Veelgestelde vragen

Veelgestelde vragen

Praktisch

Offerte

More than 6 months ago I received a proposal from you which has now expired. Do you want me to send new pictures?

As we try to improve our techniques all the time we would like to make a new proposal. Ideally this is done during a consultation in person. If this is not possible, please send your pictures as explained in http://2pass.eu/practical/proposal/, preferably without make-up.

Do I need a Paypal account to be able to pay with Paypal?

You don’t need a Paypal account to be able to pay with Paypal. Just click on the bottom link on the right in the Paypal window (see screenshot below).

You don’t need a Paypal account to be able to pay with Paypal, just a credit card

Will it be possible to make a professional proposal based on pictures of the face only?

We prefer a face to face consultation if reasonably possible. Being able to touch the face is better for analysing a face. In most cases though good pictures as described in http://2pass.eu/practical/proposal/ will give the doctor enough information to make a professional proposal. If necessary the proposal can be slightly adjusted the day before surgery during the preoperative consultation.

Consult

Do I need a Paypal account to be able to pay with Paypal

You don’t need a Paypal account to be able to pay with Paypal only a credit card. You can click on the link at the bottom right of the Paypal window if you don’t have a Paypal account.

Can I wear make-up during the consultation?

It is no problem to come with a light make-up to the consultation. Try not to make it to heavy so Dr Bart van de Ven can make a good assessment of your natural facial features.

Boek uw operatie

Kan ik het geld in maandelijkse termjinen betalen?

Wij bieden onze patiënten geen kredietmogelijkheden. Het volledige bedrag dient voor de operatie te worden betaald. Banken hebben mensen in dienst die kunnen beoordelen of u er verstandig aan doet een lening te nemen. Wij begrijpen dat u uw operatie zo snel mogelijk wilt ondergaan, maar onderschat de stress niet die te hoge financiële verplichtingen kunnen veroorzaken.

Can I be put on a waiting list to be contacted just in case someone cancels her surgery?

Yes, we can put you on a waiting list if you want. You will be contacted if someone cancels. In our practise this rarely happens by the way.

What if you are ill at the moment of the scheduled surgery?

If a letter of a medical doctor saying the patient really was not able to be operated because of physical illness, the surgery will be rescheduled without cost.

How long is the waiting time to book an operation?

The average waiting time for an operation at the moment is two months. For big surgeries it can be a bit more, for small surgeries often less. You can check availability through our online operation planner.

Can I pay my deposit with Paypal or credit card?

We don’t accept payments for operations by Paypal. The only way to pay the operation is by bank transfer.

Can I pay for my surgery at arrival using credit card or check?

No you can’t. We only accept bank transfer or cash payment (bank notes).

Why can I not book more than 6 months in advance?

The maximum in advance that can be booked is 6 months. We do this because we noticed a lot of things can happen in 6 months that disrupt planning (in the life of the patient but also in the life of the doctor).

Dates automatically open up 6 months in advance. So if you want to book a particular date, best is to schedule in your calendar to do this 6 months before this date. As the date is blocked for everybody, you don’t have the risk somebody else takes the date (you do have the risk Dr Bart van de Ven is on holiday).

Voorbereidng voor de operatie

Ik ben iets te zwaar. Wat is de maximale BMI voor deze operatie?

In principe is de maximale BMI 30. Als uw BMI hoger is, maar u in goede gezondheid verkeert, wordt uw specifieke geval door onze anesthesioloog beoordeeld.

Do I need to remove nail treatment prior to surgery?

The reason this is sometimes requested is for the anesthesiologist’s monitoring of the pulse oximeter, which measures the level of oxygen in the blood. This can also be monitored and measured by attaching the sensor to the toe or earlobe, so our anaesthesiologist does not request to remove gel nails.

What if I take any coagulant like Aspirin or Sintrommitis? Do I have to stop taking them?

Please contact the doctor that prescribed this medication to you and ask him if you can just stop it for a while. Ideally we would like you to stop Aspirin from 10 days before the surgery till 3 days after the surgery.
If you take Sintrommitis it should be stopped a few days before surgery, but often you will need some other anticoagulant that is more controllable to replace it. Your doctor will give you the correct instructions.

Can my partner sleep in the hospital with me?

We have two double rooms in the clinic. Please let us know if you want your partner to sleep in the hospital as well and we will arrange this for you if the room is available. An extra 100 euro is charged for this (if no further stay in the Guesthouse is reserved).

Is it mandatory to book the place to stay in Antwerp after discharge?

If you live not too far from Antwerp it is not a problem you return home the day after surgery and come for a postoperative consultation with Dr van de Ven 8 days after surgery.

Is the preoperative consultation obliged?

Yes it absolutely is. Without this, Dr Bart van de Ven cannot operate.

