Meet our theatre team
Dr Sharp is fortunate to be supported by an amazing team of surgical professionals, including skilled anaesthetists and nurses, at Greenslopes Private Hospital, Southbank Day Hospital and St Andrews Ipswich Private.
Surgery can be an exciting - and slightly nervous - moment for most patients, and so it’s nice to see some familiar faces when you arrive at theatre!
Step inside Dr Sharp’s theatre at Southbank Day Hospital to meet anaesthetist Dr Rob Miskeljin and assistant Sr Emily Gaeta - two team members who will greet you when you arrive and walk beside you during your surgical journey.
Our anaesthetic team also includes Dr Tim Sampson and Dr Paul Scott.
Thanks to the team at Southbank Day Hospital for giving our patients an insight into what they can expect on the day of surgery!
Ready to experience the gold standard
in surgical care? Contact us below
The gut biome and how it impacts your skin
Anyone who has met The Sharp Aesthetic Clinics’ dermal therapist Diane Lehto will know what we mean when we say she is enthusiastic and passionate about holistic skin health! In this article, she explains her own experience with gut health, skin conditions and wellbeing. To learn more about Diane’s unique approach to looking and feeling great, book a complimentary consult with her in our Brisbane or Ipswich clinics.
Microbiome. Gut health. Good Bacteria. Bad bacteria. When did this all start? I don’t even recall exactly when I first heard about it, but I think the father of medicine, Hippocrates was onto something here!
Nobody was talking about maintaining a healthy gut environment or microbiome when I was growing up. Flash forward to 2020, isn’t it ironic that it is now as ubiquitous as seeing fast food ads on television?
My microbiome journey began when I experienced a terrible bout of gastritis. It was the most uncomfortable thing I have ever been through; it was painful and it was a big wake-up call for my own dietary habits. I must admit, my diet wasn’t the best at that time; I was always highly stressed, was always getting sick, had terrible, lacklustre skin and breakouts. I always felt tired and I couldn’t understand why. After being assessed, I was handed a FODMAP dietary eating plan, and prescribed medication that was designed to help decrease the amount of acid my gut was producing, while allowing it to heal.
I left the hospital feeling a bit lost. I felt like I didn’t know enough, and nobody really explained what causes these issues. I wanted to prevent and treat the multifactorial, underlying root causes.
Wanting more answers, I went back to my GP and saw multiple health professionals who helped me realise the answer was right in front of me all along; it was my diet and stress levels. It all made sense; I ate crap, and so I felt like crap. I did this to myself!
“All disease begins in the gut.”
I reasoned that - if ‘all disease begins in the gut’ and I don’t have any underlying conditions or diseases - with some patience, I should be able to heal my gut through the use of good probiotics, eating healthy unprocessed foods, reducing my daily intake of fat and processed sugar - and cutting down on alcohol. Stress also plays a huge part on the microbiome, and can affect our immune system - and even post surgery recovery. You can read more about the effects of stress on the gut and skin in my article here.
I know for a fact that I will never go back to the way I ate before gastritis. I don’t ever want to feel like that ever again - and who doesn’t want to feel good!
So do we all need probiotics?
It is always important to speak with your doctor or health professional before taking any kind of medication or health supplement to see if it is right for you. Especially if you have an immune deficiency, or are being treated for an illness. I always believe it is also important to discuss with your health professional regarding any probiotics you intend to take. Always look for a good quality trusted brand that has been backed by research and clinical data. Different probiotics do different things, and you can get them through supplements or pre or pro biotic rich foods. Our clinics offer a particular probiotic that is suitable for everyday use, as well as after surgery and antibiotic use.
In general, unless you are stress-free, 100% living the healthy eating life, there is going to be times in life where you may have been ill, not eating well, run down, and where you simply feel yuck! And let’s be honest, we are only human so we will have times like this. So probiotics can certainly help you feel much better if your gut biome is impacted by these factors.
There are more clinical trials and studies being conducted into the world of the microbiome than ever before, and although there’s so much information already out there, we still are only at the tip of the iceberg in terms of the connection the microbiome has over our daily lives.
From the research that is currently available, medicine is realising that an unhealthy microbiome can lead to a whole range of illnesses. There is no coincidence that the advent of fast food, excess alcohol, caffeinated drinks and overuse of antibiotics has come with a range of chronic complaints including bloating, skin conditions, weight gain and low energy levels. Scientists are now looking into not only gut microbiome, but the oral microbiome and its impact on high blood pressure and diabetes.
Scientists are also looking into the impact of pollution, combined with UV radiation, and UV light on the skin’s micro flora. Research suggests that this puts a high amount of oxidative stress on the skin, and can accelerate the ageing process. Skin is after all the largest organ on our body, so it totally makes sense. The air quality is not as good as it use to be, especially in the big cities.
Good microbiome care works on the inside - and the outside!
There are some great skincare probiotic products on currently on the market to help balance a healthy skin microflora, such as Synergie Dermiotic which helps to boost and strengthen the skin’s integrity, while helping to address the underlying cause of skin conditions, such as oil, congestion, inflammation, redness and hydration. Stay tuned to watch this space explode in the next few years.
I am very excited to see what scientists are able to discover in the fascinating world of microbiome and gut health, and can’t wait to bring these developments into my care of our patients’ skin - so we can maintain optimal health, inside and out.
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in surgical care? Contact us below
Vitamin B and Probiotics: The Dynamic Skin Strengthening Duo
The benefits of prebiotics, probiotics and vitamin B are often espoused by skincare companies - but what do they actually do for your skin?
Prebiotic and probiotic skincare
Just as prebiotics and probiotics set your gut up for optimal function, they also balance the beneficial and harmful bacteria and optimise the skin’s environment. Synergie Skin’s Dermiotic is a nutrient packed pre-serum elixir with pre and probiotics, formulated to boost the skin’s resistance to physical and chemical aggressors by tackling the underlying causes of acne, ageing, sun damage and sensitivity - rather than just masking them. Just a few drops of Dermiotic prior to your serums will boost the barrier strength of skin and will be an essential for those with skin sensitivity.
How does it work? Prebiotic Alpha-glucan oligosaccharide feeds the ‘good bacteria’ and probiotic Bifida ferment lysate balances the microbiome. Together these active ingredients defend from environmental damage and relieve sensitivity and symptoms of skin stress, including redness and inflammation.
Vitamin B infused skincare
Thought of as the great multi-tasking cosmeceutical, by using Vitamin B your skin will ‘learn’ to make more of its own moisture. Formulated to increase the production of ceramides in the epidermis, this essential product is a must for increased hydration levels, a luminous even complexion and a reduction in the appearance of fine lines.
How does it work? Vitamin B serum increases the production of ceramides in the epidermis, essential for preventing water loss and maintaining a dewy complexion. High levels of niacinamide also boosts collagen and skin immunity, strengthen the barrier and reduce uneven skin tone.
Why do probiotics and vitamin B work so well together?
The combination of these two hero products will give your skin its ultimate barrier protection and support the skin to stay strong, work at its optimum and look healthy and luminous every day.
“Fortify and revive your skin’s barrier by coupling Dermiotic with Synergie Skin’s iconic Vitamin B (niacinamide) serum to deliver the optimal environment for healthy skin,” our dermal therapist Diane Lehto explains.
Optimal Ageing: 5 skin tips to get your glow on at any age
After 12 years in the dermal science field, skin therapist Diane Lehto believes that having beautiful healthy glowing skin starts from the inside out; taking care of the mind and body through good nutrition, and using good quality skin care products to help maintain a gorgeous glow. She shares her top 5 tips for healthy, glowing skin all year round…
We know how great our skin looks after we’ve had some much-needed time out. For me, usually a good exfoliation, a relaxing facial and rejuvenating mask does the trick; my skin looks healthy and has a nice glow. It’s amazing what good skin can do for your confidence. You feel brand new again.
