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Textured implant update

The TGA are reviewing textured implants. Not all textured implants are the same; there are different types of textured surfaces (macro, micro and nano) and each carry different safety profiles.   No decision has been made to suspend or cancel the implants Dr Sharp uses.   When a textured implant is required to achieve a specific result that a patient desires, in consultation with the patient, either Mentor Siltex (microtextured) and Motiva (nanotextured) implants are used.   The latest research shows that the Mentor microtextured implants carry a 1 in 86,029 chance of developing BIA-ALCL. If you have textured implants or are considering them, we understand recent news might raise some questions and concerns for you and your loved ones. Nothing is more important to us than the health and safety of the women Dr Sharp operates on.   Current literature and real world evidence shows that the risk of developing BIA-ALCL differs between different textured implants and has been shown to be rare with the implants we use. Motiva are relatively new to the market in Australia and are nano textured, meaning their surface has been created to specifically avoid the causes of BIA-ALCL. Mentor breast implants are supported by long term clinical data, including three 10 year prospective clinical trials.   If I have textured implants, do I need to have them removed? If you have no symptoms, you do not need to have your implants removed. What are the symptoms of BIA-ALCL? The common presentation is fluid swelling around the breast implant and in the space between the implant and breast implant capsule – called a ‘late...

Breast implant safety update

France’s ANSM (their equivalent of Australia’s TGA) recently decided to prohibit the use of 13 macro-textured and polyurethane coated implants from six manufacturers. In Australia, the TGA has asked textured implant suppliers to provide detailed information and samples of their implants for analysis before considering whether to suspend or ban the products. Our clinics do not use ‘macro’ textured implants; the two implant brands that we currently use are not included in France’s ban list; we chose our implant brands based on their very high quality standards. The TGA announcement has caused understandable concern among women who have had breast augmentation surgery, with many wondering if their implants are safe, or require removal and replacement. The brand we predominantly use had its certification mark (CE) renewed by the European Union only two months ago, and carries the lowest rate of complications - such as BIA-ALCL and capsular contracture - partly due to the quality of its ‘micro’ coating. Among other factors, breast implant related lymphoma (BIA-ALCL) has been linked to ‘macro’ textured breast implants. Due to their quality, the ‘micro’ textured implants we use are some of the more expensive on the market in Australia, but we believe the additional investment is worth the cost, offering unparalleled safety - and peace of mind. What does this mean? Now more than ever, it’s important to: Know the brand and type of implants your surgeon uses Dr Sharp use Mentor and Motiva implants. Being able to identify the type of implant your surgeon uses is an important part of your pre-surgery education and informed consent. We believe patients deserve to know the brand of the implant...

In the media: Dr David Sharp plastic surgery

Dr Sharp was featured in the QT this month, discussing the tips, trends and pitfalls of plastic surgery in 2019. He said more Australians are undergoing plastic surgery as taboos fall and surgical advancements evolve. Below are some excerpts from the interview with QT Editor Shannon Newley:   Why I chose a career in plastic surgery… The reason I chose plastic surgery as a sub-specialty is because I love performing the full spectrum of procedures it offers. They are all rewarding because they effect positive change in patients’ lives in different ways. For example, blepharoplasty surgery provides an instant reward because the recovery is so quick and it’s a small operation that makes a big change, whereas post pregnancy abdominoplasty and breast lift surgery is rewarding – even though the recovery is longer – because it restores core strength and improves back pain, pelvic floor issues and skin irritations after a woman has given so much of her body over to having a baby. Future trends in plastic and cosmetic surgery We will see more interest in minimal downtime surgery such as lip lifts, mini-facelifts and procedures that combine fat grafting. For skin condition and improvement, there is a growing interest in medical grade lasers, micro-needling and PRP therapy to help stimulate the skin’s own natural responses. It’s a more holistic approach than we’ve seen in the past, and I think it’s going to achieve more natural, sustainable results for patients. Current trends in plastic and cosmetic surgery The interest in having cosmetic surgery is definitely still on the rise. This is because the taboos that previously existed around...

HOW CAN I PREVENT OR TREAT SCAR TETHERING?

