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 4 of 4: The Facility

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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 beer place to have the procedure performed because of the availability and back-up of an intensive care and other highly specialised health staff.

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 this outcome. Another requirement of accreditation is to assure that personnel are trained, experienced and skilled health care 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, comfortable surroundings and 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 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.

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A Mommy Makeover may be performed in one or more stages. Age, health, needs and desires are all considered carefully when formulating a plan for each patient. Many patients choose to do more than one procedure at a time.

The abdomen tends to experience the greatest change following pregnancy with stretch marks, loose skin and lower abdominal fat being the most common complaints. The abdominal muscles may also be stretched to the point that they remain separated in the midline, accentuating the patient’s lower abdominal bulge. To treat these problems, an abdominoplasty (tummy tuck) can be performed where excess skin and fat is removed from the abdomen and the muscles tightened.

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 accumulate around the waist and on the thighs. On these areas, liposuction is frequently performed as part of a Mommy Makeover. My preferred technique is power-assisted liposuction (PAL), the safest and most effective way to remove fat from these areas.

The breasts also 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 Mommy Makeover include:

  1. Breast augmentation
  2. Breast augmentation and lift (Augmentation Mastopexy)
  3. Breast lift
  4. Breast reduction

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

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A body lift is designed to tighten the skin of a patient all the way around their body. The improvements may be dramatic like the patient above. Patients who benefit from this surgery have typically lost a large amount of weight and have significant deformity from skin laxity. The body lift may address the lower body or the upper torso.

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

VECTRA® 3D Imaging Can Simulate Cosmetic Procedures

Here is an update from CosmeticCulture SkinSpa & Laser Clinics  about the recent advances in three dimensional (3D) photography combined with revolutionary new software allow prospective patients to preview what they will look like after a breast augmentation, facial procedures, and more…

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New technology allows patients to preview how they will look with cosmetic procedures

Both the VECTRA® 3D camera and Sculptor software were developed by Canfield Imaging Systems of Fairfield, NJ, the world’s leading provider of medical photography systems. The process starts with a VECTRA® 3D session which produces a three-dimensional photograph of the patient. Then, using Sculptor software, the surgeon is able to simulate the expected results of a variety of cosmetic procedures.

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During each breast augmentation operation, a long-acting local anaesthetic is placed around the implant so that patients will feel only minimal discomfort following surgery. Most of my breast augmentation patients take only a few days off from work to recover whilst others take up to a week. Patients may ease back into their normal exercise routine beginning several weeks after surgery.

 

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

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.

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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 info@drtim.com.au.

Discover the Amazing Benefits of Breast Lift Surgery

We live in a world and age where more and more women want to feel appreciated, adored and loved. But unfortunately over time, their self-esteem and confidence can can be challenged when their breasts droop and lose their upper pole volume. A breast lift, also called mastopexy, can help, allowing women to regain the youthful aspect of their breasts.

 

An Annoying Process

Over time, the internal ligaments and the skin of your breasts lose its elasticity, making your breasts drop to a lower position. Aging, pregnancy, weight loss or weight gain are some of the causes that trigger this annoying and sometimes painful process. Instead of enjoying those perky and round breasts, you will have to be content with flat and broad breasts. The problem arises when you want to wear a bra. Instead of supporting your breasts, the bra will only accentuate the skin wrinkles. In the end, the only viable option you have to deal with this annoying problem is breast lift surgery.

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Benefits of Breast Lift Surgery

 

Your breasts have their own ‘personality’. In time, they lose their youthful aspect, becoming flat. This can lead to serious self-esteem problems and may affect your confidence and even relationships.

The first benefit of breast lift is that your breasts become firmer and uplifted. The position of the nipples and areolas is also enhanced. Even though the breasts are not symmetrical, they can be made more even in size and shape. Remember that your breasts are “sisters, not twins’ and there will always be a slight difference between the two sides. Although this procedure does not increase the size of your breasts, they will certainly appear perkier because they are firmer and lifted. If you combine breast lift with breast augmentation, your breasts can gain one or two cup sizes usually.

Another huge benefit of mastopexy is that it dramatically increases your self-esteem and self-confidence. Of course, this procedure won’t turn you into a celebrity, but will definitely improve your appearance, enabling you to live each day at its fullest and enjoy life again.

A breast lift procedure is relatively safe, especially when performed properly by a professional and experienced plastic surgeon and the side effects are quite uncommon. However, some women could experience scarring, infections, bleeding or loss of sensation in the nipples. Overall, more than 95% of patients who undergo a breast lift are extremely happy with the results.

 

Breast Lift Options

Because each of us is different and breast shapes vary greatly, you need an individualised plan in order to enjoy optimal breast lift results. Your plastic surgeon should be able to refine their technique and become well versed in breast lift with or without breast augmentation. They will help you choose the right surgical option for your needs. Generally speaking, you will have to decide between using an implant (augmentation mastopexy) vs no implant (breast lift only) and full incision (‘lollipop’ or ‘anchor’) vs short incision (within the breast fold).