There are many reasons why our skin suffers from time to time, and there are moments where we may wonder why our skin can be looking dull - even though we think we may be doing all the right things!
Our body is very clever and it lets us know if something is not quite right. But many of us fail to act upon these cues. If our car starts to splutter and malfunction, we put it in for a service to make sure it’s mechanically working well, right? The same should go for our bodies! However, unlike a car, our body and skin is a living thing; everything works synergistically to keep us healthy - and our organs functioning the way they should. Unhealthy skin is often a sign of what’s going on inside our bodies.
Our skin is the body’s largest organ, and we have our body for our whole life, so it makes total sense to take good care of it. When I speak to patients, I usually find that their bodies are letting them know that something is happening through their emotions, how they are physically feeling and how their skin looks.
Sunscreen is your best friend
Over 80% of premature ageing is caused by the Australian sun. And on top of that, we have the highest rates of skin cancer in the world, which is astonishing. Keeping this information in mind, it is vital that we think of sunscreen as our best friend; the thing we can’t live without! Use it everyday, and even on those days where it may look cloudy outside and we think we don’t need it. The sun’s powerful rays are working even harder to penetrate through to your skin.
So what is the best sunscreen for our skin? Most of us believe the higher the SPF the better, right? Well that’s not necessarily true. The best way to protect your skin from UVA/UVB rays is to use zinc. The natural mineral power of zinc oxide will not only protect our precious skin from burning (UVB) but it will also help to shield our skin from ageing (UVA).
UVA penetrates much deeper into the skin, and is responsible for all of our unwanted pigmentation, fine lines and wrinkles and skin cancers. So if there is one thing everyone can do to prevent this from happening, my secret weapon is sunscreen!
Our favorite go to broad spectrum for solar protection is Uber Zinc, the incredible 4 in 1 sunscreen/foundation with iron oxides for blue light protection - Mineral Whip and the Uber Zinc Body. Always remember to reapply every few hours, after going for a swim, or excessive sweating.
Dehydrated skin means fine lines
Picture what happens when you don’t water your garden for a days - especially during hot weather; you eventually find the leaves are all crispy and shrivelled up! Our skin wilts and dehydrates in the same way; premature fine lines start to be more visible, slackening starts to occur, we get puffiness and dark circles around the eyes - and we may even get a few breakouts. This is because our skin is crying out for some water. Our body is essentially made up of 80% water so if our skin is thirsty, it can look dull, and feel dry. Paradoxically, it can also feel oily due to lack of water. You might also notice enlarged pores and the skin can look shiny and feel tight.
Combine dehydration with regular hot showers, excessive coffee and alcohol consumption - and not drinking enough water - and your skin is on it’s way to ageing much quicker. Water helps your digestive system flush out toxins, prevents brain fog, bloating, helps with constipation, and it helps maintain a healthy and happy skin. When your skin is hydrated, fine lines are not as visible and your skin appears to be more clear. Click here to find out how much water our bodies actually need. Water consumption requirements vary between each individual, determined by how much daily activity you do, your age, weight and any medications that can affect fluid etc. The general rule is 4 to 6 cups of water a day, on top of your other fluid intake (tea, juice etc). A good indication is clear urine - if you urine is not clear, you might not be drinking enough.
Stressing less is best
“You need to relax!” We’ve all heard this one before and sometimes it’s easier said than done. With most of us leading much busier lives these days, the mountain of stress that we get from everyday life; family, work, financial burden, or illness can really take a toll on our mental and physical health. Stress can have a huge impact on our skin.
We don’t need to have big moments of stress to notice dull, unhappy skin. Low level everyday stress contribute and eventuate to high levels of anxiety, or depression, and it can take a toll on the skin.
When we are stressed our body releases the hormone cortisol, which contributes to the breakdown of collagen and elastin accelerating the ageing process, it can even bring on skin conditions such as eczema, psoriasis, and it can stimulate the body to produce more oil, which can make our skin breakout. In general our skin can look tired; in some cases the body becomes so stressed, the skin becomes ultra sensitive, breaking out in a stress rash or hives - which makes the skin look red and feel dry. This is a big message from our body to take a step back and get some relax time.
How do we de-stress? There are many ways; and finding time doesn’t mean you need to spend 2 hours meditating everyday, it can simply start with 10 minutes. Finding that 10 minutes for yourself each day where you are interrupted, clearing the mind, whether it be practicing mindfulness and gratitude, going for a gentle walk, doing some stretches or listening to some music. Getting into a good routine of giving back to yourself, by finding the time to de-stress is an important part of slowing the ageing process down.
Remember that we all get stressed from time to time, and to not forget that we are only human. I believe we should give ourselves permission to be happy; be kind and talk kindly to ourselves more, because we deserve the very best, and we are all doing the best we can. It’s okay to have boundaries, and say no from time to time. We are not super human and need those boundaries and limits. If it all gets too much, there is also no shame in talking to someone. Whether it is a good friend, a professional counsellor, psychologist, or a friendly voice over the phone.
Regular self- care with a customised skin routine that is full of active vitamins and cosmeceuticals, including monthly facials is also a fantastic way to optimise the ageing process, and de-stress through relaxing, lymphatic drainage massage. Facials and good skin care go hand in hand. It’s like bringing your skin to the gym. You wouldn’t go to the gym, work out, then come home, sit on the couch only to eat hot chips! We need regular facials which will help to improve collagen, elastin, tone and texture, combined with good skin care to help treat our skin topically with only the best ingredients. Your skin will thank you for it later! Combining this with daily exercise and activity is essential for ultimate de-stressing, glowing skin, preventing fine lines and wrinkles and simply feeling great.
Eat well to feel good
Have you ever noticed how amazing your skin looks when you have been eating well? And do you also notice how dull the skin looks when you don’t?
The skin can have acneic breakouts, feel less hydrated and fine lines look more prominent when our nutrition is poor.
This is because we are not feeding the skin the right nutrients to glow from the inside out. We don’t have to eat perfect all the time, but making a few little changes can make all the difference to achieving your ultimate skin goals.
Research shows that Omega-3 fatty acids, which can be found in wild salmon, sardines, trout and mackerel, help restore and maintain healthy skin. It can also be found in Chia seeds, hemp seeds, flaxseed, seaweed, algae and walnuts. Other benefits include shiny hair, strong nails, heart and brain health - and the ‘holy grail’ of ageing: skin elasticity, as it improves the quality and texture of the skin, preventing wrinkles. For those who suffer with acneic breakouts, omega-3 fatty acids have been shown to reduce the inflammation associated with this skin condition, and helping the skin to heal much quicker. Have a read about some of the other benefits here.
You may have heard the saying “eat the rainbow”. This is all about making sure we get as much colour onto our plate as possible; eating wholesome food, full of fresh vegetables that are packed with fibre and essential vitamins and minerals such as zinc and fresh fruits and nuts - packed full of polyphenols that fight free radical damage, allowing the skin heal - and optimising the ageing process. We should consume more of these foods, and consume less foods that are highly processed.
This also means cutting down on alcohol and caffeine consumption. Eating well also helps to balance the good bacteria in the gut, resulting in less breakouts, less constipation, reduced illness - and studies have shown it can also help with reducing anxiety and depression. 70% of our serotonin is produced in the gut. When the gut health is not balanced, it can lead to high levels of anxiety, which can also in turn affect our skin. Taking a good pro biotic in conjunction with a balanced diet can help restore the natural gut flora.
