Question of the week: what are cohesive gel or form stable breast implants?

I know I want silicone implants for my augmentation, but I’m confused about the difference between gummy bears, cohesive gel and form stable implants. How do I choose the safest implants for my breast augmentation? - patient Dr Sharp: It’s good to hear you are thinking about these factors and how they may impact your breast augmentation surgery, as they are important pre operative considerations! Essentially all of the implants you mention come from the same ‘family’ of silicone implants. Implant manufacturers use words such as cohesive gel, form stable silicone and gummy bear implants to describe variants of the same thing; breast implants that contain a silicone that maintains its shape and consistency inside the body - and has a solid (rather than liquid or runny) consistency. This kind of silicone has been successfully used for many years - and in millions of patients. Most specialist plastic surgeons in Australia use modern implants that contain this gel. Breast implants are very strong and ruptures aren’t common, but even when cohesive gel implants do rupture, the gel stays inside the implant - hence the term ‘form stable’. Silicone implants have dramatically changed over the past 40 years; the original silicone gel that was used as early as the 1970s, consisted of a liquid gel. If the outer layer of the implant ruptured, the liquid would leak into the body. In 2006, cohesive gel implants became available in the United States. You may have heard them referred to as the “gummy bear implant”. The big difference between a liquid gel and cohesive gel is that the cohesive gel stays in one solid form...

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...

What is lip lift surgery?

Kylie Jenner recently kissed goodbye to the over-inflated lip look that once made her famous, opting for a more subtle pout. The key to beauty is proportion, and rather than looking naturally hydrated and full-lipped, those who emulated her style often looked as though they were suffering from anaphylaxis. So what’s the next ‘big thing’ in lips? If demand in our Brisbane and Ipswich clinics is any indication, ‘lip lift’ surgery is growing in popularity among women who want to make changes to their lower face that lip fillers haven’t been able to achieve for them. The procedure involves an incision under the nose (usually discreetly located in the junction where the nostrils meet the upper lip). A small segment of skin is removed and the incision closed. The procedure results in a shorter distance between the lip and nose (this area of the face is called the philtrum), enhancing the cupid’s bow and helping the top lip roll outward more, making it appear larger and increasing the amount of pink (vermillion) lip showing. Results can be as subtle or dramatic as the patient wishes. In our clinics, lip lift surgery is also sometimes teamed with rhinoplasty, facelift surgery or chin augmentation surgery, to harmoniously rebalance facial features. Lip lift surgery is also known as philtrum shortening. It is a minor procedure, and can be performed under local or general anaesthesia. But it’s not for everyone; when patients are not carefully selected, the surgery can unbalance a face that already has good upper lip proportions. Lip lift also comes with risks and potential complications, such as prominent scarring, nerve damage, asymmetry and unnatural results that are difficult to conceal with...

Question of the week: is Fraxel laser painful?

I’ve wanted to have laser resurfacing for many years for lines and pigmentation, but the images of crispy skin and stories of painful treatments has put me off. Does Fraxel laser hurt and is there any way to reduce the pain? - patient Deborah: One of the things I love most about Fraxel is that the technology has been industry-leading for around for two decades; it is proven and well-tested science that has stood the test of time and millions of treatments. Like most of the first rejuvenation lasers, it’s true that the first generation of Fraxel was known to have a sting, but the technology has been refined and that reputation is no longer valid. The ‘new’ Fraxel is not painful for most patients; a mild prickling sensation can be felt. We ensure patients are comfortable by applying a topical anaesthetic cream before the treatment and the machine now comes with a Zimmer device, which blows chilled air on the skin as the laser works, distracting nerve endings. I have personally used most of the other leading lasers, radio frequency and pulsed light machines on the market over the past 15 years and Fraxel is by far the most comfortable. It manages to achieve great results without being ablative, so you don’t get the discomfort, persistent burning sensation, hot spots or ‘crispy’ skin you describe. Fraxel downtime is quite brief in comparison to other lasers, and initially looks like sunburn and develops into a grainy ‘ground coffee’ appearance as the skin exfoliates - you can view pictures of this process on the video we posted here. The Fraxel The new Fraxel...

