Dr Efraim van der Walt - Plastic & Reconstructive Surgeon

05/04/2023

Looking in the mirror, and seeing the tiredness in your face, while you do not feel old? You have heard about face lift procedures, but you are frightened by the long scars and the even longer period of anesthetic that you will need just to make you look and feel better?

The answer is probably in the MACS lift procedure. It has been developed by two plastic surgeons, Patrick Tonnard and Alexis Verpaele.
The quest for shorter and less obvious scars led to the evolution of this procedure.

The main advantage and improvement, besides the shorter scars, is the fact that the lifting is in a vertical direction, and not a horizontal plane as before. It makes sense, as we are fighting against gravity, and not against some mysterious forward pulling mechanism!

In this procedure, which is usually performed under local anesthetic with a bit of sedation, the scar is limited to the area in front of the ear, stretching from the earlobe up to the temple, in or just in front of the hairline. In this way the telltale scarring behind the ears is avoided, as well as the upward shifting of the hairline in front of the ears.

Another advantage is the fact that dissection into the deeper planes of the face is totally avoided, therefore almost eliminating the much-feared damage to the facial nerves which can lead to an asymmetric face.

The fact that the procedure can be performed without an anesthetist and an operating theatre, makes it much more affordable than the conventional face lift procedure. It is however up to the patient: if she or he does not feel comfortable with the procedure being done under local anesthetic, it can be done under GA in a theatre.

It is important to consult with your Plastic Surgeon to determine whether you are a good candidate for the procedure. He or she may tell you that you do not yet have “enough” loose skin to benefit from the procedure or, on the other hand, there might be too much skin in the midface and the neck, so that a more extensive lift will be needed. The vast majority of patients will benefit from the MACS procedure.

Although it will obviously differ from patient to patient, the downtime is usually limited to less than two weeks.

To me the greatest benefit is the natural looking appearance that is achieved. The classical stiff, pulled back and unnatural face is eliminated!

10/03/2023

The quest for a smoother forehead with elegantly lifted eyebrows, has been there forever. The formal surgical procedure, the coronal forehead lift, produces excellent results if executed by a skillful surgeon on the right patient. It comes, however, at a price. A long scar across the scalp, loss of sensation of the scalp behind the scar, and the fact that it usually needs to be done in theatre under general anesthetic, caused people to seek for less invasive procedures, with less scarring .

That lead to the advent of mini brow lifts, thread lifts and endoscopic brow lifts, all which produced variable results. When botulinum toxin finally arrived on the scene, it basically eliminated the need for the brow lift, as it can elevate the brow, and at the same time give a smooth forehead. The negative aspect is the temporary nature of the botulinum injections. Depending on the amount injected, and the skill of the injector, it will only be effective for 3-6 months.

The Brazilian Plastic Surgeon, Dr Fausto Viterbo, came up with a novel technique to elevate the brow and produce a smoother forehead.

Creating the ideal aesthetic eyebrow shape and position is an important goal in facial rejuvenation. One challenge of an eyebrow lift is to find a predictable procedure that balances the advantages and disadvantages of the available strategies. The gliding brow lifting (GBL) is a technique that provides minimal incisions, an effective and stable eyebrow lift, and offers the advantage of precise reshaping of the eyebrow.

The procedure is performed under local anesthetic with a bit of sedation. Two small incisions are made just behind the frontal hairline. Specially designed dissectors are used to loosen the skin of the forehead and release the muscular attachments to the skin.
When the skin is completely loosened, sutures are placed through the skin and muscles right down to the periosteum, a dense fibrous layer covering the bone of the skull. This technique is called the Auersveld mesh. It prevents bleeding after the procedure, and fixate the forehead skin to its new, elevated position. These sutures are left in place for 3-5 days, and then removed.

Downtime is minimal, and the advantage is that, as stated before, the eyebrows can be accurately shaped and asymmetric eyebrows corrected or improved. It also produces a Botox-type effect, with less wrinkling of the forehead.

This procedure is performed by Dr van der Walt with excellent results

18/01/2023

Are you a smoker?

Most people are under the impression that smoking only harms their hearts and lungs. Smoking has more side-effects, of which includes the healing of wounds, the most important in the field of plastic and reconstructive surgery.

A single puff of a cigarette closes up your arteries. This means that the necessary oxygen and nutrients for healing a wound are temporarily unable to reach the wounded area. Thus the healing process gets prolonged.

This means that wounds will struggle to fully heal or not heal at all. In some cases it even kills tissue in the wounded area with the consequences being increased scarring.

In the case of an emergency surgery, that cannot be delayed, you can help your body improve its healing ability by even reducing the amount that you smoke before and after the surgery. However, the best results will come through completely "kicking the habit".