It’s always best to speak with a good naturopath, nutritionist or your doctor to get the best advice if you have any underlying health questions or concerns, or simply want to know where to start. So the message I give to my lovely patients is that a healthy gut equals a healthy mind and beautiful looking skin.
Get more sleep
When was the last time you had a good night’s sleep? Sometimes it hard to switch our busy brains off at the end of a long day. For others, it’s as easy as laying their head on the pillow and they’re off to dreamland. Why is it important that we get enough sleep? Sleep is vital for the overall health of our brain and body. It helps to boost our immune so we can reduce the chances of illness, balance our moods - and our body is able to do its job in removing the day’s waste, through the digestive and lymphatic system. Sometimes it can be a bit embarrassing to talk about bowel movements, and what is considered healthy, but I am never afraid to politely talk about poop habits with my patients, especially when it comes to skin conditions. Acne, and flare ups of psoriasis and eczema are also more common when we don’t get enough rest. If we are unable to flush out the days toxins through lack of sleep, those toxins just add onto the next day, resulting in bad skin. Think of sleep as helping us detoxify the garbage from our body. Here is a great article on what a healthy poo should look like.
Less sleep means we can become more anxious, irritable, lethargic - and we are more prone to illness. The skin can generally look more aged as the body is not able to regenerate. Adults need a good 7 hours sleep every night -if you are far off that, even just one hour’s extra quality sleep a night can make a significant difference.
Some of my tips for a good night’s rest are:
1. Put your mobile phone or computer away one hour before sleep. The blue light from our devices can be stimulating, putting the brain into party mode! At home, I turn off the Wi-fi at the box, and keep the bedroom mobile free so I can avoid reaching for the phone - or the screen turning on throughout the night with notifications, which can interrupt your sleep.
2. Keep bedroom dark, and cool. You could even use a diffuser with relaxing essential oils in your space, a few hours before sleep to let the brain know it’s bedtime.
3. If you are a light sleeper, try to avoid stimulating beverages such as alcohol, or caffeinated drinks too close to bed time, as well going to bed straight after eating a heavy meal. Allow 3 hours for food to digest before bed time.
4. Deep breathing and visualisation techniques before sleep are fantastic ways to calm the mind and body, so that you are able to slow the heart rate down and fall asleep much quicker. The same breathing techniques can be used in the morning as a way to start the day with mindfulness!
Want to learn more about Diane's holistic approach to healthy skin?
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Dr Sharp Visits Uganda With The Medical Training In Africa Team
Dr David Sharp recently spent time in Uganda, working in a remote hospital in the small village of Kagando - in the foothills of the Congo - to assist local women and children with vaginal reconstruction, burns and congenital deformities.
It was the first time a plastic surgeon had accompanied the international team from Medical Training in Africa, consisting of Professor Judith Goh AO, Dr Hannah Krause AO, Dr Alex Mowat, Dr Jackie Smalldridge, Mr Darren Diserens and Dr Geerte den Hollander.
The journey began with a flight to Entebbe, Uganda, with the team transporting their surgical equipment in their luggage - including a donated diathermy machine, dressings, sutures, anaesthetic medication and scrubs to wear in theatre.
From there, a small chartered plane took them from Entebbe, to a grassy landing strip near the isolated village of Kagando.
Their first clinic commenced within hours of arriving.
The two week clinic saw over 80 women receive life changing surgery. Surgery was mostly performed with patients awake during the operation, using spinal anaesthesia, due to a lack of anaesthetic resources in the isolated hospital.
Dr Sharp operated on patients suffering from complex obstetric fistula, where flaps or skin grafts were required to effectively repair vaginal wounds that could not otherwise be surgically closed.
Soon after arriving, nearby villagers who had heard of his arrival made their way to the hospital with children also suffering from a range of other issues, including burns, scars and facial deformities - which previously been untreatable in the region.
One six year old patient had sustained burns to the left side of his body, leaving him with severe scarring that was painful, and limited the movement of his neck - causing his head to be tethered to his shoulder.
Dr Sharp performed scar release surgery, which enabled the brave young man to move his head freely for the first time in two years.
He is pictured, left, receiving a bag of small gifts, during his final consultation with Dr Sharp.
Another child had sadly fallen into a fire during an epileptic seizure, leaving him with a burn that went untreated, fusing his hand to his forearm.
After his scar was released and skin grafts performed, the patient was able to hold his hand out and regain some function.
The courage and resilience of both children - through fear and pain - was incredibly humbling.
Ideally, both children would have gone on to have further surgery and intensive rehabilitation, including compression garments and therapy.
However at this stage, local villages do not have access to the resources required to provide this level of ongoing care.
There is still much work to be done in this area and it’s hoped that future fundraising and resourcing through generous donations (which you can learn more about here) can make it possible to provide the kind of optimal post operative care and rehabilitation all children deserve.
In the second week of his visit, two mothers arrived unexpectedly at the hospital with very young babies, to see if Dr Sharp could repair their children’s cleft lips.
Both children received cleft repairs and recovered well, leaving days later to return to their villages without the stigma attached to facial deformities.
The impact of the trip extended beyond time spent performing surgery; it was also about creating long term knowledge and skills locally – to help future generations of healthcare providers and patients.
Dr Sharp taught local doctors new surgical techniques, including a procedure where muscle flaps from women’s thighs were used to reconstruct their vaginas.
Operating conditions were challenging, with high temperatures and a lack of air conditioning or fresh air in theatres leading the surgeons to work up a sweat. At times, the theatres experienced electrical outages, with loss of lighting.
Throughout, the clinical teams of local doctors, nurses and healthcare workers were enthusiastic, diligent and professional. Fully conscious patients stoicly remained calm and still on the operating table, while surgeons performed (and taught through) lengthy operations.
At the end of their time at the hospital, patients and their families treated the Medical Training In Africa team to a moving farewell song and traditional dance.
For Dr Sharp, seeds for this particular trip were planted two years ago, when he spoke to Professor Goh at a Greenslopes Private Hospital event.
She asked him to explain how he would approach a complicated reconstructive challenge she often faced when operating on women in Uganda.
On the back of a napkin, he sketched out a diagram demonstrating how the thigh tissue can be used to effectively close up some of the large wounds that are left after a fistula repair.
After looking at his diagram on the napkin, Professor Goh asked if Dr Sharp would be interested in joining her to operate and teach in Africa.
Medical Training In Africa also donates surgical instruments, consumables and disposables to hospitals at the end of each visit.
About Medical Training In Africa
Medical Training in Africa was founded by urogynecologists Professor Hannah Krause and Dr Judith Goh to offer specialist urogynaecological surgery to women living in remote parts of Africa and Asia, particularly those living with fistulas. Fistula is a condition caused by prolonged and obstructed childbirth.
Obstructed labour occurs disproportionately in girls and teenagers giving birth in regional Uganda, often because the mother’s pelvis is too small. The protracted labour usually results in the baby’s death, and the prolonged pressure of the baby against mother’s the pelvis damages the soft tissues around her bladder, vagina and rectum, causing tissues to die and tears or holes (fistula) to develop.
If the fistula is between the mother’s vagina and bladder, she experiences urine leakage, and if it is between her vagina and rectum, she leaks faeces. Women with fistulas constantly suffer from infections and pain as well as the embarrassment of wet clothes and a strong odour. They are often shunned or abandoned by their partners and communities.
The operations performed by Medical Training in Africa are inexpensive, costing $215 to treat a prolapse and $324 to repair a fistula. But for a woman in rural Africa, the cost of surgery is usually out of reach. An estimated 2 million women and girls live with fistulas across Africa and Asia.