“I’ve had surgery and experienced scar tethering in the past. I’d like to have more surgery, but I’m worried it will happen again.   Is there a way of removing it - and how can I make sure it won’t happen again?”    - patient Dr Sharp: Scar tethering is sometimes part of your body’s scar healing, with scar tissue under the skin adhering to deeper structures. The scar healing process takes about 24 months in total, and during this period the scar progresses through a number of phases and presentations. How it looks, feels to touch - and the sensations in the area - also change during this period. During the early phases of healing, everything tightens and can feel very firm and thick. During this time we generally recommend massage as your best prevention/optimisation tool. This can be done without lubrication or with the assistance of an over-the-counter silicone gel from the pharmacy to help with the movement. If you have a surface wound, you can also use our Healing Gel. Following your post operative instructions and being patient are the best tools in the early stages of recovery, to optimise your results. Attending your post operative consultations so your surgeon can assess your scar development is also essential. Prevention can be difficult, especially if the area has been operated on before and previously experienced tethering. Sometimes the surgeon can try to release the scar using subcision, whereby they undermine the fibrous bands holding the scar down, however this is not always successful, particularly on tighter areas where the skin is stretched across the bone such as...

Considering surgery in 2019? Here are four things to think about…

Great surgical results are the coming together of good preparation, great surgical skills, optimal post operative recovery, good health/nutrition and mental wellbeing. New rules that came into play in recent years ensured that patients and their surgeons can’t rush into cosmetic procedures - which is a good thing! Planning ahead, taking the time to get informed and ensuring that you have considered your recovery process, financial costs and surgical goals, helps set you up for the best possible outcome, and an enjoyable experience along the way. Here are some questions that our practice director, Liz, recommends patients ask themselves if they are considering surgery in 2019: What do I want to achieve? Ask yourself to articulate what you don’t like - and importantly - what you do like about your appearance. Think about the specific changes you’d like to see. Is there a certain look you definitely don’t want to achieve? And how do you expect having surgery will make you feel; both during and after the process? Consider whether you’ll be okay with the possibility that your results might be immediately visible (as is the case of breast augmentation) or could take a full year to reveal themselves, as rhinoplasty results can. Talk to a trusted person about your concerns or desires - and feel free to bring them along to the consultation with your surgeon; it might make you feel more comfortable, and can also help you remember what was discussed during your appointment! What is my ideal time frame for surgery? If you have your heart set on a specific time of year for your surgery, ideally, book your first consultation 4 - 6 months...

2018 Highlights: before and after plastic surgery with Dr David Sharp

It’s been a big year of operating for us - and we love nothing more than to look back through our patients’ surgical journeys and see the improvements they’ve experienced! From facelift and blepharoplasty through to breast augmentation, abdominoplasty and wrinkle injections - here’s a small selection of results from the thousands of procedures that Dr Sharp performed during the past 12 months. We love being part of every patient’s surgical journey, and witnessing the positive life changes that self improvement can bring; which often reach far beyond the physical transformations seen here. Thank you to all of our patients, for entrusting your care to us - and making us part of your 2018. A special thank you to those patients who generously permitted us to share their results, to help educate others about procedures they might be considering. Keep an eye out for more on our Facebook and Instagram pages! Considering surgery in 2019? The best results are planned ahead! Contact us to take the first step... learn more...

What is the short scar breast augmentation technique?

As breast augmentation techniques evolve, the visible signs of surgery have become less prominent. One of the techniques that Dr Sharp employs during almost every breast augmentation procedure he performs at our Brisbane and Ipswich hospitals, is the short scar augmentation. This technique provides a reduced incision length and less scaring for our patients. In order to insert the implant, an inframammary incision is made under the breast. In the past, surgeons had to dissect the implant pocket and squeeze an implant through this incision, so they had to make the cut wide enough to accommodate the implant. However, Dr Sharp is able to make a smaller incision due to his use of a special sleeve to enable narrower insertion of the implant. A tool known as the ‘Keller Funnel’ (which you can watch Dr Sharp use here), allows the smaller incision to be made; the implant is passed into the chest via the funnel and in most cases, the scars are completely concealed in the fold (see images below, taken from underneath with the patient lying down). above left: six month old breast augmentation scar   |   above right: six month old breast augmentation scar  In addition to aesthetic benefits of a shorter scar, the funnel also has safety benefits; it enables the silicone gel implant to be placed into the breast without the need for touching, and with more control by the surgeon. While Dr Sharp does everything possible to minimise every scar created by his surgery, there are certain circumstances where a short scar incision isn’t possible. This includes some removal and replacement or revision procedures. All surgery leaves scars. Sometimes...

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

I want silicone implants for my augmentation, but I’m confused about the difference between gummy bear, cohesive gel and form stable implants. How do I choose the safest? - 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 if cut or ruptured, mimicking a gummy...

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...

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: 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. [Right: before and after breast implant removal, replacement and lift surgery with Dr Sharp]. 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...

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...
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