Supplements and Cosmetic Surgery

Herbal supplements and vitamins are known to have a significant and measurable effect on promoting wound healing, reducing bruising,  enhancing immunity, and reducing oxidation caused by both surgery and anaesthetic drugs. However, these supplements are still drugs that could cause dangerous side effects during cosmetic surgery. About 50% of cosmetic surgery patients take supplements (usually more than one), but often do not tell their surgeons because they assume they are safe.  Some  of  the  most  popular  herbal  supplements  taken  are  chondroitin,  echinacea, and  glucosamine:

  • Chondroitin is often used to treat osteoarthritis.  People using chondroitin may suffer from bleeding complications during surgery, particularly when used in combination with doctor-prescribed blood-thinning medications (like warfarin).
  • Echinacea is often used for the prevention and treatment of viral, bacterial and fungal infections, as well as chronic wounds, ulcers, and arthritis.  However, it can trigger immunosuppression, causing poor wound healing and infection.
  • Glucosamine, often offered in conjunction with chondroitin, contains chemical elements that mimic human insulin, and may artificially cause low blood sugars during surgery.

Other common supplements taken by patients that may cause thinning of the blood are the “4  Gs”  (gingko biloba, garlicginseng, and ginger), fish oils and Vitamin E.

Cosmetic surgery should be viewed with the same care and concern as heart or brain surgery. Everything we do is important for our patients, so every precaution and safety should be taken to minimise complications from surgery and anaesthesia. Remember, we need your help and cooperation at all times.  Advise us of every drug you take, prescribed and non-prescribed and cease taking any blood thinning agents 2 weeks prior to surgery unless otherwise directed by your doctor.

Thanks for reading!

Dr. Tim  –  Sydney  Cosmetic  Plastic  Surgeon

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

Why a Body Lift Can Help You After a Massive Weight Loss

If you desire a firmer, more youthful-looking body contour, then a surgical body lift may help achieve your goals. It improves the shape and tone of the underlying tissue that supports fat and skin. In addition, the procedure(s) can improve a dimpled, irregular skin surface, commonly known as cellulite.

Body lift surgery essentially sculpts the body by excision of excess skin and fat and reconstruction of what remains into some reactive contours. Body lifts can be performed in two different ways, to treat either the upper or the lower body:

  • Lower body lift: The lower body lift is the most common type of body lift in my practice. It typically includes a tummy tuck (abdominoplasty), thigh lift, and buttocks lift performed at the same time. The incision is concealed around the hipline so that it’s not visible when wearing underwear or a bikini.
  • Upper body lift: For patients with severe skin laxity of the upper torso, an upper body lift may be the appropriate treatment. This typically includes a bra line back lift and upper abdominoplasty. The procedure is individualised for the particular patient.

Candidates for body lifts typically have lost large amounts of weight. They should be healthy and well-nourished without vitamin or mineral deficiencies. They should not smoke, as smoking increases the risk of complications.

Body lift is performed under general anaesthesia, with the patient positioned on their stomach, and the surgeon removes a large, belt-like segment of skin above the buttocks, up to the lower back. When the wound is closed, the thighs and buttocks are lifted. The patient is turned over and the surgeon continues to work on the front of the thighs and abdomen. Indeed, when a surgeon performs a circumferential removal of skin and fat of the lower abdomen, and when combined with undermining of the thighs, it will lead to a lift of the buttocks and thighs. A body lift can be done in two stages, with a three-month gap between procedures, or as a single stage surgery.

Patients usually take at least two weeks off from work following a body lift. I encourage patients to ambulate shortly after surgery. They may resume full exercise approximately 6 weeks following surgery. The results of a body lift are visible almost immediately. However, it may take as much as one to two years, or more, for the final results of the body lift procedures to fully develop. Since weight loss patients have poor skin elasticity, the closure must be as tight as possible. However, over-resection of the skin followed by overly tight closure of the tissues can lead to wound rupture or to broadly depressed scars resulting from suture pull through, breakage or premature dissolution. At the same time, insufficient removal of skin and low-tension closure leaves sagging tissues, skin rolls and/or wrinkles. A body lift should be seen as a critical step in overcoming obesity, with the potential of ceasing or reducing medications used for diabetes and high blood pressure. Patients need to take steps following surgery to maintain a healthy lifestyle, ensuring that their new shape will be long term.