Obstetric care in Australia is so good, fistulas rarely occur. So these reconstructive procedures don’t often arise in Australia; plastic surgeons usually perform them for infrequent cases of invasive genital cancer.
But women in remote Uganda do not have access to optimal preventative healthcare yet, and that’s also what we hope to change.
Since 1995, Professor Goh and Dr Krause have spent time every year training doctors in Asia and Africa on how to treat fistulas. In 2018, Prof Goh was named the AMA’s Woman in Medicine.
The medical team pay their own costs for the trip, and the charity uses donated funds to pay the hospital for the patient’s surgery, accommodation and post operative care.
Retired gynaecologist Dr Barbara Hall and her husband, retired GP Dr John Taylor, have also been an integral part of the Medical Training In Africa team’s visits to Uganda since 2013. The duo treated women suffering from prolapse and fistula in another hospital, in Kasese, eight hours from Uganda’s capital.
The need for better surgical facilities and maternal and paediatric care is great in Uganda, and small contributions can make a great difference to healthcare in developing countries.
Want to help women and children in Africa? You can make it possible to conduct future trips to this and other regions in need. Donations go directly to funding surgery, training and local education initiatives for women and healthcare workers in villages, via the HADA website.
Diane explains why Hydrafacial will become your next obsession!
With so many skin therapies and treatments on the market these days it’s sometimes hard to know what treatment will be the best for our skin. One thing is for certain, we all want our skin to feel good, look radiant - and as we get older, we are all wanting to achieve a healthier, less stressed appearance.
I have seen so many amazing skin technologies and treatments during my time in the industry, that I am constantly amazed and excited about what the ‘next big thing’, or new trend will be.
There is one treatment that I am super impressed and obsessed with, not only because the results are instant, but also because for someone like myself who doesn’t always have the time to do extra long beauty treatments, I can ultimately fit this facial into my busy lifestyle and have it done on my lunch break!
If you haven’t heard of it yet, I am talking about the next generation of facials, exfoliation and nutrient infusion all in one treatments, call the HydraFacial.
It’s the go to treatment that the Hollywood stars have to give their skin a boost, plump out fine lines, and remove unwanted dead skin build up and blackheads, and the good thing is, you too can also experience and have that celebrity red carpet ready skin in only 30 minutes!
What is HydraFacial?
Hydra facial is a next level microdermabrasion. It’s a 5 step process to upgrading your skin from economy - to first class! It is similar to an aggressive microdermabrasion, but gentle enough to leave no irritation as it is extremely hydrating.
The treatment involves the exfoliation of superficial dead skin cells using the latest Vortex technology, while also infusing, extracting, loosening dirt and debris, hydrating and removing toxin build up in the skin. The infusion of the antioxidants, hyaluronic acid and peptides leaves the skin with a beautiful dewy glow.
As the treatment is not abrasive, there is no downtime, and even the most sensitive skins can have it done. If you want that extra boost, I love adding some LED lights to your treatment for extra plumping, hydration and rejuvenation to help minimise the appearance of fine lines and wrinkles.
As our skin regenerates itself every 28 days, it’s ideal to do a HydraFacial every month to maintain that beautiful healthy glow - but even if that sounds like too great a commitment, just one treatment will have you seeing results. Come in a experience one for yourself today!
2019 Before and After Highlights: plastic and cosmetic surgery results
2019 was a big year for the hundreds of women and men that underwent surgery or treatments at our clinics in Brisbane and Ipswich!
Here’s a small snapshot of some of the results our patients achieved this year, across breast augmentation, facelift, post weight loss or post pregnancy mummy makeovers, breast reduction, implant revision, abdominoplasty, rhinoplasty and blepharoplasty procedures - as well as non surgical transformations using cosmetic injectables, laser and skin therapies.
Thank you to every patient that made 2019 such a special year! It was an honour to be part of your individual surgical journeys.
A massive thank you also to the patients who kindly permitted us to share their results; being able to view before and after photos is an important component of most patients’ surgical research and we are grateful to those patients who enable this to happen.
For more before and after photos or to discuss your surgical options in 2020, please get in touch using the form below or call 3202 4744.
Happy New Year! In 2020 we hope you…
call to book a consultation with Dr Sharp
Implant selection and your breast profile: tailoring with augmentation
French slope, ski jump, full and voluptuous or bolt-ons? Breast augmentation results are often spoken about in terms of size, but the desired profile of a breast is equally as important to consider when selecting your implants.
During the planning stage of your augmentation, your plastic surgeon will take into account the shape of your existing chest anatomy, as well as your overall body type and height.
A patient who is slim and long is usually best suited to a proportionate breast enlargement that compliments her elongated look. Conversely, a shorter statured woman might find that widening the upper chest with implants that add too much volume to the sides of the body, exaggerates her short appearance.
Breast augmentation surgery should do more than create beautiful, big breasts, it should compliment and enhance, creating an overall improvement to the shape of the body.
When patients visit Dr Sharp’s Brisbane and Ipswich clinics for breast augmentation consultations, one of the first things he seeks to learn from them is what shape they desire; a very natural size, projection and profile - or a breast that appears very full, or even round. Along with their body shape, this forms the basis of his surgical plan.
“Different implants can produce a natural look, a round appearance - or something in between - based on the implant choice and surgical technique,” Dr Sharp says.
The two key considerations Dr Sharp makes when selecting an implant with his patients takes into account:
Your natural breast anatomy
Little differences you might not notice; like a shorter nipple-to-breast-fold distance, asymmetry or a lack of upper breast tissue can direct implant selection and placement. The quantity and location of pre existing breast tissue, as well as your chest wall width and torso height are also factored. Your surgeon will measure the distance between landmarks of your anatomy, such as your nipples, navel and collarbone.
Your desired breast shape
Do you like lots of upper pole fullness, or do you prefer the flatter, more natural ski-jump like shape - also sometimes known as the ‘French’ look? Is cleavage or side boob important? These are also important considerations to make when choosing your ideal implant.
Breast augmentation goals: profile, shape and size
Forget about comparing implant size: the exact same implants can look totally different on on two different women!
Implants are placed under breast tissue (subglandular) or the pectoral muscle (submuscular). This determination may be based on the amount of natural breast tissue a woman has and the size of the implant. Most surgeons refer to ‘dual plane‘ when determining breast implant placement. This modern augmentation technique involves placing the implant underneath the pectoral muscle, with the muscle releases sequentially to a more advanced degree. Dual plane placement enables the surgeon to raise the pectoral muscle slightly upward, giving the lower part of breast tissue contact with the breast implant. This technique is especially effective on selective patients that have some degree of breast ptosis or slightly droopy breasts. Your surgeon will be your best resource in determining the right implants and placement for you. The below images show a range of natural breasts and the end results they have achieved through breast augmentation surgery with Dr Sharp, through the selection of different implants. Observe the slope of the upper pole of the breast and the fullness of the lower pole. Each one has a different starting point and desired result.
When looking at the breast from the side, a line can be drawn between the upper pole and the lower pole (see right). The breast slope runs down the upper pole, and end at the top of the lower pole. In a natural appearing breast, the slope is either straight or concave.
In general, when a breast implant is placed in an anatomically normal breast, the plastic surgeon can either maintain a natural straight slope, or a rounder projecting curve can be created in the upper pole of the slope.
Your natural breast tissue, along with what your plastic surgeon does to create the pocket for the implant - and what type of implant is inserted - will determine this shape.
