Facial Surgery (aging)
Neck & jawline, Mid face, Temple and lateral eyebrow, Browlifts, Eyelids,
Facial Contour Surgery
Nose, Chin, Ears, Cheeks, Jaws
Facial Surgery (Asian)
Reduction, Uplift, Enlargement
Thigh and Upper Arm Reductions
Body Contour enhancement
Calf implants, Surgery of skin
Skin care programmes
Cosmetic Surgery Consultant
Procedures Performed by Dr Trott
This list is by no means comprehensive but seeks to outline the
range of procedures performed. While technical excellence and attention
to operative detail are critical, so too are careful patient selection
and development of a tailored management plan which may include
recommendations of lifestyle changes, and para-surgical treatments in
addition to the surgery itself.
Neck and Jawline
Procedures can correct looseness and bands in the neck and
excess fat deposits as well as jowls and looseness of the jaw
Excess fat under the chin in younger patients can be treated by
liposuction alone but aging changes require more extensive
This includes surgery to correct the deepening lines between
cheek and upper lip but also the dropping of cheek fat away from
the cheek prominence and lower eyelid.
In addition to repositioning the deeper structures fat injection
may be offered where appropriate.
skin care and a series of chemical peels is also recommended to
improve the quality and texture of the skin itself.
These may require lifting.
It is important that, where corrective surgery of one part of
the face is performed, that this blend naturally into the
Where indicated this is usually done via scalp incisions and
using a fibre optic light source to minimise scarring.
Sometimes a brow lift can be performed via lateral temple scalp
incisions and upper eyelid incisions. the frowning muscles are
usually rendered unusable.
may be upper or lower or both. Always carefully tailored to the
patient's problem and the degree of correction the patient
wishes (we are not all the same).
Skin and muscle
redundancy will actually need correction as will fatty bags. fat
distribution rather than resection is producing better long term
outcomes. Occasionally fat injection of the lower lid contour
may also be indicated.
injections may be recommended as an ancillary as may light laser
resurfacing of lower lid skin.
Badly wrinkled lips will usually need treatment with laser
resurfacing or dermabrasion.
Where lips have
become thin, fat injection can provide significant improvement
while in situations where the upper lip has lengthened with
aging, this can be reduced surgically.
Permanent lip line
and/or full lip tattooing is also an option to enhance the lips.
FACE CONTOUR SURGERY
These comments apply to male and female patients.
Where the nose alone is deformed or out of balance with the
contours of the chin and cheeks the surgery can provide subtle
or dramatic correction.
once again, careful planning and tailoring of the procedure to
the patient's desires are imperative.
As with the nose, the chin may be out of balance with the
general facial profile and careful analysis is essential.
Quite often chin
and nose surgery will be combined to provide the optimal
The point of
the chin can be moved forward or back, up or down or sideways.
as with the nose, the outcome is stable.
The commonest problem seen is the prominent or 'bat' ear. This
is often corrected in childhood but there is no age limit to the
Augmentation or reduction can be carried out. Minor augmentation
may be done with fat but implant materials are used where more
significant changes are required. The planning of this surgery
is more difficult as patients are not always able to visualise
Jawline augmentation or reduction can be carried out in selected
cases. Usually implant materials will be used.
ASIAN FACIAL SURGERY
While all of the above apply to Asian patients, they have two unique
situations which will require surgery for correction.
the double eyelid procedure will provide an aesthetically pleasing
transverse groove in the upper eyelid where this is found to be absent.
Augmentation of the nose bridge line to provide more projection is a
common procedure for the very flat Asian nose. this can be done using
silicone rubber or using cartilage from the chest wall of the patient
via a small scar under the breast.
While this is largely a female problem, males can also suffer an
unnatural breast development.
In the female, a
technique is chosen to provide the optimal outcome with minimal
scarring on the breast. In the young patient there is the hope,
but not the promise, that breast-feeding will be possible after
patients, liposuction of the lateral chest wall may also be
necessary while in patients with grossly enlarged breast who
desire to be extremely small, the nipple complex may be
transferred as a full graft. In such cases, breast-feeding will
not be possible.
