Plastic Surgery — Town Hospital

Plastic and reconstructive surgery at Town Hospital: an overview

Town Hospital's Plastic and Reconstructive Surgery department in the Fifth Settlement, New Cairo, deals with operations that concern both how the body looks and how it works: from liposuction, body contouring and surgery of the nose, face and breast, to repairing the scars and deformities left behind by accidents, burns and earlier operations. Cosmetic and reconstructive surgery are two sides of one specialty, using the same surgical skills whether the aim is a better appearance or a restored function. The department's doctors specialise in plastic and reconstructive surgery; you will find them in the list of doctors below.

Operations are done in the hospital's operation theatres. Smaller procedures that need no overnight stay are done in the day-care unit; patients who need longer observation stay overnight, and the intensive care unit is there for anyone whose condition calls for it. The laboratory and radiology run 24 hours a day for the tests needed before surgery, and the emergency department is also open 24 hours a day. The outpatient clinics are open every day from 10 am to 10 pm; each doctor's clinic days and times are shown in the up-to-date clinic schedule.

Conditions and procedures the department looks after

After the consultation, the surgeon decides whether surgery is suitable at all, which approach fits your case, and what can realistically be expected from it. These are the reasons patients most often come to the department.

Liposuction and body contouring

Liposuction removes localised pockets of fat that do not respond to diet and exercise, on the abdomen, waist, thighs, arms or under the chin, through small openings and a thin tube. It is not a treatment for obesity and not a substitute for losing weight: it suits people whose weight is close to normal and stable and whose skin still has its elasticity. It is done under local or general anaesthesia depending on the size of the area. Swelling and bruising appear in the first weeks, the result then emerges gradually over several months, and it differs from one person to another according to skin type, weight and lifestyle after the operation.

Tummy tuck and body contouring after weight loss

After a large weight loss, whether through bariatric surgery or dieting, or after pregnancy and childbirth, loose excess skin may remain on the abdomen that liposuction alone cannot deal with. The department then offers a tummy tuck (abdominoplasty): it removes the excess skin and fat and tightens the abdominal wall muscles if they have separated, leaving a horizontal scar low on the abdomen that fades with time but never disappears completely. Your weight usually needs to have been stable for several months beforehand and you need to have stopped smoking. It involves an overnight stay and a recovery of several weeks during which you avoid strain and heavy lifting.

Rhinoplasty

Rhinoplasty reshapes the nose, for example its size, a hump on the bridge or the shape of the tip. When breathing through the nose is difficult because of a deviated septum, the septum operation and sinus surgery are the work of the ENT department, and the two doctors decide whether both are done in one session or in two stages. Nasal allergy and sinus problems are medical conditions looked after by the ENT department, not by plastic surgery. The surgeon plans the operation after examining the nose inside and out and discussing what you want against what can actually be achieved while keeping the airway open. Swelling lasts for the first weeks, and the final shape of the nose takes about a year to settle, so the result is not judged before then.

Facial procedures: eyelids and face lift

With age, the skin of the upper eyelids loosens until it sometimes weighs on the eye, puffiness appears under the eyes, and the skin of the face and neck slackens. Eyelid surgery deals with the excess skin and fat around the eye and can widen the field of vision when drooping skin blocks part of it, while a face lift tightens the slack tissues of the mid-face, jawline and neck. The incisions are hidden as far as possible in the natural creases of the skin, and the surgeon shows you where the scars will be before the operation, because every operation leaves a scar, however small. The aim is a more rested, natural appearance, not a change in your features.

Breast surgery: reduction, lift and reconstruction

The department deals with reduction of large breasts that cause neck, back and shoulder pain or skin irritation underneath, with lifting of breasts that have drooped after breastfeeding or weight loss, and with correcting a marked difference between the two sides. The department also reconstructs the breast after all or part of it has been removed for a tumour, with the body's own tissue or with implants, either in the same operation as the removal or some time later, in coordination with the treating surgeon in the general surgery department, which handles the diagnosis of breast lumps and the removal surgery. Before any breast operation there is a clinical examination and the imaging appropriate to your age.

Scar and burn reconstruction

Wounds and burns may heal with scars that are thick, raised or contracted, pulling on the skin and limiting the movement of a nearby joint, especially on the hand, neck and armpit. Treatment usually starts with non-surgical measures, such as pressure, moisturising and local injections as the surgeon sees fit, and when these are not enough the options are revising the scar surgically, or releasing the contracture and covering the area with a skin graft from elsewhere on your own body or with neighbouring tissue. The realistic aim is a better-looking scar and a better-working area, not removing the scar altogether: no operation can erase a scar completely.

