Daily Mail Web Chat
1 June 2006
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Our consultant answers Daily Mail readers' cosmetic
surgery questions
Mr Mark Ho-Asjoe, one of our Consultant Plastic
Reconstructive and Aesthetic Surgeons, was recently featured on the
Daily Mail web chat where he answered readers' cosmetic surgery
questions. The transcript of this live web chat can be found
below:
Daily Mail Web Chat 2006
Thousands of women and men are going under the knife
each year, inspired by cosmetically enhanced stars such as Sharon
Osbourne. Leading plastic surgeon Mark Ho-Asjoe came online to
answer your questions in a special live chat with the Mail online.
Read the transcript:
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Administrator: Todays chat is with Mr Mark
Ho-Asjoe. Hello Mark, How are you? Looking forward to the
chat?
Mark Ho-Asjoe: I'm very well thanks, looking
forward to it!
Administrator: Great, let's get started.
Rachel: Hi. I had upper and lower eye bag removal
2 years ago. It was not a great success and has left me with odd
eyes, one rounded at the outer corner and the other larger,
slightly tugging and often watery. What, if anything, can I do
about this?
Mark Ho-Asjoe: You may need an operation called a
canthopexy. What it means is that the eye that is slightly larger
and watery needs suspension at the outer corner.
Mark Ho-Asjoe: It is difficult to say whether we
can match the shape without seeing it.
Scooter: Had upper and lower blepharoplasty on 9th
may - everything seems fine apart from lump under one eye - please
tell me this will go - getting married on 1st July - wanted to look
good!
Mark Ho-Asjoe: It may take up to three months but
gentle upward massage of your lower eyelid will speed up the
process.
Scarlet85: I'm 16 and I'd like larger breasts. my
mum wants me to wait until I'm 21 but I know I stopped growing when
I was 14. what do you think?
Mark Ho-Asjoe: All form of surgery has pros and
cons...silicon implants do not last forever and will have to be
changed probably a few times in your lifespan...there is no reason
why you cannot have an augmentation at 16 as you have now stopped
growing. But like everything else, it would be nice to have the
support of your family and a proper consultation.
Scarlet85: If I have a breast augmentation will I
be able to breastfeed my babies in the future?
Mark Ho-Asjoe: Yes.
diesel: Hi. I had a nose job about 18 months ago.
It has healed well apart from I have a small bump at the tip of my
nose which is the bone jutting out. I have been back to see the
surgeon who said he wouldn't recommend another operation as the tip
of my nose might drop even more and my nose would look really
hooked. I'm quite self conscious of this now and wondered if you
had any advice.
Mark Ho-Asjoe: It is difficult to comment without
seeing your nose. It really depends on the thickness of your skin
on your nose and how prominent the bony tip is. An operation may
improve the tip by re-positioning the tip cartilage or covering
internally with fascia.
cosmetic_queen: Many of my friends who are in
their 20's seem to think that having breast implants or liposuction
is normal. Do you think there has been a rise in this and why do
you think more and more people are turning to surgery?
Mark Ho-Asjoe: I think the figure from the
American Aesthetic Surgery Association shows only a small rise in
the two procedures you describe. I think the reason why you feel
there has been an increase is because of all the different TV
cosmetic programmes which makes it less of a taboo for people to
have the surgery or talk about it amongst their peer groups.
Mark Ho-Asjoe: My feeling on why more people are
turning to surgery is probably because of availability and peer
pressure, to look better.
cosmetic_queen: Do you think programmes like
nip/tuck give an accurate view of cosmetic surgery?
Mark Ho-Asjoe: Ultimately it's a sensationalised
drama, great fun to watch but not truly a reflection of what
happens in real life.
john: How come there are no female plastic
surgeons? Are they in hiding?
Mark Ho-Asjoe: There are! I know at least
10!
andyM: Do you think it's morally wrong for people
to want to change what they were born with?