In the male breast
reduction, a combination of direct tissue excision through a
small incision on the nipple, with liposuction will usually
produce a dramatic improvement.
Breast Uplift (mastopexy)
This is a female problem.
Skin tightening is
always required but the use of breast implants may enhance the
best time to perform this surgery is when no further pregnancies
This must be carefully planned and tailored for each patient.
Planning must take into account the wishes of the patient, but
it is not always possible to predict the outcome with precision
due to variation in tissue and skin stretchability. other
difficulties may include the position of the groove under the
breast in relation to the nipples and differences in the nipple
heights as well as variations in the skeletal anatomy of the
There may also be
significant anomalies in the skin envelope of each breast.
Once all of these
areas have been assessed a plan can be produced and limitations
explained. Outcomes can be extremely pleasing.
This can apply to both males and females but is not done where the
patient is obese.
elements of the abdomen are assessed - skin, fat and the muscular wall.
there is skin redundancy this will need to be excised. This is best done
leaving a scar running in each groin and across the pubic area. Often a
scar will need to be left around the navel (umbilicus).
deposits will often be trimmed at the same time as the skin, but, in the
rare case that there is no skin redundancy, fat will be removed with
Liposuction may also be used as an ancillary for fatty deposits in the
hip and upper buttock region to re-contour the entire circumference of
the lower trunk.
Initially the muscular wall of the abdomen is assessed. In most
instances following pregnancy this part of the abdomen wall is badly
stretched and contributes significantly to the appearance of a "pot
belly". Repair of this layer will result in a flatter "tummy".
THIGH AND UPPER ARM SURGERY
This surgery is done in male or female patients. Once again it is most
important that the surgical plan is tailored to the individual to take
into account the extent and localisation of the fatty deposits as well
as the presence or otherwise of skin laxity. It must be emphasised that
this surgery is not carried out in the presence of generalised obesity.
Where there are localised
fat deposits then liposuction alone provides the best solution. Where
there is skin laxity and redundancy then surgical excision of this will
be needed at the expense of a scar. While scars will be placed in the
most cosmetically acceptable sites, they will still present a negative
impact and this must be weighed up carefully before committing to such
recommended post liposuction to further enhance the smoothness of thew
skin and help with cellulite reduction.
BODY CONTOUR ENHANCEMENT
Apart from the face and female breast the only area to be enhanced or
augmented by Dr Trott are the lower legs or calf region.
done using soft silicone implants carefully measured to correct the lack
of size in this area.
SURGERY OF SKIN
Benign and malignant skin tumour usually require surgical treatment.
With pre-malignant and malignant (cancerous) conditions of the skin,
surgical treatment will be carried out in the context of the
protocol of lifestyle review and regular follow-up checks.
Some scars resulting from injury or surgery may be amenable to
improvement by surgical revision, but not always. It must be
remembered that any surgery to the skin will result in a scar.
Sometimes injection with steroid will provide improvement or the use
of silicone gel tapes may also be considered.
Injection of minute traces of chemical agents to block the
transmission of nerve impulses to muscles have become a popular,
non-surgical way of treating the frown lines and smile lines around
Current injection technique including accurate placement of the
material injected is mandatory to produce reliable outcomes and to
minimise unwanted effects.
This technique can
also be used in the treatment of neck bands and unsatisfactory
position of the eyebrows.
treatment is not appropriate (for example, the lips) re-surfacing
methods with laser or dermabrasion are employed.
Fat can be harvested from almost any site in the body and after
preparation, reinjected back into selected problem areas.
This has been used to
enhance the lips and cheeks, as well as contour depressions in the
facial region. Apart from purely cosmetic cases, Mr Trott has used
fat injection to enhance the upper lip in patients with cleft lip
who have reached adulthood.
These terms describe the removal of fatty tissue from selected areas
of the body to enhance overall body form and contour.
Mr Trott uses a
tumescent technique and power assisted cannulae, and has been
performing liposuction on all areas of the body for twenty years.
It is important to
point out that liposuction is not a treatment for obesity, but is a
means of improving body contour. It will often be used in
conjunction with other surgical procedures such as facial
rejuvenation, breast reduction surgery and abdominoplasty (tummy