Author: drngsw

Vaginal rejuvenation is a procedure that can make a woman feel better for beauty and health reasons.

With ageing and life experiences, many changes come. Some are visible – wrinkles, grey hair, sagging skin – while others take place in private parts of our bodies. Precisely because they are so private, these changes can be a source of deep distress, as they strike at our identity as sexual beings.

With ageing, just as the facial skin tissue loses elasticity and sags, the same can occur in the genital area and the vaginal lining. The most common cause of vaginal wall laxity is overstretching of the vaginal wall during childbirth, which worsens with the number of normal deliveries.

Concomitant weakness in muscles of the pelvic floor can result in stress incontinence. This manifests as urine leakage when the patient coughs, sneezes or laughs.

Similarly, the labial skin can become excessive with ageing and after multiple childbirths. The labia minora becomes floppy and protrudes significantly beyond the labia majora. This can result in discomfort and rash, and can be a source of embarrassment when wearing tight-fitting clothing.

Vaginal rejuvenation procedures have become increasingly popular to restore function and improve aesthetics in the genital area. This new field of medicine is also called intimate surgery.

What’s involved?

The two main groups of procedures done for vaginal rejuvenation are vaginal tightening and labiaplasty (shaping of labia).

Laser vaginal rejuvenation

Loss of tissue tensile strength can increase the inner diameter of the vaginal canal. This can result in loss of friction and sexual satisfaction for both the patient and her partner.

In the past, vaginal tightening required surgery. But with the advent of better laser equipment, this can be achieved using non-surgical methods. Laser Vaginal Rejuvenation is a non-invasive procedure that can address this issue. The laser can also be used to rejuvenate the outer part of the female genital (labia minora and labia majora). Most patients also observe improvement in mild stress incontinence after the laser procedure.

This procedure uses a laser probe that is inserted into the vagina canal and emits a non-ablative laser for tightening the vaginal wall. It heats up the genital mucosa to initiate collagen remodelling and subsequent production of new collagen. There is no external wound after the procedure and patients can return to work the next day. This treatment is done over 2 laser sessions 6-8 weeks apart. Significant results are usually experienced within 6 weeks. It has been reported to provide an over 90% patient and partner satisfaction rate.

Labiaplasty

Labiaplasty involves using surgical techniques to improve the shape of the labia by removing excess labial tissue. This provides a better aesthetic outcome. It is done under a combination of local anaesthesia and sedation. Because the surgical field is an extremely sensitive area, local anaesthesia alone would be too uncomfortable.

Depending on the location and amount of labial excess, various excision methods are available to remove excess and re-shape the labia. Usually the focus is on the labia minora. Occasionally the labia majora may need re-shaping. This is a day-surgery procedure. Wound care is uncomplicated and requires regular application of antibiotic ointment. There is no need for suture removal and most patients return to work within 3-4 days.

Related procedures

Many patients opt to have other procedures done at the same time as vaginal tightening. The most popular procedures include G-spot augmentation, clitoral unhooding and hymen repair. The G-spot is an area in the anterior wall of the vaginal canal which is perceived to result in heightened sensation when stimulated. This area can be augmented by injection of hyaluronic acid filler or fat transfer.

Clitoral unhooding is a minor surgical procedure to reduce excess tissue of the “hood” that protects the clitoris from abrasion or over-stimulation when not engaged in sexual activity. Some women who have excess tissue find it difficult to achieve orgasm because of the excess tissue that sometimes even covers the clitoris.

The hymen is a thin layer of tissue that serves as a barrier to the entrance to the vagina. Hymen repair involves surgically repairing a tear or reconstructing a new one.

Who to consult

The two groups of specialists active in intimate surgery are plastic surgeons and gynaecologists. Plastic surgeons have a long history of performing vaginal reconstruction post-tumour resection. They further apply their aesthetic sense in female intimate surgery.

WHAT IS BREAST RECONSTRUCTION?

Breast reconstruction is the surgical restoration of breast morphology and volume after mastectomy (usually done for breast cancer patients).

WHAT ARE THE PROS AND CONS OF IMMEDIATE AND DELAYED BREAST RECONSTRUCTION?