Question: Do you feel that a body lift can improve self-esteem following massive weight loss? You can leave a comment below.

Laser Hair Removal Mythconceptions

There is no such thing as a single “best” laser for hair removal on all patients.  The best laser for laser hair removal for each person really depends on his or her skin colour. Thus, multiple lasers exist for hair removal. Different laser types, which emit distinct wavelengths of light, are better for treating different skin types. There are a number of manufacturers that make these laser types:

  • Alexandrite lasers. These emit laser light at 755 nm. These lasers work best on lighter skin. In my opinion,  it has been the most impressive laser for hair removal for light to olive skin types.
  • Diode Lasers.  These emit light at a wavelength of 810  nm.  Lighter skin types do well with this type of laser, as do some darker skin types.
  • Nd: YAG lasers.  These emit a 1064 nm wavelength.  This laser is best for darker skin types, as the higher wavelength reaches deeper into the skin.  This helps to avoid superficial skin melanin,  which pigments our skin.
  • IPL or  Intense  Pulsed  Light. It has been used for hair removal.  Lasers emit light at one wavelength (like laser pointers in PowerPoint presentations).  IPL machines produce a range of wavelengths  (like the cone of light from a torch one sees in cartoons) and are not lasers.  So,  there  is  no  such  thing  as  an  “IPL  laser”  or  “IPL laser  hair  removal”-  it’s  a  marketing  ploy  for  businesses  that  have  IPL  machines  and  not  hair  removal  lasers (the  only  exception  to  the  rule  are  the  few  machines  out  there  that  have  both  lasers  and  IPL  machines  in them).  Several studies have shown that  IPL is not as effective as dedicated hair removal lasers, and carry a higher risk of burns, blisters, and changes in pigment.

In my experience,  the Alexandrite laser is the most effective laser for removing hair on the lighter skin, whereas the Nd: YAG is the safest and best laser for more darkly pigmented skin.  Remember,  every laser  has  a  “target.”  For hair removal lasers, the goal is to selectively target the pigment (in other words colour) which in this case is called melanin found in hair follicles.  Melanin is the reason why we have black or brown hair or shades in between.  The hair follicles are living cells which make hair below the surface of the skin.  When the melanin is selectively heated, this destroys the hair follicle cells.  The lighter the hair, the less melanin the hair follicles will have in them.  As a result, hair that is blonde, white or grey does not improve with laser hair removal.  In my practice,  I have actually seen some patients notice a decrease in lighter hairs,  but it ’s the exception and not the rule.

Melanin is also present in skin and is the cause for dark skin and suntans.  It is the same target that the hair removal laser is trying to reach in hair follicles.  Hair removal lasers may target the melanin in the skin as well as in the hair follicles which sometimes results in burns,  blisters, and change in skin pigmentation.  As a result,  lower settings and longer laser pulse times must be used for darker skin to avoid damage.  As a consequence, more overall treatment sessions will usually be necessary.

Remember, laser hair removal is a medical procedure and you should always consult with a doctor who has extensive experience in lasers and laser hair removal.  This will maximize your chances of a great result.

Thanks for reading!

Dr.  Tim  –  Sydney  Cosmetic  Plastic  Surgeon

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

BC3.004

Following a tummy tuck, patients should take at least 3-4 weeks to recover before returning to work. Normal exercise routines may typically be resumed approximately 6 weeks following surgery.

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

BC2.007

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 

 

Dangers of Excessive Weight Loss

Many women that I see for body contouring usually have tried exercise and dieting to some extent or other prior to resorting to liposuction or surgery. A minority of women have taken drastic measures like excessive gymming or starvation diets to try and fit into single digit or low teen dress sizes. This can, however, cause irreparable health problems like the following:

  • no menstrual cycle or abnormal menstruation in women.
  • prevent women from becoming pregnant.
  • cause premature delivery, the birth of low-weight babies who are also undernourished.
  • loss of libido due to suppression of Follicle  Stimulating  Hormone (FSH) and other secondary sex hormones in the brain.
  • suppress the hypothalamic-pituitary-adrenal axis which is responsible for the release of sex hormones
  • anorexia or poor nutrition can lead to osteoporosis.

