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The two main categories of breast implants are silicone gel or saline-filled implants. Silicone gel implants have been popular since the early 1960s, and they have gone through multiple generations of improvements since that time. Silicone gel implants have undergone rigorous studies which have shown they are safe and do not cause breast cancer nor connective tissue disorders.

The main advantage of silicone implants is that they feel more natural than saline implants. Gel implants are less prone to rippling than saline, which makes them particularly advantageous for thin patients. The current 5th generation of silicone implants are cohesive, meaning that the gel is viscous enough that even if the implant ruptures the gel tends to remain in the same place, a little like jelly. Previous generations, the silicone was more like thick maple syrup.

Saline (ie. saltwater) implants have a long record of safety too and are less expensive than silicone gel implants. They are generally placed when they are empty and filled once they are inside the breast pocket, so that the access incisions may be even smaller. When a saline implant leaks, most of the saline from the implant is rapidly and harmlessly absorbed by the body. The deflation is usually obvious, and the patient returns for removal and replacement of the saline implant. This may be done under local anaesthesia if the patient is an appropriate candidate. The primary disadvantage of saline implants is that they don’t look or feel as natural as the silicone gel implants. This is a particularly important issue for women who are thin or have decreased elasticity of their skin.

 To learn more about breast augmentation, request a consultation by contacting us at 13000DRTIM or emailing us at info@drtim.com.au 

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An abdominoplasty (tummy tuck) procedure involves the following steps:

  1. Removing a large amount of lower abdominal skin (and stretch marks)
  2. Removing a large amount of lower abdominal fat
  3. Tightening the rectus abdominis muscles of the abdomen
  4. Redistributing the upper abdominal skin over the entire abdomen
  5. Creating a new belly button within the tightened abdominal skin
  6. Tightening the pubic area

To learn more about abdominoplasty (tummy tuck), request a consultation by contacting us at 13000DRTIM or emailing us at info@drtim.com.au 

 

Cosmetic Surgery Tip #17: Reconsider having breast augmentation with a strong family history of breast cancer, are obese, or smoke

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All these factors increase risks and complications during and after surgery. If you have any significant medical issues, you need to be evaluated by your GP or specialist and cleared before having cosmetic breast surgery.

Photo Credit: Saul Steinberg “Masquerade”

 

Mommy Makeover with Body Lift & Breast Reduction. The Mommy Makeover is a term for a group of cosmetic procedures that many mothers seek following pregnancy. After multiple pregnancies and breastfeeding, many women find it impossible for diet and exercise alone to restore their figures. Fortunately, mothers with permanently altered figures find that a Mommy Makeover is an excellent solution just like this patient found after having a Body Lift and Breast Reduction. The B & A photos at 3 months show a much more youthful figure and perkier, more shapely breasts.

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Breast Augmentation Part 1 of 4: The Patient

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There are generally three groups of women who frequently consider breast augmentation:

1) Nature ”missed a beat” during breast development

This usually occurs during puberty where the breasts may not develop at all or slightly, resulting in a ”bowling pin” type of a look. Apart from making one feel inadequate because their is a disconnect between the narrower chest to the wider hips, it also makes it difficult buying clothes that fit. Some people revert to using fillers and enhancers but they can never seem to compensate, are temporary measures, and they never feel a natural part of you like breast augmentation. Breasts can also develop unevenly during puberty, causing both difficulty in buying and wearing clothes, as well as, making one feel abnormal or a ”freak”.

2) Nature ”took a toll” during pregnancy and breast feeding

During these times, the breast enlarges and deflates repeatedly. This cycle stretches the breast skin especially in the lower pole, resulting in stretch marks. After breast feeding, the breast tissue itself may ”melt away” (especially in the upper pole), sometimes to a size less than before pregnancy. However, the skin never shrinks back to its original size, therefore, the breasts will appear saggy (think of the skin like an overstretched elastic band which frays at the edges). This is where a breast augmentation and/or a breast lift (mastopexy) can be of great benefit to restore the shape, size and contour of the breasts to the pre-pregnancy state.