Are the postoperative controls obliged?

No they are not obliged. Just let us know which control you can not attend.

Why you don’t ask for the blood group?

Dr Bart van de Ven needed to do a blood transfusion in his patient so far twice in his life. So the incidence is very low. If it is necessary the blood lab will ALWAYS do a cross test with the blood of the patient before giving the blood so why test it before? In the case of acute need for blood the blood group O-negative is given. This occasion did not ever occur in our practice (but Dr van de Ven’s blood group is O neg which means he would be able to give his own blood…:).

When do you need to have the results of the bloodtests? What if the results are abnormal?

If the results of your tests are all within normal range you can bring them to your pre-operative consultation so we can add them to your file. It is not absolutely necessary you scan them and send them by email. In case some of the results are clearly abnormal you should ask your GP or a specialist if it has any consequences for the planned surgery. Per definition 5% of test results is out of normal range. That means that very often it is without consequence.

When should I stop my HRT treatment before FFS?

You can continue your HRT treatment before, during and after your FFS. You will receive an anti-thrombotic injection the day before surgery to prevent blood clothing. We prefer you to continue taking your hormones because FFS is emotionally already perturbing enough without messing with your hormone balance.

When should I stop my electrolysis / laser hair removal sessions before FFS?

There is no problem for us if you have a hair removal session two days before your surgery.

What happens if I need to see a doctor when I return to my home country?

We would advise you to see your GP or the doctor that is on call. We would then discuss the problem with this doctor once you’ve been seen, and recommend the appropriate treatment. In extremely rare cases it might be necessary for you to come to Antwerp.

When will I be able to get up and walk around after the surgery?

In the hospital, once the catheter has been disconnected, you should gently work up to getting out of the bed and walking around a bit, unless your doctor advises differently. Listen to your body carefully and get plenty of rest, but don’t stay in bed all day. After a few days you’ll like to go outside, which you should do.

Will I be able to eat?

If you haven’t had any treatment involving your teeth a sliding genioplasty or orthognathic surgery, you’ll be able to eat normally quite soon. Due to the effects of general anesthesia, you should only feel nausea for the first few hours. You may prefer to eat softer or pureed foods initially if you have intra-oral sutures. Patients should prepare accordingly in advance and purchase juices, yoghurt and soups to have during for the first few days after surgery.
After a sliding genioplasty you should be very careful not to put too much force on the lower jaw e.g. by eating raw meat (steak) or biting an apple. The jaw is really weak in the chin area and it will take about 6 weeks until it has regained it’s original strength.

What kind of pain can I expect?

Pain is surprisingly mild, considering the extensiveness of the surgery performed. Many patients don’t speak of pain at all but more of discomfort. With normal pain suppressants and anti-inflammatories, any pain and swelling can be well managed.

When should I expect to return to work?

Normally our patients return to work after 2 to 6 weeks, according to the extent of surgery.

What about smoking?

As smoking counteracts wound healing we strongly advise against smoking during the 3 weeks before surgery until 3 weeks after surgery. Smoking dramatically increases the risk for skin necrosis and should be avoided at all times.

How long should I stay in Belgium after surgery?

When it is an extensive surgery you can fly home 8 days after surgery. For a typical schedule have a look at the following webpage: http://2pass.eu/practical/operation/typical-stay-in-belgium/

Veelgestelde vragen over de procedures voor de operatie

Algemeen

Ik ben iets te zwaar. Wat is de maximale BMI voor deze operatie?

In principe is de maximale BMI 30. Als uw BMI hoger is, maar u in goede gezondheid verkeert, wordt uw specifieke geval door onze anesthesioloog beoordeeld.

What happens if there are complications after the procedure and is this covered?

We will correct the complication if surgically possible, without charging any surgical fees. Hospital, material and traveling costs are for the expense of the patient.

What type of care is needed after the treatment? Will I require check-ups in my own country?

All care in Antwerp is provided. In general no extra care is needed in your home country. Check-up with Dr Bart is after 4 months and can be in any city where Dr Bart van de Ven provides consultations.

When can I judge the final result?

After three weeks you would look presentable but it takes at least 4 months to get a good impression of the final result. Sometimes after chin and jaw work it can take up to a year for the swelling to completely disappear. Scars take about a year to fully mature.

How would the clinic deal with an emergency if serious complications were to arise during the procedure?

If a patient needs hospitalisation we would transfer her to the Middelheim hospital which is 8 minutes or 3,5km from our clinic.

We have had this situation 2 times in more than 700 surgeries. In case this would be because of a mistake from our side we have an insurance that covers the cost. More likely is that it happens without anyone having made a mistake. In that case most health insurances cover these costs.  If you don’t have a health insurance it’s your (financial) risk.

How long is the waiting time to book an operation?