In immediate breast reconstruction, skin- sparing mastectomy preserving native breast skin envelope and breast reconstruction are performed on the same day. Immediate breast reconstruction has a huge positive psychological benefit for the patient who wakes up from the surgery without feeling the loss of body form. It is also more cost-effective as a single stage procedure.

Delayed breast reconstruction tends to result in more scars and is less natural in appearance. However, it is preferred in advance breast cancer because of the high risk of recurrence.

WHAT ARE THE VARIOUS METHODS OF RECONSTRUCTION?

The transverse rectus abdominis myo-cutaneous (TRAM) flap is the most common autologous breast reconstruction procedure which removes excessive lower abdominal skin and fat together with a portion of the abdominal muscle, transferring it to the breast for reconstruction. The nett result is a flatter tummy and reconstructed breast.

The latissimus dorsi (LD) flap is more suitable for those who wish to be pregnant after the treatment. The LD muscle is a thin fan-shaped muscle from the back. Reconstruction using the LD muscle flap may be combined with a breast implant to provide more volume.

Breast reconstruction using only implants is a simpler and faster procedure. In some instances, a tissue expander is used to serially stretch the skin before placing the definitive breast implant. In the long run, implant replacement may be required in the event of implant rupture or capsular contracture (scarring around the implant).

HOW SHOULD THE PATIENT DECIDE ON THE METHOD OF BREAST RECONSTRUCTION?

Autologous reconstruction is recommended if the patient wants a reconstructed breast that is natural in appearance and feel, and has long- lasting results. She must be willing to accept a higher initial cost, longer surgery and additional scar from the tissue donor site.

Alloplastic reconstruction using an implant is suitable for a patient who wishes for a simpler and shorter surgery with lower initial cost. She would also accept a less than ideal match of breast shape with the contralateral un-operated side.

ARE THERE ANCILLARY PROCEDURES AFTER THE INITIAL RECONSTRUCTION?

Nipple reconstruction is planned four to six months after the first stage of breast reconstruction followed by nipple areolar tattooing one to two months later.

Fat transfer may be done at a later stage to improve the minor contour of the breast.

伍修永美容整形外科手术中心(Sweng Plastic Aesthetic and Reconstructive Surgery)的专业医疗团队服务优质、实力雄厚, 设备齐全的医疗中心提供顶尖疗程,完美改造近在咫尺。

资历非凡的伍修永医生(Dr.Ng Siew Weng), 是新加坡卫生部认证的整形外科医生,亦是伍修永美容整形外科的创办人及首席顾问。

伍修永医生毕业于新加坡国立大学医学系,其后就读其他研究生文凭课程, 再专研皮肤科。他也曾在新加坡中央医院的整形、重建和美容外科部门完成高级外科培训。

在卫生部的医疗人力发展计划下, 伍修永医生成为首位飞往韩国接受医疗整形与重建培训的新加坡中央医院整形外科医生。期间,他与闻名国际的韩国整形医生密切合作,因此熟练韩式手术技巧,尤其是脸部整形、鼻部整形、拉皮术和隆胸术。

伍修永医生不吝于分享心得,他之前在新加坡中央医院举办有关移植脂肪整容术的讲座,让本地医生有机会向他讨教。

他也活跃于研究工作,他在手外科实习时便运用政府资助的款项,研发出扳机指(trigger finger)的创新治疗方针,其目前已获得专利。

除了贡献于本地整形外科领域,伍修永医生也时常参加海外志愿工作,为当地病患进行无偿的矫正唇腭裂手术,以及创伤或烧伤的重建手术。他造访过的国家包括寮国、中国、印度尼西亚和乌兹别克斯坦。

一站式医美设施

位于花拉公园医院的伍修永美容整形外科, 是由新加坡卫生部认证的日间手术中心, 为患者提供全面性的非侵入性手术、侵入性手术和重建手术。

院内设有卫生部认可的门诊手术中心,及最先进的医疗设施,确保患者在会诊至痊愈的过程中,能够享有一流和完善的照料与服务。诊所位于繁华中心地段,大厦内设有酒店、医院和医疗中心,患者与家属也可在手术进行前或是日后复诊入院前优先办理入住手续,享受周到体贴的一站式服务。

