Normally in social life, we greet someone by looking them in the eyes and shaking their hand. Those brief moments already give us an impression of the person standing before us. For this reason, the eyes and the look are so important. The look…is not only the eyes themselves, the colour of the iris, the uniformity of the white and the light in the iris (things that are always touched up by computer in the photos of celebrities and models on the cover pages), but the look has to include the eyebrows, the upper lids, the eyelashes, the lower lids, the bags and shadows under the eyes, the crows feet.

When we meet someone, we always look first at his or her eyes. Our attention then passes to the mouth. These two parts of the face allow us subcon sciously to obtain information will help us to guess the approximate age of that person, and perhaps also some traces of his or her character.

If the mouth and lips are frequently the first question for a woman, the eyes are usually the object of consultation for a man. For some it is the aesthetic aspect, for others, it is a question of practicality or aesthetics, but the motive is really the increasing demand for this type of surgery.

We should try to look at it from a different viewpoint, particularly regarding the correction or increased volume of a woman’s lips. The first thing we should remember is that when we look at ourselves in the mirror, we have a tendency to focus our attention on details, slight imperfections. But other people don’t look at us in the same way, they don’t observe us in so much detail.

When we meet someone, we always look first at his or her eyes. Aesthetic surgery can be of great help to give a fresh and seductive touch. (see pictures before and after)

In our day to day life, most people we meet will greet us by looking us in the eye, to establish whether our look is deep or empty, warm or cold, straight and honest or, on the contrary, evasive, etc….Throughout the ages, the eyes have been considered to be the mirror of the soul. The brain immediately registers the forms and movements of the face, which give us an idea of the vitality and emotional state of that person.

Only the professionals, (and this can include best friends!!!), make a critical analysis of tones, texture, the skin condition, etc, in order to determine more precisely the age and the requirements for face care. Eye contact is therefore by far the most important, followed by the lips. In most cases, the need is to correct, rejuvenate and “sweeten” the look.

Patients generally understand this concept, but they immediately state that they do not wish specifically to change the expression of their look. The role of the professional is then to focus the attention on the fact that our look is not the same at all stages of our life and that maturity is sometimes synonymous with sadness, associated with a drooping of the eyelids and the outer corner of the eye.

The youngest patient on whom I have performed an eye operation was 27, and oldest was 79. Both were motivated for different reasons, but their circumstances were identical. They both had drooping eyelids which gave them a weary look and feeling, the younger patient because of her natural anatomy and the older one due to her age. The younger one, naturally, wanted not only to look younger but also to appear fresher and above all, sexier. The older patient only wanted to continue working without the feeling of tiredness.

Well, now I have used the word “sexy”. It could also be “seductive”. It’s true that drooping eyes, whether the eyelids or the outside corner (called the external canthus) do not look very sexy, but tired and even sad. Eyes that are larger and somewhat drawn out (feline) look more attractive. Throughout the centuries, women have painted their eyes to make them look larger and wider. This reminds us of Cleopatra, but apparently the men of Ancient Egypt also used to paint their eyes.

“the

LOOK”

The truth is that there is an almost magical attraction with large eyes. They are the symbol of an open vision towards others and to the world. Wide eyes are also associated with the natural shape of the eyes when we smile. They send out a message of sweetness, like a smile. In fact, there are people who are cruel and cold but who naturally have this kind of eyes, and they seem to always give a sweet smile, even when they are very angry.

It is very important to point out that the eye is closely joined to the upper and underlying structure. In fact, upper lids that are heavy and wrinkled are possibly, in the majority of cases, the result of sagging forehead skin. Lax lower eyelids, with circular rings, are often due to a loosening of the facial skin. In this way it is understood that the eyes can normally be operated on, independently from the rest of the face, whilst they should really be analysed as an integral part of a harmonious whole. This way it is preferable to create younger eyes, raising the “outer corner”, eliminating the excess skin, with a little of the muscle in the case of the upper lid, but trying to tuck in the skin without tensing the muscle too much at the level of the lower lid.

A final detail, it is possible to give a touch of embellishment to the eyes, creating or recreating at the external part of the upper lid, what Steven Hoefflin, the famous surgeon to the stars in Hollywood, calls a “beauty egg”. The study of thousands of faces has, in fact, demonstrated that the beauty of the features is almost a mathematical equation. It depends on the face having certain areas of fullness, seven for women, that are common to all of the most beautiful faces in the world. If these small areas of fullness do not exist, they can be created by fat injections, synthetic injectable products or implants.