My advice is that no weight loss or fitness program should be undertaken without the direct supervision of your doctor.  Whether you should lose weight, how much you should lose and how you should lose it are decisions that should be made by a medical professional, who may need to refer you to a nutritionist or endocrinologist for further work-up and counseling.  If you want to lose weight and keep it off, your doctor must be part of the equation.

Thanks for reading!

Dr. Tim  –  Sydney Cosmetic Plastic Surgeon

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

BC3.002

Candidates for an abdominoplasty (tummy tuck) have some or all of the following problems:

  1. Loose skin on the lower abdomen
  2. Stretch marks on the lower abdominal
  3. Abdominal muscle laxity
  4. Pubic laxity

Good abdominoplasty candidates should be healthy non-smokers. Avoiding smoking is important to decrease risks. Although it’s better for patients to be near their ideal weight, many patients who are overweight are still good candidates for the procedure.

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

Brazilian butt lift surgery task force set up after alarming death rate

A DANGEROUS butt procedure has a higher death rate than any other and Aussie women are being warned to think carefully before committing to it.

A NOTORIOUS surgical procedure, known as the Brazilian Butt Lift, is now considered so dangerous that a specialist Aussie task force has been set up to warn women of its risks.

Inspired by “bootylicious” celebrities and social media stars such as the Kardashians, Jennifer Lopez and Beyonce, the risky operation has raised alarms after a number of complications and number of deaths.

BBL is the colloquial term for buttock fat grafting, an elective cosmetic procedure which can cost up to $14,000 and involves removing fat from one part of the body via liposuction and transplanting it via injection into the butt for a fuller, perkier effect.

According to the Australasian Society of Aesthetic Plastic Surgeons (ASAPS), the mortality rate for BBLs is estimated to be one in every 3000 operations — meaning it has a higher rate of death than any other cosmetic procedure.

THE BOOTYLICIOUS EFFECT

The BBL’s popularity has increased over the last few years, with the American Society for Aesthetic Plastic Surgery tracking a 26 percent jump from 2016 to 2017, making it the surgical procedure that saw the second most significant increase performed year over year.

However, its complications have thrust it into the medical spotlight and plastic surgeons across the world have expressed deep concerns over its increasing popularity.

ASAPS has now backed a new “patient safety task force” to investigate the risks and improve patient safety of the increasingly popular procedure in Australia.

“In short, the butt is becoming the new breast,” Dr Tim Papadopoulos, specialist plastic surgeon and past president of ASAPS said.

Kim Kardashian has always denied having a BBL procedure. Picture: Mega Agency
Kim Kardashian has always denied having a BBL procedure. Picture: Mega Agency Source: Mega
‘Bootylicious’ singer Beyonce is an inspiration for many young women. Picture: Mega Agency
‘Bootylicious’ singer Beyonce is an inspiration for many young women. Picture: Mega Agency Source: Mega

Five of the world’s leading plastic and cosmetic surgery-related organisations have banded together to form an “Inter-Society Buttock Fat Grafting Task Force” to research complications and deaths associated with BBL.

“Action must be taken now in order to prevent further tragedies from occurring,” Dr Papadopoulos said.

“The task force is concerned with the high mortality rate of this operation and is aggressively investigating ways to make this procedure safer.

“This new warning emphasises the continued risk that is being encountered with this procedure. Patient safety is the highest priority for plastic surgeons and this multi-society task force is an important and unprecedented collaboration.”

He said the procedure had resulted in an “alarming rate of mortality”.

“This rate of death is far greater than any other cosmetic surgery,” he said. “Having said that, there has been no reported case of a death from BBL in Australasia.”

He this may be due to the cultural and ethnic differences and perceptions of beauty regarding bums.

“Although social media has had a huge influence in promoting BBL, especially with celebrities like Kim Kardashian and Jennifer Lopez, the volumes of buttock fat transfer overseas don’t necessarily translate to what’s going on here in Australia,” Dr Papadopoulos said.

The surgery can cost up to $14,000. Picture: Supplied/ Cosmos Clinic website
The surgery can cost up to $14,000. Picture: Supplied/ Cosmos Clinic website Source: Supplied

“In the USA, the large African-American and Hispanic populations have generally dictated their beauty norms which promote larger backsides and smaller breasts.

