Breast Augmentation Part 4 of 4: The Surgical Facility

Your safety is of paramount importance when undergoing breast augmentation. Always have your surgery in an accredited hospital or day surgery facility. If you are young and healthy, then a day surgery facility is fine. If you are older and have health problems, then a hospital would be a better place to have the procedure performed because of the availability and back-up of an intensive care unit and other highly specialised healthcare professionals.

Accredited means that the surgical facility has passed a set of rigorous examinations to assure that the equipment and procedures meet standards for optimal safety. The hospital or day surgery facility should be fully accredited by the Australian Council on Healthcare Standards (ACHS) or a set of ISO standards that provide the highest standards of service. Patient health, safety, and comfort should be the surgical facilities main concerns and they should continually monitor and evaluate their performance to achieve these outcomes. Another requirement of accreditation is to assure that personnel is trained, experienced, and skilled healthcare professionals and procedures and equipment are in place to deal with any emergency from a power outage to cardiac arrest.

Sometimes it’s reassuring to visit the accredited facility yourself. If you’re not comfortable with a surgical facility, don’t have the breast augmentation surgery there. What you want to see is modern and comfortable surroundings, as well as caring and warm personnel. The operating room should appear state-of-the-art, spotlessly clean, and equipped with the most up-to-date equipment. The recovery area should be immediately adjacent to the operating rooms. Some surgical facilities provide overnight accommodations with one-on-one nursing care especially for patients who need overnight care for more extensive procedures.

The following checklist should help you “tie things up” when organising your breast augmentation:

1)  Check the date of surgery and pay scheduling deposit if required

2)  Review surgeon’s financial policies and policies for refunds

3)  Sign informed consent and operative consent forms for breast augmentation

4)  Schedule laboratory tests and mammography/ultrasound if required

5)  Review medications to avoid and ones to take before surgery

6)  Review post-operative instructions the night before surgery

7)  On the day of surgery wear comfortable clothes, get someone to drive you home and be with you overnight, wear no make-up, and leave your jewellery and valuables at home

Question: What things do you consider important in the surgical facility when having a breast augmentation? You can leave a comment below

Cosmetic Surgery Tip #4: Meet them in person

 

It is crucial that you meet the plastic surgeon who will carry out your procedure before the day of your treatment. Not all practices demand that patients meet the practitioner who will deliver the procedure in advance. If you are advised that it is not possible to meet in person with the practitioner ahead of treatment, you should not progress any further and choose to go elsewhere. Any reputable plastic surgeon will demand that they meet the patient themselves beforehand. It is also important that you feel comfortable with your plastic surgeon and that you trust them.

 

Why “Celebrity Imitation” with Cosmetic Surgery?

Why do people try to imitate celebrities’ actual faces and bodies? Why do people think that a celebrity’s physical appearance can be copied? Occasionally I would get a patient presenting to my office for consultation requesting Nicole Kidman’s nose or Kim Kardashian’s butt. Cosmetic surgery is not the same as Mr. and Mrs. Potato Heads, with interchangeable noses, ears, lips etc.

Plastic surgeons must work with what you have (reality) and you must understand that what you want (desire) may not be achievable.

We as plastic surgeons are trained to perform delicate operations to enhance or improve people’s physical characteristics in an effort to acquire a more desirable feature. We are also taught to operate within the safest parameters possible because cosmetic surgery is elective surgery, which means it’s a want not a need. Therefore, it is vital for us to properly screen all prospective patients to be certain that they are safe candidates for this surgery. There are basic conditions that should be considered, contraindications to surgery which include physical abnormalities, medical problems that can complicate the surgery or put the patient at unnecessary risk, psychological abnormalities, unrealistic expectations, inappropriate motivations and inherent physical characteristics that hinder the achievement of the best possible result.

For people considering “celebrity imitation”, you should reconsider why you want to look like a particular celebrity.

Why is it that you are trying to become someone else? Why are you unhappy with you?  Furthermore, what if a celebrity’s image changes? As they say, “the media darling of this week is the rehab tabloid queen the next.”

