the form of ‘mummy makeover’ surgery forwomen who are dissatisfied with thesechanges, giving them the opportunity torestore their pre-pregnancy appearance. Amummy makeover refers to a combination ofplastic surgery procedures that are chosen byyou and your surgeon in order to address thechanges to your post-pregnancy body. Themost commonly performed proceduresduring a mummy makeover include breastaugmentation, breast lift with or withoutimplants, breast reduction, full or minitummy tuck, and liposuction, and fattransfer. However, there are many additionaltreatments such as thigh lift or cosmeticinjections that can be performed during amummy makeover, depending upon yourspecific concerns.

For many women, whilst giving birth is undoubtedly a wonderful experience, they may find that their body has changed as aresult. Whilst diet and exercise alone can often help to rectify this, many women find that it can be a struggle to get back to how they were pre-pregnancy. Happily, at Nuffield Health Bristol Hospital, The Chesterfield, help is at hand.

Here we learn more about surgical options which may be of interest to new mothers.

Surgery Preparation

During an initial consultation, MrsProusskaia will discuss your post-pregnancybody goals and procedure options. Whendiscussing the areas of your body that youwould like to improve, it is important foryou to be as specific as possible so that shecan advise you on the most suitableprocedures for your needs. The number andvariety of treatments you choose as well asyour general health will determine whetheryour mummy makeover will be completed asone combined procedure, or as a series ofsurgeries performed over a greater period oftime. If combined into one stage, themummy makeover typically lasts from threeto six hours, but the actual length of the

MUMMY MAKEOVERADVERTISEMENT FEATURE

Many women experiencesignificant physicalchanges followingpregnancy and breast-feeding, many of which

can be persistent and difficult to correct withdiet and exercise alone. Changes to thevolume and shape of the breasts, stretchmarks and sagging of the abdominal skin, aswell as fat accumulation on the hips, thighs,and love handles are all common results ofpregnancy and nursing.

Consultant Plastic, Reconstructive andCosmetic Surgeon, Mrs Elena Prousskaia atNuffield Health Bristol Hospital, TheChesterfield, is very familiar with thesechanges, having seen them in many of herpatients. She therefore offers a solution in

76 THE BRISTOL MAGAZINE | OCTOBER 2016

Nuffield dps.qxp_Layout 1 12/09/2016 12:28 Page 1

surgery depends upon the number and typeof procedures being performed. Prior tosurgery, your surgeon will draw incisionlines on your breasts, abdomen, and outerthighs. You will be placed underanaesthesia. Your anaesthetist willadminister general anaesthesia which causesyou to sleep during the procedure.

We will now take a look at some of themost common mummy makeoverprocedures.

Breast Enhancement

Following pregnancy, breast appearance canbe dissatisfying for many women as thephysical demands of childbirth and nursingcan change breast shape and volumedramatically. Some women find that theirbreasts sag and lose significant volume afterpregnancy and breast-feeding. Dependingupon the amount of remaining breast tissue,breast augmentation, a breast lift, or abreast lift with implants is necessary inorder to return breasts to their pre-pregnancy state. Alternatively, some womenfind that their breasts are excessively largeand disproportionate to their body sizepost-pregnancy. In these cases, a breastreduction is required in order to alleviatediscomfort and achieve more balanced andshapely breasts.

Tummy Tucks

Pregnancy can affect the abdominal areadramatically. Abdominal muscles often pullapart and can be separated permanently,requiring surgical closure and tightening torestore the abdomen to its pre-pregnancystate. Additionally, abdominal skinundergoes significant stretching duringpregnancy, often resulting in stretch marksand loose, sagging skin. These conditionsmay persist despite proper diet and exercise,and can make the abdomen appeardisproportionate with the rest of the body.

A tummy tuck, or abdominoplasty, canrestore the appearance of a firmer, flatterabdomen. A full tummy tuck removesexcess fat, loose skin, and stretch marks, as well as tightens the muscles in theabdominal wall. Alternatively, a minitummy tuck concentrates on removingexcess fat, loose skin, and stretch marksbelow the navel.

Liposuction

Often the weight gain that accompaniespregnancy can be difficult to lose afterward.Post-pregnancy, it is common for women tohave excess fat accumulation on the hips,thighs, and love handles, but almost anypart of the body can be affected. Most bodyfat is located on top of muscle tissue, justbeneath the skin. Blood vessels supply thearea with blood, and nerve endings provide

sensation to the skin. The amount of fat thataccumulates under the skin varies dependingupon inherited traits, body type and lifestylefactors such as exercise and diet.

Liposuction works by removing the excessfat surgically, resulting in improved contoursin the desired areas.