In the case of cosmetic surgery, it will be best to postpone the surgery until you are at least 6 weeks clean from smoking. If that is not possible, you will have to make peace with the fact that you will have increased scarring.

Certain procedures such as the abdominoplasty - "Tummy Tuck", Face lifts and breast reconstruction - "Flap Procedure" are not performed on smokers by Dr Van der Walt as the risk is too great.

Smoking also accelerates aging of the skin at an upsetting rate.
In the interest of your own health and appearance, we plead with you to:

PLEASE STOP THIS HABIT!

23/11/2022

A cancer diagnosis is very difficult to accept. Understanding that treating your skin cancer may result in scars or disfigurement can also be troubling. Your plastic surgeon understands your concerns and will guide you through treatment and explain the resulting effect on your health and appearance.

Skin cancer, much like any form of cancer, may require surgery to remove the cancerous growth. Your plastic surgeon can surgically remove cancerous and other skin lesions using specialized techniques to preserve your health and your appearance.
Although no surgery is without scars, your plastic surgeon will make every effort to treat your skin cancer without dramatically changing your appearance.

Contact Dr Efraim van der Walt today.

17/11/2022

As we age, we develop lesions that may be skin cancer. This is especially true in individuals who have had excessive sun exposure as a teenager. It has been proven that one severe sunburn during adolescence contributes to the development of subsequent skin cancers.

Most basal and squamous cell cancers (as well as pre-cancers) are treated by dermatologists – doctors who specialize in treating skin diseases. However if the cancer is more advanced and removal may cause more severe scarring or require reconstruction, you might require a plastic surgeon. A plastic surgeon can surgically remove cancerous and other skin lesions using specialized techniques to preserve your health as well as your appearance. Although no surgery is without scars, your plastic surgeon will make every effort to treat your skin cancer without dramatically changing your appearance.

With summer officially here, make sure you check regularly for any skin irregularities.

20/10/2022

Whether it’s been 20 days or 20 years since your Lumpectomy or Mastectomy, you’re likely a candidate for reconstruction.

More than 70 percent of women who forgo reconstruction at the time of their breast surgery don’t know it’s an option, don’t have access to a plastic surgeon, or are focused and worried about managing their diagnosis.

In light of Breast Cancer awareness month, here are some things you might not know about delayed breast reconstruction.

Contact us for more information.

Source: Johns Hopkins Medicine.

17/10/2022

Breast Reconstruction Surgery

Breast Reconstruction is surgery to recreate breasts after a mastectomy or lumpectomy. There are several types of breast reconstruction. Some techniques use implants, others use tissue from your body (such as the belly) to form a breast. Breast reconstruction can happen right after a mastectomy or much later and you may need multiple surgeries over several months.

How do I know what type of breast reconstruction surgery to get?
Your provider will recommend the most appropriate technique for you based on your age, overall health and lifestyle. The kind of mastectomy or lumpectomy you had and how much tissue remains as well as whether you need additional treatments for breast cancer (such as chemotherapy or radiation) will also play a role.

What are the advantages of breast reconstruction surgery?
Breast reconstruction surgery can improve self-confidence after a mastectomy or lumpectomy, and many people feel better about how their clothes fit and are more comfortable wearing a swimsuit.

What are the risks or complications of breast reconstruction surgery?
As with any surgical procedure, risks of breast reconstruction include infection and bleeding. Results vary depending on the type of procedure and how much tissue remained after breast cancer surgery and radiation. After surgery, you’ll probably have little or no sensation in your newly reconstructed breasts. Over time, you may regain some sensation in the skin. But it won’t feel like it did before.

When can I go back to my usual activities after breast reconstruction surgery?
Everyone recovers from surgery differently. Your recovery time depends on several factors. These include your overall health and the type of procedure you had. You will need to avoid lifting, exercising or doing some activities for a while to give your body time to heal. Talk to your provider about when you can get back to the activities you enjoy.

Do you need more information? Contact us today!

In my practice, I strive for excellence in the care of each patient. We all want every patient to ha

17/10/2022

Let’s get it off our chests… October Breast Cancer Awareness Month

Breast cancer is a serious disease that affects millions of people and their loved ones each year — in fact, it’s the second most common type of cancer in women after skin cancer. Research has shown that a regular Breast Self-Examination (BSE) and regular screenings plays an important role in discovering breast cancer, compared to finding a breast lump by chance. While not all breast lumps indicate cancer, they should be investigated. It’s vital to educate yourself and get to know the warning signs and symptoms.

20/09/2022

A very informative article on Tummy Tucks on a Budget by MediFin Financial Services.

For more information on this procedure, visit https://medifin.co.za/blog/tummy-tuck-on-a-budget/ or contact our practice.