“This is not the case in Australia where women generally prefer larger breasts and smaller backsides.”

WHAT THE TASK FORCE WILL DO

The task force will examine the causes behind complications and deaths to try to prevent them from occurring through a variety of doctor and patient safety education measures, including unprecedented research.

Once those results are finalised, a comprehensive set of guidelines for the procedure will be submitted for publication in major clinical journals.

“Interestingly, while this procedure has been done for decades, it wasn’t recognised as risky until recently,” Dr Papadopoulos said.

The alarm bells started to ring for some surgeons after a 2015 study which looked at 19 BBL-related deaths in Colombia and Mexico over a 15-year period.

A 2017 report also noted at least 25 fatalities in the United States in the preceding five years.

WHY IS THE BBL SO DANGEROUS?

Dr Papadopoulos says every BBL-related death is caused by bits of fat (or “emboli-globules”) which enter the blood stream and clog up the patient’s heart.

“The cause of death is emboli-globules of fat that inadvertently enter the gluteal veins and swiftly make their way up to the heart and lungs, causing patients to arrest and die usually in the operating room during the procedure or in the recovery room shortly after,” Dr Papadopoulos said.

Tim Papadopoulos said women should research the procedure carefully.
Tim Papadopoulos said women should research the procedure carefully. Source: News Corp Australia

“These emboli are unique to the buttock area, as fat injections in the breast, face and thighs don’t produce this same phenomenon.

“The gluteal veins’ distinctive anatomy makes them especially vulnerable because they’re very big and thin, and only one tributary away from the inferior vena cava, which is the major vein in the body running from the pelvis to the heart.

“If a surgeon nicks one of these gluteal veins or they tear because of traction from pooling of fat beneath the muscle, it’ll act like a siphon, sucking in fat around it, and ultimately sending fat up into the heart.”

WHAT TO DO IF YOU WANT A BBL

Dr Papadopoulos said any patients interested in the procedure should research and trust only FRACS-qualified Specialist Plastic Surgeons at accredited and licensed facilities or hospitals. “You should ask to see before-and-after photos and ask for patient references,” he said.

“You, too, should stay informed on the issue, and when consulting with doctors, don’t hesitate to question their approach.”

To find a suitable surgeon search through the Australasian Society of Aesthetic Plastic Surgeons Member Database.

– Ben Graham 

Article Source: news.com.au

Tummy Tuck: 3 essential things you must know!

  1. Before a tummy tuck

When you continually gain and lose weight, the excess tissue composed of skin and fat in the lower part of the tummy becomes a real problem for some people. This excess tissue along with the underlying lax muscles can be dealt with by a surgical procedure known as a tummy tuck, otherwise known as an abdominoplasty. Removing the “muffin top” (the tissues between the belly button and pubis), then re-draping the skin from above the belly button to meet the skin on the pubis and repositioning the belly button, are the basis of all tummy tucks.

One of the keys to a tummy tuck is finding out how much excess skin and fat, as well as, muscle laxity you have in your tummy, is to bend over at the waist and “let it all hang out.” The next step is to pinch these tissues and tighten the tummy muscles, which will give you an idea of how much of the tissues need to be removed.x

Also, you will notice that most of the tissue bulk is in the midline and fades out at the sides. If you imagine this excess tissue as an ellipse on the lower tummy, it will give you an indication of how long the scar will be from one side of the hip to the other. I tell all my patients that the resulting scar can be concealed, that it will generally fade with time, but will always be there.

 

  1. Tummy tuck operation

Just prior to beginning the tummy tuck, I mark the tummy while the patient is standing up. I mark the midline from the xiphoid (“breast bone”) to the pubis. This enables me to realign the midline after removing the excess tissues and to place the belly button in the midline. A second line indicates the position of the lower-tummy incision. This usually lies quite low in the tummy since the most common garment worn by women today is jeans. Finally, areas for liposuction are marked in the upper tummy, the hips and lower flanks (liposuction thins the tissues and allows them to re-drape better).

Our anaesthetists use a laryngeal-mask airway (a breathing tube that sits at the back of the throat) and do not paralyse the patient, allowing them to breathe independently during the entire operation. I begin the tummy tuck operation with liposuction to the tummy, hips and lower flanks.  Then, I incise the skin around the belly button which is still attached to the underlying muscle wall. After making the lower tummy incision, I widely undermine the tissue up to the level of the belly button. I continue the dissection above the belly button to the level of the xiphoid process (lower part of the sternum), making a central tunnel (about the size of a hands width). I then “lace-up” the separated muscles of the midline from above and below the belly button.