Recovery

The mummy makeover is often performed intheatre with a 1-2 night stay depending onwhich procedures are undertaken. You willneed to wear special garments, which help to

Nuffield Health Bristol HospitalThe Chesterfield, 3 Clifton Hill, Clifton, Bristol BS8 1BN

Tel: 0117 405 8978 • www.nuffieldhealth.com/hospitals/bristol

THEBRISTOLMAG.CO.UK | OCTOBER 2016 | THE BRISTOL MAGAZINE 77

ADVERTISEMENT FEATURE

reduce swelling by preventing fluid build-up,while providing comfort and support duringyour recovery. Swelling, bruising, anddiscomfort are normal, and you may beprescribed medication to manage your painas you heal. Bandages will likely be removedwithin the first week following surgery,normally all the sutures are dissolvablesutures and do not need to be removed. Youmay be instructed to wear the compressiongarments and to avoid excessive exertion orheavy lifting for a month or more, but isimportant to discuss your recovery plan withyour surgeon as your healing process willdepend upon your specific procedures.

About Mrs Prousskaia

After completing eight years of training inPlastic and Reconstructive Surgery, MrsProusskaia successfully undertook threeyears of one of the UK’s most prestigiousFellowships in Microsurgical BreastReconstruction and Breast OncoplasticSurgery at Guys and St Thomas Hospitalsin London, Manchester UniversityHospital, Broomfield Hospital inChelmsford and The Queen VictoriaHospital in East Grinstead.

This was followed by a further ninemonths of travelling fellowships abroad, ina number of world renowned centres,including: The University Hospital in Ghent(Belgium), Sant Pau Hospital in Barcelona(Spain), Ganga Hospital in Coimbatore(India), The European Institute of Oncologyin Milan (Italy) and The UniversityHospital in Tokyo (Japan), where she learntabout the latest, international advances inPlastic Surgery.

She holds many international awards andcertificates, specialising in Microsurgery,Breast, Lymphoedema and all aspects ofCosmetic Surgery.

Talking about her work as a surgeon,Mrs Prousskaia says: “The one thing thatmatters most to me when I am with apatient is empathy. It is only when you areable to identify and understand yourpatients’ problems that you can begin tohelp resolve them satisfactorily. A goodsurgical outcome is not the only thing thatmatters. Everything that you do and say toa patient has to come from your heart. Iconsider myself very lucky to be able toshare my passion for what I do andhopefully bring a bit more happiness intomy patients’ lives”.

If you would like to learn more aboutthe mummy makeover, or cosmeticsurgery in general, Mrs Prousskaia isholding a free information evening atNuffield Health Bristol Hospital, TheChesterfield on Wednesday, 26thOctober at 6.15pm. Free parking isavailable and light refreshments will be provided. Spaces are limited andbooking is essential. Please call 0117 405 8978 to book your place or visitnuffieldhealth.com/hospitals/bristol/events to learn more.

Mrs Prousskaia also offerscomplimentary ten minute mini advicesessions on an on-going basis. Whilstthese do not replace a full consultation,they are a great way of getting someinitial expert advice. To book yoursession please call 0117 405 8978 orvisit nuffieldhealth.com/consultants/elena-prousskaia-peregudova to learnmore.

Nuffield dps.qxp_Layout 1 12/09/2016 12:28 Page 2

Mr Baker is a Consultant Orthopaedic Surgeon at Nuffield Health Bristol Hospital, The Chesterfield, who specialisesin hip and knee joint replacement surgery for the treatment of osteoarthritis. Here he discusses osteoarthritis,

its symptoms, diagnosis and treatment. We also find out more about Nuffield Health’s ‘Recovery Plus’ – a unique programme designed to speed up your recovery after surgery, getting you back to the life you love.

LET’S TALK ABOUT HIP AND KNEE SURGERY

ADVERTISEMENT FEATURE

Nuffield dps.qxp_Layout 1 12/09/2016 12:28 Page 3

Osteoarthritis is the mostcommon condition to affect ahuman joint. It can affect thesmallest through to the largest.Essentially the joint has “wornout”. A number of

predisposing conditions or traumatic injuries mayprecipitate this degenerative condition, but in themajority of cases, a cause is not identified. Itoccurs more frequently as we age, accelerating infrequency in patients over the age of 40. It isestimated that over 4 million people in the UKhave osteoarthritis of the knee and a further 2.5million of the hip.

Osteoarthritis occurs when the articularcartilage, which lines the joint, is graduallydamaged. The articular cartilage is needed todecrease friction as a joint moves. With damage,the articular cartilage loses its smooth glidingsurface and the joint surfaces become rough.Eventually all the cartilage is lost and the joint isleft with bone articulating on bone. Sadly, thesechanges are irreversible.

Typical symptoms of an osteoarthritic joint arepain (made worse with exercise), swelling,stiffness and night pain. When the knee or hipare osteoarthritic, a patient will notice slowing oftheir walking speed and a decrease in thedistances they can cover before pain limits them.