 

Areola and Nipples

Breast lift is aimed to relocate your nipples to a higher position, restoring the original breast projection. The breast shape and contour are therefore enhanced. When evaluating your breast, your plastic surgeon will takes into account the position and size of the areola. The areola is usually altered in size in order to achieve optimal proportions with the new raised nipples and to maintain the youthful aspect of your breasts.

 

Short Recovery Period

Recovery is generally swift for a breast lift. Most women need less than a week to recover before returning to work and 2 weeks for the incision to heal. The scars fade away to a pencil thin, white line in about 12 to 18 months.

 

Get a Consultation

The best way to understand how a breast lift works and to grasp its benefits is to have a consultation with your plastic surgeon. They can explain the difference between various treatment options and can offer you precious insights on how to make sure you enjoy a short recovery period.

 Question: What is the most challenging aspect of having droop breasts? You can leave a comment below. 

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.

 

How Can a Brow Lift Benefit You?

Appearance is everything these days and unfortunately, the ageing process is something we all must inevitably suffer whether we like it or not. There is still hope, however, for those of us who suffer from droopy eyebrows, sagging skin or deep furrows on the forehead, in the form of a brow lift.

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If you’ve had enough of those tired and weary eyes staring back at you in the mirror each morning, a brow lift is a simple procedure that can turn back the years and restore the youthful vigour you once possessed. It’s common knowledge that when you look great, you feel great and your plastic surgeon can offer you two different brow lift techniques to reinvigorate your face.

 

Brow Lift Benefits

A brow lift has many clear benefits for patients choosing this procedure. Apart from improving your overall facial appearance, making you look more awake and less stressed, this procedure will give you an immediate confidence boost to aid you in social and work settings. When this procedure is carried out by a skilled and experienced plastic surgeon, the benefits are increased and you’ll see an improvement in regards to:

  1. Brow height, meaning you appear more alert and vital.
  2. The frown lines between the eyebrows which will lessen with the lifting of the forehead.
  3. Sagging brows which will be re-positioned to reduce the severity of the drooping over the eyelids.
  4. Forehead and nose-bridge creases. These will be reduced as the forehead is lifted.
  5. Shape of brows for women. A brow lift can give women a more aesthetically pleasing arched brow shape.
  6. Tired or irritated appearance, which will make you look more approachable and friendly.

Brow Lift Procedures

There are generally two types of brow lift procedures: The traditional brow lift and the minimal incision brow lift. The type of brow lift procedure you choose depends on the severity of your symptoms.

Traditional Brow lift

The traditional brow lift is generally more suited to patients with excess skin hanging over the upper eyelids, making your brows droop and giving you an unfriendly, angry appearance. Also known as a “temporal brow lift,” this procedure is for patients who wish to raise the outer 2/3 of the brow line. The  brow line can be raised by making a 4cm incision in the temporal region of the scalp, before removing excess skin from the scalp and lifting the brow line to give you a friendly and bright eyed appearance. The advantages of the traditional brow lift are:

  1. The forehead or brow can be lifted higher for more severe cases.
  2. The skin is more easily mobilised.

Minimal Brow Lift

Aside from the obvious benefit of reduced and inconspicuous scarring, the minimal brow lift also minimises the loss of sensation around the site of the incisions. In general, the minimal brow lift is considered more suited to younger patients as this procedure does not involve the removal of excess skin. The incisions are also much smaller than those in the traditional brow lift and are skilfully concealed within the hairline. Whilst the traditional brow lift is rarely used today due to the extensiveness of the incisions, the minimal brow lift is becoming more popular because of the following advantages:

  1. Less visible scarring
  2. Less elevation of the hairline
  3. Less numbness around the incision site
  4. Minimal hair loss
  5. Less invasive
  6. Shorter recovery times
  7. Very little bleeding

Are You a Brow Lift Candidate?

If you are fed up of looking tired and stressed out, and friends have commented on how much older you look these days, it may be the right time to opt for a brow lift. On occasion, low brows are hereditary and because of this, plastic surgeons carry out this procedure on patients younger than 30 years-old.

Recovery Time for Brow Lift Surgery

In the early stages after surgery, you may experience some mild discomfort but nothing that cannot be easily allayed with mild pain medication for up to several days after surgery. Day three is usually when bruising and swelling is at its worst and within two weeks you should be able to fully appreciate the results of the procedure.

Are there Any Risks Involved?

The risks for the brow lift procedure are minimal at worst. You may experience some bleeding or infection and in very rare cases, nerve damage or hair changes but with a skilled and trusted plastic surgeon, the risks are negligible.

If you’ve had enough of looking overworked and unapproachable, it might be time for you to seek out a professional plastic surgeon to carry out a brow lift procedure and restore your youthful gaze.

Question: What is the most annoying feature of having sagging brows? You can leave a comment below.