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

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

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 .

Breast Augmentation revisions: 3 facts you must know!

Designing a surgical plan that can deliver a satisfactory result for women seeking surgical revision after breast augmentation can be quite difficult.  It still requires the plastic surgeon to obtain a good history, perform a careful clinical examination and identify the woman’s concerns and goals.

Revisional surgery after breast augmentation is typically more complex, because of the diversity of presentations and the interval elapsed since their primary surgery.  Additional surgery may be required because of anatomical changes caused by the previous procedure or that have occurred over me.  This information must be explained to and understood by women who may be expecting an easy fix. Furthermore, plastic surgeons may face the challenge of communicating with a dissatisfied and angry patient and therefore, in-depth and honest discussions outlining the risks, benefits, and costs of the various options remain paramount for achieving success.

There are 3 key facts women seeking revisional surgery after breast augmentation need to consider:

1)  Your plastic surgeon needs to listen carefully to what you’re saying.  They must find out what’s motivating you in order to satisfy your goals.  If your problem, however, is imperceptible to them, or you’re seeking an outcome they consider unattainable, they may not be able to help you reach your goals.

2)  Use visuals to enhance your consultation.  Visuals are extremely useful in helping you to understand all your options.  Your plastic surgeon should draw schematic diagrams to explain the various techniques and present you with lots of pictures of previous patients, which should be catalogued by physical attributes, rather than by implant volume or bra size.

3)  Make sure all your options are given to you in detail.  Your plastic surgeon should take a systematic approach to counseling you about your surgical options, beginning by describing the simplest, least-expensive procedure and moving up in terms of complexity and cost. Outlining all of the information so that you understand the basis for your recommendations and the likely outcomes should help you reach an informed decision and choose an operation that will deliver a satisfactory result.

If you have cost in mind and are dissatisfied after your recent primary surgery, then try and rectify the situation by returning to your previous surgeon. If this is not an option because of poor surgeon-patient communication, then you should seek another surgeon.

Thanks for reading!

 

Dr Tim – Sydney Cosmetic Plastic Surgeon

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

 

Mommy Makeover: Combined Surgical Procedures for Today’s Moms

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After multiple pregnancies and breastfeeding, many women find it impossible for diet and exercise alone to restore their figures. Fortunately, mothers with permanently altered figures find that a Mommy Makeover is an excellent solution. The Mommy Makeover is a term for the group of cosmetic procedures that many mothers seek following pregnancy. These include the following:

  • Tummy Tuck
  • Liposuction
  • Breast Augmentation
  • Facial surgery

There are multiple variations of the Mommy Makeover, of course, and a plan must be individualised for each patient depending on their needs. Many women will not need or desire all of these procedures. Each patient determines what her personal Mommy Makeover will involve after we discuss her concerns and options in a thorough consultation.Combined Surgical Procedures

A Mommy Makeover may be performed in one or more phases. The patient’s age, health, needs and other emotional considerations. desires are all considered carefully when a plan is constructed for each patient. The majority of patients choose to do more than one procedure at a time.

Tummy Tuck

The abdomen tends to change appearance following pregnancy with stretch marks, loose skin and lower abdominal fat. 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, a tummy tuck may be performed where the excess skin and fat is removed from the abdomen and the muscles are tightened.

Liposuction

After having children, fat tends to redistribute in many unwanted areas of the body. This is often true even for women who were 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. A preferred technique is power-assisted liposuction, the safest and most effective way to remove fat from these areas.

Breast Surgery

The breasts go through dramatic changes with pregnancy and breastfeeding.  The most common breast procedures performed as part of a Mommy Makeover are:

A Mommy Makeover refers to the common group of procedures that many mothers seek after they decide not to have any more children. Many times, the operation is performed at once, but other moms prefer to do the procedures over time. In either case, it gives many mothers comfort to know that the changes they see in their bodies following pregnancy may be improved dramatically by a skilled plastic surgeon.

To learn more about what a Mommy Makeover can do for you, request a consultation online or call our Sydney clinic at 13000DRTIM.

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One of the amazing 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:

  1. A few days to recover before returning to work
  2. A month for the incisions to heal before resuming exercise
  3. A year to 18 months for the scars to fade to a subtle colour

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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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 

Look Younger for 2019!