Mark Ho-Asjoe: No...I feel that if the changes
alter your perceptions to life and make you a more confident person
then ultimately it is helping one's social and professional life,
providing that they understand the complications associated with
surgery. That is why you need to visit respectable
establishments...such as The London Clinic.
sa: I would like to ask what the best procedure
(most long lasting and giving the best results) is fro a tear
trough deformity where the eyes look sunken in and hollow . Please
can you advise about the best non-surgical and surgical methods for
this? tMany thanks
Mark Ho-Asjoe: Tear trough deformity is a very
difficult problem. Surgically, you can have a lower lid
blephoroplasty with fat draping on the arcus. Other people have
tried Colman Fat injection with some good results. Non surgical
methods usually involve injecting a deep filler.
sa: Do you advise fillers for this? and which is
the most long-lasting and gives the smoothest results? also what
causes a tear trough deformity to occur?
Mark Ho-Asjoe: Tear trough deformity is related to
ageing with mid-face ptosis. I have no great experience with using
filler to this area but they are not long lasting. You can contact
my colleagues in The London Clinic who have more experience with
this than I have.
Walker: What is the strangest surgery you have
ever been asked to do?
Mark Ho-Asjoe: No comment.
tasha: I want to start looking into tummy tucks or
liposuction for my stomach. What's the difference between the
two?
Mark Ho-Asjoe: Liposuction will leave you with a
couple of small scars and have the fat removed. It's a very good
operation if the quality of your skin allows it to contract
afterwards.
Mark Ho-Asjoe: A tummy tuck involves the removal
of excess skin and fat, this will leave you with a long transverse
scar between your two hip bones.
tattyboo: What challenges do breast
reconstructions hold that other types of reconstructive surgery
don't? What drew you to this area of the field?
Mark Ho-Asjoe: Breast re-constructions is a
combination of surgical techique and aesthetic vision. The surgical
techniques involve joining two vessels under the microsope in
autologus reconstruction which is always challenging. The aesthetic
side is to try and match the reconstructed breast with the
contralateral one. The combination of the two makes it really
challenging and worthwhile to do when the patients retain their
femininity.
Maude: I'm only 23 but my breasts are horribly
stretched and I think my nipples are the wrong shape, they look
like teardrops, not circles. If i was to get surgery could the
surgeon make my nipples nice and round?
Mark Ho-Asjoe: Yes. Your case sounds like you
require mastopexy. This will re-position your nipples and make them
more circular.
liz: if i have a breast lift/recontruction will i
be left with any numbness would this last for ever.
Mark Ho-Asjoe: The sensation to your nipples may
be slightly altered in a breast lift operation but will usually
recover. This does not apply to breast reductions or breast
re-construction surgery.
jo: I had cheek implants two years ago but I hate
them. They look uneven! How much scarring would there be if I
removed them?
Mark Ho-Asjoe: We should be able to remove them
through a lower lid incision with an intra oral incision if
necessary. This should not leave you with a noticeable scar at the
end.
Clara: I'm in the process of losing weight but I'm
also getting some implants in the summer. How long do I have to
wait after surgery before I can go to the gym again?
Mark Ho-Asjoe: You probably can go back to the gym
for lower limb excercise in 2-3 weeks providing there is minimal
movement to the upper body. The advise for upper body excercise is
around 6 weeks.
matt: Is it now more acceptable for men to have
cosmetic surgery? I'm a man and I would quite like a nose
job!
Mark Ho-Asjoe: There are more and more men having
cosmetic surgery. Acceptability depends on how you feel and not the
rest of society.
Maude: Do you have any advice on picking the right
surgeon? How do I know just because I'm paying more I'm going to
get a better result?
Mark Ho-Asjoe: The British Aesthetic Association
of Plastic Surgery's website can answer this question for you.
Unfortunately, even the best surgeon can have complications and as
long as the surgeon is well trained and accredited, it boils down
to the rapport between you and whether you have confidence in your
surgeon.