A natural breast shape is like a teardrop also known as a ‘ski jump’ or ‘French slope’ - with most of the fullness in the lower half of the breast. When we talk about upper pole, we are referring to the breast fullness above the nipple. When we talk about lower pole, we mean how full the breast is below the nipple.
Upper pole goals:
Whatever implants and implant placement you opt for, you will have some temporary upper pole fullness right after surgery. This is especially so with implants placed under the muscle as they tighten after surgery and move your implants higher up on your chest. It’s why your surgeon will impress upon you pre operatively, the importance of being patient during the recovery period. When post operative swelling goes down and your tissues relax with the drop and fluff process, the upper pole you’re left with will depend on a few things, including:
Size - larger and bigger implants (cc’s) generally give more upper pole fullness
Width - the wider the implant, the more likely it is to reach and fully fill the upper pole
Profile - higher profile and ultra (or extra high) profile implants give the best chance of upper pole fullness
Cohesive silicone gel - the material of a cohesive silicone implant is made specifically so it keeps its shape
If you are aiming for an obviously augmented look (round, high and fuller) be sure to communicate this to your plastic surgeon. There’s no guarantee though that you’ll get prominent upper pole. You will, in some part, be limited by your existing anatomy.
Lower pole goals
One of the most important parts of a breast augmentation can be the aspect only a few people ever see; lower pole fullness. This is especially true if you’re starting with deflated breasts after breastfeeding or weight loss. A round implant will generally give you upper and lower pole fullness, but if you are looking for a naturally beautiful breast shape, where there’s more lower fullness than upper - an anatomical implant could be recommended. If you have very mild breast sagging, a well chosen implant can provide a mini lift, providing support for the nipple and raising its projection.
Whatever look you’ve opted for, don’t assess your outcome until at least 6 months after surgery; anatomical and textured implants can take even longer. By this point you should be about 90% there with the settling and softening and you’ll know what your new breast shape is.
The best way to get what you want out of your breast augmentation journey is to pick an experienced specialist plastic surgeon, to express your goals clearly and to ensure you have realistic expectations.
Different breast implants can be used to achieve varying breast profiles:
Breast implants have a flat base and a curved outer surface. When the implants are laying on a flat surface, the amount of height that the outer curved surface has is called the implants projection. Round implants come in four basic types of projection or profile: low, moderate, high and very high.
When the patient and implant are upright, the volume of the implant flows to the bottom of the implant. This makes the implant have a more teardrop appearance. This varies somewhat with the different profiles. Low profile implants tend to produce the most natural teardrop appearance. Moderate profile implants can also produce a natural appearance with more projection to the breast. High profile and very high profile implants produce less of a teardropped shape and more of a round shape with more fullness in the upper pole of the breast.
Round breast implants
- More upper breast fullness
- Are sometimes the preferred shape to restore upper breast volume lost through breast-feeding or weight loss
- Being perfectly round, implant rotation cannot produce any deformity of breast shape
Anatomical (tear drop) breast implants
- More fullness in the lower half that tapers off towards the top
- An attractive and natural straight line drape of skin from collarbone down to nipple
Breast implant profile options
Low profile breast implant: the low profile implant shell is wider (larger diameter) and flatter (less height or depth) than moderate profile breast implants. This implant style is commonly used for women who have a wide broad chest frame. The extra width of the implant shell will fill the chest anatomy correctly, achieving a natural look and realistic cleavage. The implant will not project as far off the body as other implant styles, creating a subtly enhanced look. The main criteria used to select low profile implants are the base diameter of the breast and dimensions of the chest; the implant should be smaller than the base diameter of the natural breast mound, which is often substantial in wider framed women.
Moderate breast implant profiles: the low profile implant shell is wider (larger diameter) and flatter (less height or depth) than moderate profile breast implants. This implant style is commonly used for women who have a wide broad chest frame. The extra width of the implant shell will fill the chest anatomy correctly. The result, achieving a natural look and realistic cleavage. The implant will not project as far off the body as other implant styles,. This makes it the right choice for women who want fullness, but not an overly round and obviously enhanced look. The main criteria used to select low profile implants are the base diameter of the breast and dimensions of the chest. The implant should be smaller than the base diameter of the natural breast mound, which is often substantial in wider-framed women. This is one of the most commonly used profiles.
Moderate plus breast implant profiles: moderate plus implants are a half step compromise between traditional moderate profile implants and popular new high profile implants. The moderate plus profile is a popular choice among women who want a bit more projection than is typically provided by a moderate profile, but not as much projection as is found with the high profile shell.
High breast implant profiles: high profile implants project the further off the chest wall when compared to other common implant profiles. The high profile implant will achieve this projection by having a smaller base diameter than an identically sized (in cc’s) moderate or low profile implant shell. By decreasing the diameter of the shell - but keeping the same fill volume - the implant manufacturer is able to increase the depth or forward projection.
High profile implants are usually for women with a narrower chest frame who still want a considerable size increase during their breast augmentation surgery. Instead of using a wider base diameter moderate implant, the plastic surgeon will choose a narrower high profile shell which will suit the patient’s anatomy and project out to accommodate the volume of the filler material. This modified mastopexy, like many breast lift operations, sometimes squares off the breast shape slightly, making it appear wider and less round. The shape of the high profile implant shell restores the rounded shape of the breast, while still allowing the considerable benefits of the mastopexy lift.
Ultra high breast implant profiles: ultra high profile implants provides the narrowest base and highest projection for women with a narrower chest frame who still want a considerable size increase. Instead of using a wider base diameter implant, the plastic surgeon may choose the ultra high profile breast implant. This may suit the patient’s anatomy and project out to be able to accommodate the volume of the filler material.
There are two ways to increase projection in an implant. The first way is to add more volume to the implant. The other way to add projection is to make the base (diameter) of the implant smaller. Therefore, for any given volume, a smaller base has more projection. This is what ‘high profile’ implants do; they have a smaller diameter with a higher projection.
Breast implant inspiration: should I bring photos to my consultation?
Yes….but! One of the most challenging and exciting parts about considering a breast augmentation is looking at breast implant inspiration photos - also referred to as “Wish Boobs” or “Boob Goals.” Remember that when you’re looking through breast augmentation inspiration photos, it’s important to keep your expectations realistic when it comes to your own breast surgery.
Dr Sharp’s approach to augmentation surgery uses breast implant as the basis of your augmentation and often enhances the results with fat grafting. Small amounts of thigh or abdominal fat are transferred to your breast, to soften the transition between implant and body - and sometimes, to enhance cleavage. This is also known as the blended breast augmentation.
Ultimately, the implant you choose - and the type of breast profile you prefer - is a personal and intimate decision that should not be impacted by anyone else’s opinion or expectations. Conforming your body to a trend or another person’s opinion might leave you feeling dissatisfied with your appearance in the long run, so choose a breast profile that appeals to you.
Remember that the ageing process, as well as weight fluctuations and breastfeeding, will alter your breast profile over the years, so what it looks like now won’t be reflective of what it will look like in 10 or 20 years!
Call our helpful patient care team on 3202 4744 to explore your breast augmentation options or book a consultation with Dr David Sharp in his Brisbane or Ipswich clinics.
What makes a surgeon a ‘surgeon’?
Confused by the different titles used by plastic, cosmetic and aesthetic surgeons in Australia? You aren’t alone.
The results of a survey commissioned by the Australasian Society of Aesthetic Plastic Surgeons were released today, highlighting widespread concern and confusion around the misuse of the title ‘surgeon’.
According to the survey, 93% of Australians agree that it would be easier for patients to distinguish qualified surgeons from doctors, if medical professionals were to only use their Australian Health Practitioner Regulation Agency (AHPRA) title.
