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.

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.

Why a Body Lift Can Help You After a Massive Weight Loss

If you desire a firmer, more youthful-looking body contour, then a surgical body lift may help achieve your goals. It improves the shape and tone of the underlying tissue that supports fat and skin. In addition, the procedure(s) can improve a dimpled, irregular skin surface, commonly known as cellulite.

Body lift surgery essentially sculpts the body by excision of excess skin and fat and reconstruction of what remains into some reactive contours. Body lifts can be performed in two different ways, to treat either the upper or the lower body:

  • Lower body lift: The lower body lift is the most common type of body lift in my practice. It typically includes a tummy tuck (abdominoplasty), thigh lift, and buttocks lift performed at the same time. The incision is concealed around the hipline so that it’s not visible when wearing underwear or a bikini.
  • Upper body lift: For patients with severe skin laxity of the upper torso, an upper body lift may be the appropriate treatment. This typically includes a bra line back lift and upper abdominoplasty. The procedure is individualised for the particular patient.

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.

Body lift is performed under general anaesthesia, with the patient positioned on their stomach, and the surgeon removes a large, belt-like segment of skin above the buttocks, up to the lower back. When the wound is closed, the thighs and buttocks are lifted. The patient is turned over and the surgeon continues to work on the front of the thighs and abdomen. Indeed, when a surgeon performs a circumferential removal of skin and fat of the lower abdomen, and when combined with undermining of the thighs, it will lead to a lift of the buttocks and thighs. A body lift can be done in two stages, with a three-month gap between procedures, or as a single stage surgery.

Patients usually take at least two weeks off from work following a body lift. I encourage patients to ambulate shortly after surgery. They may resume full exercise approximately 6 weeks following surgery. The results of a body lift are visible almost immediately. However, it may take as much as one to two years, or more, for the final results of the body lift procedures to fully develop. Since weight loss patients have poor skin elasticity, the closure must be as tight as possible. However, over-resection of the skin followed by overly tight closure of the tissues can lead to wound rupture or to broadly depressed scars resulting from suture pull through, breakage or premature dissolution. At the same time, insufficient removal of skin and low-tension closure leaves sagging tissues, skin rolls and/or wrinkles. A body lift should be seen as a critical step in overcoming obesity, with the potential of ceasing or reducing medications used for diabetes and high blood pressure. Patients need to take steps following surgery to maintain a healthy lifestyle, ensuring that their new shape will be long term.

Question: Do you feel that a body lift can improve self-esteem following massive weight loss? You can leave a comment below.

Breast Implants & Anaplastic Large Cell Lymphoma (ALCL)- No Cause For Alarm

Breast Implant & ALCL

Only recently described, breast implant–associated anaplastic large cell lymphoma (ALCL) usually presents as an effusion-associated fibrous capsule surrounding the implant and less frequently as a mass. Little is known about the natural history and long-term outcomes of such disease. It is estimated that between 5 and 10 million women have breast implants. Due to the rarity of a diagnosis of ALCL (3 in 100 million per year in the USA diagnosed with ALCL in the breast) a worldwide collaboration is required to provide robust data to investigate this possible link.

ALCL is a lymphoma and not cancer of the breast tissue. When breast implants are placed in the body, they are inserted behind the breast tissue or under the chest muscle. Over time, a fibrous scar called a capsule develops around the implant, separating it from the rest of the breast. In women with breast implants, the ALCL was generally found adjacent to the implant itself and contained within the fibrous capsule. ALCL is a lymphoma which is a type of cancer involving cells of the immune system. It is not cancer of the breast tissue.

The most recent clinical studies state that it is not possible to confirm with any certainty whether breast implants have any relation to an increased likelihood of developing ALCL, and particularly whether any one type of implant can create a higher or lower risk than another of developing the disease. It should be noted that ALCL is extremely rare and treatable. This is evidenced in particular by three recent papers:

  1. A Danish nationwide study – ‘Breast implants and anaplastic large-cell lymphoma: a Danish population-based cohort study’– concluded that in a nationwide cohort of 19,885 women who underwent breast implant surgery between 1973 and 2010, no cases of ALCL were identified
  2. A review of cases within another recent comprehensive article, ‘Breast implant-associated anaplastic large-cell lymphoma: long-term follow-up of 60 patients’ concluded that: “most patients with breast implant-associated ALCL who had disease confined within the fibrous capsule achieved complete remission. Proper management for these patients may be limited to capsulectomy and implant removal. Patients who present with a mass have a more aggressive clinical course that may be fatal, justifying cytotoxic chemotherapy in addition to removal of implants.”
  3. In a study reported in the Journal of Clinical Oncology, Roberto N. Miranda, MD, Associate Professor in the Department of Hematopathology at The University of Texas MD Anderson Cancer Center, and colleagues assessed disease characteristics, treatment, and outcomes in 60 cases. They found that outcomes are better in women with effusion confined by the fibrous capsule, whereas disease presenting as a mass has a more aggressive clinical course.Patients should be advised that ALCL is a very rare condition and until any further evidence is presented there is no need to remove breast implants as a matter of course.