Losing abdominal fat can be a real pain, whether it's caused by weight gain, pregnancy, or simply getting older. A tummy tuck procedure can help...

20/09/2022

After more than 25 years Dr Efraim van der Walt still strives to serve the entire community of the central region of South Africa.

Operating at Life Rosepark Hospital, Bloemfontein Mediclinic, 3 Military Hospital Cureday Day Clinic and Citymed Day Hospital at Preller Square in Dan Pienaar and still involved on a part-time basis as a consultant at the Department of Plastic and Reconstructive Surgery at the University of the Free State. Dr Efraim van der Walt is member of the Association of Plastic and Reconstructive Surgeons of South Africa (APRSSA), member of the South African Cleft Lip and Palate Society, as well as an active member of ISAPS (the International Society of Aesthetic Plastic Surgeons).

In my practice, I strive for excellence in the care of each patient. We all want every patient to have a positive experience of this wonderful branch of medicine, in spite of the pain and discomfort that they might encounter during their treatment.

20/09/2022

Whether you’re just looking after your health or want to show off your beach body once again, MediFin have got the perfect tummy tuck loan just for you this September.
Find out more here: https://medifin.co.za/tummy-tuck/

For more information on this procedure, visit https://medifin.co.za/blog/tummy-tuck-on-a-budget/ or contact our practice.

16/09/2022

A tummy tuck, sometimes referred to as an abdominoplasty, is a cosmetic procedure that changes the way the abdomen looks and feels.

Excess skin and fat are removed from the abdomen during a tummy tuck and connective tissue in the abdomen are usually tightened with sutures as well. The remaining skin is then repositioned to create a more toned look.

From wanting excess skin removed to improving your self-confidence, there are a variety of reasons people get tummy tucks.

We are proud to be partnered with MediFin, who offer life-changing medical finance. Visit https://medifin.co.za/tummy-tuck/ for more information or contact our practice.

Losing abdominal fat can be a real pain, whether it's caused by weight gain, pregnancy, or simply getting older. A tummy tuck procedure can help...

29/08/2022

This year's 10th Annual Best of Bloemfontein Reader's Choice Awards are open!

Your vote would mean a lot! Dr Efraim van der Walt can be nominated in the Medical Section of the Living in Bloemfontein Category under Best Medical Doctor/Specialist.

Voting closes on 12 September 2022.

Follow the link to vote
https://www.bloemfonteincourant.co.za/.../living-in.../

We're talking the hottest faces and places in Bloem...

10/08/2022

After 25 years in practice this is still what drives Dr. Efraim van der Walt to serve the community of the central regions of the Free State. Located in Bloemfontein he specialises in Aesthetic and Cosmetic surgery as well as Reconstructive surgery.

“𝐼𝑛 𝑚𝑦 𝑝𝑟𝑎𝑐𝑡𝑖𝑐𝑒, 𝐼 𝑠𝑡𝑟𝑖𝑣𝑒 𝑓𝑜𝑟 𝑒𝑥𝑐𝑒𝑙𝑙𝑒𝑛𝑐𝑒 𝑖𝑛 𝑡ℎ𝑒 𝑐𝑎𝑟𝑒 𝑜𝑓 𝑒𝑎𝑐ℎ 𝑝𝑎𝑡𝑖𝑒𝑛𝑡.” - 𝐷𝑟. 𝐸𝑓𝑟𝑎𝑖𝑚 𝑣𝑎𝑛 𝑑𝑒𝑟 𝑊𝑎𝑙𝑡

10/08/2022

“𝑰𝒕 𝒊𝒔 𝒕𝒉𝒆 𝒅𝒊𝒗𝒊𝒏𝒆 𝒓𝒊𝒈𝒉𝒕 𝒐𝒇 𝒆𝒗𝒆𝒓𝒚 𝒉𝒖𝒎𝒂𝒏 𝒃𝒆𝒊𝒏𝒈 𝒕𝒐 𝒍𝒐𝒐𝒌 𝒉𝒖𝒎𝒂𝒏”

These were the words that inspired me to become a plastic surgeon.
Although my interests were mainly in Reconstructive surgery at first, I realised that it requires artistic skills and three dimensional insight and planning from the Plastic Surgeon. These same skills are needed in Aesthetic or Cosmetic surgery, and it was a natural evolution out of the reconstructive field to Aesthetic and Cosmetic surgery. Because there are constant demands for arresting the ageing process and for more perfection in the field of reconstruction, the specialty develops and expands daily.

After 25 years in practice, I still strive for excellence in the care of each patient. We all want every patient to have a positive experience of this wonderful branch of medicine.

I look forward to welcoming you to my practice soon.

In my practice, I strive for excellence in the care of each patient. We all want every patient to ha

10/08/2022

05/08/2022