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 anesthetic 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 minimize complications from surgery and anesthesia. 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

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.

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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.

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.

Can you achieve the perfect nose?

Rhinoplasty or nose surgery is one of the most common cosmetic procedures. You only notice the nose if it’s too big, too wide, or seems to be misshapen. In these type of cases, most people would want to have a rhinoplasty, also known as a nose job, to make an improvement in their appearance and thereby, increase their self-confidence and quality of life. Rhinoplasty are also performed to correct an accidental fracture or to improve chronic nasal congestion. In such cases, the surgery falls under functional surgery.

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Who Are Good Candidates for Rhinoplasty?

Rhinoplasty is suitable for anyone in good health. It is advisable that the procedure be done on a fully developed nose. Complete maturation of the nose is developed by the age of 16 for girls and 18 for boys. The commonest age group for a rhinoplasty are the late teens and early twenties. Adolescence and early adulthood exposes individuals to great pressure from their peers and society with regards to the way they look. Having a nose that is unappealing places enormous stress on one’s self-esteem and can cause severe effects on a teenager’s confidence.
Fixing bumps or making the nose smaller usually gives the face better proportion, leading to an improved appearance that will give teens and early adults the confidence they need to tackle  life and their foray into the real world. Older individuals who have rhinoplasty done either do it for cosmetic or for functional reasons, the latter usually to correct difficulty in breathing caused by chronic nasal congestion and other conditions.  For many, a drooping and sagging nose caused by ageing makes them look a lot older and having rhinoplasty can rejuvenate them again.

Insurance Issues

Cosmetic surgery is generally not covered by health funds. However, when a rhinoplasty is needed to correct an injury like a fracture, nasal obstruction, or to correct a congenital nasal deformity, then it can fall under functional surgery and therefore be covered. It all depends on the reason behind the nose job. Make sure you know what your medical insurance covers so you know how to proceed with your planned surgery.

The Steps to Having a Rhinoplasty

Before you consider a nose job, make sure you know where to have it done. Do your research and choose the best clinic or plastic surgeon who will help you achieve the look you want for your nose.  Set an appointment with the plastic surgeon and gauge whether or not you are comfortable and confident with the professional who will be doing the procedure. If everything is in place, such as the look you are going for, the budget, and the schedule, then it’s time you make the appointment for your rhinoplasty. Advanced technology like the VECTRA 3D Imaging System is available in certain clinics, which provide you with computer simulations of your before and after pictures. If you don’t like what you see, you can discuss further with your plastic surgeon about how you want the structure of your nose to look like.

What to Expect with the Rhinoplasty

Rhinoplasty is an outpatient procedure performed under general anaesthesia. The entire procedure takes about 1 to 3 hours or longer for complicated cases. Most plastic surgeons today perform an open rhinoplasty where the the incisions are made just under the nose, as well as,  inside the nose so the scars are inconspicuous once the nose heals. Depending on what needs to be done, plastic surgeons either remove bone and cartilage to make the nose smaller, or add tissue to make it bigger especially in Asians and African-Americans. Once this is done and the structure of teh nose is in place, the skin is re-draped and the incisions closed with fine sutures. A splint is then placed on-top of the nose to provide support to the new shape until it heals.

Recovery

Patients can go home after a rhinoplasty but for more complicated surgeries, patients would need to stay overnight at the hospital. Splints are usually taken off after 7 days. Many patients get to return to work after 1 week but swelling and bruising will still be present. Expect your face to feel puffy, especially on the areas around your eyes and nose. Swelling usually improves after 10-14 days.

Risks

The risks involved with rhinoplasty include infection, bleeding, nasal blockage due to swelling, and asymmetry. It is best to consult with your plastic surgeon should there be any unexpected side effects of the procedure.

Question: What do you think are the  main benefits of rhinoplasty? You can leave a comment below. 

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There are many reasons why women seek breast augmentation. Some women feel that increasing their breast size will give them greater self-confidence. Others would like to feel more proportional between their top and bottom so they fit better into their clothing. Mothers frequently seek breast augmentation to restore what was lost with breastfeeding and ageing. Supporting loose skin and giving upper breast fullness are also common reasons for choosing breast enlargement.

Good communication with patients in breast augmentation is key. There’s a need to review their medical histories and ask patients what their goals are for breast augmentation. In some cases, it is a modest increase in size to fit better in their clothing. Other times it’s a significant increase in volume to change their look. A patient may desire an improved breast shape or, possibly, better symmetry is their goal. Still others may want to restore their pre-pregnancy figure and may choose to combine their augmentation with a breast lift or other procedures.