伍修永美容整形外科的医护团队由受过专业训练及经验丰富的护士和工作人员所组成,致力让你在最安全、最舒适和最具隐私性的环境中进行改造,并达成最佳效果。

疗程

• 脸部 眼皮手术、鼻部手术、下巴整形术、 脸部整形手术、面部提升术、颈部拉皮手术、 耳部整形手术、脸部肿瘤切除术。
• 乳房 丰胸、缩胸、乳房提升术、乳头内陷矫 正术、男性缩胸手术、乳头缩小术。
• 身体 体型塑造、阴道整形手术。
• 再造手术 胸部重建手术、肿瘤切除后重建手术、慢性淋巴水肿、修复烧伤部位、疤痕缝合手术、变性手术。

The quest for youth has spurned a multi-billion dollar industry. The multitude of rejuvenation options is bewildering. The choice of rejuvenation technique is generally determined by the patient’s physical state, patient acceptance, tolerance for pain and downtime, and financial constraints.
The clinical problems to be addressed usually include : pigmentation, superficial textural imperfection, wrinkles (dynamic or static), deep folds or contour deformities and skin laxity.
Rejuvenation options are divided broadly into non-invasive (non-surgical) and invasive (surgical) procedures with a few options in the borderline zone. Patient must understand that all these rejuvenation techniques have a common goal to cause controlled damage to the various layers of the skin to stimulate repair and regeneration. Sun avoidance and strict usage of sunscreen is the key to maintenance of result and prevention of hyperpigmentation.

NON-INVASIVE (NON-SURGICAL) PROCEDURES

Chemical peel using glycolic acid of varying concentrations used to be popular. This has been largely taken over by phototherapy.
The commonest phototherapy used is intense pulsed light (IPL) or Broadband Light (BBL). It is able to improve the general complexion, lighten pigmentation, improve fine wrinkle and mildly tighten the skin. It is also effective for permanent hair removal. IPL or BBL are suitable options for regular maintenance without downtime.
To achieve further textural improvement to the superficial layer of the skin, laser resurfacing is more effective. Erbium Yag or carbon dioxide lasers are commonly used to ablate a thin epidermal layer. Erbium Yag laser is more suited for Asian skin type due to its high water affinity, shallow depth of ablation per pass with lower collateral heat damage. The treated area is raw and require regular application of antibiotics. The downtime for microlaser peel is about 3-5 days after which patient can resume putting on make-up.
Various treatment modalities are available to further tighten the dermal layer to for lifting and improvement of static wrinkles. Profractional Erbium Yag (or carbon dioxide) laser, radiofrequency, focused ultrasound and infrared wave can be used to cause thermal injury to the dermal collagen and elastin in a controlled manner. This induces regeneration of new collagen with skin firming effect. The clinic results are best assessed 3-4 month after the procedure although most patient would notice clinic improvement after about a month.

Profractional laser ablate narrow channels into the skin unlike conventional laser resurfacing which ablates the entire treated area. This allows for faster epithelialisation from the surrounding intact skin. Profractional laser is commonly used to treat atrophic acne scars. The raw treated area require regular topical antibiotics. Epithelialisation takes place after about ve days. Most patients are able to return to work 4-5 days after the procedure.
Radiofrequency, focused ultrasound and infrared wave therapy for skin tightening does not result in open wound and incur less downtime than laser resurfacing. Post procedure oedema and erythema commonly resolve within a few days. However, clinical result may not be as dramatic as ablative laser procedure.
Botulinum toxin injection is the standard treatment for dynamic wrinkles i.e. wrinkle that are worsened by facial animation. It can improve crow feet, frown lines and forehead wrinkles. Its effects usually last for 3-4 months. Mild bruising may be present at the needle entry sites. Clinical judgement needs to be exercised to deliver the optimal amount of toxin to alleviate wrinkles without causing unnatural mask-like appearance.
Filler replaces volume and is used correct static deep facial folds (e.g. tear trough and nasolabial fold) and contour deficits (e.g. sunken temporal areas). It is also used to volumise the cheeks for more youthful appearance. It provides an alternative for those patient who wants augmentation of nasal dorsum without undergoing rhinoplasty. However very rarely, the injection of filler into the nose can result in blindness or tissue necrosis. The chemical composition of fillers can be biological (e.g. hyaluronic acid or collagen) and synthetic (e.g. polytetrafluoroethylene). Hyaluronic acid has largely replaced collagen as the most common filler material and resorption occurs within about 6 months. Synthetic fillers may last for more than a year but there is risk of infection and granuloma formation. In the interest of safety shorter-acting filler material is preferable.
Botox and filler complement each other and some patient require both for optimal outcome.