Cosmetic surgery is a big change and so it’s important not to lose yourself as you start to look like someone else. I am reminded from a quote of Oscar Wilde, ”Be yourself; everyone else is already taken.

Question: Is it worth getting cosmetic surgery to look like a celebrity?  You can leave a comment below.

Wabi-Sabi In Cosmetic Surgery – Imperfect, Impermanent, and Incomplete.

Celebrities, models, and socialites have highlighted some severe complications (including death) from undergoing cosmetic surgery in their pursuit of perfection. This is very concerning and makes me reflect on what beauty is all about. I am reminded at this point of Wabi-Sabi, the Japanese philosophy that embraces the beauty of things imperfect, impermanent, and incomplete.

It is a beauty of things modest and humble. It would be interesting to see how much of this ancient Japanese philosophy could be embraced in the world of cosmetic surgery and what a difference it could make.

Wabi-Sabi represents the exact opposite of the Western ideal of great beauty as something symmetrical, extraordinary and enduring. Wabi-Sabi is about the minor and the hidden, the tentative and the ephemeral: things so subtle and evanescent they are invisible to unrefined eyes.

Simplicity is at the core of things Wabi-Sabi. Wabi-Sabi embraces the “less is more” ideal talked about today, yet often ignored. Cosmetic surgery needs a lot of Wabi-Sabi.

Thanks for reading!

Dr.  Tim  –  Sydney  Cosmetic  Plastic  Surgeon

www.cosmeticculture.com.au
www.drtim.com.au

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 #23: Your boobs do not need to be a minimum size for a reduction

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This is all based on personal preference. Think of boob size in terms of a scale from small to large. Based on breast size before the procedure and desired breast size afterward, there are a number of incision options for a reduction for a huge range of results. You can even choose to get a reduction and an implant to replace some of the volume that you’ve lost over time.

Photo Credit: Saul Steinberg “Masquerade”

Cosmetic Surgery Tourism: Is It Worth It?

Cosmetic surgery tourism is a price-driven phenomenon that has experienced increased growth over the past decade. Numerous companies offering all-inclusive vacation packages that include cosmetic surgery are popping up all over the world and can be easily located via the Internet. The offers generally include private hospital services and tout ”highly trained” and ”credentialed” medical staff. Since elective cosmetic surgery procedures are not covered by insurance, the price is the major selling point of cosmetic surgery tourism, with entire vacation/surgical packages costing less than individual procedures in Australia.

Although there are many skilled and qualified plastic surgeons practicing all over the world, cautions is warranted as it may be difficult to assess the training and credentials of surgeons outside of  Australia.  Patients may take unnecessary risks, when choosing cosmetic surgery vacations, by unknowingly selecting unqualified surgeons and having procedures performed in non-accredited surgical facilities.  Patients should consider the potential complications, unsatisfactory results, and risks to general health that may occur.

I very occasionally see patients who have had cosmetic surgery tourism done abroad that have gone horribly wrong.

This is commonly due to either bad surgical technique, sloppy post-operative care, or misinformation that leads to a  less than satisfactory outcome for both patient and surgeon involved.  I  can understand that the lure of cheap cosmetic surgery and a holiday in some exotic destination thrown in for less than the price of comparable surgery at home is often too much of a temptation to resist.  Sadly, most people spend more time anguishing over the purchase of the latest and greatest gizmo than their plastic surgeon.  Before you next consider cosmetic surgery abroad, always remember to check:

  1. The plastic surgeon is well trained and reputable and that you feel comfortable with them.
  2. Make sure that you can communicate fluently in their native language or vice versa.  Also, don’t forget that you need a good anaesthetist to keep you safely asleep during the procedure.
  3. Make sure that the operation you are having is the right one for you.  Often with cosmetic surgery tourism, planning and decision making is necessarily rushed.  You cannot have ‘second thoughts’ and when surgery is planned, too often without seeing the operating surgeon or seeing them just before the surgery for the first time, there is no time to contemplate on the decision made or any informed consent.
  4. Determine that the operation is being performed in a safe environment and any prostheses used (eg. breast implants) are of the highest quality. Cosmetic surgery trips are often marketed as vacations  – but vacation activities should be avoided after cosmetic surgery eg; sunbathing, drinking alcohol,  swimming, jet skiing, taking extensive tours by bus or foot.  These can all compromise wound healing and increase infection rates and other problems.
  1. Lastly, you need to establish that there is appropriate after-care in place.  Whilst most things that go wrong usually happen within 48  hours, there are many things that can occur weeks to months down the track.  Revisional surgery may be required when you’re back home and in these instances can be more difficult because of the uncertainties in surgical techniques used.  Remember,  “forewarned  is  to  be  forearmed.”