The average waiting time for an operation at the moment is two months. For big surgeries it can be a bit more, for small surgeries often less. You can check availability through our online operation planner.

Can I loose feeling permanently in some areas following FFS surgery?

Some temporary numbness in any of the areas where bone work is done is an absolute certainty. That could include the scalp, forehead, chin, jaw or even cheek areas depending on where the surgery has been done. This is simply because the flesh is detached from the bony area. Several thousand minor nerves are severed, and it will obviously take some while for those areas to heal. Up to 18 months is not unusual, but less than that is more common.

Is FFS painful?

There is no complete answer to this. It depends entirely on the pain threshold of the patient, and the operation procedures performed.Most procedures will involve the need for some incisions, and closure with sutures. Inevitably these will lead to some level of discomfort for some period post-operation. Mostly patients describe it as ‘uncomfortable’ rather then ‘pain’.

Will I have numbness?

The treatment areas will feel numb in the beginning. It will take 3-6 months to recover feeling, and you may not regain the same level of feeling as before.

Should I wait with FFS until I have taken hormones long enough?

The hormones will have their effect on the soft tissues of your face: the fat will redistribute and the muscles will atrophy a bit. Also the facial hair will diminish and hair to the scalp will become denser and thicker. All this will make your face look softer and more feminine.
Dr van de Ven will try to make your face as feminine as possible and there is no negative effect to your face becoming even more feminine after your FFS due to the hormones. Those last changes will be very subtle. Therefore Dr van de Ven does not see a reason to postpone FFS if you have only started taking hormones recently.

Recontouring van het voorhoofd en verlaging van de haargrens

For the forehead recontouring, is there any shaving required?

No, shaving is never required for the incision.

Is it safe for titanium screws staying inside my body for long term?

Yes it is. Two of the greatest benefits of titanium are its high strength-to-weight ratio and its corrosion resistance. Couple this with its non-toxic state and its ability to fight all corrosion from bodily fluids and it’s no wonder titanium has become the metal of choice within the field of medicine. Titanium is also incredibly durable and long-lasting. In principal they are not removed anymore and stay in the body. Only in case of an infection on the plates (rare) they will have to be removed.

Another benefit to titanium for use in medicine is its non-ferromagnetic property, which allows patients with titanium implants to be safely examined with MRIs and NMRIs.

How long does it take for the final result to be visible and the blue stains to disappear completely?

After the forehead recontouring procedure patients heal relatively quickly. However, healing is different for every patient. Mostly for this procedure a final result can already be visible after one to two weeks. But if the blue stains are severe (10% of patients, and there is no way to predict to whom this will happen), it can take up to 4 weeks for the blue stains to completely disappear.

Does bone grow back once it has been cut or shaved down?

In our experience no bone has ever grown back.

Is there a risk for sinus problems after forehead recontouring type 3?

Until now we have never had a patient complaining about sinus problems after this procedure.

 

Is de schedel na de ingreep minder sterk?

Verzwakking van de schedel is niet aan de orde; de schedel is erg sterk en blijft  sterk.

What are the chances that I will experience hair loss after the operation?

Many patients experience temporary hair loss. On average the hair grows back in about 6 months.

Is it possible to have hair replacement done at the same time as the procedure to give a female hairline?

If you have just a hairline lowering it basically is possible to do hair transplantation at the same time. But practically this is not possible as Dr van de Ven doesn’t do hair transplantation himself. This is done by the hair transplantation clinic, which uses a different operating theatre.

Will I experience loss of nerve sensitivity in the scalp area?

For sure there will be temporary numbness of the scalp which recovers to a variable degree. I can be that the sensation of the scalp will never be as before, but nobody really makes a big deal of this.

Wat voor litteken krijg ik bij de haarlijn ?

Het litteken bij de haarlijn zal onregelmatig van vorm zijn voor een natuurlijk effect. In het begin zal het rood en behoorlijk zichtbaar zijn, maar na ongeveer 6 weken zal het minder opvallend zijn en zal het haar door het litteken heen beginnen te groeien. De rijping van het litteken duurt ongeveer een jaar.

Zal het litteken zichtbaar zijn ? Dat hangt af van de dichtheid van het haar vlak achter de haarlijn. Als het haar daar dik is, zal het litteken nauwelijks zichtbaar zijn als de haarwortels die onder het litteken zijn geduwd, er doorheen beginnen te groeien. Als het haar dun is kan het litteken minder zichtbaar zijn als u het haar naar achteren trekt.

Haargrens verlagen met expander

Is it common to have complications during the expansion?

Complications during expansion have become very rare since we place the expander on the back of the head. Leakage of the expander or a serious infection have never occurred.

Is the expansion very painful or disfiguring?

Thanks to a new technique developed by Dr van de Ven the expander can be placed on the back of your head. With the new technique patients don’t complain of pain during the expansion anymore and it has become much easier to hide the expander.

