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

 

Watch Dr Tim on Channel 10’s The Sunday Project, discussing the new Brazilian Butt Lift (BBL) task force he is heading up. The task force is investigating the risks associated with the BBL procedure as well as improving patient safety.

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

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

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

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

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

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

THE BOOTYLICIOUS EFFECT

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

WHAT THE TASK FORCE WILL DO

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

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

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

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

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

WHY IS THE BBL SO DANGEROUS?

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

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

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

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

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

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

WHAT TO DO IF YOU WANT A BBL

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

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

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

– Ben Graham 

Article Source: news.com.au

Dr Tim Papadopoulos Named President of ASAPS

dr.tim papadopoulos

President of ASAPS

We are proud to announce that our cosmetic plastic surgeon, DrTim, has been named the new President of the Australasian Society for Aesthetic Plastic Surgery (ASAPS). ASAPS is the most elite and prestigious organisation for cosmetic plastic surgeons in Australia and New Zealand.   DrTim has previously served as Treasurer of ASAPS and says he feels honoured to have the support of his colleagues and fellow ASAPS members. He has received much valued education, support and training from the ASAPS organisation, and he is both privileged and committed to giving back to the organisation over the next 2 years of his term.   Throughout his term, DrTim’s top goals will continue to centre around patient safety and improving surgical outcomes. DrTim also has a passion for mentoring up-and-coming Plastic Surgeons. He is very involved in developing a strong Aesthetic Fellowship program for new plastic surgeons so that they will appreciate and pursue ASAPS membership to keep the quality of cosmetic plastic surgery high for patients.   At the CosmeticCulture Clinics, our entire staff feels privileged to work alongside a surgeon so devoted to bettering the level of care that plastic surgery patients receive not only in our practice, but in practices all across the Australia and New Zealand. Congratulations, DrTim!

Breast Augmentation Part 4 of 4: The Surgical Facility

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 better place to have the procedure performed because of the availability and back-up of an intensive care unit and other highly specialised healthcare professionals.

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 these outcomes. Another requirement of accreditation is to assure that personnel is trained, experienced, and skilled healthcare 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 and comfortable surroundings, as well as 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 the 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

 

Watch Dr Tim on Channel 7’s Sunrise morning show, discussing with the crew about the new Brazilian Butt Lift (BBL) task force he is heading up. The task force is investigating the risks associated with the BBL procedure as well as improving patient safety.

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Supplements and Cosmetic Surgery

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

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

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

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

Thanks for reading!

Dr. Tim  –  Sydney  Cosmetic  Plastic  Surgeon

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

Breast Augmentation Part 3 of 4: The Plastic Surgeon

I am amazed at how many patients spend more time shopping for a TV or washing machine than they spend selecting a plastic surgeon. Selecting your surgeon should be the single most important thing that you can do to assure an optimal result.

You should have a checklist of essential things to look for in a plastic surgeon:

1)  Certified by the Royal Australasian College of Surgeons, the only college recognised by the Australian Medical Council that can train surgeons in Australia

2)  Be a Member of the Australian Society of Plastic Surgeons (ASPS) and the Australasian Society of Aesthetic Plastic Surgery (ASAPS)

3)  Has hospital privileges to do breast augmentation at an accredited hospital or day surgery facility

4)  Subspecialises in cosmetic surgery

5)  Super specialises in breast augmentation

6)  Recommended by a knowledgeable friend or doctor

7)  Has a curriculum vitae that documents scientific presentations and publications

There are also a few less reliable points that I would like to address when choosing a plastic surgeon. Advertisements and media coverage is paid for by the plastic surgeon and does not necessarily reflect how knowledgeable, competent or experienced they are. Your local doctor may not be in the know of who is best to do breast augmentation and may not have an interest in cosmetic surgery to find out either. Some just refer to surgeons who are their friends from medical school, are in the local area and thus convenient, or who may be paid for by the surgeon to refer you. Never listen to recommendations from anyone who is an “armchair expert” or who has no in-depth knowledge of breast augmentation.

At the end of the day, look at the plastic surgeon’s results to see how good they are. Be very careful with “glamour shots” that can deceive because of lighting, patient positioning and camera angle. They may even be “photo-shopped” or airbrushed. Some plastic surgeons may have models as patients that they have operated on their face but not their breasts (which was performed by another surgeon) and use them for advertising breast augmentation.

There are a further number of “red flags” that you should take notice of. These are:

1)  Completed training in a specialty other than plastic surgery

2)  Certified in an unrelated college

3)  Not a member of ASPS and ASAPS

4)  No hospital privileges

5)  If you are given false or misleading information – claims that are too good to be true.