92% of Australians believe that a patient’s safety is put at risk when a doctor performs surgery without having completed surgical training.
86% of Australians agree it is wrong that doctors without any surgical training are allowed to call themselves surgeons.
81% of Australians agree that the title cosmetic surgeon implies the doctor has completed surgical training.
77% of Australians are in support of calls to ban the term ‘cosmetic surgeon’, to help patients separate doctors from qualified surgeons.
A loophole in the current regulatory framework allows doctors who are not registered as Surgeons by AHPRA to title themselves ‘Surgeons’ and advertise cosmetic surgery. The survey of over 2,000 Australians is the latest addition to mounting evidence pointing to the need to restrict the title of ‘Surgeon’ to only doctors registered as specialist surgeons by AHPRA.
ASAPS President, Dr Naveen Somia said the peak body is calling on the Council of Australian Governments (COAG), through the review of the National Law to mandate all medical practitioners to use their official AHPRA title and restrict the title Surgeon to only those registered as Surgeons by AHPRA.
“The title of ‘cosmetic surgeon’ has no official status with the Australian Medical Board, AHPRA, Medicare or the health insurers, making banning its use a logical step,” he said.
“The use of fake and fabricated titles in cosmetic surgery by doctors not registered as Surgeons is a serious issue that requires urgent intervention in the interest of patient safety.”
The survey provided measurements of understanding and beliefs around certain terms used to describe people who perform cosmetic surgery, with a total of 2,001 responses received over a three week period in October 2019.
A qualified specialist plastic surgeon has completed not only their medical degree (indicated by the letters ‘MBBS’ in their credentials), but they have then completed an additional 7-10 years of post graduate surgical training.
For Dr Sharp, this involved serving two years in regional and metropolitan hospitals as senior house officer and principal house officer, before being accepted onto the Royal Australasian College of Surgeons’ general surgery training program. He then spent three years training in general surgery, followed by an additional five years training under the College’s plastic surgery fellowship training program.
This training culminates in a Fellowship of the Royal Australasian College of Surgeons (indicated by the letters ‘FRACS’ in credentials).
A RACS qualified plastic surgeon has the letters FRACS (Plast) after their name. Most plastic surgeons are members of the Australian Society of Plastic Surgeons and the Australasian Society of Aesthetic Plastic Surgeons, which require them to comply with the societies’ codes of conduct; protecting patients and upholding world-class standards of professional conduct.
In Australia, the Royal Australasian College of Surgeon’s fellowship programs are the only surgical training programs recognised by the Medical Board, however there is no legal requirement for doctors to undergo this training in order to call themselves a ‘surgeon’. It is important to understand that if your doctor is not a registered member of the Royal Australasian College of Surgeons, they have not undergone the rigorous selection process, advanced surgical training and passed the clinical and theoretical examinations required to become a qualified plastic surgeon.
Patient resources:
- Click here to find out if your surgeon is a qualified plastic surgeon, via the RACS Find A Surgeon portal.
- Read more about the survey results here.
- For a refresher on what gives a qualified specialist plastic surgeon their title, click here.
Lymphatic massage with HydraFacial boost
HydraFacial is a medical grade facial that combines lymphatic drainage with deep cleansing and pore extraction.
In combination with your HydraFacial treatment, lymphatic drainage works to improve circulation, as well as detoxify, tone and firm skin.
Gentle lymphatic massage can stimulate the opening of the lymphatic system, increase lymph flow and assist in the drainage of fluid and toxins.
This can be integrated into your standard HydraFacial treatment to reduce puffiness and fluid retention, but it can also be used after facelift surgery to stimulate lymphatic drainage and optimal recovery.
The lymphatic system is responsible for filtering our blood from toxins, bacteria and viruses. It also helps to drain and channel away swelling after surgery. It is therefore imperative we keep this defense mechanism operating well for a healthy immune system and our general wellbeing. The Sharp Clinic provides this treatment as part of our HydraFacial services.
The HydraFacial device uses high pressure suction applied in a specialised directional method to manually massage and drain lymph nodes.
HydraFacial is a medical grade facial that combines lymphatic drainage with deep cleansing and pore extraction, before saturating the skin with treatment serums and finishing with intensive infrared.
This is the only procedure that combines cleansing; exfoliation, extraction, hydration, antioxidant protection and red LED light therapy all in one.
HydraFacial is different from any other facial in that it is a clinically proven treatment that is designed to work beneath the skin, rather than just ontop of the skin to produce instantly visible results that last.
Each HydraFacial experience uses a series of HydroPeel tips with a unique spiral design, which creates a vortex effect to easily dislodge and remove impurities while simultaneously introducing hydrating skin solutions with potent active ingredients.
How long after acne medication can I have Fraxel laser treatment?
Acne can affect teenagers and adults of all ages; impacting their health, wellbeing and self confidence. Isotretinoin, also known as 13-cis-retinoic acid and sold under the brand name Accutane or Roaccutane (among others), is commonly used to treat severe acne. Laser therapy isn’t recommended while patients are taking this medication, due to the skin sensitivities it causes.
After coming off acne medication, patients often still have pits, blemishes, red bumps, box-car scars or general unevenness in their complexion.
Fraxel Dual laser is a popular scar-reduction and skin-refining treatment for patients after they finish taking acne medication; not only does it refine residual scarring, but it also helps to regulate the skin and reduce pigmentation and congestion.
How soon after finishing acne medication can I have Fraxel laser?
Some studies show that laser treatment can be undertaken as early as one month afterwards, but in general, nonablative fractional laser therapy is deemed to be safest approximately 3 to 6 months after ceasing oral isotretinoin treatment.
What are the different types of acne scars?
The Sharp Clinic’s skin therapist Diane Lehto says there are two different types of acne scars: acne scarring and post-inflammatory hyperpigmentation or hypopigmentation.
“Post inflammatory hyperpigmentation are dark spots where pimples used to be; hypopigmentation are light-coloured spots,” Diane says.
“They can make your skin look patchy and uneven, and can be difficult to cover up with makeup or concealer.
“The second type of acne scarring is a textural problem often referred to as ice pick scars, which look like small punctures or divots in the skin.”
This occurs when a sebaceous oil gland develops an infection large enough that it tears the skin layers apart, damaging the structure of the skin.
Over time, these scars can become less visible, but in some cases of severe acne scarring, they might always be evident. Laser and dermal fillers can often reduce their appearance.
How Fraxel helps
Diane explains that Fraxel uses light energy to create tiny micro-columns in the skin, so the body’s natural collagen response is stimulated, and collagen is produced. At the same time, the upper surface of the skin exfoliates off, removing pigmentation - so essentially the rejuvenation occurs on both the skin’s surface, and deeper below.
Fractional laser leaves a lot of the skin intact, meaning patients don’t lose healthy skin along with scar tissue. It also reduces the downtime associated with the treatment. Patients usually look like they have sunburn for a few days, and then experience flaking skin for up to a week on their face; or longer on other parts of the body that have less oil production.
How much does Fraxel cost?
Full face Fraxel treatments start from $990 and face and décolletage packages start at $1200. It is also suitable for the neck, back and other areas of the body that can be impacted by acne scarring. Some patients are satisfied with their results after just one treatment; others with very extensive acne scarring will need 2-3 treatments to achieve their final result. Spot treatments are also available.