How often should I inflate the expander?

Twice a day you will have to inflate 10ml of water (saline). We will supply you with all the necessary things after the expander has been placed.

How much time should there be between placement of the expander and the actual hairline lowering?

Depending on the amount of hairline lowering necessary you will need 6 – 8 week for the expansion

Wenkbrauwlift

Rinoplastiek

Hoe vaak is revisie-chirurgie nodig na een rinoplastiek?

Rinoplastiek wordt beschouwd als een operatie met grote risico’s, voornamelijk omdat het esthetische resultaat maar ten dele is te voorspellen. Post-operatieve misvormingen worden gezien als het voornaamste risico van rinoplastiek, waardoor revisie-chirurgie in 5% tot 15% van de gevallen noodzakelijk is. Wat zijn de oorzaken? Een perfect resultaat onmiddellijk na de operatie kan er een jaar later heel anders uitzien. Beperkte voorspelbaarheid wordt vooral veroorzaakt door het dynamiek van het genezingsproces. Er zijn veel verschillende typen weefsel bij betrokken: bot, kraakbeen, slijmvlies, huid, vet, bindweefsel, spieren, zenuwen, vaten, perichondrium en periosteum. De chirurg heeft de individuele reacties van deze weefsels niet altijd onder controle. Dat geldt vooral voor kraakbeen, de belangrijkste structuur voor ondersteuning van de neus.

Met toenemende operatie-ervaring wordt het risico op complicaties bij een rinoplastiek sterk verminderd. Daarvoor is voortdurende educatie een vereiste alsmede een serieus onderscheid tussen een complicatie en een fout. Dr. Bart van de Ven heeft gedurende zijn carrière een respectabele ervaring met neuzen opgebouwd. Om het genezingsproces te helpen heeft hij de zogenaamde ‘neus-vorm’ ontwikkeld, die de esthetische complicaties na een rinoplastiek drastisch heeft verminderd. Het resultaat van de druk is veel minder vochtophoping tussen de huid en het onderliggende weefsel. Vocht kan door het lichaam worden vervangen door littekenweefsel, waardoor het esthetische resultaat wordt aangetast. De druk fixeert ook de botinsnijdingen. Dit resulteert in een significant rechtere neus.

test

Could breathing be more difficult after a reduction rhinoplasty?

In a normal nose the respiratory route is critical at just one point which is the internal valve. By the use of spreader flaps or spreader grafts Dr van de Ven will make sure that there the nose doesn’t become smaller.

Wangvergroting met medpor-implantaten

Are all the cheek augmentation contours the same or can the doctor decide on the shape and size?

The doctor can decide on the size and shape of the implant. In 80% of cases the same implant is used, but if indicated other sizes and shapes are used.

Kaakhoek- en kinrecontouring

Can a facelift be performed at the same time as a jaw angle reduction?

The swelling after a jaw angle reduction can be massive. That is why a facelift is best not performed at the same time as a jaw recontouring. The results will be suboptimal. We recommend at least 4 months between the two operations. The facelift helps enormously to show off the newly formed jaw and chin, resulting in a very female shape of the face.

Will the skin adapt to the new shape of the jaw?

The volume of the jaw and chin will be reduced and the swelling after this type of surgery can be massive. In a young patient with good elastic skin, the skin recuperates from all that stretching.  If you are older, the skin will possibly not completely readapt to the new jaw shape resulting in a previously not existing sagging skin. That is why a lot of older FFS patients (late 30’s and older) may need a facelift. A facelift is best not performed at the same time as a jaw and chin recontouring because the result is suboptimal. We recommend at least 4 months between the two operations. The facelift helps enormously to show off the newly formed jaw and chin, resulting in a very female shape of the face.

Is it possible for the lower lip to move upwards after a chin height reduction? Does the smile change?

Yes, if you reduce the height of the chin and you suture the muscle well, the lower lip moves upwards.

Is it safe for titanium screws staying inside my body for long term?

Yes it is. Two of the greatest benefits of titanium are its high strength-to-weight ratio and its corrosion resistance. Couple this with its non-toxic state and its ability to fight all corrosion from bodily fluids and it’s no wonder titanium has become the metal of choice within the field of medicine. Titanium is also incredibly durable and long-lasting. In principal they are not removed anymore and stay in the body. Only in case of an infection on the plates (rare) they will have to be removed.

Another benefit to titanium for use in medicine is its non-ferromagnetic property, which allows patients with titanium implants to be safely examined with MRIs and NMRIs.

With a chin height reduction is there significant sagging of the skin around the chin?