3) Nature ”didn’t match desires” of women who want to enhance the shape and appearance of their breasts

Some women want to be the best they can be. Others have developed unattractive breasts or have uneven breasts that makes buying clothes difficult. Still others want to ”marry” or improve the balance between their chest with their hips. Breast augmentation to enhance the chest further or balance the hips can make an enormous difference to ones’ body shape and self-esteem.

Women who fall into any one of the above groups have every right to want to optimise any aspect of their breast appearance. If this involves breast augmentation, then she needs to also think about:

  1. The Procedure
  2. The Surgeon
  3. The Facility

These factors will be individually discussed in subsequent blog posts. Remember that no choice(s) is perfect and that every choice has trade-offs (you need to know them) as well as benefits. Therefore, choose carefully.

Question: What are your reasons for wanting to have breast augmentation? You can leave a comment below.

Breast Reduction for Symptomatic Macromastia

Breast reduction surgery patients are among the happiest  because they both look and feel better following surgery. When women have large, burdensome breasts, they frequently suffer from a condition called symptomatic macromastia which may include the following symptoms:

  1. Pain in the neck, shoulders, breasts, and upper or lower back
  2. Bra strap indentations
  3. Rashes underneath the breasts (intertrigo)
  4. Little finger numbness
  5. Difficultly exercising, fitting into clothing or examining the breasts

Breast reduction surgery is designed to make the breasts smaller and lighter to alleviate the problems of symptomatic macromastia. However, the plastic surgeon performing the breast reduction is the most important determinant of the quality of the result. There are many different techniques for breast reduction, and each surgeon has their own preferences based on experience and patient needs. Often, breast reduction is combined with a breast lift on the other side.

Techniques

There are basically 2 types of techniques used commonly throughout the world:

  1. Wise Pattern (also known as the “Inverted T” or Anchor Scar) describe a technique with a scar around the areola with a vertical scar extending downwards to a horizontal scar in the breast fold.
  2. Vertical (also known as the Circumvertical or “Lollipop” Scar) describe a technique with a scar around the areola with a vertical scar extending downwards to meet the breast fold.

The choice depends on the extent of ptosis (sagging) and the surgeon’s experience. Liposuction is commonly used with the Vertical techniques and less frequently with the Wise pattern except to remove unwanted fatty tissue from the armpit regions.

Medicare & Health funds

Breast reduction surgery is considered to be medically necessary if a patient suffers from symptomatic macromastia. The typical criteria for Medicare Item no. coverage of a breast reduction include: bothersome symptoms detrimental to quality of life, failure of medical therapy prescribed by another doctor, physiotherapist or chiropractor, and removal of a minimum estimated weight of breast tissue.

Most health funds  will cover this procedure for patients with these symptoms if they have attempted conservative medical treatment without success. Most commonly, this conservative medical treatment is provided by a GP, physiotherapist or chiropractor. Typically, there is a minimum weight of breast tissue that must be removed from each breast to qualify as a medically necessary breast reduction for health fund coverage. The best way to determine if your procedure is medically indicated is in a consultation with me at the clinic.

Recovery

One of the best things about recovering from breast reduction surgery is how quickly patients experience relief from their symptoms. The morning after surgery many patients already feel symptomatic relief, even though their recovery has just begun. Many comment that they even breathe easier when they no longer have so much weight on their chests.

Recovery from a breast reduction tends to be quick because it does not involve the underlying muscles, bones or internal organs. Most women will need a few days to recover before returning to work, up to 2 weeks for the incisions to heal before resuming exercise and 12-18 months for the scars to fade to a subtle colour.

To learn more about your breast reduction options and whether or not you are a candidate, email us at info@drtim.com.au or call our clinic at 13000DRTIM .

Breast Augmentation Part 2 of 4: The Procedure

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The things you need to know to make better choices regarding breast augmentation are the following:

1) Match your desires with reality

The surgeon can only work with the tissues you bring him. If you want the best result, you have to balance what you want with what the tissues will allow you to have and what they can support over time. Also, no woman has two breasts that are the same, and no surgeon can create two breasts exactly the same. Cup size is extremely variable and inconsistent from one brand of bra to another and women buy a bra that they can fill (or to push breast tissue where they want it to go to create a specific appearance), not necessarily a bra that fits. Last of all, the bigger the breast you request (ie. the bigger the breast augmentation), the worse it will look over time and you can’t pick out a breast from a book or magazine and expect the same result unless the woman in the picture looked exactly like you before surgery.