In early osteoarthritis, simple treatments areappropriate. These include painkillers,physiotherapy, walking aids, weight loss andinjections into the affected joint. Whenosteoarthritis is established and causes significantdiscomfort joint replacement is often needed.Thankfully joint replacement is a successfulprocedure. Hip replacement is often quoted asbeing one of the greatest medical inventions ofthe 20th century. Indeed, in 2015 100,000 hipand 105,000 knee replacements were performedin the UK.

When a joint is replaced the damaged jointsurfaces are removed and replaced with artificialcomponents. In the case of a hip replacement,replacing the socket with a cup and placing astem into the patient’s thigh bone to recreate aball and socket joint. A spherical head is appliedto the stem and this articulates with the cup.

In a complete knee replacement, the ends ofthe thigh and shin bones are removed andreplaced with metal components. A polyethylenebearing is positioned between the twocomponents and finally the kneecap is resurfacedwith a polyethylene button. Partial kneereplacements exist and these address disease thatis localised to one side of the joint only.

Mr Baker holds regular knee and hip clinics at

the Nuffield Health Bristol Hospital, TheChesterfield. To find out more or to book aconsultation, please call 0117 405 8978 or visitnuffieldhealth.com/consultants/mr-richard-baker

Recovery Plus – getting you back to the life youlove

Recovery Plus is an optional 3 month enhancedrecovery programme that starts after you havefinished your post-operative physiotherapyfollowing on from a procedure. It enables you tocontinue your recovery at your local NuffieldHealth Fitness & Wellbeing Centre, at no extra cost.

Everyone’s recovery is different. We work withyou to understand what you want to get out ofrecovery. Whether it is getting back to a weeklyround of golf, tending to the garden, or playingwith the grandchildren, our priority is gettingyou back to doing the things you love doing.

The Recovery Plus journey is a programmetailored around you. After surgery ourphysiotherapist will guide your post-operativerehabilitation, both as an inpatient and anoutpatient. Once your recovery has progressedand you are getting about relatively easily,regular low impact exercise can make a bigdifference to your recovery. Suitable exercises,together with activities such as walking,

Nuffield Health Bristol HospitalThe Chesterfield, 3 Clifton Hill, Clifton, Bristol BS8 1BN

Tel: 0117 405 8978 • www.nuffieldhealth.com/hospitals/bristol

If you would like to learn more about hip or knee replacements, ourspecialist Consultant Orthopaedic Surgeons are holding free information

evenings this autumn at Nuffield Health Bristol Hospital, The Chesterfieldwhere you can come along for some free expert advice. Tours of the hospital

will be available, and light refreshments will be provided. The hipreplacement information evening is taking place on Thursday 22nd

September at 18:15, and the knee replacement information evening is onThursday 13th October at 18:15.

Spaces are limited so please call 0117 405 8978 to reserve your place or visitnuffieldhealth.com/hospitals/bristol/events for more information.

THEBRISTOLMAG.CO.UK | AUGUST 2016 | THE BRISTOL MAGAZINE 73

swimming and stationary cycling, can help youto regain strength, movement and flexibility.Normally these activities are done alone, and youmay feel worried that you are not exercisingcorrectly. However, through our Recovery Plusjourney we’re with you every step of the way,helping you progress at your own pace. You willbe given a tailored exercise plan, stretching over3 months, which includes membership to yourlocal Fitness & Wellbeing Centre. Prior tostarting your exercise plan you will also receive aHealth MOT – a health check delivered by ourrecovery coach. This will allow us to tailor theprogramme to achieve the right results for youand to meet your needs in line with yourconsultant's and physiotherapist's advice. Thisensures activities, exercises and levels ofprogression will be carefully chosen to ensuresafe and effective progress.

Throughout the 12 week programme you alsowill have access to nutritional advice, as ahealthy diet will help you towards a goodrecovery. It doesn’t matter if you haven’texercised in years, are nervous about using theequipment or are nervous about going to a gym,our exercise professionals will ensure you areworking in line with your personalisedprogramme and there will be always someone onhand to explain things, so that you feelcomfortable and confident.

Recovery Plus is the first programme of itskind in the UK and our Consultants tells us thatnot only does it improve a patient’s experience, itimproves recovery rates too. The professionals atour Fitness & Wellbeing Centres, who have allreceived additional training from experiencedphysiotherapists, will monitor your progress,ensuring that your care doesn’t stop when youleave the hospital or have completed your post-operative physiotherapy.

To find out more about Recovery Plus, pleasedon’t hesitate to contact Nuffield Health BristolHospital, The Chesterfield, on 0117 405 8978for a confidential discussion. Alternatively pleasevisit nuffieldhealth.com/hospitals/bristol for moreinformation.

Richard Baker and Steve Tolchard

Nuffield dps.qxp_Layout 1 12/09/2016 12:28 Page 4