Of course there will be relatively more skin around the chin after a bony reduction of the chin. A hanging chin can however be avoided by meticulous suturing of the muscles of the chin and by wearing of the facemask that Dr van de Ven will provide you with after the surgery for 3 weeks. The facemask gives a strong upward support to the chin. If in spite of these measures the skin is still sagging around the jaw and chin (this happens mostly in elderly patients with less elastic skin) one of the 3 types of facelift that Dr van de Ven performs can bring the solution.

Can a chinplasty or jaw recountouring be performed when you have dental implants in that region?

Dental implants normally have a maximum length of 14mm. Natural teeth are longer. That’s why dental implants never create problems during a chinplasty or jaw recontouring.

Can dental implants still be inserted after a recontouring of jaw and chin?

The removal of bone will be done at the lower border of the jaw, far away from the teeth. So dental implants can be inserted after just as before.

Does bone grow back once it has been cut or shaved down?

In our experience no bone has ever grown back.

Liplift

How visible is the scar?

Initially the scar will be visible as a red line just under the nose, partly hidden inside the nostrils. Because of a technique developed by Dr van de Ven there will be hardly any downward pull caused by the orbicularis muscle (sfincter muscle around the mouth). Therefore the scar will remain thin and after about 12 months it will be difficult to detect.

Lipofilling

How long does the fat stay?

In general 70% of the fat stays forever. Therefore a little overcorrection is done during the operation.  Repetition is needed for about 50% of our patients. There are many factors that determine how long fat grafting lasts. Some fat is always reabsorbed by the body, the amount can vary considerably from body to body. The fat that stays after 6 months, stays forever. After 6 months, if necessary, another fat graft may be performed until the desired effect has been obtained.

Adamsappel-verkleining

How will the scar be after an adams apple reduction?

All incisions leave a small white line in the end.

As this line is placed in an discrete spot (angle between neck and chin), it will be as good as invisible from most angles.

After two weeks nobody should notice from a distance. After 1 year the scar will be completely healed (white).

Hoe lang duurt het meestal voordat de stem na de operatie weer “normaal” is?

De stembanden hebben ongeveer 2-3 weken nodig om normaal stemgebruik mogelijk te maken. We kunnen niet precies zeggen wanneer uw stem weer voor 100% terug is, als u in de uitoefening van uw beroep uw stem veel en/of op een bijzondere manier gebruikt. We hebben geen feedback ontvangen over deze kwestie.

How the swelling and the bruise of the tracheal shave looks after 2 weeks?

In general you will hardly notice anything. But occasionaly (1 every 50 patients) there is some postoperative bleeding, which needs about a 6- 8 weeks to completely dissolve.

Heeft het verkleinen van de adamsappel negatieve gevolgen voor mijn stem?

Dat is de reden dat we een CT-scan maken zodat we precies weten waar de stembanden zich bevinden en hoeveel kraakbeen er kan worden verwijderd. Tot op heden hebben we geen patiënten gehad bij wie deze complicatie zich voordeed.

Het is niettemin mogelijk dat oedeem (zwelling) van de stembanden optreedt, die wordt veroorzaakt door irritatie door het slangetje dat door de anesthesist wordt ingebracht of door de operatie zelf waardoor de stem ongeveer twee weken zwak en/of hees kan zijn.

Facelift

Can a facelift be performed at the same time as a jaw angle reduction?

The swelling after a jaw angle reduction can be massive. That is why a facelift is best not performed at the same time as a jaw recontouring. The results will be suboptimal. We recommend at least 4 months between the two operations. The facelift helps enormously to show off the newly formed jaw and chin, resulting in a very female shape of the face.

How long does it take to completely recover from a facelift?

You should count on not being as socially active as normal for about two to three weeks. The swelling starts to subside on the third day, and is usually hardly visible after a week to ten days. You can go out (for shopping, etc.) from the first day after the operation.

What about smoking?

As smoking counteracts wound healing we strongly advise against smoking during the 3 weeks before surgery until 3 weeks after surgery. Smoking dramatically increases the risk for skin necrosis and should be avoided at all times.

Crotonolie-huidpeeling

Kan de crotonolie op het gebied onder het oog voor kraaienpootjes en oogrimpels worden gebruikt?

De oogleden zijn een uitstekende plek voor gedeeltelijke peelings. De huid van het onderste ooglid reageert heel erg goed op een een peeling met crotonolie. Als de peeling goed is uitgevoerd, is de dunne huid van het ooglid dat omsloten wordt door de randen van de oogkas erg vergevingsgezind en wordt genezing goed getolereerd en kan de peeling ook gemakkelijk worden gecamoufleerd met make-up of met een bril. Een ander voordeel van een peeling van het onderste ooglid is dat de ingreep bij de patiënt eenvoudig is en stukje bij beetje kan worden uitgevoerd onder lokale anesthesie. Als een patiënt een sneller herstel wil, kan een lichtere peeling worden gedaan en in de toekomst worden herhaald met toegevoegd resultaat. Het onderste ooglid wordt zo uiteindelijk naar volle tevredenheid van de patiënt behandeld.