 

These are my top 10 hints for looking good next year:

  1. Eat well. Preferably, eat smaller meals as the day goes by and eat frequently. Make it a habit not to eat after 9 pm.
  2. Exercise regularly. Remember: ”healthy body, healthy mind!”
  3. Keep your weight stable and within normal limits. Being overweight can predispose you to certain cancers and diabetes, not to mention, heart attacks, strokes and leg ulcers.
  4. Get your general practitioner to do a physical examination and if necessary, run some basic blood tests.
  5. Avoid the 4”S”: sun, stress, smoking and sleepless nights. These can hasten your aging!
  6. Think skin rejuvenation i.e.; microdermabrasion, peels and laser skin tightening. These will give your skin a definite glow!
  7. Start getting anti-wrinkle injections to iron-out those wrinkles that make you a more youthful appearance!
  8. Use fillers to pump-up that lost volume in the cheeks etc. As we age, the fat melts away in certain pockets in the face as does the underlying bony platform. The end result is excess skin that combines with gravity to make it sag. This effect can be countered by using either synthetic fillers or fat injections.
  9. Think minimal scar surgery to rejuvenate the face e.g. a neck lift or remove those bags under the eyes.
  10. Think about a surgical rejuvenation of the upper eyelids and brows by giving them a lift. The eyes and brows are often the first signs of aging in a woman and they usually start to sag in their early 40s.  Remember, ”the eyes are the windows of your soul” and may tell us a lot about your self-esteem and body image.

Thanks for reading!

Dr. Tim – Sydney Cosmetic Plastic Surgeon

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

Eyelid surgery for a more youthful look

Eyelid surgery is an operation that can dramatically improve a patient’s appearance within a relatively short recovery time. Droopy eyelids is one of the major reasons why some people often consider eyelid surgery (blepharoplasty) to get rid of excess eyelid skin for a youthful appearance. In other cases, eyelid surgery helps in improving ones vision by offering a field of view that is less obstructed after the removal of excess skin.

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How is eyelid surgery performed?

Eyelid surgery can be performed on your upper eyelids, lower eyelids or both. The plastic surgeon will carry out pre-operative evaluation on factors such as your facial muscles around the eyes, the symmetry or droopiness of your eyebrows and underlying bone structure. After the evaluation your plastic surgeon will be able to determine the amount of skin and/or fat to get rid of. Some points to consider:

  • your plastic surgeon will make accurate markings to show where the excess tissues will be removed on your lower and upper eyelids.
  • On your upper eyelid, they will make a surgical slit concealed in the natural fold of the upper eyelid.
  • In the lower eyelid, the surgical slit will be concealed below your lower eyelashes. When unwanted fat only is being removed, the slit can be made inside the lower eyelid which is referred to as a transconjunctival incision. Laser resurfacing may at times be used together with this method so as to make the lower eyelid skin tighter.
  • The plastic surgeon will also get rid of excess tissue through these slits.
  • At times, fat may need to be redistributed in the lower lids to completely remove bulges or puffiness. Other changes may be made so as to correct special problems such as muscle laxity.
  • The scars are generally inconspicuous after healing.
  • For patients who have dry eyes, very little amounts of tissue are removed to avoid exposing more of the eye to the air which may worsen the symptoms.

When to consider eyelid surgery

  1. If you have too much skin hanging or covering the upper eyelids natural folds.
  2. If loose skin hangs down from the upper eyelids over the eyelashes.
  3. If the under of your eyes has deep grooves and bulges.
  4. If both your upper and lower eyelids look puffy, making your eyes appear aged and tired.

Many people who consider blepharoplasty also consider facelift, wrinkle smoothers, brow lift and dermal fillers for a complete facial rejuvenation look.

What will my eyelid scars look like?

  1. Upper eyelid surgery: The plastic surgeon will mark the natural lines and creases of the lids and keep the incisions as concealed as possible along the natural folds. Thin sutures will be used in closing up the incisions hence making the scars visibility minimal.
  2. Lower eyelid surgery: In the traditional blepharoplasty, the doctor will make the slit in a hidden side along the lash line and smile creases of the lower lid. In the transconjunctival approach, the doctor amends the eyelid puffiness that results due to excess fat by making a cut inside the lower eyelid. This technique doesn’t need an external slit but it cannot be used in the removal of extra skin.

Recovery

This is one of the fast healing surgeries that I undertake. However, it is important that you adhere to all the postoperative procedures that are given. This will include instructions about iced eye pads, bandages and taking of antibiotics if prescribed. I will also offer detailed instructions about the normal symptoms and any signs of complications. The amount of recovery also varies among people so it’s good to be patient and not rush things.

Risks

Fortunately, eyelid surgery has very minimal complications. Thousands of people undergo successful blepharoplasty and are happy with their transformation. However, all surgical procedures come with some degree of risk. Some of the complications may be watery eyes, infection and bleeding, allergic reactions, sensation changes, asymmetrical scarring and haematoma.

Question: What is the most troublesome thing you find with droopy eyelids? You can leave a comment below.

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.