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.

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 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