 

These data suggest that there are two patient subsets. Most patients who present with an effusion around the implant, without a tumour mass, achieve complete remission and excellent disease-free survival. A smaller subset of patients presents with a tumour mass associated with the fibrous capsule and are more likely to have clinically aggressive disease. We suggest that patients without a mass may benefit from a conservative therapeutic approach, perhaps removal of the implant with capsulectomy alone, whereas patients with a tumour mass may need removal of the implants and systemic therapy that still needs to be defined.

 

We continue to advise that any women with breast implants who experience any sudden unexplained changes, lumps or swelling should speak to their GP or their surgeon.

3 Tips to Consider Before Body Lift Surgery

Body lift surgery is a complex operation that requires a lot of information to be processed and considered. There are 3 main points that people interested in this procedure should keep in mind especially that this involved both a major physical and psychological recovery period.

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1. Make Sure You Have Appropriate Motivation & Realistic Expectations

Make sure you are doing the body lift surgery for yourself and for the right reasons and that you have realistic expectations.  Be aware that an improvement in the problem area may not necessarily translate to an overall improvement in your life or home situation.  You are bound to be disappointed with results of body lift surgery if your motivation is not intrinsic.
 Timing of your body lift surgery is crucial. Generally, it is not a good idea to have body lift surgery done during or immediately after a stressful period in your life e.g. divorce or death of a loved one. The additional stress of body lift surgery will undoubtedly be  more challenging to deal with if your emotional reserves are already exhausted. Take note that an improvement in your physical appearance will not necessarily translate to an improvement in your life situation.
 Lastly, keep in mind the end results as you go through the sometimes tough, emotional times after your body lift surgery.

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

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.

What’s wrong with sharing cosmetic surgery information?

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I am always wary of people who do not want their partners to know they are having or about to undergo cosmetic surgery. There are a number of reasons for this:

  1. I do not want to be held responsible if the partner finds out and an argument ensues.
  2. Relationships should be built on trust and respect for each other, and that usually implies having an open and honest dialogue between two grown-up individuals.

I encourage patients and clients to bring their partners in during the consultation so that he or she can understand what options are available for cosmetic surgery, including their benefits and trade-offs so that we can arrive at a reasonable informed consent. I do not want to be the last person to find out that what should have been spent on a child’s education was placed in my hands and then the partner gets annoyed or whatever.

Ever thought what it would be like if you were discovered with an unexpected bruise or swelling? How would you explain that? Will you carry a guilty conscience if you didn’t tell your partner? I simply want every patient or client to know that I support cosmetic surgery or non-surgical procedures for enhancing people’s looks but I encourage an open and sharing relationship with one’s significant other about such things. After all, we are grown-up individuals and should not withhold information from a person that probably should know what we are doing. If you have questions, please bring them up with your plastic surgeon during the consultation.

In the end, the decision to tell your partner, friends or family is a very personal one that largely depends on you and your relationships. For most of our patients, we find the question of telling their partners, friends or family is very simple and they find that the added support helps in making the entire process easier. Occasionally, however we have some patients who feel that they have a partner, family or friends who simply will not accept their decision to proceed with surgery. Occasionally, these patients want to remove some family-defining characteristic, such as a nasal hump that they feel their family would want them to keep. For other patients, especially those who are still in school, we will wait to have surgery over the winter or summer break so that changes are not quite so obvious to classmates.

Overall, however we have found that the social stigma that used to be associated with cosmetic surgery is no longer really an issue and, in general, when our patients discuss their reasons for wantng to pursue surgery, their partners, families and friends are generally much more supportive throughout the process than you may otherwise expect. In those cases, when our patients are from out of town or when they do not have support, it is important to have a comprehensive team and program to help take care of all your postoperative needs and to make you feel comfortable every step of the way.

Ultimately, the choice to have surgery should be yours alone. So, you can consider what others will think, but you should do what will make you most happy. Often, involving loved ones can make for a very positive experience. More information is available on our website www.drtim.com.au , including descriptions of cosmetic surgery and non-surgical procedures. You can also email us for more information at info@drtim.com.au or call us on 13000DRTIM.

 

Question: Do you think your partner, family or friends can be supportive of cosmetic surgery or it doesn’t really matter because the choice is yours? You can leave a comment below.

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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 

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.