Stunted calves are due to incomplete development of the three muscles (two superficial and deep) that give her shapely leg. To correct this muscle hypotrophy, the surgeon places, in depth, an elongated implant, silicone gel. The surgeon shapes the léger with fat grafting

Implants: Implants were originally designed to treat the sequelae of poliomyelitis. There are of different lengths (12 to 20 cm) and thicknesses. They adapt to the anatomy of each leg and recreate a harmony between the volume and profile of the thigh, knee and ankle. The location of the implant is crucial for a good cosmetic result, but also it does not move then and it is not seen by transparency under the skin. To position it properly, the surgeon performs first marks on the skin while standing before the patient lying on his stomach. The implants are then introduced through a small incision of 3 cm in a fold placed behind the knee. Depending on the volume to correct, it uses one or two implants and that they are stable enough, he places at depth beneath the muscles. The scar, very discreet, almost invisible after five or six months.

The deal: The procedure takes one hour under local or general anesthesia, and ends with the establishment of adhesive strips to wear for four weeks in stockings. The hospitalization lasts a day and a night. The pain gradually fades in the first week, giving way to a feeling of discomfort that persists a few days. The result, if it is immediate, is slightly distorted due to the edema which is completely resorbed at the end of six weeks. The suites must reduce its activities, restrict movement during the week following the operation and avoid exercising for at least six weeks. Several control consultations are needed: after ten days to three weeks, then every two months for six months and finally to eighteen months. The main risk is phlebitis. Also the stockings are they necessary during hospitalization, as well as massages the calves during surgery and anticoagulants for fifteen days. Displacement prothesis are rare if they were set up by an experienced surgeon. However, this can occur when the patient shows reckless or too eager to resume a normal life.

Results: The results are excellent and are very popular, especially when one has suffered from abnormally skinny legs on which neither sticky nor lampshades and boots that required the constant wearing of pants. That said, it is important that this operation is fully justified.

The buttock implants are used to transform flat buttocks. The implants are filled either with a silicone gel. Round or oval, they are covered with a smooth or irregular silicone membrane (called textured) to avoid travel and fibrous hulls that make it very hard and painful buttocks. The choice of form is based on the desire of each patient, the morphology of her pelvis and buttocks. These implants also exist in different widths .Les implants correct only the upper part of the buttocks, because of the passage of the sciatic nerve in the middle of the buttock. The prothesis is must not be in contact. The operation is performed in the clinic under general anesthesia and takes about an hour and a half. The patient is installed on his stomach before an incision 5 cm in the cleft to introduce the prosthesis, after detachment of the superficial muscles and means. The patient usually stays two nights in the clinic, still lying on her stomach, only permitted with the standing position during the first two weeks position: it should never be sitting on the prothèse.the short scars are hidden in the gluteal fold and easy to correct. This is a slightly painful procedure requiring the taking of analgesics for fifteen days. No return to work before then and no sport for a month and a half. There may be movement of the prothesis, if not rare resumed activity too early which require a second operation. The lifetime of the implant is greater than fifteen.

Buttock augmentation with fat grafting: Many people who desire a fuller, more rounded buttock will opt for a “Brazilian butt lift,” which uses fat transfer to provide a more curvaceous buttock without the use of an implant. Liposuction is commonly used to both sculpt the surrounding area and collect the autologous fat to be injected.

A thigh lift reshapes the thighs by reducing excess skin, and in some cases fat, resulting in smoother skin and better-proportioned contours of the thighs and lower body. It may be indicated in patients who have lost a significant amount of weight or in those that have lose skin elasticity with time and now have a sagging appearance to the inner thigh region. Thighs that have significant fatty deposits may require liposuction to better contour the area. This can be done in a staged manner and sometimes at the same time.
Techniques for thigh lift surgery
There are two primary types of thigh lifts. A medial thigh lift is commonly used to tighten the skin and remove excess fat from the inner thigh region. The incision is made it the inner crease of the leg and hides well. However, the risks with this procedure are greater and can include infection, scar widening or migration, sensory alteration and possible distortion of the labia in women. On larger legs or those with more significant skin excess, a vertical incision thigh lift, along the medial thigh, may be an option to perform the thigh lift procedure.

Recovery following Thigh Lift surgery
Temporary changes in the sensation of the thigh skin are normal after surgery,We will discuss with you what you can expect as far as skin shrinkage and pigmentation changes. This will depend on your skin tone and quality as well as your preoperative proportions.