Guess to win!

Want to enter? Estimate the number of bottles in the vase Deb is holding Go to Facebook or @dr_david_sharp on Instagram and comment on the post with your estimate The person who places the closest guess will recieve a $200 PRAHS Skin Voucher Winner will be announced 12th of October 2018 Terms and conditions: Voucher can be redeemed on any skin treatment with Deborah. Cannot be redeemed on surgical fees, surgical consultation or medical treatments. Not redeemable for cash or transferrable. Voucher valid until the 1st of January 2019. Please note the bottles in the image shown are for display purposes only, and do not contain any products. What's your Summer Skin Plan? Get started with a complimentary consultation with Deborah to discuss how wrinkle injections, dermal fillers, Fraxel resurfacing laser, micro needling or key active ingredients can help you reach your skin goals! click here to book...

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...

Medicare plastic surgery changes: will they impact you?

Medicare has announced significant changes to plastic surgery item numbers on the Medicare Benefits Schedule (MBS) that will be effective from the 1st of November 2018. If you do not have item numbers listed on your informed financial consent document, this news won’t impact your costs. This will impact rebates and health fund coverage for patients with certain item numbered procedures, so if you are having plastic surgery from the 1st of November onwards, it’s important to be aware of these changes and read on. What does this mean? Some MBS item numbers are being abolished altogether, while others will have a tighter eligibility criteria. If we have issued you with a quote that lists an item number, this quote is only valid for surgery performed up until the 31st of October 2018.
 Dr Sharp’s fees are not changing, but some rebates are, and so for surgery that’s planned from the 1st of November onwards, we will need to provide you with an updated quote based on the final version of the new Medicare item numbers. Which procedures are impacted? This list covers some popular procedures involved, and is not comprehensive: otoplasty: must be performed before the age of 18 or costs will increase by approximately $2,500 blepharoplasty: an optometrist or ophthalmologist will need to confirm that your excess eyelid skin obstructs your vision - if you don’t meet the criteria, costs may increase by approximately $2,500 breast reductions and lifts (mastopexy): in you don’t satisfy the criteria, costs will increase by approximately $3,000 - $6,500 (depending on inpatient stay) removal and replacement of breast implants: if you don’t satisfy the...

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...

Safe breast augmentation surgery – the 14 Point Plan Pledge

Breast augmentation surgery is a very safe procedure. Statistically it has a low rate of complications and research shows it provides measurable improvements for women’s quality of life and sense of wellbeing. Despite this, safety is at the forefront of women’s minds when considering a breast augmentation - and so it should be! Key considerations pertain to the choice of surgeon, selection of implant, the facility where the surgery is performed and the technique used. It’s important to put your safety interests ahead of finding the cheapest ‘deal’ or a surgeon that can perform your surgery asap! Optimal safety measures take time, and steps such as using an accredited hospital and anaesthetist - or taking extra precautions to avoid bacterial contamination - might add to the costs involved, but they can also significantly impact your short and long term outcomes. Macquarie University has put together a 14 Point Plan which offers proven strategies for surgeons to use when they are inserting a breast implant. Published in 2013, it is now adopted around the world as best practice for plastic surgeons who frequently perform breast augmentation surgery.  Each step aims to reduce bacterial contamination, which in turn minimises the risk of breast implant complications. Dr Sharp is one of the specialist plastic surgeons in Brisbane and Ipswich who has chosen to taken the 14 Point Plan Pledge. This means he has committed to using techniques and practices that help reduce the risk of bacterial contamination (listed below) including the use of a Keller funnel to deliver the implant into the breast pocket, using form stable breast implants and submuscular placement. While it isn’t possible to completely eradicate the chances...

Question of the week: what ingredients do wrinkle injections contain?

