Cosmetic Surgery Tip #7: Don’t strive to look like a celebrity

 

Make sure that you are doing this for the right reasons. There tends to be “trivialisation’’ of certain cosmetic procedures, particularly those that are popular amongst reality TV stars. A cosmetic procedure of any kind is something to consider carefully, and is not a decision to be taken lightly. It is also unrealistic to want to try and emulate someone else’s results. Every individual is different and all cosmetic treatments should take into account, and be sympathetic towards, the individual’s existing body shape. If someone comes in clutching an image of a celebrity then alarms bells should instantly ring for the plastic surgeon. More often than not, they will have unrealistic expectations and if that is the case the plastic surgeon will most likely advise that they don’t go ahead with treatment.

Cosmetic Surgery Tip #18: You can move fat from elsewhere on your body to your boobs or butt

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It’s a new process called autologous fat transfer. The purpose of fat grafting is to augment or fill in volume-deficient areas. Of course, you must have donor sites from which fat can be taken. It is important that you do not have any circulation problems, either from a medical condition or smoking. Few people are candidates for this procedure to the breasts. If you desire a modest increase in breast size, you are a good candidate for fat grafting to the breast, but your breasts should already have a nice shape and good skin tone. If you have poor skin, sagging breasts, or want a significant increase in breast size, breast augmentation with fat transfer is not for you. The problem with only using fat for breast enhancement lies in getting large volumes of fat to predictably “take.” Many people who desire a fuller, more rounded buttock will opt for a “Brazilian butt lift,” which uses fat transfer to provide a more curvaceous buttock without the use of an implant. Liposuction is commonly used to both sculpt the surrounding area and collect the autologous fat to be injected.

Photo Credit: Saul Steinberg “Masquerade”

Cosmetic Surgery Tip #9: Understand the recovery process

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Being fully informed about the recovery process is vital so that you can prepare yourself in advance. Patients often neglect to think about many important post-op factors: Is it a day-surgery procedure? Will you need assistance leaving the hospital or facility? How should you travel home? Will you be in pain? Do you need to take time off work? What does the post-operative care entail?  When are the post-operative follow up visits?  There are a number of factors to take into consideration and your plastic surgeon should discuss all of these thoroughly with you in advance.

Photo Credit: Saul Steinberg “Masquerade”

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 .

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. 

 

Breast Reduction using the Wise skin pattern. DrTim demonstrates a breast reduction using the Wise pattern, often referred to as an “anchor” or “inverted-T” technique. This is the skin pattern outlined on the breast. The blood supply or “pedicle” to the nipple is supplied superomedially in this case.

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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.

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.