Some bruising is normal after surgery. This usually goes away in the first few weeks. Your incisions will be noticeable immediately following surgery but they will gradually fade and flatten for up to a year after surgery. You will also have some puckering around the incision after surgery. This will smooth out over a month or two. If your skin has lots of stretch marks or is extremely thin, this is a sign of poor skin elasticity. Patients with poor skin elasticity may be more prone to widening of the scar after surgery. Your skin will also be firm and numb at the outset. It will soften and normal sensation will return gradually.

laser thigh lift without scars and without surgery in Tunisia

DR GHARBI NEDRA is the only surgeon who has introduced the smartlipotriplex cellulaze in AFRICA and TUNISIA, it is possible to do a lifting of the inner side of the thighs or even the other sides of a thigh with laser and WITHOUT SCARS, DR NEDRA GHARBI specialist in cosmetic laser surgery begins with laser liposuction to stimulate the skin thanks to the laser passge so that it produces its collagen and elastin, the skin rejuvenates, shrinks and becomes smoother, the risks are minimal compared to surgical lifting

The results are perfect after a few months. To keep them, we recommend doing targeted gymnastic movements ten minutes a day, and thirty minutes of brisk walking daily.

The movement as well as the iterative lose of weight are “demanding” a lot to the skin of the inner part of the arm. It’s why the number of skin ptosis ( not amenable to an isolated aspiration ) is higher than the simple fat hypertrophies. The aim of the surgery is to take away the excess of skin, to decrease the underneath fat infiltration and to redistribute the skin.

A meticulous clinical examination will determine the more appropriate type of surgical procedure, you need ( choice of incision, associated lipoaspiration indicated or not ). Type of anesthesia
The inner arm lifting can be done under general anaesthesia, under local anaesthesia completed by tranquillizing drugs, injected in veins (“vigil” anaesthetic) or also, in some cases, under simple local anaesthetic.
• THE PROCEDURE

Each surgeon is using his own technique, he may adapt to each case, in order to get the best result.
Different techniques have been described.
The fat infitrated the skin is removed by lipoaspiration. The skin excess is removed, what leaves a scar which location and length depend on the amount the skin laxity and on the procedure choosen.
The skin incision can be vertical, longitudinal,along the arm inner side or horizontal, following a armpit fold. Sometimes, the two types of incisions can be combined.

Arm lifting with longitudinal incision along the arm inner side

At first, a lipoaspiration is done, each time fat is found infiltrating the arm region.
Then, the skin excess is taking away as necessary, with a longitudinal incision along the arm inner side.
Considering the disadvantages of this type of arm lifting, from a scar point of view, we try to propose, as often as possible, a less ambitious surgery but with more acceptable scar: as an arm lifting with an isolated armpit incision or a combined procedure with an armpit incision plus a short vertical one of less than 10 cm.

Arm lifting with horizontal armpit incision
This type of surgery is aimed at a patient with less skin excess and laxity, mainly located at the upper third of the arm.
From a single horizontal incision, hidden in an armpit fold, combined, if necessary, with a lipoaspiration, we can take away the skin excess of the upper part of the arm inner side.
The average time of surgery is one hour.

Because this procedure is lighter than the previous one, we can do it, most of the time, as day care, under

• THE RESULT

It will be appreciated within 6 to 12 months after surgery.
Most of the time, we can see a good correction of fat infiltration and skin laxity, what improves a lot the arm aspect.

Arm lift with laser without scars Tunisia:

DR GHARBI NEDRA expert in cosmetic surgery and laser introduced in TUNISIA the laser arm lift without scars, the procedure using smartlipotriplex  consists in making a laser liposuction through two small hidden points, it tightens the triceps muscle  then it stimulates collagen and elastin in the dermis of the skin , the tightenning  of the skin  begins from the 15th day and continues over a few months. this technique provides revolutional and awesome results WITHOUT SCARS  thats why DR NEDRA GHARBI no longer makes longitudinal and unsightly scarring in the arms since  few years , sometimes and in some extreme cases it ‘s possible to do  a minimal scar in the armpit. To keep the results, we recommend doing targeted gymnastic movements that restore a little volume to the muscles and shapes the  arms.

Abdominal skin and fat excess often alters self confidence.
Liposuction has improved dramatically the outcome of abdominal aesthetic surgery, by reducing the amount and the length of scars.

There are different types of abdominoplasty depending on the patient’s examination.

Usually, there are two groups of patients : one requirering isolated liposuction and another requirering abominoplasty

The aim of this procedure is to remove the impaired abdominal skin (stretched skin, scars, stretch-marks) and tighten the remaining surrounding skin

Localised fat excess can be removed during the same procedure by liposuction and impared abdominal wall muscles may be treated too (widening, herniae).