Alternatives to Fraxel laser for acne scarring
Dermapen microneedling can be used to treat textural acne scars. Microneedling involves using a device that creates micro traumas to the skin, to kick start the production of collagen to repair the damage. Diane says that Dermapen can improve the texture of your skin over time to be flatter and smoother, with minimal downtime. It can also be combined with platelet rich plasma (or PRP) treatments, which use your own stem cells to help stimulate the skin’s natural healing response. Patients usually find their skin is a little red for 24 hours afterwards, and can feel slightly tight or dry for around seven days after the treatment. Each session costs from $250 for a standard full face Dermapen treatment, and 2 to 5 treatments are needed, depending on the severity of the scarring.
Call 3202 4744 to book a complimentary consult with Diane to learn more about the scar reduction treatments suitable for you.
Report: Australian Breast Device Registry
The Australian Breast Device Registry (ABDR) has released their Annual Report, detailing 3,544 reconstructive and 9,337 aesthetic breast procedures performed in public and private hospitals during 2018 and a total of 10,762 reconstructive and 29,206 aesthetic procedures from 2012 to 2018.
The report provides important insights into procedures and implant details, surgical techniques, complications and revision rates on data from 37,000 patients.
Established in 2015, the ABDR is a world-leading registry service led by Monash University, with the support of Australian Society of Plastic Surgeons (ASPS) and the Therapeutic Goods Administration (TGA).
Surgeons are able to voluntarily submit information about the implants they place in patients. This enables patients to have a central national point of registration for their implants, while also facilitating the monitoring of prosthesis’ safety profiles and enhancing quality of care for breast implant patients.
Each of Dr Sharp’s patients have their implants registered (it is free of charge), but can choose to opt out of the registry if they wish.
Australia wide, 514 surgeons operating at 280 hospitals and day surgeries had contributed data. Key findings included:
• The total number of procedures captured by ABDR in 2018 was 13,718, including 3,544 reconstructive and 9,337 aesthetic procedures.
• At the end of 2018, 37,603 patients had procedures captured by the ABDR, an addition of 11,990 in 2018.
• 74% of breast implant procedures were registered (up from 65% in 2017 and 44 % in 2016).
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Considering surgery in 2020? 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 patient coordinator, Katy, recommends patients ask themselves if they are considering surgery in 2020:
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 prior, especially if you’re planning surgery during busy periods, such as Christmas or school holidays. The only downside to choosing a great surgeon is that there might be a wait to get an initial appointment (with good reason - they’re busy because they’re popular!) but we understand it can be very disappointing to find that the theatre lists during your scheduled annual leave break are all booked up. Ask your surgeon if they have a Priority Waiting List. In our clinics, we can often bring our patients’ appointments forward by weeks or months, just by registering them on this list. Most of the time, your surgery will be anywhere from 2-4 months after your initial consultation, depending on availability on theatre lists at your preferred hospital. Often you will have a second or third complimentary consultation in the interim. And don’t plan to have surgery just before major life events; give yourself plenty of time to heal before a wedding, reunion or big holiday!
Can I take enough time off work?
Most procedures require 1-2 weeks off work, and if your job involves heavy lifting or lots of physical activity, you may need to return on reduced activities for up to 6 weeks, longer if you’re a slow healer or have other health issues. Talk to us so we can help you plan ahead. If you have a cosmetic procedure with Dr Sharp, you will have at least 3 post op consultations, so it’s also good to consider how you will be able to attend these around work commitments after your surgery.
Do I need private health insurance?
It’s always beneficial to have private health insurance if you are having surgery. Some procedures, such as abdominoplasty, brachioplasty or thigh reduction after massive weightloss, carry MBS item numbers which significantly reduces your out of pocket costs, and gives you peace of mind knowing you have any post operative hospital admissions covered. But even if your planned procedure doesn’t have MBS item numbers (and is considered entirely cosmetic), if you experience any complications or health issues after surgery, your private health insurance usually covers most of the associated costs. Readmission to hospital after cosmetic surgery is very rare amongst our patients, but it does happen from time to time and when it does, private health insurance is very reassuring.
Have more questions for us?
Our experienced patient care team have extensive experience navigating these questions, and are available for an obligation free phone chat on 3202 4744 to discuss the procedure you are interested in, the potential costs involved and whether or not you might be eligible for rebates.
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Breast implant safety update: the TGA announcement
In recent months the Therapeutic Goods Administration have undertaken an enormous amount of work, commissioning internal scientific reviews, meeting with external advisory groups, liaising with overseas regulatory authorities and research groups to advance public safety on sound scientific evidence for breast implant safety. We welcome news today that following the Therapeutic Goods Administration’s (TGA) thorough review of breast implants sold in Australia, they have taken a range of regulatory actions to address BIA-ALCL risks.
We are also pleased to advise that the high quality implants Dr Sharp uses (Mentor and Motiva) are not involved in any of the suspensions or voluntary recalls resulting from the TGA’s investigations, due to their low incidence of complications and BIA-ALCL rates.
All surgery carries risks, and patient safety is front of mind in every decision we make; as such, breast implant risks have been addressed by Dr Sharp in our clinics for years, with:
- the use of high quality micro and nano textured implants
- Dr Sharp taking the Macquarie University 14 Point Plan Pledge
- use of the Australian Breast Device Register for all breast implant procedures performed by Dr Sharp
- to promote patient awareness, the risk of BIA-ALCL is always included in the informed consent and consultation process with Dr Sharp. We believe that every patient deserves to be fully informed, and so this has been part of our practice, since long before it was recommended or required.
Even if you have macro textured breast implants, the TGA says removal is not required
Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) is very rare. Evidence based recommendations are that removal of breast implants is not required in a person who has no symptoms or concerns. If you have a breast implant and detect any change in the breast or armpit such as swelling, a lump or pain, you should consult your plastic surgeon.
Some breast implant devices have been suspended. This means that these implants will not be available on the Australian market for the next six months. During this period, the implant providers will have the opportunity to provide additional information to the TGA about their implants’ safety and performance.
The implants Dr Sharp uses are not included in the suspension
Suspended implants are those that are macrotextured - grade 3 and 4 and some microtextured implants associated with higher incidences of BIA-ALCL and other clinical concerns. To support the ongoing monitoring of BIA-ALCL, all cases of BIA-ALCL must be reported to the TGA by implant suppliers within 10 working days of becoming aware of the adverse event.
To support greater vigilance and increased awareness and data collection on this issue, the TGA requires implant suppliers to provide reports every six months. These reports must include supply data and detail all adverse events and complaints received regarding breast implant and tissue expander devices, both in Australia and worldwide, including BIA-ALCL, capsular contracture, or rupture of the implant.
In addition to this, Dr Sharp chooses to independently use the Australian Breast Device Register which records all implants he places. The Australian Breast Device Registry (ABDR) is a Commonwealth Government health initiative that records information on surgeries involving breast devices, such as breast implants. It is are a long term project to help safeguard the health of people undergoing breast device surgery. For many patients, the ABDR provides peace of mind that their device details are recorded. If you’ve had an augmentation, reconstruction or removal and replacement with Dr Sharp, your implant details are registered here for perpetuity.
What are micro and nano textured implants?
Textured implants were an innovation in implant science, developed to reduce the risk of a common complication, called capsular contracture. By texturing the implant’s surface, the body was less likely to create a thick, hardened capsule that constricted the implant and created a hardened, sometimes uncomfortable, result years after implantation. Also, because the implants weren’t textured, they didn’t tend to move around as much or rotate, so different shapes could then be used in a texture implant, like the tear drop or anatomical implants commonly used today - to create a beautifully sloped, natural looking breast many women desire. Prior to this, only smooth implants were used, and these always had to be round. This is because their smooth surface meant they could rotate, and an anatomical or tear drop implant that rotates will distort the breast shape.
