit, so don't heal up so well. It'll wounds, might need a little dressing, might need some ointment and creams and maybe even some antibiotics. And that's just difficult if you're on holiday. So if you can, I would probably say that's not an ideal situation to go on holiday two weeks after your mole move. Plus the sun, not only where you go, but if you're going somewhere hot, you don't get the sun on it. So I would say if you ask me, don't have it removed now. And I think this is what I said to the patient. Have your holiday, have a great time, and then come back when it's, you know, when you haven't got holiday coming up soon. So you can, but I wouldn't recommend it, I think that's the, that's the, um, the, um, packaged answer. That's the package answer it is. Phew, well, I'm out, as they say in SWAT. Cover me. So I am, um, done. If you do have a question, um, for goodness sake, what are you waiting for? Get a message out there. Type it in. Type it in the chat. Yeah. Message me on whatever platform this is. This is YouTube or Facebook or, well, that's it. YouTube or Facebook, um, and I will do my level best to answer it. Um, next week's after probably not going to do it after. So we, it's a rollover. We've got a rollover week, so it'll be the week after next. Um, so if you have any questions, you can call me. You can message me if you email me, whatever, um, direct message or comment, you can comment me. Um, goodness knows there's enough ways to get hold of me. Uh, if you, what's this? If you, um, click show to fit. Oh, okay. Okay. Fine. Sorry. That's okay. Shouldn't have clicked that. That was for, uh, test purposes only. So I'm going to check out of here, uh, and, uh, order a minute. Hold on a minute. Steady on. Anti-tailors got himself in there. What procedure would be appropriate for multiple, like the mixed and bunched large as well? Um, the best thing for lipomas is, um, excision. And often multiple lipomas, particularly if they're close to the skin, the beauty of it is if they're not close to the skin, they're probably not a bother because they're deep and you can't, you don't know, they're there. The ones that are bothersome are usually the ones that are close to the skin, which means that they're a little bit more easy to, to remove. So in multiple lipomas, often you can just do a little incision over the lipomer and pop it out. So you can remove multiple lipomas and I'm not proud of it, but I have removed like a hundred lipomas or 200, like a ridiculous number of lipomas of someone once. It's general aesthetic, arms, legs, absolutely littered with scars. I don't think, I don't think it was a good thing to do. I'm not, I'm not putting that down as a good thing, but it just shows you can remove it a lot. So it's certainly, you know, possible to remove 10 or more lipomas in a session, you know, lots of little stamps. If you don't mind having lots of little stamps all over your arm, your leg, or your tummy, or whatever they are. But I think the best treatment is in answer to your question, Anthony, is an excision of those lipomas and you can get larger and smaller ones, you know, I mean obviously larger ones, maybe it's a slightly bigger cut. And oh, that's the other thing, so I'll probably do it on a local and I say to you, that one when I did loads, I did it on a general. If you really have got loads and you have loads done, you could have a general. It just makes things a little bit more difficult in terms of, you know, going to a hospital and still don't do it as a day case, but it would be a GA day case. So you could have it if you're, it depends on what works. It's not what we're talking to you Anthony, it turns out what we're talking, but if, so yeah, you could have a, so Vienna said it would be in question, local or a general, you could take more under a general, but it's a bit more of a parlava, a bit more cost associated with it because you've got to pay an anesthetist and you've got to pay a hospital, but obviously you could take more out. So Jackie is here, Jackie is the one, well done Jackie, thank you, enjoy your evening too. Anthony's back at me, situated around the tummy and sighs, hundreds in this case. I mean, yeah, so I reckon we could remove 10 or more, you know, 10 or so under local. If you, if you're talking, if you literally, I don't think we can move hundreds, but we could remove more under a general, just bang, bang, bang, boom, boom, boom. So yeah, couldn't move more in a general, but as I say, it does escalate the price, but it escalates, like I'm as we can remove, so one for a discussion there, Anthony, call me, message me, maybe this is it, we can message you, if you want to, if you want to wrap about it and you want to talk about a cost of doing such a thing, but yeah, the other thing, Anthony, you've got to be aware of is you will have loads of scars. So it's kind of like you're trading bumps in for scars, hopefully the scars will fade, but when you have multiple lipomas, you have to put the scars over the lipoma, sometimes you can get two out of one scar, but you know, broadly speaking, you have loads of little stamp incisions, try them as small as possible, but there'll be loads of them. But yeah, it's, it's, it's, it's a thing, it's a thing, doable. And we could certainly explore that if you are interested in such a thing. Hello, Anthony, I'm Jackie for the last minute reprieve on the activity, but yeah, much appreciated what you've got. Probably best of ranging, if you're a review, yeah, what we're doing nowadays, Anthony, we're trying to make things easier for us, I don't know where you, well, if you want to see me a bit, or someone at my clinic, we, what we're doing is we're encouraging people to send us a photo, I appreciate it can be difficult to see lipomas on a photo, but to try and save them an initial, so we try, it's up to you, you can come from an initial consultation, if you want, that's fine, but we don't want to kind of say something to an initial consultation, you think, well, get it then, and then you kind of think, well, that wasn't worth it, that was a waste of time. So we can do quite a lot with photos and, you know, we can give you ideas of prices and stuff. If you're showing down at a low-clanesthetic, we do a C-in-treat service at a clinic where we do it on the day, but if you're literally having, you know, many, many tens, I don't think we could remove hundreds, but many tens, that might be a GA, so we probably would need a consultation in the first instance, and then we could look at the general anesthetic, where they put you to sleep, and as I say, it would still be a day case, but it would be kind of like all day, you'd be in hospital all day, as opposed to a local year, just in for a few hours. But yeah, yeah, it's, if you're looking for multiple lipoma removal, and to me, you come to the right place, you can just say that, yeah, because multiple lipoma removal is my game, so I know it's my name, so, yeah, you're welcome, Anthony, thank you for participating, to be honest with you, I don't know what I've done without you and Jackie, but thank you for being here, yeah, so without further ado, that was a good reprieve, that was a last minute reprieve, I am going to check out and be here a week after next, but I think most of these questions, I do answer them when people ask the question, I just roll them over for the live Q&A, but I do, if you do have a question, I will try and answer it to you, and then answer it properly here, so yeah, have a good evening, Anthony, have a good evening, Jackie, thank you very much for being here and commenting, and give them up to everyone else who knows me, thank you and good night, has it stopped? Have a question, not covered in today's show, then send it over to info@styonoplasticsurgery.co.uk using the hashtag #AskJJ, we'd love to hear from you. [MUSIC PLAYING]
