Cosmetic Surgery Tip #35: Take a Bromelain supplement

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Bromelain is an enzyme extracted from pineapple.  A number of studies have found that the compounds in bromelain are effective in reducing inflammation, swelling and pain that often accompanies a surgical procedure or soft tissue injury.

Photo Credit: Saul Steinberg “Masquerade”

Breast Augmentation Part 2 of 4: The Procedure


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.


Arm Lift: The Beauty of Brachioplasty

For those patients that have what is colloquially known as ‘bat wings,’ undergoing an arm lift is probably the best way to get rid of it. These so called ‘bat wings’ are nothing more than loose excess skin that jiggles back and forth when the arms move. The cause can be one of two things. The first one is age. As we get older our skin tends to lose its elasticity. Secondly, we also tend to lose some body volume. When you combine the two you get excess skin that doesn’t contract as the underlying volume of tissue disappears. As a result you get flabby loose skin that many find to be unsightly.

The cosmetic procedure known as an arm lift, officially known as a brachioplasty, removes the loose excess skin.  Liposuction (CoolSculpting can be used as well depending on the surgeon’s opinion) may also be performed in conjunction with the brachioplasty to assist in removing stubborn fat, resulting in a more refined arm contour. Once the excess hanging skin is removed, the arm is sutured tightly leaving a firm arm devoid of any flabbiness.

Arm Lift in Sydney

Types of Arm Lifts

There are a number of different procedures when it comes to arm lifts. The type of procedure performed depends on the patient themselves. This is because every person has varying degrees of skin laxity and flab in the arms which means they may not all need the same type of procedure. It also depends on what they like and the results that they are looking for.

  • Elbow to Axilla – In this procedure an incision is made from the fold of the elbow to the axilla or armpit. Liposuction is often used in conjunction with this procedure. The liposuction is used to remove stubborn deposits of fat that give the arm a better final contour. This is a widely common procedure chosen by many patients. 
  • Mini Arm Lift – This procedure is for those who have excess skin mostly in the upper portion of the arm. It is also for those who don’t want  a lot of scarring which can happen in the procedure above. Here, the incision is made under the armpit only. 
  • Arm and Axillary Lift – For those who have too much excess skin in the upper arm and armpits this procedure is for you. This procedure gets rid of the sagging skin from the upper arm and from the armpit as well. The incisions are usually done in two places – the upper arm and under the armpit onto the chest. 
  • Elbow Lifts – This procedure is just what is says: a lifting of the elbow portion of the arm. Some people will have loose and sagging skin over their elbows. This procedure is targeted just for that portion of the arm.
  • Liposuction – If you still have elastic skin then you may not need to have a lift at all. For patients like this, liposuction may just be the solution. With liposuction the incisions are not that dramatic (only 3-4mm long) which means scarring is kept to a minimum.

The Right Candidate

Typically a likely arm lift candidate is one that has lost a lot of body weight. This means that they have lost a lot of body volume that resulted in the excess skin that was not able to adapt quickly to the loss of volume underneath it. It is highly recommended that you be at your target weight before the operation. If you are still in the process of losing weight you should wait until you hit that weight plateau in order to get a good final result from the arm lift. There’s a good reason for this. If you have the procedure and still lose the weight you may find that your arm will still have flabbiness in it even after the operation. That’s because since you still had weight to lose the skin is still stretched out resulting in the extra, loose skin.

It is a good idea to consult with a plastic surgeon when you want to have this cosmetic procedure done. This way the procedure can be explained to you including what you can expect, how your recovery will be and the risks that are involved. For further information call us on 13000DRTIM or email us on

Cosmetic Surgery Tip #34: Participate in relaxation techniques

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Listening to relaxation tapes or soothing music, taking a yoga or meditation class are examples of relaxation techniques that help to reduce stress.

Photo Credit: Saul Steinberg “Masquerade”

Cosmetic Surgery Tip #33: Discontinue taking certain supplements

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Some nutritional supplements may cause adverse reactions during or after cosmetic surgery, including prolonged bleeding, interference with anaesthesia, cardiovascular disturbances, and interactions with prescription drugs.  These supplements including dong quai, echinacea, fish oil caps, garlic, ginger, ginkgo biloba, ginseng, kava kava, ephedra, St.John’s Wort, and vitamin E, should be discontinued two weeks prior to surgery and two weeks after surgery.

Photo Credit: Saul Steinberg “Masquerade”

Cosmetic Surgery Tip #5: Don’t be influenced by price or advertising


While offers and discounts might be attractive in a supermarket, a cosmetic procedure is not something which should be offered at cut price. Remember that ‘cheaper’ does not necessarily mean ‘better’. Focus on the reputability of the plastic surgeon and the quality of their treatment. Never be coerced into undergoing a cosmetic procedure by a clever marketing campaign or a financial offer.  Take your time in making informed decisions.

Photo Credit: Saul Steinberg “Masquerade”

Cosmetic Surgery Tip #32: Get enough essential nutrients

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You should supplement your diet before and after surgery with high levels of vitamin A, vitamin C, zinc, copper and selenium.  Each plays a role in wound healing and in building the immune system thereby reducing the chance of infection.   Obtaining sufficient nutrients is especially important for recovery after more comprehensive procedures like a tummy tuck, facelift or liposuction.

Photo Credit: Saul Steinberg “Masquerade”