INVASIVE (SURGICAL) PROCEDURES

Fat transfer (grafting) has gain much popularity over the recent years for volume replacement. Fat is a good filler option because it is autologous and contains a small amount of stem cells with rejuvenating properties. Fat grafting has been shown to improve the healing of post-irradiated chronic wounds. Fat is usually harvested from the patient’s abdomen or thighs. Post procedure swelling and bruising last for a few weeks. The final result is firmer skin with increased volume and improvement in wrinkles. This procedure may be repeated for better cumulative result.
Thread lift provides added level of skin lifting to the cheeks and temporal area. Several barbed threads made of absorbable material are inserted skin deep and best stabilised by suturing to the temporal area. Swelling and bruising can last for a few weeks. The initial appearance may appear over corrected and this normally improve over a few weeks to months. The clinic effects may last for 1-2 years.
The common surgeries for facial rejuvenation include: blepharoplasty, browlift, temporal lift, facelift, and neck lift. These procedures can be done singly or as a combination depending on the clinical state.
The management of aged droopy eyelids may involve upper blepharoplasty with levator mechanism correction (levator plication or advancement), and brow or temporal lift.
Lower blepharoplasty for eyebag may include judicious removal of excessive fat and redundant skin, followed by fat redistribution, tightening of the lower lid mechanism and fat injection to improve contour and skin texture. This may be combined with a mini-face lift to achieve more harmonious appearance.
Sagging chin and jowl may need a face and neck lift with division of platysmal band for turkey neck deformity.
When we performing surgery to rejuvenate an isolated site may result in it appearing out of sync with the surrounding area. Combined procedures aim to achieve a harmonious look.

皮肤会随着年龄，逐年失去弹性、光泽与紧致度。除了效果极佳的传统拉皮手术之外，如今也有不同的疗程，让你的肌肤焕然一新，回复紧致。

肌肤老化是许多成年人面对的困扰，随之而来的包含皮肤松弛、颈部松垮、皱纹加深等问题。自1990年代，面部拉皮手术广泛被使用于除皱、修饰皮肤下垂，以及紧实眉头、脸颊、下巴和颈部部位的肌肤。

近年来，医美科技突飞猛进，拉皮手术变得更安全，恢复时间更短，疤痕减少，效果也更加理想及自然。

你可以针对各种问题和肌肤松弛度，选择全脸或局部拉皮。传统面部拉皮手术，结合颈部拉皮或提眉术，能够创造出较有和谐性的效果，因此十分普遍。

拉皮手术

传统拉皮较适合年长者，或肌肤严重松弛的人。“长疤痕”拉皮手术，是在太阳穴做一个切口，穿过耳朵前面，再往后切开头皮。

“短疤痕”拉皮手术免于在太阳穴动刀，并减小耳后切口。切口越长，代表需解决的松弛问题越大。医生将皮下组织层（表浅肌肉腱膜系统）与皮肤分开，接着把前者折叠、移位再缝合，以增强拉提作用，而多余的皮肤则被修剪掉。该手术所达成的效果最为突出，亦最持久。

“迷你拉皮”近来相当流行，此手术涉及较少皮肤组织分离，因而减少瘀伤和肿胀的副作用。虽然效果没有传统全脸拉皮来得明显，但恢复时间缩短许多。

埋线拉皮

埋线拉皮（Thread lift）属微整形技术，适合肌肤轻微松弛的人，效果可维持长达两年。

手术在局部麻醉下进行，医生运用细针在皮下不同位置植入特殊的线，这些线不仅有紧致肌肤的作用，还能促进生成胶原蛋白。手术后或出现的瘀伤和肿胀，一般在几小时内便会消退，针孔留下的疤痕则在一星期内消失。