Dit is een van de beste toepassingen van de crotonolie-peeling en is een goed startpunt voor diegenen die aarzelen om aan een algehele peeling van het gezicht te beginnen.

Can a chemical peeling of the whole face also be done without general anesthesia?

We offer a complete chemical peeling in local anesthesia with deep sedation. The anesthesiologist is present, the patient is asleep but breathes spontaneously.

A peeling just around the eyes or just around the mouth can be done without any anesthesia. There will be an absolutely bearable burning sensation that lasts for about 10 seconds. After that the treatment is completely painless.

Ik ben tijdens de afgelopen drie weken behandeld met efudix topische crème 5%, in verband met huidkanker in mijn gezicht. Ik wil graag weten hoelang ik moet wachten voordat ik een peeling met crotonolie kan krijgen.

De huid moet eerst volledig zijn genezen. Ik zou minimaal 8 weken wachten. Een peeling met crotonolie kan trouwens net zo curatief en beschermend zijn als Efudix.

Welke producten of behandelingen moet ik vermijden voor een chemische peeling?

Vermijd een week voor de peeling ontharen/epileren met was, elektrolyse, ontharingscrèmes, en haarverwijdering via laser. In het algemeen dient u alles te vermijden dat huidirritatie kan veroorzaken, waaronder de door ons aan u voorgeschreven medische voorbereidingszalven (5 dagen tevoren stoppen is voldoende).

Hoeveel tijd voor de peeling kan ik een laserbehandeling om haar te verwijderen ondergaan?

U kunt een laserbehandeling om haar te verwijderen ondergaan tot een week voor de peeling. Een week geeft de huid voldoende tijd om te herstellen van deze irritatie.

Veelgestelde vragen over het herstelproces na de operatie

General

How long after the operation should I wait to apply make-up and other creams?

You can start to use make-up and perform your daily cleaning rituals almost immediately on all areas without wounds. For the incision areas you should wait about two weeks.

What happens with the sutures? How long until they dissolve?

How long does it take for the skin sutures to dissolve?

White skin sutures are dissolvable, blue or black ones have to be removed after about 6 – 8 days. The white skin sutures dissolve in 1 or 2 weeks. If they would still be in the skin after 2 weeks they will easily break when you pull with your fingers.

How long does it take for the sutures in the mouth to dissolve?

That normally takes 5 – 7 weeks. If they would still be in your mouth after 7 weeks you can easily remove them just by pulling as they will immediately break.

Wanneer mag ik weer sporten nadat ik FFS heb ondergaan?

Na osteotomie (neuscorrectie, sliding genioplasty (kinverlenging), voorhoofd recontouring type 3) moet u ongeveer 6 weken wachten voor u weer sporten gaat beoefenen waarbij u per ongeluk in uw gezicht kunt worden geraakt. In andere gevallen moet u zelf AANVOELEN of uw lichaam weer klaar is om te sporten.

Als vuistregel zouden we zeggen dat het ongeveer 3 tot 8 weken duurt voordat u na FFS weer kunt gaan sporten. Dit is afhankelijk van de uitgebreidheid van de operatie, uw leeftijd en uw fysieke conditie voor de operatie.

What happens if I need to see a doctor when I return to my home country?

We would advise you to see your GP or the doctor that is on call. We would then discuss the problem with this doctor once you’ve been seen, and recommend the appropriate treatment. In extremely rare cases it might be necessary for you to come to Antwerp.

How do I clean the extra-oral incision areas? What should I do and for how long?

If there are steri-strips covering the wound or you have a bandage you should not touch it and keep it dry. If there are no strips or bandages, extra-oral incision area’s should be cleaned carefully on a daily basis by bathing the area as advised and patting it dry carefully. After about 2 weeks the wounds will be healed enough to begin applying a special ointment to improve the scars. For this we recommend Dermatix gel, which you can buy at any pharmacy. Use this ointment with gentle massage for about 3 months until the scar has matured.

Where will the swelling be?

Immediately after surgery the swelling will be mostly in areas of loose connective tissue (cheeks, lips, around eyes). During the first few days, the swelling will move downwards towards the lower jaw and neck due to gravity. Swelling and bruising differ strongly from one person to another and can be anywhere. Preferential places are around the eyes and in the lips, but can also involve the lower jaw and neck. Bruising may not appear immediately and will gradually fade over the course of several weeks.

How long will I have swelling?

About 80% of swelling will have disappeared after 2 to 3 weeks. For a final result you’ll have to wait up to 1 year.

Can I stay in the sun?