6)  Unwilling to provide you answers to questions regarding credentials or their curriculum vitae

7)  When the office staff are not courteous, knowledgeable, or don’t spend enough time with you, and don’t tell you what you need to know. Beware of staff who give you all fluff, but no substance, and don’t offer to send you any information. Always insist that the price is broken down into the following categories: surgeon fees, anaesthetist fees, costs of implants, operating room fees, hospital stay fees, laboratory fees, mammogram or ultrasound fees, any other fees. Ask how long the prices on the quote last for. Remember, there is no such thing as bargain surgery. Have you ever seen top-quality surgery for a bargain price? How is the bargain surgeon able to offer such a good price?

When visiting the plastic surgeon’s rooms, look around and take notice of the little things. It should be a quiet, comfortable and modern, an atmosphere that reflects the good taste of the plastic surgeon. The organisation, function, and flow of the plastic surgeon’s office is a reflection of the surgeon’s personality and habits. Think about it. If the office looks messy and unclean, doesn’t that reflect badly on the surgeon who accepts this scenario?

Most of the time, you will recognise a good plastic surgeon without the surgeon having to tell you. If they have integrity, are caring and thorough, then this will definitely contribute to what you will get in the operating room and after.

Question:  What factors do you consider important when choosing a plastic surgeon to perform a breast augmentation? You can leave a comment below.

Wabi-Sabi In Cosmetic Surgery – Imperfect, Impermanent, and Incomplete.

Celebrities, models, and socialites have highlighted some severe complications (including death) from undergoing cosmetic surgery in their pursuit of perfection. This is very concerning and makes me reflect on what beauty is all about. I am reminded at this point of Wabi-Sabi, the Japanese philosophy that embraces the beauty of things imperfect, impermanent, and incomplete.

It is a beauty of things modest and humble. It would be interesting to see how much of this ancient Japanese philosophy could be embraced in the world of cosmetic surgery and what a difference it could make.

Wabi-Sabi represents the exact opposite of the Western ideal of great beauty as something symmetrical, extraordinary and enduring. Wabi-Sabi is about the minor and the hidden, the tentative and the ephemeral: things so subtle and evanescent they are invisible to unrefined eyes.

Simplicity is at the core of things Wabi-Sabi. Wabi-Sabi embraces the “less is more” ideal talked about today, yet often ignored. Cosmetic surgery needs a lot of Wabi-Sabi.

Thanks for reading!

Dr.  Tim  –  Sydney  Cosmetic  Plastic  Surgeon

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

Breast Augmentation vs. Breast Lift – Know it all!

Like many women, you may find yourself choosing between these two procedures or choosing both. Each has its own unique goals, and the procedures are often combined to achieve an even more attractive curvature.

Breast Augmentation Goals
The goal of breast augmentation surgery is to make your breasts bigger and/or fuller (more projected). Women differ so vastly in shape, size, and frame that a number of options have been developed that offer something for everyone. You can choose from:

  1. Silicone gel or saline implants
  2. Textured or smooth surfaced implants
  3. Implant placement behind the breast tissue or behind the pectoralis muscle
  4. Round or tear-drop (anatomical) implants
  5. Various sizes of implants
  6. Different sites for the incision (breast fold, armpit or nipple areola complex)

Breast Lift Goals
Breast lift surgery is designed to elevate sagging breasts and restore their youthful, perky stature. Gravity, pregnancy and weight gain have a way of stretching even smaller breasts over time. Weight loss may leave breasts less firm and a bit saggy. Breast lift surgery involves elevating the nipples and lightening the breast skin to restore breasts to an attractive shape.

Breast Lift with Breast Augmentation Goals
The lift removes the excess skin and reduces sagging (pushes things “up and in”). The implant fills the remaining breast skin, adding contour and fullness where minimal breast tissue is insufficient (pushes things “out and down”). As you can see, the forces are opposing, and for that reason, there is a 20 % revision rate for this procedure.

What Makes the Difference?
What makes the biggest difference in outcomes is that the most successful plastic surgeons use the following techniques and protocols:

  1. Minimal blood loss, bruising and swelling by using electrocautery for dissection of the pocket, as well as, gentle manipulation of the tissues
  2. Smaller incisions
  3. No sutures for removal
  4. Specialised instruments for accurate placement of an implant
  5. Adequate pain relief postoperatively
  6. No drains or wraps to manage
  7. Avoidance of blood thinning agents perioperatively (cease multi-vitamins, aspirin, NSAIDs etc.)

 

Thanks for reading!

Dr. Tim – Sydney Cosmetic Plastic Surgeon

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