The standard abdominoplasty (Tummy Tuck) removes a large amount of redundant tissue (skin and fat) from the middle and lower abdominal wall, between the belly button (umbilicus) and the pubic region, according to preoperative planning.

The healthy skin from the upper middle part of the abdomen is then redraped downwards in order to replace the removed impaired skin.

The belly button is preserved and put in its normal position through a hole cut and countoured in the newly draped skin.

This procedure leaves a scar. It’s length and position may vary with the amount and location of skin to be removed.

• THE PROCEDURE

Every surgeon has his or her personal technical habits which he or she adapts to every new case, in order to obtain the best possible results. However, there are common principles:

The position of the skin incisions, which will correspond to the future scars, depends on the amount of skin to be removed. The more skin there is to remove, the longer the remaining scars.

The excessive fat is aspirated with liposuction and the stretched abdominal wall muscles are tightened.

A molding dressing is made at the end of the procedure.
Depending on your surgeon and the extent of fat and skin tissue necessary to remove, the operation takes about 90 minutes to 3 hours.
• AFTER THE OPERATION

It is recommended to wear a pressure garment for 2 to 4 weeks, day and night.
You shall not go to work for 2 to 4 weeks.
The scars are often red during the first 2 or 3 months and progressively become paler starting from the third month onwards, during a period of 1 to 3 years.

• THE RESULT
It can be best appreciated one year after the procedure:
Concerning scars, you should know that they do fade away with time but never completely disappear. The surgeon does the sawing, but scarring is a patient-related process.

However, abdominoplasty offers an often noticeable aesthetic .

Abdominal skin and fat excess often alters self confidence.
Liposuction has improved dramatically the outcome of abdominal aesthetic surgery, by reducing the amount and the length of scars.

• THE RESULT
It can be best appreciated one year after the procedure: During this period, it is recommended to be patient while scars slowly fade, and collaborate with your physician for a regular follow-up consultation every 3 months during one year.
Concerning scars, you should know that they do fade away with time but never completely disappear. The surgeon does the sawing, but scarring is a patient-related process.

However, abdominoplasty offers an often noticeable aesthetic improvement. It enhances the patient’s comfort, quality of life and self confidence, thus helping him or her to reach for a better weight-control.

• POSSIBLE COMPLICATIONS

Abdominoplasty, even if performed for aesthetic reasons, is a genuine surgical procedure, with the consequent risks related to all medical acts, no matter how mild they might appear.
There are surgical and aesthetic complications.

Concerning anaesthesia, the anaesthesiologist will inform you about all the anaesthetic risks. You must be aware that anaesthesia can sometimes cause unpredictable body reactions that can be difficult to control. The presence of an experienced anaesthesiologist, in a surgical environment, means that the risks are statistically practically negligible.
In fact, techniques, products and monitoring methods have progressed considerably over the last twenty years, offering optimal safety, especially when the operation is elective and the patient is in good general health.

Concerning surgery: by choosing a competent and qualified Plastic Surgeon, experienced in performing this procedure, you limit, but do not entirely eliminate, surgical risks.

Liposuction is a popular type of cosmetic surgery. It removes unwanted deposits of excess fat to improve body appearance and to smooth irregular or distorted body shapes. The procedure is sometimes called body contouring.

Liposuction may be useful for contouring under the chin, neck, cheeks, upper arms, breasts, abdomen, buttocks, hips, thighs, knees, calves, and ankle areas.

Liposuction is a surgical procedure with risks, and may it involve a painful recovery.

Tumescent liposuction (fluid injection) is the most common type of liposuction. It involves injecting a large amount of medicated solution into the areas before the fat is removed (sometimes, the solution may be up to three times the volume of fat to be removed). The fluid is a mixture of local anesthetic (lidocaine), a drug that contracts the blood vessels (epinephrine), and an intravenous (IV) salt solution. The lidocaine in the mixture helps to numb the area during and after surgery, and may be the only anesthesia needed for the procedure. The epinephrine in the solution helps reduce the loss of blood, the amount of bruising, and the amount of swelling from the surgery. The IV solution helps remove the fat more easily and it is suctioned out along with the fat. This type of liposuction generally takes longer than other types.

Most patients are satisfied with the result of the surgery.

Your new body shape will begin to emerge in the first couple of weeks. Improvement will be more visible 4 to 6 weeks after surgery. By exercising regularly and eating a healthy diet, you can help maintain your new shape.