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...

Question of the week: changes to the blepharoplasty item number

My heavy eyelids make it hard for me to see, especially when I’m tired. I often find myself raising my eyebrows to try and elevate my lids. I’ve heard that Medicare’s recent changes mean that I might not be covered by my private health insurance for this procedure anymore. How have the rules changed, and can it be done under local anaesthetic in your clinic, if my fund won’t cover surgery in hospital? - patient above: before and three months after blepharoplasty surgery with Dr Sharp Dr Sharp: Up until the 1st of November 2018, if you had loose eyelid skin that rested on your eyelashes (when looking straight ahead), your procedure met the Medicare Benefit’s Schedule item number criteria for a ‘medically required’ blepharoplasty, as Medicare deemed that the procedure was required to improve your vision. Medicare recently decided that the current criteria wasn’t adequate, and as of last week, the item number criteria was revised. It no longer relies upon only the plastic surgeon’s assessment of the patient, so if you wish to access Medicare rebates or use private health insurance cover, you now also have to make an appointment with an optometrist or opthalmologist to undergo examination and have obstructed vision confirmed, before undergoing surgery with the plastic surgeon. If you think this applies to you, mention this when you book your consultation, so we can provide you with a referral letter to an optometrist or opthalmologist explaining why you require the examination and report. Once this occurs, we can determine your rebates and out of pocket costs. So what do out of pocket costs for blepharoplasty surgery look like now? If you don’t have private health insurance: If...

In the media: Dr Sharp featured in breast lift guide

  Breast lift (or mastopexy) surgery can be confusing: it’s often mistaken for breast reduction surgery and it’s sometimes recommended alongside a breast augmentation to ensure optimal results. What makes you a candidate for breast lift surgery instead of breast reduction, and in what circumstances should you consider a mastopexy with your augmentation? Style Magazines’ recent breast lift feature addressed some of the misconceptions about mastopexy surgery, answering some commonly asked questions about this transformative procedure. Journalist Siobhan Taylor spoke to Dr Sharp about the surgical process - as well as the risks, recovery and what makes someone an ideal candidate for breast lift surgery: While the breast lift (or ‘mastopexy’ as your doctor would say) sounds simple enough, there’s a lot going on under the surface that you may not be aware of. In fact, the details of the surgery are significantly different from that of a standard boob job altering everything from your initial consultation right through to the end results. Because we want everyone to have the tools to make an informed decision, we decided to speak with Dr David Sharp, a highly-regarded Brisbane-based FRACS credentialed plastic surgeon, to learn more about breast lifts. Assisted by a team of clinical and administrative professionals, Dr Sharp is highly sought after for his expertise and down-to-earth approach. We asked him six of the most common questions our readers have about breast lifts. Read the full article here! Is breast lift surgery right for you? Get in touch with our patient care team and find out more... Name Email Address Contact number I'd like to know more about... 1...

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...

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? 1. Estimate the number of bottles in the vase Deb is holding 2. Go to Facebook or @dr_david_sharp on Instagram and comment on the post with your estimate 3. The person who places the closest guess will recieve a $200 PRAHS Skin Voucher 4. Winner will be announced 12th of October 2018 Good luck! 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...