Next, the patient is bent at the waist to 45 degrees, and the excess tissues removed so that the two skin edges may be closed without tension. Two drains are brought out below the pubic hairline to capture any excess fluid that may build-up in the tissues. These usually are taken out between day 3 to 5 when the drainage is less than 30 ml’s or so. Lastly, I bring out the belly button at the midline, usually 12 to 15 cm above the lower tummy incision and place a tummy binder on the patient at this time and adjust it to allow for moderate compression.

The patient is kept in a bent position at the waist and knees as they are transferred to the recovery bed.

 

  1. After tummy tuck surgery

After a tummy tuck, the patient will continue to wear TED (compression) stockings and automated calf compressors for 24-48 hours and be commenced on blood thinning agents the following day to lessen the chance of deep vein thrombosis (clots in the legs) or pulmonary embolism (when these clots break away from the legs and migrate through the venous system to the lungs causing a “lung attack”).

The patient is instructed to sleep with several pillows behind her back and a pillow beneath their knees.

They are encouraged to walk to the bathroom the following day, have showers and to undergo regular chest physiotherapy. Patients are advised to wear the tummy binder continuously for the first 4 weeks after surgery, except when they wash themselves or the binder. After this period, I allow them to wear it only at night if they wish, but many choose to wear it longer. I also advise patients that it takes 4 weeks to get back to normal activities of daily living and 6 weeks to resume aerobics exercises.

 

Question: What questions do you have about tummy tuck surgery? You can leave a comment below.

What Is a Mummy Makeover?

Many of today’s mums don’t feel they should sacrifice the way they look just because they’ve had children. After multiple pregnancies and breastfeeding, many women find it impossible for diet and exercise alone to restore their figures. These women usually want their tummies and breasts back the way they looked before pregnancy.

These so-called “Mummy Makeovers” are usually performed on women in their 30s or early 40s. There are multiple variations of the Mummy Makeover, of course, and I individualise the plan for each patient depending on their needs. Many women will not need or desire all of these procedures. Each patient determines what her personal Mummy Makeover will involve after we discuss her concerns and options in a thorough consultation.

A Mummy Makeover may be performed in one or more stages. Age, health, needs, and desires are all considered carefully when I formulate a plan for each patient. The majority of my patients choose to do more than one procedure at a time. I’ve had a great deal of experience performing these combined surgeries over the past decade. We take many steps to assure both minimal pain and maximum safety during our procedures:

  1. TUMMY TUCK: The tummy tends to experience the greatest change following pregnancy with stretch marks, loose skin and lower tummy fat being the most common complaints. The tummy muscles may also be stretched to the point that they remain separated in the midline, accentuating the patient’s lower tummy bulge. To treat these problems, I perform a tummy tuck where I remove the excess skin and fat from the tummy and tighten the muscles. Whenever we do a tummy tuck as part of the Mummy Makeover, we perform liposuction and pay special on to the belly button to help create a nice looking midriff.
  2. LIPOSUCTION: After having children, fat tends to redistribute to new areas on the body where it may be unwanted. This is frequently true even if women are successful at losing their baby weight. Most often, bulges of fat accumulated around the waist and on the thighs. On these areas, I frequently perform liposuction as part of a Mummy Makeover.
  3. BREAST SURGERY: The breasts go through dramatic changes with pregnancy and breastfeeding. Patient concerns about their breasts vary greatly, but the most common breast procedures I perform as part of a Mummy Makeover include:

Many of our patients for the Mummy Makeover travel from places outside of Sydney. Our staff can help with the planning of these sorts of trips through our CosmeticCulture Makeover Vacation Program, which makes travel for cosmetic surgery quite easy. More information is available on our website www.cosmeticculture.com.au, including descriptions of tummy tuck and breast augmentation or breast lifts as well as liposuction. You can also email us for more information at info@drtim.com.au or call us at 13000DRTIM.

Question:  Which parts of your post-childbirth body would you like to change with a Mummy Makeover? You can leave a comment below.