Question: What are some of the reasons you would entertain having cosmetic surgery tourism?  You can leave a comment below.

Cosmetic Surgery Tip #20: Any breast surgery can have a small effect on breast cancer screening in the future

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Breast health is important. Before the surgery, have a proper breast exam with your GP or gynaecologist. If you’re of age, get a mammogram. Most mammographers don’t have an issue if the implant is placed behind the muscle, but it is important to discuss this with your plastic surgeon. The x-rays used for mammographic imaging of the breasts cannot penetrate silicone or saline implants well enough to image the overlying or underlying breast tissue. Therefore, some breast tissue (approximately 25%) will not be seen on the mammogram, as it will be covered up by the implant. In order to visualise as much breast tissue as possible, women with implants undergo additional views as well as the standard images taken during diagnostic mammography. In these additional x-ray pictures, called Eklund technique or implant displacement (ID) views, the implant is pushed back against the chest wall and the breast is pulled forward over it. This allows better imaging of the forward most part of each breast. Sometimes it is more difficult to perform the Eklund technique in women who have severe scar tissue or capsular contracture and women who have very dense or fibrous breasts. Implants placed above the muscle can also make it more difficult to determine microcalcifications. Scar tissue around the capsule can be difficult to differentiate from calcification, which could be associated with cancer and thereby require an actual biopsy. The ID views are easiest to obtain in a women whose implants are placed underneath (behind) the chest muscle.

Photo Credit: Saul Steinberg “Masquerade”

Cosmetic Surgery Tip #37: Use homeopathic Arnica Montana

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Homeopathic Arnica Montana has been used for centuries to treat bruising and swelling from soft tissue injury.  Arnica, which is offered both topically and orally, is ideal for facial surgical procedures like a facelift, eyelid or nose surgery.  This remedy is also perfect for fillers and injectable procedures.

Photo Credit: Saul Steinberg “Masquerade”

Avoiding Difficult Patients

As a cosmetic plastic surgeon,  I try and avoid the potential wrath of a disgruntled cosmetic surgery patient.  I do this by trying to predict who will not be a “good”  post-operative patient.  The key is the initial interview which is used as an effective screening process to pick out the patient with inappropriate motivation,  unrealistic expectations or those obsessed with imagined physical defects.  I then simply do not operate on these patients who  “fail” the screening.  Certain  patient  types  to  interview  carefully  before making  the  final  decision  on  whether  to  operate  or  not  include:

  • Patients whom my staff or I don’t ”gel with”for some reason. Initial “gut instincts” may be correct.
  • Perfectionists: Those seeking a flawless result, cannot accept minor asymmetries or slight imperfections after surgery.  They have the potential to be unrealistic patients.
  • Dissatisfied patients: Some of these were dissatisfied with previous cosmetic surgery by another surgeon. She or he wants me to  “fix it”.  They often put you on a lofty pedestal ready for when they fall when things don’t work out so well.
  • VIPs: Someone highly visible to the public, such as actors,  TV personalities, and politicians, have bigger stakes.

Research shows that a small percentage of cosmetic surgery patients are at risk of experiencing psychological problems, such as depression, after undergoing elective surgery.  Some of these patients sue, harass and even threaten the doctor who performed their surgery.  It ’s important then for every patient to get it straight with their surgeon as to whether they have a policy about who pays for revisions when necessary and to make sure the policy ’s provisions are clear before surgery.

Thanks for reading!

Dr.  Tim  –  Sydney  Cosmetic  Plastic  Surgeon

www.cosmeticculture.com.au
www.drtim.com.au