John: Have you or will you consider having surgery
yourself and if so who will you use?
Mark Ho-Asjoe: I don't have time to look into a
mirror and consider what I need! Probably a face transplant will do
me well!
sa: Can you advise about the Titan laser for skin
tightening and also thermage? Are they suitbale for jowls? or do
they cause dents in the skin?
Mark Ho-Asjoe: I don't use laser and therefore I'm
unable to answer your question. You can look at The London Clinic's
website (www.thelondonclinic.co.uk) for a laser specialist.
Lana: How long does the effect of a face lift
last? I am planning on having one later this year. I am having
neck, jowels (lower face) lift.
Mark Ho-Asjoe: Average is between 5 and 7 years -
please remember the ageing process continues despite having a
facelift.
dave: My surgeon has told me I should quit smoking
before surgery, but I'm so nervous about it that I can't! Do I
really need to?
Mark Ho-Asjoe: Yes, smoking affects wound healing,
increases the risk of infection, skin necrosis, implant rejections.
At the end of the day, if you really want to have the surgery, it's
a good excuse to give up smoking.
liz: some people have mentioned washing in a
special soap after surgery, do you know what this soap is and why
it's better to wash with it?
Mark Ho-Asjoe: There is no need to use anything
special unless you have an infection. There is always bacteria on
the skin, the most important thing is regular cleaning.
cosmetic_queen: When people decide on what they
want their breasts like should they bring in pictures of what they
want?
Mark Ho-Asjoe: Are you talking about size or
shape? There is a limitation of how much we can change in relation
to the shape.
susan: I'd quite like a nose job but I think most
of them look unnatural. How can I get my thoughts across to my
surgeon without upsetting him?
Mark Ho-Asjoe: You have to tell your surgeon what
you want as you have a set idea about the end result you want to
achieve. The surgeon's job is to provide you with what is
achievable. If the two do not match, you can consult another
surgeon but if both surgeons give you the same answer you probably
should accept that your vision is not achievable technically.
Helen: I had a breast implants 6 years ago, how
many years do silicone implants last before they need changing?
Also, when they get replaced will the scars be in the same place as
the last ones - are there any added risks to having second
implants?
Mark Ho-Asjoe: You don't need to change your
implants unless the size and shape has changed or is causing you
discomfort. Manufacturers say implants last forever but data from
the last generation implants average out to be 10-15 years. They
can be replaced through the old scar and the risks would be the
same as the first implants.
cosmetic_queen: How did you get into this line of
work?
Mark Ho-Asjoe: I went through training as a
doctor, then a surgeon and subsequently specialised in plastic
surgery because it interested me the most.
liz: Could I have my breasts augmented at the same
time as liposuction on my hips?
Mark Ho-Asjoe: Yes, you can.
sa: What are your thoughts on Isolagen?
Mark Ho-Asjoe: I don't wish to comment on
this.
Angela: Should people bother travelling overseas
to get surgery and where should they go? can you recomend countries
for say... value for money, best finish and reconstruction?
Mark Ho-Asjoe: Angela, travelling overseas for
surgery is probably cheaper but there will be no aftercare if there
is a problem. No surgeon in this world is complication free and
it's a risk you will have to take whichever country you go to.
Having surgery in the UK by a respectable surgeon will provide you
with the aftercare if there is a problem.
Administrator: And the last question is from
Cosmetic Queen...
cosmetic_queen: Do you recommend people get
counselling before having surgery?
Mark Ho-Asjoe: If I feel they are doing it for the
wrong reasons I would recommend it.
Administrator: And that is it, thank you for your
time Mark. Did you enjoy the chat?
Mark Ho-Asjoe: Yes, I enjoyed it very much and I
hope I have been helpful in answering your questions.
Administrator: I'm sure our readers found it very
useful. Thanks for coming!