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.

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 info@drtim.com.au.

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Breast reduction surgery is considered to be medically necessary if a patient suffers from symptomatic macromastia. The typical criteria for health fund coverage of a breast reduction include: bothersome symptoms detrimental to quality of life, failure of medical therapy prescribed by another doctor, 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. The best way to determine if your procedure is medically indicated is in a consultation with me at the clinic.

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

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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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During pregnancy, skin may be stretched to the point that microscopic fractures form in the skin, or dermis, resulting in stretch marks (also known as striae). Caesarean section scars may accentuate fatty bulges by tethering the skin to the underlying muscles, causing the fat and loose skin to fold over the scar. The rectus abdominis muscles on the abdomen may become separated in the midline, creating a potbelly appearance. Fat also redistributes with age, becoming concentrated in the lower abdomen. The hourglass waistline of youth gives way to a larger midsection. That’s why many women choose abdominoplasty as part of their “Mommy Makeover” and as a bonus the Caesarian scar can be removed at the same time.

Although abdominoplasty (tummy tuck) can achieve dramatic improvements, it’s important to also consider adjacent areas of the body for optimal results. For many patients, liposuction around the waist and thighs will provide more comprehensive results. Mothers will frequently choose breast surgery as well. This combination of procedures completes their transformation back to the hourglass figure they once had.

To learn more about abdominoplasty (tummy tuck), 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.

Is CoolSculpting® An Alternative To Liposuction?

CoolSculpting is a non-invasive, clinically proven procedure to selectively reduce fat layers in problem areas using a patented cooling technology. It is a safe procedure that gently cools unwanted fat cells in the body to induce a natural, controlled elimination of fat cells. This reduces bulges in treated areas of the body without harming surrounding tissue.

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Brachioplasty (aka Arm Lift) for “Bingo Arms”

Brachioplasty (or Arm Lift) removes loose skin and fat from the upper arm. It ranks high on the wish list for many plastic surgery patients who have lost large amounts of weight or who have heavy upper arms due to simple genetic factors. Loose skin hanging from the arms tends to make patients self-conscious, limits clothing options and can even cause people to avoid certain activities, like swimming or playing tennis. Good candidates for brachioplasty are often weight loss patients who shed many kilograms, resulting in excess skin and stray fat deposits. Furthermore, post-bariatric patients should be near their desired weight and well nourished. Men or women with loose upper arms due to heredity and ageing may also be interested in brachioplasty. It’s best not to smoke for proper wound healing.

Techniques

There are a variety of techniques to chose from, so choosing the best approach for each patient’s particular needs is the no. 1 priority of the plastic surgeon. Each patient is unique in terms of skin laxity and other factors. Patients may benefit from one or a combination of the following techniques:

  1. ELBOW TO ARMPIT: An incision from the fold of the elbow to the axilla, or armpit, yields dramatic improvement. This approach is frequently combined with liposuction to eliminate stubborn fat pockets and loose skin. Most brachioplasty candidates choose this method.
  2. LIPOSUCTION ONLY: Patients with some skin elasticity remaining may opt for liposuction only. An advantage to this approach is that scarring is minimal. The right candidate can expect significant improvement, but not as dramatic as when skin is removed as well.
  3. MINI-ARM LIFTS: A mini-arm lift is an option for patients with excess skin in the uppermost portion of the arm, and for those concerned about scarring. In this case, I make an incision in the armpit, sometimes extending a 6-8 cms down the arm.
  4. ARM AND ARMPIT LIFTS: Upper arm skin is thin and sags over time. Some people lose so much elasticity that skin hangs down from their armpits as well, causing embarrassment and difficulty with clothing. These patients are candidates for a combination arm/armpit lift with incisions on the upper arm and in the armpit.
  5. ELBOW LIFT: A smaller group of patients have loose skin above and below the elbow. These men and women benefit from an arm and elbow lift. Great care needs to be taken with the incision across the elbow to remove excess skin while preserving range of motion.

Recovery

Most arm lift patients take a week or two off work after surgery. Most of the swelling subsides after 3-5 days and the wound takes about 10-14 days to heal. You will be encouraged to walk as soon as possible, gradually adding light activities over a few days and resuming full workouts and lifting within 6 weeks.

Risks

Complications of brachioplasty have been rare in my experience. These uncommon risks include infection, slow wound healing, bleeding, seroma and venous blood clots. Even if a complication were to occur, diligent post-operative care would still likely lead to a nice result.

 

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

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Most plastic surgeons favour the infra-mammary incision location for most breast implants. The peri-areolar incision is made as a semicircle at the lower border of the pigmented areola. It does heal beautifully in most cases and uses the interface of the darker and lighter pigmented skin to camouflage the incision. For patients with small areolae, it may be preferable to use the infra-mammary incision, located underneath the breast. This incision also heals very well, and is especially useful for women with well defined creases under their breasts.

The axillary incision (in the armpit) is another option, but it’s better suited for saline implants than silicone gel. Because this access incision is a greater distance from the implant pocket, it’s less precise than the peri-areolar and infra-mammary approaches. Studies have confirmed that there is a higher implant revision rate using the axillary approach. Usually the axillary scars heal well, but they may still be visible when the patient wears sleeveless outfits. There is also a higher rate of breast implant infections with the peri-areolar and axillary approaches.

Patients frequently ask what effect the incision location has on maintaining nipple sensation after surgery. The answer is that the access incision usually has little effect on nipple sensation. Rather, it’s the size of the implant pocket that has the largest impact on nipple sensation. Large implants may require a pocket that stretches the nerves to the point that they do not function well, increasing the odds of impaired nipple sensation. Even so, the vast majority of my patients maintain normal nipple sensation.

Breast implants may be placed over or under the pectoralis major muscle. In the early days of breast augmentation, all implants were placed on top of the muscle. However, in recent decades, it has become more common to place implants underneath the pectoralis major muscle. The muscle covers the top half of the implant, providing additional thickness of coverage over the implant in the critical cleavage area. This makes it less likely that the implant edges or ripples will be visible when wearing a bra or swimsuit. Studies have also shown that the rate of capsular contracture is lower when the implants are placed under the muscle. Breast imaging to screen for breast cancer is more accurate when the implants are placed behind the muscle. For these reasons, I prefer to place implants underneath the muscle for most of my breast implant patients.

 

To learn more about breast augmentations, 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