Question of the week: what is a Keller funnel and why does it make breast augmentation surgery safer?

My friend has had a breast augmentation and said her surgeon used a funnel to insert her implant and make her surgery safer. Does Dr Sharp use a funnel, and if so, how does it make the surgery safer – and does it cost extra? - patient Dr Sharp: It’s great to hear you are thinking about these factors before your breast augmentation surgery, as they are an important pre operative considerations. The Keller funnel is an implant delivery system for inserting breast implants into the surgical pockets; a clear funnel shaped tool that allows for easier insertion of the breast implants into the chest cavity without over-handling of the prosthesis. The Keller funnel was a game-changer in breast augmentation, alleviating the need to insert breast implants by hand, and offering three key advantages: Decreased breast implant contact Being able to use additional anti-bacterial measures with a Keller funnel reduces the risk of breast augmentation complications. It offers less risk of damage to the breast implant during insertion, helping to minimise the risks of pre-insertion damage to the breast implant product by reducing the  need to manually handle the breast implant. Excessive manual handling of implants has been identified as a potential factor in the compromise of the implant shell, reducing the longevity of the implant. Easier breast implant insertion The Keller Funnel’s clear polymeric surface is also believed to help make it easier for the insertion (and potentially orientation) of some types of breast implants. The clear funnel allows for greater visibility of the breast implant at all stages of the implant insertion; assisting surgeons with breast implant placement for cosmetic and plastic surgery breast enlargement procedures. The funnel’s low friction coating allows...

Tummy tucks ease incontinence and back pain

Abdominoplasty surgery is far more than just a cosmetic procedure designed to remove a small post pregnancy pouch of skin. Most tummy tuck procedures reshape and strengthen the abdominal wall, reducing back pain and urinary incontinence after pregnancy. Earlier this year an Australian study found abdominoplasties provided significant functional and medical benefits to women post partum so… Why aren’t abdominoplasties considered a ‘medical’ procedure and subject to rebates after pregnancy? If you’ve lost 5 BMI points (outside of pregnancy) and have excess skin that can’t be conservatively managed, the Medicare Benefits Schedule criteria may deem you eligible for a ‘medical’ abdominoplasty - that is, one that is billed under an item number. However, since late 2015, if you’re a women experiencing rectus divarication, chronic back pain or urinary incontinence post partum, Medicare and health funds will consider the procedure to be ‘cosmetic’. So essentially, if a man undergoes extreme weight loss after bariatric surgery and has excess skin, some of his abdominoplasty costs will be reimbursed under Medicare (and private health insurance if he has an eligible policy), and yet a woman who has torn muscles, incontinence and back pain as a consequence of pregnancy cannot.   above: before and three months after abdominoplasty surgery with Dr Sharp Abdominoplasty repairs rectus diastasis (muscle separation after pregnancy), reconstructing the abdominal wall, removing hernias and restoring core strength - as well as removing excess skin from the lower abdomen. The authors of the 2018 Australian study highlighted the fact that this not only restores the abdomen’s shape, it can also improve core strength, and can impact back pain and pelvic floor control. The study...

What is rectus divarication?

Diastasis recti (also known as rectus divarication or abdominal separation) a gap (usually greater than 2.5cm) between the two sides of the rectus abdominis muscle. The distance between the right and left rectus abdominis muscles is created by the stretching of the linea alba, a connective collagen sheath (see right). In pregnant or postpartum women, the condition is caused by the stretching of the rectus abdominis by the growing uterus. It is more common in women who have had multiple pregnancies, but can occur after just one. Sometimes, the uterus can be seen bulging through the abdominal wall, beneath the skin. Women are more susceptible to develop diastasis recti when over the age of 35, high birth weight of child, multiple birth pregnancy, and multiple pregnancies. Abdominal muscles separation can appear as a ridge running down the midline of the abdomen; it becomes more obvious with straining and may disappear when the abdominal muscles are relaxed. In an abdominoplasty or tummy tuck, diastasis recti is corrected by creating a plication or folding of the linea alba and suturing together. This creates a tighter abdominal wall and restores the stomach to a flatter, more aesthetically pleasing appearance while most importantly restoring core strength, and often, pelvic floor integrity. Sometimes, hernias may also be present alongside abdominal wall weakness. In most cases, Dr Sharp’s abdominoplasty procedures include the repair of any hernias as well. To find out if you have muscle separation after pregnancy, speak to your GP. If this is causing back ache, urinary incontinence, poor core strength or difficulty with certain exercises, ask for a referral to a qualified plastic surgeon to...

The Aston Baker Cutting Edge 2017 Highlights

The Aston Baker Cutting Edge Aesthetic Surgery Symposium has been running for 37 years and brings together some of the world’s leading aesthetic plastic surgeons. This year, Dr Sharp and practice director Liz Washington joined hundreds of plastic surgeons and their clinic teams to learn more about the innovative techniques for facial and body rejuvenation. The program featured 94 instructive surgical videos, 26 presentations, 13 expert panels and 8 debates. Dr Sharp loves being abreast of the latest advancements in plastic and cosmetic surgery, and these forums provide a valuable opportunity to hear about the techniques, trials, anecdotal experiences and standards from across the world. The overall message from the symposium was: aesthetic surgery has changed, and the over-stretched, over-enhanced, over-done look is a thing of the past. Progressive surgeons are working together to develop new techniques to approach cosmetic surgery to achieve a more balanced, proportionate and natural look than ever before. We thought some of our patients may be curious to hear more about the ideas discussed, so in these videos, Liz briefly covers some of the symposium topics that often arise in our discussions with patients. Fat grafting Fat grafting has been used for reconstructive purposes for many decades, but its use for rejuvenation and enhancement is still a relatively new concept, and something that surgeons are still experimenting with to perfect and hone the right technique for different areas of the body. We saw some exciting results from the panel, and of particular interest was ‘micro’ and ‘nano’ fat grafting for facial rejuvenation, which is providing not just volume replacement, but also dermal rejuvenation. The faculty also addressed the...

Post pregnancy tummy tuck: what you need to know

Pregnancy stretches the abdominal muscles and skin, often leaving a pouch like appearance where the muscle are permanently separated, lax and weakened. This is called rectus divarication and it can lead to secondary problems such as hernias, difficulty exercising, pelvic floor problems, incontinence, skin infections, core strength deficits and back pain. A reconstructive abdominoplasty resolves this by rejoining the separated muscles, repairing hernias and removing loose skin. Far from being only a cosmetic procedure, it can have a significant impact on a woman’s core strength, continence and self esteem after having babies. During this procedure, permanent stitches are used to pull the abdominal muscles together, restoring midsection support and creating a firmer abdomen. Sometimes the laxity of the lateral abdominal muscles (obliques) also requires permanent sutures to create an ideal shape; this is called muscle plication. Up until 2016, the Medical Benefits Scheme included post partum abdominoplasty, offering a rebate on the procedure where it was deemed medically necessary. However, after 45 years of being allocated an item number, the procedure was removed from the scheme in December 2015, meaning the 6,000 women who require this surgery each year would have to pay around $10,000 to have it performed. As reported in The Australian, the Australian Society of Plastic Surgeons (ASPS) requested recommended against the removal, amid concerns over the life long repercussions women may experience if abdominal function is not restored. Currently, women requiring reconstructive abdominoplasty must access this surgery through a private plastic surgeon. The cost varies depending on the surgeon, anaesthetist, hospital facility and length of inpatient stay, but generally ranges from $9,000 to $12,000. Patients who require a post...