Reconstruction after accidents

Accidents can leave deep wounds on the face, hand or limbs that expose the bone or tendon underneath, take away an area of skin, or cut through tendons or nerves. The surgeon assesses whether the wound needs reconstruction, such as covering it with a skin graft or neighbouring tissue, and facial wounds are repaired with both appearance and function in mind. Hand injuries that involve fractures are the work of the orthopaedic department, and many hand injuries need both specialties together. After any hand operation the hand needs a period of splinting and then gradual exercises to recover movement, and the outcome depends on the type of injury, how quickly it was treated and how closely you keep to the follow-up.

Removal of skin lesions

Among the small procedures a plastic surgeon sees are the removal of moles, skin tags, sebaceous cysts and benign lumps under the skin when they are troublesome, changing or in a visible place. Most are done under local anaesthesia with no overnight stay, and the removed tissue is sent to the laboratory for examination when needed. Any mole that changes in colour, size or shape, or starts to bleed or itch, needs a medical examination before it is removed, not after, because the way it is removed depends on what it is.

What is available in the hospital

• Operation theatres: for operations under general anaesthesia, with an anaesthesia team that assesses you before the operation and follows you afterwards. Details on the operation theatres page.
• Day-care unit: for small and medium procedures after which you go home the same day, such as removing skin lesions and revising scars. Details on the day-care page.
• Inpatient stay and intensive care: you stay overnight after the larger operations, and the intensive care unit is available for cases that need close monitoring.
• Laboratory and radiology: blood tests and imaging before surgery, and an ECG when needed, in a laboratory and a radiology department open 24 hours a day. Details on the Diagnostics page.
• Emergency department: open 24 hours a day for wounds and injuries other than burns.

When you need emergency care straight away

Call an ambulance or go to the nearest emergency department straight away for:

• A large burn, or any burn on the face, hands, joints or genitals, or an electrical or chemical burn: go to the nearest hospital with a burns unit, as Town Hospital does not receive burn cases.
• A deep hand wound where you cannot move a finger or have lost feeling in it, or a finger that has been partly cut off; put the severed part in a clean sealed bag and then on ice, without letting it touch the ice.
• Bleeding that does not stop after ten minutes of direct pressure on the wound.
• A facial wound that is deep or wide, or that involves the eyelid, lip or ear.
• After any cosmetic operation: sudden swelling or pain on one side, fever, spreading redness around the wound or discharge from it, breathlessness, chest pain or a painful swollen leg.

Town Hospital's emergency department is open 24 hours a day for wounds and injuries other than burns.

Before and after surgery: your care, step by step

• Consultation: the surgeon asks what you hope to achieve and about your health history, such as smoking, diabetes, bleeding or clotting problems, previous operations and medicines, examines the area, and explains what can and cannot be achieved, the possible risks and the alternatives, including not operating. If your expectations go beyond what surgery can deliver, the surgeon says so plainly.
• Tests: blood tests and any imaging needed, with an ECG and an anaesthesia assessment before operations under general anaesthesia, all done in the hospital.
• Decision and preparation: the decision is made together with you, after enough time to think it over. Stopping smoking several weeks before surgery reduces wound-healing problems; medicines that increase bleeding are reviewed with the doctor, and you never stop a medicine on your own; the fasting instructions are explained, and you arrange for someone to accompany you.
• Surgery: done in the operation theatres or the day-care unit according to its size, and the surgeon tells you beforehand whether you go home the same day or stay overnight.
• The first weeks: swelling, bruising and numbness of the skin around the wound are expected and settle gradually. You may be asked to wear a compression garment, to care for the wound the way the team shows you, and to avoid strain, heavy lifting and sun exposure. The result is not judged at this stage.
• Follow-up: visits to remove stitches, check healing and look after the scar. The final result becomes clear after months, and after about a year for rhinoplasty. Results differ from one person to another, and some cases need a later adjustment; that possibility is discussed before surgery, not after it.

The hospital is contracted with more than 40 payers, including insurance companies, professional syndicates and government bodies. Cover depends on the payer and the terms of the contract, and may not include cosmetic operations.