埋线手术过程中可植 入新线或调整之前植入的线，因此该手术是可以重复进行的。

提眉手术

提眉手术（Brow lift），又称前额拉皮手术（Forehead lift），能够改善额头、上眼皮和眉毛部位的皮肤松弛，让你看起来亮丽有神。

医生可采用两种提眉术，一是传统拉皮手术方式，从发际线的皮肤开个切口，切至耳后，拉提和紧致上半脸部；二是内视镜手术（Endoscopic lift），在头皮上开几个切口，将内窥镜插入其中一个切口，然后再将另一个具功能性的内窥镜放入别的切口，进而切割和拉提皮肤。

非手术性拉皮

与拉皮手术相比之下，非手术性拉皮和微侵入式提拉疗程的效果，没那么显著或持久。不过，此类疗程能够吸引不想动刀的人，所以越来越受欢迎。非手术性拉皮疗程包括激光、射频治疗、肉骨杆菌注射、面部填充剂、换肤等，皆提供良好的效果。

由于每个人的脸型、肤状、松弛度都不同，因此所追求的效果也因人而异，并没有特定的整形方式才是正确或最理想的。建议与医生商讨，拟定最适合你的疗程。

鼻子在脸部占据重要位置,因此对长相的美丑也扮演着举足轻重的角色。倘若觉得鼻子不漂亮,有什么办法可以改善呢?
SWENG整形美容与重建手术中心顾问医生伍修永表示,鼻整形术除了美化,也有矫正功能,有助于改善鼻梁低、骨性驼峰、鼻尖歪斜、宽大或下垂、鼻底宽大、鼻小柱短等问题。

问:鼻整形术如何改变一个人的容貌?
答:成功的鼻整形术会让脸看起来更瘦削,能突出轮廓,更显立体感。从侧面看,鼻小柱和唇角之间的角度将获得改善,而上唇后退(会让人看起来比实际年龄老)的病人,在术后会显得更年轻。

问:垫高鼻梁的方式有哪些?
答:主要可分为微创手术和传统的封闭式或开放式鼻整形手术,但微创手术如注射玻尿酸填充物(hyaluronicacidfiller)和穿入美容线,无法打造完美无瑕的理想鼻形。此外,穿入美容线微创手术的技术尚新,长远来说是否会留下疤痕、美容线是否被挤压等,目前还不得而知。

问:单靠注射填充物是否能改善鼻型?安全吗?
答:注射填充物能马上垫高鼻梁,且效果可持续大约6个月之久,不过这个方法无法改善鼻尖或鼻底宽大的问题,也可能引起鼻翼组织损伤、失明等罕见并发症。
我看过几个病人,因为在别处重复接受注射填充物,导致填充物转移,结果造成鼻梁宽大扁平。和脸部其他部位相比,注射在鼻子的填充物可能需要更长时间方能分解。

问:请谈谈使用L-型植入物的鼻整形术。
答:这个耗时不多的程序能增加鼻梁和鼻尖的高度,但对改善鼻小柱短小、鼻尖或鼻底宽大等,成效不大。由于L-型植入物容易引起挤压和移位的问题,鼻整形外科医生现在已经很少采用。

问:鼻整形术有几种?如何进行?
答:鼻整形术可分为封闭式或开放式。封闭式鼻整形术是在鼻腔内开一个小切口,由此修正鼻驼峰、植入假体、以及有限度地改善鼻尖的角度。然而,封闭式鼻整形术无法像开放式鼻整形术一样,能够让医生清楚看到整个鼻子的结构,所以效果会比较逊色。
韩式开放式鼻整形术则特别针对亚洲人脸孔,只需在鼻小柱横开一个小切口,便可进行相关的整形术。
视病人的要求而定,开放式鼻整形术的目的包括:

• 植入鼻中隔软骨或耳软骨,加长鼻子,改善鼻尖和鼻小柱的角度(病人如果没有足够软骨,也可使用肋软骨)。
• 应用不同技巧缝合下侧软骨,以美化及收窄鼻尖(鼻尖整形术)。
• 植入假体以垫高鼻梁和鼻背。
• 用锉或切除鼻骨的方式,修正骨性驼峰的问题。
• 通过横向截骨,收窄鼻子两旁的骨性鼻壁。
• 植入鼻中隔软骨,让呼吸更顺畅。
• 切除小部分鼻翼,使得鼻翼变窄。

相比之下,开放式鼻整形术更具灵活性,能解决鼻型不完美的所有问题。

问:术后的复原过程如何?
答:我们会在术后,以止血棉填塞伤口24-48小时,以免伤口流血,1周后便可拆线,但病人必须在鼻梁佩戴支架1-2周。
多数病人可在1-2周内回返工作岗位,伤口则需要大约1个月才会消肿。我们会在术后的3-6个月内,评估手术的成效。

When it comes to breast reconstruction, there are several considerations patients need to take into account.

Breast reconstruction is the surgical restoration of breast shape and volume after mastectomy (complete removal of breast tissue), usually due to breast cancer. The breast surgeon performs the mastectomy and the reconstruction is typically done by the plastic surgeon.

The main considerations for breast reconstruction are timing and method. Immediate reconstruction is done on the same day as the mastectomy while delayed reconstruction is done months or years later. The reconstruction can be achieved using the patient’s own tissue from another part of the body (autologous reconstruction) or with a breast implant (alloplastic reconstruction).

When should it be done?

Before the 1990s there were fears that immediate breast reconstruction was unsafe
and that early reconstruction could risk cancer recurrence. However, studies have shown that immediate reconstruction is as safe as delayed reconstruction for early-stage breast cancer.

Pros and cons

In immediate breast reconstruction, skin-sparing mastectomy is performed. This removes the breast tissue and nipple-areolar complex while keeping the skin. The plastic reconstructive surgeon then restores the breast volume within this breast skin envelope. The ability to preserve the native breast skin envelope is important to produce a natural-looking result.

In delayed breast reconstruction, the breast tissue and overlying skin are removed. This leaves more scars and the breast looks less natural compared to immediate reconstruction.

Immediate reconstruction has a positive benefit for the patient, who awakes from surgery without feeling the loss of body form, and is more cost-effective. However in advanced breast cancer, delayed breast reconstruction is preferred since the risk of recurrence is higher.

Reconstruction methods

Reconstruction should ideally be performed using the principle of “replacing like with like”. Therefore, autologous breast reconstruction using the patient’s own tissue is preferred. The result is long-lasting and the reconstructed breast appears more natural in appearance and consistency.

The transverse rectus abdominis myocutaneous (TRAM) flap is the most common autologous breast reconstruction procedure. Like a tummy tuck, this removes excessive lower abdominal skin and fat with a portion of the abdominal muscle, transferring it to the breast for reconstruction. The result is a flatter tummy and reconstructed breast. Patients who have had caesareans may also undergo this procedure.

TRAM flap reconstruction is unsuitable for women who wish be pregnant after the treatment. The latissimus dorsi (LD) flap is more suitable for them. The LD is a fan-shaped muscle on the back. It does not provide much volume and a breast implant may be added.

Breast reconstruction using implants is a simpler and faster procedure. The recovery process is less complicated. Sometimes, a tissue expander is used to serially stretch the skin before placing the definitive breast implant. It may be also more difficult for the implant to match the shape of the contralateral unoperated breast. In the long run, implant replacement may be required in the event of rupture or capsular contracture (scarring around the implant). The initial cost of implant reconstruction may be lower than autologous breast reconstruction, but the long-term cost may even out.

Additional procedures

Nipple reconstruction is planned four to six months after the first stage of breast reconstruction. Local tissue is used to reconstruct a new nipple. This is followed by nipple areolar tattooing one to two months later.

Fat transfer can subsequently be introduced to correct contour imperfections, if any, of the reconstructed breast.