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IS MODERN BREAST AUGMENTATION SURGERY SAFER THAN EVER BEFORE?

Are breast augmentations considered to be safe - and specifically, are modern breast implants safer than the implants used in the past? - patient Dr Sharp: It’s great to hear you are thinking about these factors before your augmentation surgery, as they are important pre operative considerations. I only offer procedures that I believe are safe and ethical; if it’s a procedure that I’d caution my family against having, I will not offer it to my patients. The current data available to plastic surgeons indicates that breast augmentation surgery is a safe procedure, provided sensible measures are taken by both patient and surgeon to reduce any known risks. With new-generation implant options and surgical techniques, breast augmentation today is safer than ever and can help women get the natural look they want while also improving their breast shape and volume. While there are many different factors that contribute to ideal results and a safe outcome, there are four key benefits of modern breast augmentation surgery. Modern implants Decades of research suggest that breast augmentation surgery is safe when performed by a qualified plastic surgeon using quality implants and best practice surgical techniques. The implants I use are filled with cohesive gel silicone, which means that even if a traumatic injury was to result in a rupture, the silicone maintains its shape and usually stays within the implant capsule. These implants also feature nano or micro texturing, which balances our desire to minimise the risk of implant migration or capsular contracture by using a textured implant - with the safety benefits of a superiorly engineered implant surface. Sophisticated techniques In addition...

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...

RETURNING TO EXERCISE AFTER BREAST AUGMENTATION SURGERY

“I would love to have a breast augmentation, but I’m worried about the impact it will have on my daily exercise routine, and the muscle tone loss or weight gain I will experience during the downtime. How soon after surgery can I return to working out, and are there any restrictions?” - patient Dr Sharp: It’s great to hear you are thinking about these factors before your augmentation surgery, as they are important pre operative considerations. After breast augmentation surgery you will spend about one week not doing much - you will be able to do basic tasks like showering, getting a drink or chilling on the couch, but not much more than that! During the following week, you’ll return to tasks like making your bed, going for light walks, cooking a meal or driving a car. The most challenging restriction for many of my breast augmentation patients is the requirement to not lift anything over 2kg for at least 6 weeks after surgery. And that doesn’t mean returning to bench pressing 10kg or lifting a toddler at 6 weeks and 1 day post op! Even at the 6-8 week post operative mark, it’s important to ease back into your exercise routine and tasks like shopping, cleaning and lifting small children. Listen to your body and if you experience pain, discomfort or swelling, cease the activity for another 2 weeks and ease back into it. Upper body workouts or things like rock climbing or ergo work will need to wait much longer than 6 weeks, but in the interim there’s other activities you can do to retain your fitness. We...

New health fund tiers: what do they mean for you?

Private health insurance is a significant investment for most Australians, with 55% of us covered by some policy. Often, insurance products are complex and difficult to understand and compare. You might have recently heard from your health fund regarding new policy changes that will commence this year. In an attempt to simplify health insurance, the government has introduced a new tier system, in the hope that it will ensure consumers know what they’re covered for, when they buy a particular policy. It’s hoped that these new changes will provide more clarity for consumers - and less unpleasant surprises when it comes to claiming for procedures. This may also impact your coverage for certain Medicare item numbers. The private health insurance reforms will bring in a new system for categorising hospital products, breaking policy cover up into gold, silver, bronze or basic cover. All hospital-based treatments have been organised into 38 categories, based around different body systems, for example: ‘ear, nose and throat’ or ‘bone, joint and muscle’. Each new hospital policy will fall under one of four product tiers: gold, silver, bronze or basic. Each product tier will cover a specific number of categories in a private hospital: Basic – very little if any cover in private hospital Bronze – low cover (18 categories of services) Silver – medium cover (26 categories of services) Gold – full or top cover (all 38 categories of services) Policies that cover more than the minimum requirement will be called a ‘plus’ policy, for example ‘bronze plus’ would cover some additional benefits, above a standard bronze policy. Also, member will now be able to choose to...

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...

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 the cheek...

Question of the week: should I lose weight before I have liposuction?

Is liposuction just for people who are significantly overweight; what about people who just want to lose the last stubborn kilograms? I am close to my ideal weight but can’t seem to budge pockets of fat on my stomach and lower back. - patient Dr Sharp: Liposuction is ideal for people who have reached their ideal, healthy weight, and wish to remove stubborn pockets of fat. Lower abdominal fat and love handles respond very well, and it is also a popular treatment for reducing pockets of unwanted fat under the chin, around the knees, back/bra strap fat, inside the thighs and on the back of arms. Liposuction is not a weight loss or weight reduction procedure. Patients who are yet to achieve their ideal healthy weight can be disappointed by the results of liposuction as larger areas of fat can experience irregularities and patients can find it doesn’t give them the ‘dress size drop’ they were hoping for via liposuction, instead of weight loss. While it can be tempting to have liposuction before your weight loss journey is completed, to obtain the best results and ensure a healthy recovery, it’s important to be as close as possible to your ideal weight. Sometimes Instagram ‘after’ photos of patients on the operating table following liposuction can be misleading and give a false impression of what can be achieved, so it’s important to look at photos three, six or twelve months after surgery to get a realistic indication of your potential outcome. [Pictured left before and three months after upper arm liposuction with Dr Sharp] Ask us your liposuction question! Name Email Address Message 14 + 6...