This type of surgery is very satisfying to the surgeon and also to the patient, because the rejuvenating and embellishing effect is immediate in the majority of cases.

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Editorial: Dr. Pier Albrecht, Dr. Pierre Albrecht, Dr. Pierjean Albrecht,

Dr. Pier Jean Albrecht, Dr. Pierre F. Albrecht, Dr. Pierre Frank Albrecht,

Dr. P. Frank Albrecht, Dr. Pierjean Frank Albrecht, Marbella Clinic

A Tummy Tuck is a surgical procedure by means of which we can improve the appearance of the abdomen when there is an excess of fat and skin tissue

In the majority of cases, a tummy tuck is performed on adults over the age of 50 who are feel uncomfortable with an excessive amount of skin and have to wear loose-fitting clothes to conceal it. It can also be related to obesity problems. Generally speaking, it involves skin that has lost its elasticity, whether through several pregnancies or after a weightloss diet, and is no longer smooth and taut over the framework and muscles of the body.

There is an evident aesthetic problem and greater inconvenience with regard to clothes.

For many years, abdominoplasty has been described as a technique to eliminate a large amount of excess skin by means of an incision made from hip to hip, passing across the pubis and the navel. Several types of incisions and scar patterns are described, generally in the form of an inverted “M”. The fact of having to cut a large quantity of skin means the surgeon has to relocate the navel, making an opening higher up and stitching at that level.

During the operation it is possible to take the opportunity to stitch the abdominal muscles in cases of slackening of the stomach wall. In general it is not advisable to have a liposuction followed by an abdominoplasty because the risk of the tissue scarring badly or dying (necrosis) is much higher.

The results of a classic tummy tuck are variable. In the majority of cases patients have been very pleased at being able to dress more easily and with the image of having a new body, when clothed. When the clothes come off, then the results are not quite so satisfactory because the scar is very large and visible, which patients are somewhat embarrassed to show.

“ In the field of abdominoplasty, as in any other procedure of aesthetic plastic surgery, my concerns have always been to reduce the pain, the trauma of the anaesthetic, surgery and recuperation time, as well as the visible aspects of having undergone surgery i.e. the scars…”

My point of view

In the field of abdominoplasty, as in any other procedure of aesthetic plastic surgery, my concerns have always been to reduce the pain, the trauma of the anaesthetic, surgery and recuperation time, as well as the visible aspects of having undergone surgery. i.e. the scars… At the same time to increase the patient’s pre- and post-operatory comfort, the naturalness of the results and the discretion of the surgeon’s intervention to be able to enjoy a new life to the full.

For these reasons, I have never been fully in favour of performing a major tummy tuck, and have always tried to achieve satisfactory results with a minitummy tuck, i.e. by making only one incision at the level of the pubis that goes 2 or 3 centimetres beyond the pubic hair, respecting the original navel, or in other words, removing a crescentshaped section that is 4 or 5 cm wide.

Upper Abdominoplasty

But of course, the technique of a minitummy tuck is not enough in cases of an excess of skin, and we have to think of something additional. For this there is a new surgical option that can complement what is known as a lower abdominoplasty, and is called specifically the upper abdominoplasty. The technique, always with the aim of reducing the “visibility” of the operation and increasing the naturalness of the results, consists of lifting the skin above the navel and cutting the excess at the level of the inframammary folds. With incisions of 10 to 15 cm long, it is possible, as with the lower abdominoplasty, to remove 2 more crescents of skin of 4 and even 5 centimetres width.

NEW Abdominoplasty

(Tummy Tuck )

“…Many men ask questions, interested in this technique, particularly after the age of 55 or 60, because they do not have inframammary folds, to hide the scars”…