On examining the patient, one needs to consider many features including breast volume, width, height, nipple position, areola size, ribcage curvature, skin tone, droopiness, asymmetry, and crease position. Breasts are highly variable, and I help the patient understand what their best options are based on their physical characteristics. We then come to a common agreement about what our goal will be. Remember, that “breast are sisters, not twins” so more often than not there is quite some variation between the two breasts so you can’t expect a perfect match following breast augmentation.

When the patient returns for their pre-operative visit, typically 1-3 weeks before surgery, I have them look through many digital photographs of breasts to show me their desired result. If there is a discrepancy between what we have discussed and what the patient is showing me with pictures, I’ll identify the difference and sort out what they really want, often using the 3D VECTRA which can simulate what the breasts may look like after augmentation. At the end of our meeting, I’m fairly confident that I understand what the patient desires. Likewise, the patient feels comfortable with our communication and our plan.

The photographs are then brought with me to the operating room. When the patient is asleep, I create the pockets for the implants on each of the breasts, and I occasionally use implant sizers to confirm the volume and shape of the optimal breast implants for the patient. Most patients are back to work and most of their usual routine in several days or up to a week. Strenuous exercise should be avoided for several weeks.

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

The Benefits of Breast Asymmetry Correction

Almost every woman on the planet has one breast that is fairly different from the other. For some women though, the discrepancy can be extreme with noticeable differences in size and shape between the two breasts.

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Breast asymmetry will come in different shapes and sizes, but what remains constant is the problems they cause. Breast asymmetry will not only make finding bras that fit and clothes that hide the asymmetry a hassle, but will also impact negatively on a woman’s self-esteem and confidence.

Breast asymmetry correction is one the most recurring problems I face as a plastic surgeon specialising in breasts. During initial consultations, I often find that some patients are not even aware of their own breasts being asymmetrical. To facilitate proper planning so as to improve the outcome of surgery, these differences have to be identified early in the procedure.

Breast asymmetry types

1. Congenital Breast Asymmetry.

This means that the difference in the size of your breast is innate: it is as old as your breasts and has been becoming more conspicuous with their growth and development. There are several reasons why patients have these preexisting differences between their breasts. They include:
– Differences in breast volume
– Differences in areola size and/or position
– Rib cage (chest wall) asymmetries, as in pectus excavatum or scoliosis
– Differences in the positioning of the breast fold crease.

2. Post Surgical Breast Asymmetry

There are several conditions that would lead to development of breast asymmetry several years after a breast surgery procedure has been done on a patient; an example of such an operation is breast augmentation. This conditions include:
– Capsule contracture
– The breast tissue may be drooping
– Implant position movement
– Areolas getting stretched.

Breast asymmetry correction

There are several techniques that can be used to correct this problem and help you feel comfortable and more confident in how you look.  The first and most important step in breast asymmetry corrections is the determination of the ideal breast size for you. I work very closely with my patients to help them make this essential decision. Important questions asked at this stage are; whether smaller breasts need to be enlarged with implants, or whether larger breasts should be reduced in size for example.

In some cases, the best results can be achieved by doing the same thing to both breasts. For example; a patient with very large breasts can have both reduced with one breast being reduced more than the other to make up the difference. Where the patient has small breasts, augmentation can be done on both with one being augmented more than the other. The important thing here is to make sure that the final breasts have roughly the same amount of implant volume or breast tissue after the procedure. It’s only then that you will be able to enjoy relatively same sized breasts.

Customised treatment plan

Unlike other breast cosmetic surgeries, breast asymmetry is a more difficult procedure to perform. It thus requires careful planning, thought and consideration well in advance before the procedure. This is where the surgeons experience is crucial as they will help the patient make the smallest of decisions that will together determine the overall success of the procedure. As they say: ‘the devil is in the detail.’

Since patients have several options to choose from, I take the time to go through each option with my patients. I will help the patient make the best decision by outlining the best available options for their particular condition so as to achieve the best results. Being a trusted adviser, it’s my goal to make sure that all my patients fully understand the implications their decisions will have on their well-being and to help them choose wisely.

Implant options

If we do decide that the implant method is the best solution for your problem, you will be able to get access to a wide range of implants that are guaranteed to suit your needs. We have access to the newest generation of implants available in different styles and sizes at my patients’ disposal.

Breast asymmetry surgery is one of the most challenging breast procedures. Diligence, communication and surgeon experience are all crucial ingredients for the best results.

 

Question: What do you find are the most difficult challenges with breast asymmetry? You can leave a comment below.

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 .

 

This middle aged lady underwent a Body Lift following massive weight loss of 70kg with diet and exercise alone. DrTim demonstrates the 2 phases of the operation- starting on the back by removing excess tissue and lifting the buttock region and finishing on the front by further excising tissue, performing a lateral thigh lift, tightening the separated rectii muscles and reconstructing the belly button. The B & As show a much better contoured torso with an improved waistline.

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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