Question of the week: what’s the best time of year to have a breast augmentation?

If I want to be healed in time for next summer, what’s the best time of year to have a breast augmentation? How long will the recovery take and how soon can I swim? - patient Dr Sharp: Breast augmentation in Brisbane is a four-seasons procedure, in that it’s one of those popular operations that I perform every week, every month, of the year. Especially in Queensland, where our weather in warm or mild all year round - women tend to enjoy their results across the year instead of the very cool climates where they are more likely to be concealed by jackets and bulky knits for 6 months of the year. That said, having breasts that are fully healed by the time summer holidays roll around is a common request. For the first 6 weeks after a breast augmentation, your incisions can’t be submerged in bath, spa, pool or sea water - so if you are planning summer holidays, that’s something to consider. Likewise if you are planning a holiday to Europe during their summer, it’s wise to have the surgery at least 6 weeks beforehand, so you can swim and participate in normal activities. We also recommend that patients don’t lift anything heavier than 2kg for the first 6 weeks, so that’s something to think about in terms of returning to the gym, lifting older children, returning to a job that is labour intensive or going on holidays and lifting heavy bags. I encourage my patients to look at the next 6 months and work out where that 6 week ‘gap’ can be - and work backwards from...

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...

Question of the week: are routine MRI scans necessary after breast augmentation?

How can I tell if my implant has ruptured? I had breast implants last year and was wondering if I need to get routine breast ultrasounds or MRI scans? I don’t have a family history of breast cancer. - patient Dr Sharp: Routine MRI or ultrasounds are not recommended unless you: have a history of breast cancer have noticed changes in your breasts such as the onset of pain, distortion or discharge suspect your implant/s may be ruptured have experienced trauma to your chest and there are concerns that your implant/s may have been damaged   So if you don’t have a history of breast cancer (and aren’t of an age - or family history - to need routine screening yet), regular scans to check on the condition of your implants is not recommended in Australia. The specific silicone gel filled implants I use are of an extremely high quality; they are covered by a lifetime warranty for rupture. This means the manufacturers back the implant quality, and they will replace them for free if they are to rupture at any point in the future. Surgeons can also take certain steps to reduce the risk of breast implant rupture at the time of implant placement, including using a Keller funnel to place the implant with minimal impact on the implant itself. I use a funnel for this and other safety reasons when inserting implants. In the case of silicone implants, if the implant shell develops a small opening, due to its cohesive nature, the silicone gel will most likely remain inside the implant’s outer shell. If a tear develops in the outer shell, the silicone gel...

What Are Mondors Cords?

During breast augmentation surgery, incisions are made under the breast (in the inframammary fold) and vessels are cut; the surgeon uses an electrocautery to stop any bleeding. Once vessels are cut, blood can no longer flow through and the blood inside the veins naturally clots, causing a mild local inflammation reaction within the veins. These veins become palpable and visible through the skin, looking like ‘cords’. These care called ‘Mondors Cords’. They can occur a couple of weeks after breast augmentation surgery and they look like vertical bands below the breast, running towards the abdomen. They aren’t painful, but can sometimes feel uncomfortable to tender to touch. The cords are harmless and temporary. The clots inside are not the same as the type of blood clots or deep vein thrombosis that can form in the legs or be harmful. What do I do if I have Mondors cords? Contact your surgeon so they are aware of your symptoms; they might ask you to come into the clinic for a review appointment, or if this isn’t possible, send photos of the affected area. Most patients don’t require treatment, but if you have mild discomfort, you might find a mild anti-inflammatory like ibuprofen and heat packs (warm not hot) might be helpful. Eventually the clots break down and are absorbed by the body, and the cords will spontaneously resolve; this can take several weeks to a few months....

Question of the week: using liposuctioned fat for grafting

I want to have fat liposuctioned out of my thighs and stomach, and put into my breasts and face to fill out my sagging skin. Is it possible to do this instead of having a breast augmentation and facelift? - patient Dr Sharp: Patients also often ask if liposuctioned fat can be injected into other parts of the body, or ‘fat grafted’. The best way to explain my approach to liposuction and fat grafting is that liposuction is all about volume of fat, where as fat grafting is all about quality of fat! I often take small amounts of fat from the stomach or thighs and place these in the face to fill out areas that have experienced volume loss. Likewise, for slim women who lack fat across their chest to soften the appearance of their breast implants, I often graft small amounts of fat around the periphery of implants, to create a more natural look and reduce the visibility of implant rippling. Unfortunately it’s not an easy case of liposuctioning large amounts of stomach fat and using it to build breasts that are two cup sizes bigger. This is because liposuction technology aims to remove the maximum amount of fat with the least amount of physical damage to surrounding tissues. And the best way to do that is to break down the fat as much as possible before extracting it. This damages the fat cells and inhibits their ability to regrow when transplanted into another area; so it’s not considered to be ‘good quality’ harvested fat. One of the biggest downfalls of fat grafting is the fact that some...