Many advantages The advantages of this technique are numerous : it is a far less invasive technique than the major tummy tuck, it is not necessary to touch or reposition the navel, the scars are almost invisible because they are hidden by the weight of the breast that always falls a little and covers the fold. The recuperation period is much less and more comfortable, with far less risk of skin necrosis, infections and split stitches. While it is true that this technique cannot be used in cases of extreme obesity, many patients, both men and women, are able to enjoy having a flat tummy – not only with no fat, as would be after a liposuction – but also with smoother skin. Many men ask questions, interested in this technique, particularly after the age of 55 or 60, because they do not have inframammary folds to hide the scars. It is the same as in the case of younger women with small breasts. For these cases, the solution would be to make use of a tattoo. Nowadays it is widely accepted and not considered at all strange to wear a tatoo, which can even be discreet and simple, such as a leafy branch, for example, although some people prefer the idea of a snake tattooed all along the scar. In any case, I would tell anyone who is definite about not wanting a scar in that place, that it is far more attractive than a lot of hanging skin or a scar running from one side of the abdomen to the other. It is simply a matter of mentalizing yourself and having a tattoo applied when you had never before thought of having one.

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Editorial: Dr. Pier Albrecht, Dr. Pierre Albrecht, Dr. Pierjean Albrecht,

Dr. Pier Jean Albrecht, Dr. Pierre F. Albrecht, Dr. Pierre Frank Albrecht,

Dr. P. Frank Albrecht, Dr. Pierjean Frank Albrecht, Marbella Clinic

Beauty and perfection should go together? This is the most mistaken idea that we come across in our speciality of Plastic Surgery and Aesthetic Treatment.

For that reason there is a risk of people ending up looking like each other. It is sad to see faces with forced curves, noses that are straight but rigid, big lips that look swollen, exaggerated cheekbones, etc. The idea of perfection comes from the fact that many people imagine themselves like a car, with parts that are interchangeable with those from other types of car.

The case frequently arises when someone comes with one or more magazines and tells the doctor “I want this mouth, doctor, I’d like to have this nose, these breasts,” etc. And in the end what do we have? An image that is fabricated out of identical parts that are used by many others, an image that looks unnatural, in which the human being who is hidden behind it has been lost.

What is left of Michael Jackson on the outside? and what is left of Michael Jackson on the inside?

I always feel that the victims of this kind of image have lost their common sense. Don’t they realize that it is obvious to everyone? Even their best friends laugh when they are with other people, otherwise ask their hairdressers, who are experts in camouflaging so many scars produced by the face-lifts of which there are more and more every day.

We have come to the point of thinking that a pretty face can be the sum of a number of pretty features : lips, nose, eyes, chin, cheekbones… But this is not necessarily so. Nowadays I often hear in my surgery that people prefer perfection rather than beauty, in the same way as people prefer respect rather than love. Perfection can be worked on, in the same way as respect, it can be developed starting with standardized and normal things until it responds to defined scientific rules. I think we could even say that perfection is something that is measured by the immobility of statues. Perfection is rigid and boring, it is not in favour of contrasts.

Beauty, like love, is something that cannot be easily controlled, it is something mysterious that is perceived and is related to the world of art, a world whose rules are unknown to us and that has to be understood with the intellect of the heart rather than with the intellect of the brain. It is also related to intuition. It is possible to be handsome with a long or short nose, with large or small eyes, with irregularly shaped lips. Latin beauty is not the same as Scandinavian beauty, for example. Beauty and perfection should go together. This is the most mistaken idea that we come across in our speciality of Plastic Surgery and Aesthetic Treatment.

Beauty, like love, is something that cannot be easily controlled, it is something mysterious that is perceived and is related to the world of art, a world whose rules are unknown to us and that has to be understood with the intellect of the heart rather than with the intellect of the brain. It is also related to intuition. It is possible to be handsome with a long or short nose, with large or small eyes, with irregularly shaped lips. Latin beauty is not the same as Scandinavian beauty, for example. Beauty is something that is measured by the movement of real life. An expression, a smile, even certain movements that are almost imperceptible in the muscles of the face and body, can give an impression of beauty and seduction…..or the complete opposite. Yes, natural beauty is movement and life, it does not allow room for boredom because it changes with the circumstances.

Not long ago I saw a photo of a wellknown English singer from the 80’s on the cover of a magazine. She must have been around 50. I could see she had undergone a deep phenol skin peel. The truth is that her face had no wrinkles, nor marks nor flabby skin, but I could see that this woman must have been over 45 by looking at her eyes. The upper part of her eyes, just below the eyebrows, was very hollow, you could see perfectly what we call the skeletonization of a face…this is when the bones start to protrude…a sign of aging. Her face looked as if it were made of porcelain. It certainly did not look very inviting to kiss it. This is a typical example of a face that is perfect, but not beautiful, nor young.