2) Know about the implants

Breast implants are not perfect, don’t last forever, and require some maintenance. If you can’t accept these facts, don’t have a breast augmentation. If you do, then you need to think about:

  1. Implant pocket location. Implants can be placed in front of, or behind muscle. There is less capsular contracture rates when the implant is placed behind the muscle and you can obtain better or more accurate mammograms too. Also, in thin women, behind the muscle is preferable because adequate tissue coverage is most important. Think when you lie in bed, if you are covered by a bed sheet only, then one can see the contours of your body a lot beer, than if you were to be covered by a doona, they are less distinct. Having said that, an implant placed in front of the muscle will always more predictably control breast shape. How do you decide whether to go in front or behind the muscle? If you pinch the breast tissue in the upper pole and it’s < 2 cm, consider going beneath the muscle, otherwise, you run risks of seeing the edges of the implant. One aspect that often gets overlooked is the way the pocket is created. Blunt dissection techniques are fast and efficient but create more tissue trauma, tear tissues, create more bleeding, and result in longer recovery time. Electrocautery dissection techniques use an electric current to seal blood vessels and are thus, less traumatic and have shorter recovery times.
  2. Implant shape. Shapes of implants can either be round or tear drop (anatomical). There is a trend today of women wanting more upper pole fullness and therefore opting for round implants. Given that the breast is constantly evolving and that over time there is loss of upper pole fullness as the breast tissue ”melts away”, breast augmentation with round implants may be a good option for maintaining upper pole fullness in the long term. The other added advantage is that if it rotates, it doesn’t affect the shape of the breast. In contrast, a tear drop implant which is fuller at the bottom and tapers at the top, will give an odd shape to the breast if it does rotate. However, breast augmentation with tear drop implants may be better in women who have odd shaped chests (either long or wide for example) because you can tailor the dimensions of the implant more specifically to fit the breast ”foot print” on the chest. Tear drop implants may also be beneficial in women with mild sagging breasts who do not want scars on their breast from elevating the nipple. The tear drop implants have a ”bucket-handle” effect on the nipple, elevating them to a higher position on the breast.
  3. Implant surface (or shell)The surface of the implant is made of a silicone rubber and can be textured or smooth. Textured implants have a lower risk of capsular contracture than smooth implants.
  4. Implant ”stuffing”. The stuffing or filler of the implant can be silicone or saline. Saline is salt-water and is harmless if the implant ruptures. It’s biggest disadvantage is rippling and that it takes up the ambient temperature, so that if you went to the beach for a swim, when you get out, your implants will feel cold. Silicone gel filler on the other hand is more natural, more predictable and it is safe. There are grades of silicone gel that range from ”jelly” consistency to that of ”gummy bears”.
  5. Implant size. Remember, the larger the implant, the more tradeoffs and risks you’ll encounter, especially long term.
  6. Incision location. The scar can be placed in three areas. The breast fold incision offers the best degree of control for the wide range of breast types and is the the commonest type used by far. The periareolar incision (around the nipple-areola) usually heals well because it’s located in thinner skin but is limited and can’t be used if the areola is not large enough for access. The biggest problem is the increased exposure of the implant to bacteria if any of the breast ducts were to be cut. The armpit (axillary) incision places no scar on the breast but takes longer to perform and harder to control the position of the breast fold.

3) Get well acquainted with the tradeoffs, problems and risks

Tradeoffs always depend on the details of each specific case, the characteristics of your tissues , the experience of your surgeon with different options. Every breast augmentation operation carries inherent risks and medical complications are not totally preventable by you or your surgeon. Remember, don’t have a breast augmentation unless you thoroughly understand and accept the potential risks and trade-offs of the procedure.

4) Know about the recovery

The more tissue trauma caused by your surgery, the longer and more difficult your recovery. That is why it takes longer to recover from a pocket created behind the muscle. Excessively large implants can produce excessive stretch marks that cause more discomfort and temporary or permanent sensory loss. Most women return back to normal duties within four weeks and athletic activities by six weeks.

 

Question: Do you think that the benefits far outweigh the trade-offs for breast augmentation? You can leave a comment below.