I’d like to have cosmetic injections to reduce my crows feet and the lines on my forehead but I’m worried about the toxins and chemicals in them. What are wrinkle injections made of and are they safe? - patient Dr Sharp: It’s always important to understand the ingredients that go into anything you are putting into your body. The active ingredient is a neurotoxin. The toxin is made by the bacteria clostridium botulinum which is extracted using a fermentation process. Botox also contains two inactive ingredients called human albumin and sodium chloride. Human albumin is a common protein in blood plasma which is produced by the liver. Sodium chloride is salt, and this is used in the dilution process with sterile water. It does not contain animal products, but has been tested on animals, so that’s an important consideration to make if you are vegan, or do not use products that have been developed through animal testing. In terms of safety, it is important that the active ingredient is stored and transported correctly by a reputable supplier - and then diluted accurately with saline by a qualified clinician. And that’s before its injected. When injected, this extremely small amount of toxin attaches itself to nerve endings, temporarily stopping the synapses that trigger muscle action and reducing the activity of the muscle. This causes a temporary reduction in muscle activity lasting 3 to 6 months. Wrinkle injection therapy is very safe if administered correctly. The product we use for wrinkle injections in our clinics is the longest standing product in the market, with a remarkable safety record and TGA approval and a scheduled therapeutic drug. These muscle relaxing injection are also used clinically...

Question of the week: can I increase my implant size after breast augmentation?

I had a breast augmentation 5 years ago and after putting on a bit of weight, it feels like my breasts are now too small for the rest of my body. Is it possible to increase the implant size, and how do I find out the biggest possible size, without looking ridiculous? - patient Dr Sharp: It is certainly possible to increase your breast implant size after having a breast augmentation. This procedure is called breast implant removal and replacement surgery, and involves a very similar process to your primary (first) augmentation, occasionally with the additional removal of implant capsule, or creation of an internal sling or support to provide additional structure at the base of the breast. Often, patients undergo this procedure primarily to remove ruptured implants or to address capsular contracture, and decide to increase their implant size at the same time. Other patients are dissatisfied with the appearance of their original implants and wish to increase their size.In most cases, an implant size increase is not an issue, especially when a patient wishes to have a moderate size increase; I frequently perform this surgery in my practice. To ensure the best possible outcome, there are some important considerations to make before undergoing removal and replacement surgery to increase your implants size: If you are unhappy with the appearance of your breasts due to normal anatomical anomalies such as asymmetry, large areolas or chest wall deformities, increasing your implant size may make these more obvious, as they are being magnified by the additional size of the implant. Your surgeon will take steps to mitigate this, but it’s important to weigh this up against your...

Breast augmentation question of the week: the difference between an augmentation mammoplasty and augmentation mastopexy

What’s the difference between a breast augmentation mammoplasty and breast augmentation mastopexy, or are they both the same thing (BAM)? I’ve been told I might need the mastopexy version with my implants. - patient Dr Sharp: A mastopexy is another word for a breast ‘lift’. A breast augmentation mastopexy is a combined breast enlargement and lifting procedure; it involves the placement of an implant to increase breast size and fill out the skin, while excess skin is removed and the nipple is lifted to sit higher on the new breast shape. Incisions are made around the nipple, with a single vertical incision down the middle of the lower breast, and in the inframammary fold. A breast augmentation mammoplasty, on the other hand, is commonly referred to as a ‘BAM’ involves the placement of an implant, normally using a single incision in the inframammary fold of each breast. Mastopexies can be performed on their own to lift a breast, or in combination with an augmentation to lift and enlarge. There are a few reasons why your surgeon may recommend a mastopexy with your augmentation. For some women, the position of their nipple and areola complex sits lower on their chest. This can be due to weight loss, genetics, breastfeeding or the natural ageing process. If the nipple and areola sits below the inframammary fold (see right), this is classified as ‘nipple ptosis’. There are various grades of ptosis. When seeking breast augmentation, it is often the case that an implant alone will not move the nipple upward enough so that it’s centered on the implant, forming a more pleasing shape. A mastopexy may...