In natural beauty a face can be slightly assymetrical, with imperceptible movements of the curves that are a result of human nature. Many people have an idea of ideal beauty as in a sculpture. But a live human face has greater value than a sculpted face.

Beauty, youth and maturity In this aspect there is a difference between men and women. As in the animal kingdom, men want their women to be beautiful because in this way, through a strong sexual attraction, they can reproduce and improve the species. And in most cases, a woman’s beauty in linked to her youth, which is the ideal moment for reproduction. Age, with its wrinkles and flabby skin, relates women to the ravages of time and tiredness, and men do not want the object of their desire to be ravaged and tired.

The woman turns into a mother, and men are not keen to make love to a mother. These statements are generalities, obviously, but it becomes a global tendency, a more animal and instinctive way of seeing others. The problem is that today’s society is more in favour of this more superficial and physical way of seeing other people than through deeper and more sentimental values. This situation has always existed, but nowadays even more so.

With men it’s a different matter. Women find men to be more attractive when they are older, with wrinkles, showing signs of experience, strength and maturity. This is because women are subconsciously searching for the best father for their children and the maximum security. As in the animal kingdom, men with more experience, wisdom and strength are considered to be the most appropriate. So whilst men consider age to be detrimental with regard to women, women take it as a sign of improvement in the case of men.

In conclusion, for women we associate beauty with youth, while for men, beauty is associated with maturity.

Dr. P. Albrecht M.D. Ph. D. – 952 816 981

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Editorial: Dr. Pier Albrecht, Dr. Pierre Albrecht, Dr. Pierjean Albrecht,

Dr. Pier Jean Albrecht, Dr. Pierre F. Albrecht, Dr. Pierre Frank Albrecht,

Dr. P. Frank Albrecht, Dr. Pierjean Frank Albrecht, Marbella Clinic

By Dr. Pier Albrecht

The art of skin rejuvenation

Our facial skin is a magnificent organ being thick enough to protect our face from a lifetime of sun, wind and rain while in the meanwhile being flexible and delicate enough to express emotions and mimics in the unique way only a human being is able to do. After having undergone the changes of many seasons and the sum of emotions of a full life our skin starts to show the inevitable signs of ageing: Wrinkles, age spots, a thinning of the skin and an overall loss of elasticity.

Not long ago, any correction of these ageing effects was only accessible by more or less invasive plastic surgery procedures. But since a couple of years new treatments called Peelings are available which consist of a chemical or mechanical removal of the upper layers of the skin (Epidermis) followed by an assisted healing phase which allows for a regeneration of a new, immaculate skin.

It is very important to know that the exfoliative effect of a chemical peeling only is responsible for a part of its results, while the other part is the effects in the deeper layer of the skin (Dermis), where a deep chemical peel induces a hypertrophy and a retraction of the elastic fibres which results in the remarkable lifting effect of such a deep chemical peeling. Furthermore this lifting effect can be as well achieved in zones which are difficult to treat with classical surgical face lifting procedures (e.g. the area around the mouth and the lower eye lid area).

There are other peelings available which are targeted only on the exfoliative effect, that means they provide only the removal of old skin cells to enhance the appearance of the skin but have no lifting effect which can remove deeper creases and wrinkles. These superficial or medial depth peelings are for example the Fruit Acids peelings or the glycolic acid peelings which can not be considered as an alternative for surgical lifting procedures.

An alternative to deep chemical peeling is the EXOmask which is only available at a few selected centres in Europe. Based on a special chemical formula which has been developed over 30 years through extensive testing on human tissue samples in the laboratory, EXOmask provides a deep lifting effect on the dermis without any destruction of the underlying pigment cells (Melanocytes), which are responsible for the skin colour and the natural sun protection through the tanning effect. Most of the other deep peelings currently available have an immanent risk of permanent depigmentation of the treated area, which results in an unsatisfying skin colour and the mandatory use of permanent sun protection.

The EXOmask treatment is carried out in only one session, mostly as an out-patient procedure, under local anaesthesia and in some case including a light sedation. After the peeling lotion has been applied, an elastic silicone mask seals the face for 24 hours allowing the solution to penetrate into the deeper part of the skin. This process is painless, the patient can in most cases go home with the mask and sleep normally. After 24 h the mask is removed and a special powder is applied on the skin. This powder enhances the regeneration process and serves as a dressing for 7 days until the new skin has grown completely.