The young scar is very sensitive to the sun´s rays as it contains very few melanocytes. Therefore during the first 6 months after surgery we recommend protecting the scar with a sunblock or to stay out of the sun. During the first week after surgery it’s better to keep out of the sun completely as the risk for infection might be higher if your face and body get too warm.

How long after the operation I should wait until starting facial hair removal procedures again?

After bone surgery the area that was worked on is can be very sensitive to pressure. If this is the case we advice 3-6 weeks to heal from surgery. Some patients on the contrary experience temporary numbness after the surgery and reported us that with electrolysis that was handy, as it didn’t hurt that much.The reason some say to stay away from electrolysis or laser post FFS is to avoid infection. With electrolysis and laser bacteria can get in the bloodstream. And from there to the fresh wounds in your face. But, as the wounds are already exposed to all kind of bacterias in the mouth and on the skin, this argument is not valid in the case of facial feminisation surgery.

Of course the scar itself shouldn’t be lasered or electrolysed. Scars need to heal before they are hit by the laser. This takes until 6 months after the op. You can just get the laser technician to avoid the area.

Forehead recontouring and hairline lowering

When can I start using Minoxidil on my hair after forehead reduction or hairline lowering?

You can start Minoxidil after proper healing of the incision wounds, three to four weeks after surgery.

After a hairline lowering and browlift I now have bumps along my hairline which are irritating, do these settle down?

Those bumps are the Endotines that have been placed just inside the hair to prevent the hairline from pulling back. They will resorb in about a year, sometimes even a bit more.

How long does it take for the endotines to disappear?

According to the manufacturer it takes about 3-6 months for the endotines to absorb. According to our experience it takes about 6-18 months before the endotines dissolve completely.

When can I wash my hair?

Almost immediately. Don’t be alarmed if the wound bleeds a little bit while washing your hair. For wound healing it’s very good to remove all excessive blood cloths and crusts, even better when you use shampoo. Just remember to blow-dry thoroughly and dab with a drying antiseptic, like alchohol, afterwards to eliminate any remaining moisture.

Geeft type 1 recontouring van het voorhoofd het beste resultaat?

Bij 1 op de 3 patiënten bij wie recontouring van het voorhoofd nodig is, zal dr. Van de Ven alleen schaven (type 1). Bij alle andere alle patiënten gebruikt hij de methode type 3, waarbij de voorste wand van de voorhoofdsholte naar achteren moet worden geplaatst. Als dr. Van de Ven voorstelt om type 1 toe te passen, dan doet hij dat omdat hij van mening is dat hij zo het beste resultaat kan behalen en de patiënt kosten kan besparen (type 1 is goedkoper omdat het minder werk is). Als hij tijdens de ingreep tot de conclusie komt dat het voor de patiënt beter is om type 3 recontouring toe te passen, zal hij dat zonder meerkosten doen.

I feel air under my forehead skin after the operation, is this normal?

After a forehead recontouring there is often a connection between the frontal sinus and the space under the forehead skin. If you blow your nose, air can be pushed into that space. If you push the skin with your fingers you can hear a typical crackling sound. This is absolutely harmless.

This air escape will disappear in time when the skin is reattached to the bone. To help this process you will be provided with a forehead mask, which you should wear for two weeks. This mask will push the skin against the bone. Also care should be taken not to blow your nose too hard. After two weeks you can take the mask off and carefully try to blow your nose. If still air escapes to the space under the skin, the forehead mask must be used longer.

How long does it take for the final result to be visible and the blue stains to disappear completely?

After the forehead recontouring procedure patients heal relatively quickly. However, healing is different for every patient. Mostly for this procedure a final result can already be visible after one to two weeks. But if the blue stains are severe (10% of patients, and there is no way to predict to whom this will happen), it can take up to 4 weeks for the blue stains to completely disappear.

Hairline lowering with expander

Jaw and chin recontouring

Will I be able to eat?

If you haven’t had any treatment involving your teeth a sliding genioplasty or orthognathic surgery, you’ll be able to eat normally quite soon. Due to the effects of general anesthesia, you should only feel nausea for the first few hours. You may prefer to eat softer or pureed foods initially if you have intra-oral sutures. Patients should prepare accordingly in advance and purchase juices, yoghurt and soups to have during for the first few days after surgery.
After a sliding genioplasty you should be very careful not to put too much force on the lower jaw e.g. by eating raw meat (steak) or biting an apple. The jaw is really weak in the chin area and it will take about 6 weeks until it has regained it’s original strength.

What happens with the stitches in my mouth?

They dissolve in 5 – 7 weeks. They don’t have to be removed. If they would still be in your mouth after 7 weeks you can easily remove them just by pulling as they will immediately break.

How can I expect the feeling in my chin and lower lip to be after a chinplasty?

After a chinplasty the feeling in the lower lip and chin is always disturbed. If the mental nerve (that comes out of the jawbone just behind the chin and then runs into the lower lip and skin of the chin) has not been ruptured during the surgery, for sure sensitivity will come back. It is not possible however to predict when and to which extent. Mostly the recovery will take between several weeks and several months but it can take up to even 2 years. It is normal that sensitivity of lower lip and chin doesn’t recover completely.

If the mental nerve has been ruptured (in the hands of Dr Bart van de Ven around 1%) it can be sutured. Of course the prognosis will then be worse. Damage to the mental nerve will however not be visible to the outside world as it is a 100% sensory nerve. It doesn’t contain motor branches so function of any muscle is not involved.

Rhinoplasty

Hoelang moet ik wachten voordat ik het uiteindelijke resultaat van een rinoplastiek kan zien?

Na een a rinoplastiek moet u veel geduld hebben. Het kan gedurende de eerste 3 maanden erg opgezwollen zijn. Vooral als een dik type huid hebt, kan het meer dan een jaar duren voordat de zwelling volledig is verdwenen. De neus kan 1 tot 2 jaar na de operatie blijven veranderen.

Hoelang moet ik de neus-vorm dragen?

U dient de neus-vorm gedurende de eerste 3 weken na de operatie zoveel mogelijk te dragen. Let er goed op dat u de neus-vorm in het midden plaatst. Als het pijn doet, dient u het elastische bandje losser te maken en/of de neus-vorm een tijdje niet te dragen.

We raden u aan de neus-vorm na 3 weken elke nacht te dragen tot aan de gebruikelijke check-up 4 maanden na de operatie.

Would it help my nose swelling if I put some tape across it?

The tape helps partly to avoid the swelling from forming. Once the swelling is there, the tape will not let is disappear. Only waiting….Also the nose moulder is not useful for the swelling, this is only to keep the nosebones in place.

Croton oil peel

Hoelang duurt het voordat ik me weer kan scheren?

U moet wachten totdat de huid volledig is genezen. Dat duurt zo’n 10-14 dagen.

A few weeks ago I had a croton oil peel. Now I have some dark spots in my face. What should I do?

These darks spots are signs of postinflammatory hyperpigmentation (PIH). This This is a frequent and transient (so temporary) complication of croton oil peeling. Permanent problems have not been seen. Best is to continue the daily application of tretinoïn- and hydroquinone-ointment that you have received from us before the peeling for 3 to 6 weeks. It will help to remove the hyperpigmentation. Also it is very important for you to stay out of the sun until 6 months after the peeling and use the sunblocker that we gave you.

Hoe lang moet ik na het ondergaan van een chemische peeling wachten voordat ik via laser haren laat verwijderen?

U moet twee weken wachten voordat u een haarverwijderingsbehandeling via laser laat doen. Dit onder de voorwaarde dat alle ontstekingsverschijnselen zijn verdwenen en er geen signalen zijn van verhoogde pigmentatie.

Other procedures

De operatie waarbij een incisie is gemaakt onder de onderste oogleden is nu twee weken geleden en de onderste oogleden worden een beetje naar beneden getrokken. Wat moet ik doen ?

Vaak wordt bij het uitvoeren van de transcutane ooglidcorrectie de orbicularis spier gedenerveerd en wordt de tonus van het ooglid verminderd.  Wanneer de spierspanning terugkomt zal de positie van het ooglid dat ook doen.  Om ectropie (naar buiten gekeerd zijn van het ooglid) te voorkomen moet u twee weken na de operatie het ooglid regelmatig opwaarts masseren: 3 tot 5 minuten (minstens 3 keer per dag). Dit zal de tonus en de positie van het ooglid verbeteren. Het duurt een jaar voor de post-operatieve rijping van een correctie van het onderste ooglid is voltooid.

De operatie waarbij een incisie is gemaakt onder de onderste oogleden is nu twee weken geleden en de onderste oogleden worden een beetje naar beneden getrokken. Wat moet ik doen ?

Vaak wordt bij het uitvoeren van de transcutane ooglidcorrectie de orbicularis spier gedenerveerd en wordt de tonus van het ooglid verminderd.  Wanneer de spierspanning terugkomt zal de positie van het ooglid dat ook doen.  Om ectropie (naar buiten gekeerd zijn van het ooglid) te voorkomen moet u twee weken na de operatie het ooglid regelmatig opwaarts masseren: 3 tot 5 minuten (minstens 3 keer per dag). Dit zal de tonus en de positie van het ooglid verbeteren. Het duurt een jaar voor de post-operatieve rijping van een correctie van het onderste ooglid is voltooid.

What happens with the stitches in my mouth?

They dissolve in 5 – 7 weeks. They don’t have to be removed. If they would still be in your mouth after 7 weeks you can easily remove them just by pulling as they will immediately break.