After 7 days the results are instantaneous, the patient has a smooth and spotless skin and the lifting effect through the skin retraction is completed. Due to the ongoing regeneration process of the deep elastic fibres the new skin is widely vascularized and therefore shows a redness which will slowly fade during the next 8-10 weeks but can be covered up completely with make up.

In conclusion the EXOmask peeling is an attractive alternative for patients who have an overall ageing of the facial skin and want effective facial rejuvenation without undergoing classical surgery procedures.

The EXOmask treatment is carried out in only one session, mostly as an out-patient procedure, under local anaesthesia and in some case including a light sedation.

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Editorial: Dr. Pier Albrecht, Dr. Pierre Albrecht, Dr. Pierjean Albrecht,

Dr. Pier Jean Albrecht, Dr. Pierre F. Albrecht, Dr. Pierre Frank Albrecht,

Dr. P. Frank Albrecht, Dr. Pierjean Frank Albrecht, Marbella Clinic

By Dr. Pier Albrecht, Director de Marbella Clinic

The most recent advances in lifting involve various techniques and work on the different layers of the skin, achieving results with a more natural effect For several decades now, and even as far back as the nineteenth century, surgeons have attempted to correct the effects of ageing by lifting the skin on the face. All kinds of techniques have been employed, with early attempts resulting in visible scars right in the middle of the forehead or the temples, and later attempts more successfully hiding the scars in the hair or in front of the ears.

The idea was to re-stretch the skin which progressively loses its elasticity, not from top to bottom in line with gravity, but at an angle from the chin to the ears, and from the eyes to the temples, dividing the face into three horizontal segments: The neck and jaw, the cheeks and eyes, and the temples and forehead.

THE REJUVENATING EFFECTS OF THESE FACE-LIFTS UNFORTUNATELY DID NOT YIELD LONG LASTING RESULTS, WHICH MEANT that surgeons had to operate three or four times on the same patients over a period of twenty years. The Surgical look or cat look, in other words the expressionless masklike appearance that resulted from these operations, was indeed free from wrinkles and taut, but was rather unattractive and unnatural looking.

It wasn’t until 1992 that surgeons in France hit upon the idea of associating the skin’s elasticity with the tension of fat and tissue, which cover facial muscles.

Whilst this produced more durable results, surgery was still carried out at an angle, so that after the second or third face-lift, the effect was increasingly less natural.

We have to thank a few plastic surgeons for a new approach, which consists in recognising that the skin loses its elasticity in line with gravity, i.e. vertically, and that it is therefore preferable to divide the face into three vertical rather than horizontal segments. You can observe how the central segment of the nose and chin, and the outer segment close to the ears, wrinkles but does not sag. Only the skin on the cheeks and lower cheeks drops, in a similar way to the breast area. The new technique consists in lifting vertically the whole lower cheek-cheek-eyelid-eyebrow-forehead area, which enables these parts of the face to be repositioned where they were twenty years earlier. The position of and distance between each facial element is respected, which enables a totally natural look to be achieved.

To complement this new approach, I also offer patients the option of stretching the neck and jaw tissues, replacing the cut, which is visible in front of the ear lobe and is hidden behind the outer ear. Nowadays we are therefore able to offer a natural looking remodelling of the face, as long as the first face-lift is not left until too late to be performed, before the skin loses its elasticity.

Finally, it is important to point out that face-lifts affect the skin and the muscles, but do not change the quality of the skin or the volume. In order to obtain better results, it is advisable to use a gentle facemask called microdermabrasion and to restructure the skin by fat injection in the areas, which lack flesh, and/or semipermanent or permanent products to smooth out wrinkles. In short, the new approach to face-lifts provides natural results, by combining techniques, and by working on several levels of tissue – the surface of the skin, the skin and the hypodermic levels of the skin – as well as by focussing on tissues and muscles.

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Editorial: Dr. Pier Albrecht, Dr. Pierre Albrecht, Dr. Pierjean Albrecht,

Dr. Pier Jean Albrecht, Dr. Pierre F. Albrecht, Dr. Pierre Frank Albrecht,

Dr. P. Frank Albrecht, Dr. Pierjean Frank Albrecht, Marbella Clinic