We often warn that ‘all implants are not created equal’, because (among other factors), the type of texturing involved in the implant’s surface can determine how much bacteria it holds when being implanted. Some texturing holds a lot, while other texturing is cleverly engineered to offer ‘textured’ benefits with much lower risks of bacterial contamination and ensuing BIA-ALCL. These are the implants Dr Sharp uses.
When placed under a microscope, the difference between the surface topography and area of each implant brand can be seen, as they use very different techniques to create texturing. Learn more here about different breast implant surface textures, safety profiles and quality.
Breast implants and risks
To support informed patient choices, patients undergoing breast implants placement always have access to a patient information documentation that includes information about warnings and risks associated with implants. Information relating to the Australian Breast Device Registry is also included, to support ongoing reporting and monitoring. BIA-ALCL is very rare, and the clinical advice remains that, without symptoms, it is not necessary to remove your breast implants. Instead, patients who have breast implants, should regularly check their breasts and see their doctor if they notice any changes.
The Australian Society of Aesthetic Plastic Surgeons (ASAPS) response
As the preeminent body representing Specialist Plastic Surgeons who specialise in cosmetic surgery, the Australasian Society of Aesthetic Plastic Surgeons (ASAPS) has welcomed the TGA’s findings into breast implants and breast tissue expanders that were released today.
Dr Naveen Somia, President of the ASAPS, said the review has prioritised patient safety with the breast implants that have the highest risk of Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL), while leaving viable implant options for patients on the market.
ASAPS recommends that patients prioritise their safety when considering breast augmentation surgery by taking the following steps:
1. Seeking a surgeon who is accredited as a Specialist Surgeon by the Australian Health Practitioner Regulation Agency (AHPRA). These surgeons are committed to life long learning and best practice techniques and procedures
2. Ensuring their surgeon uses stringent breast implant infection control standards, such as the 14-Point-Plan
3. Having the procedure in a licensed facility
4. Confirming that their surgeon only uses TGA approved implants
If you have any questions or concerns regarding breast implant safety, call us on 3202 4744 to book a consultation with Dr Sharp and learn more about the steps you can take to ensure your optimal outcome and long term health when undergoing breast augmentation surgery.
call to book a consultation with Dr Sharp
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Our top four melasma treatments
Melasma is a type of skin pigmentation, related to sun exposure and hormones. It occurs more frequently in women (often after pregnancy), but can also be seen in men. It is experienced by patients of all skin types, with most common location on the cheeks, upper lip, chest/neck and forehead.
Due to our high sun exposure levels in Queensland, melasma is one of the most common skin condition complaints we see in our clinics. We have developed a range of scientifically proven therapies to effectively treat this persistent skin concern. Skin therapist Diane Lehto explains our treatment options below:
1. Sun protection
Prevention is always best, so sunscreen and sun protection are the most important aspects of our approach to keeping melasma under control.
Daily sunscreen use is imperative, all year round in Australia.
We recommend SPF50 and above. View our range of high quality sunscreen products here.
For those who like a quick two-in-one solution, we love our Synergie Mineral Whip makeup.
2. Microneedling with platelet rich plasma (PRP)
If you are prone to melasma, even with great sun protection unfortunately you’re still likely to see it pop up, especially after hormonal changes or a summer holiday.
Dermapen microneedling is a quick and easy way to exfoliate the superficial layer of the skin and stimulate healthy skin growth.
We often combine Dermapen with PRP for a boost of collagen and to address fine lines and poor skin condition.
3. Fraxel laser therapy
Fraxel laser therapy is used to resurface the skin and peel the abnormal skin off so it can be replaced by normal non-sundamaged skin. If you have recurrent melasma, it might be necessary to have maintenance Fraxel treatments every 1-2 years to keep your pigmentation at bay and boost your results.
Left, before and 7 days after Fraxel laser treatment for melasma at The Sharp Clinic.
4. Maintain with high quality skincare
Once you’ve lifted off the melasma, it’s important to maintain your results.
Our skincare range addresses sun damage, by reversing and preventing UV induced genetic errors - while regulating melanogenesis, to reduce hyperpigmentation; resulting in a bright and even skin tone.
Combination therapy is best
For optimal results, we recommend a holistic approach to melasma treatment that includes high quality topical treatments and periodic active facials to prevent and maintain your skin - and advanced resurfacing technology to reduce any melasma that develops. This requires some commitment to maintaining good skin health.
But the great news is, these solutions not only improve melasma, but also help reduce your chances of developing some forms of skin cancer - so you are helping to protect you skin for the long term too!
Book a complimentary consultation with Diane at our clinics by calling 3202 4744.
How much do facelifts cost?
I’m interested in having a facelift but I’ve heard they are very expensive - and involve a long recovery.
How much do they cost, and how long will I need to take off work?
Dr Sharp:
In contemporary plastic surgery, facelift procedures fall on a spectrum of operations that can be performed to reduce deep folds around the mouth, mid face excess skin, an undefined jawline and sagging in the lower face and upper neck.
Therefore some patients with early lower face aging only require a small amount of excess skin to be removed in front of - or below - the ear to see an improvement in the jawline definition they seek. These are commonly called ‘S’ lifts or mini lifts and are sometimes performed under local anaesthetic, or under general anaesthetic as day surgery. The procedure takes 1 to 1.5 hours and patients can return to work the following day, but most take a week off work until their sutures are removed.
Generally, most facelifts involve some plication or detachment of the SMAS layer, so the underlying facial structure can be lifted and tightened. When this occurs, the surgery is performed under general anaesthetic and takes anywhere from 2.5 to 4 hours. Small drains are required for 24-48 hours and a support garment is worn following surgery.
Most patients take at least 2 weeks off work to allow bruising and initial swelling to dissipate. Patients return to our clinic at intervals during the first 6 months for diligent post operative care.
The total cost factors in the surgeon, surgical assistant, anaesthetist, hospital and theatre fees - as well as post operative compression garment and multiple post operative appointments. Each facelift procedure is tailored to suit the patient, so the cost can vary.
Mini facelifts performed under local anaesthetic start from $4,500.
Full facelifts (including upper neck) cost around $19,500. This includes post operative laser resurfacing/scar optimisation treatment (valued at $1,000).
Facelift is ideal for patients who are at a healthy weight, and is often teamed with fat grafting and blepharoplasty surgery. When other procedures are added, the total cost increases, due to the additional time required in theatre.
As with all cosmetic surgery, our patients are provided with a comprehensive estimate of fees document following their initial consultation, detailing all inclusions.
Cost is an important consideration when undergoing surgery, but its also important to weigh up:
- whether your surgeon performs this procedure frequently
- the information provided to you at your consultation; was your surgeon transparent about the risks and expected results. Honesty (even the bits you don’t want to hear) is very important
- how your surgeon makes you feel during your pre operative process; feeling respected and heard is paramount when embarking upon a surgical journey. It can be an emotional process, so you need to resonate with your surgeon and their interpersonal approach.
Facelifts are expensive, but please keep in mind that this is a lengthy, complex procedure that requires advanced anatomical knowledge, many years of specialist surgical training and skilled post operative support. Ask lots of questions at your pre operative consultations, and seek the opinion of more than one specialist plastic surgeon when planning this procedure.
Ask us your facelift question!
Lower face aging: what are my options?
I’m 55 and over the last 5 years I’ve noticed a rapid change in my lower face. In what felt like a very short amount of time, I felt like I aged very quickly. I still feel young on the inside, but on the outside I have loose skin around my jaw, jowls and the beginnings of my dad’s turkey gobble neck! What are my options?
Dr Sharp:
The lower face, jawline and upper neck commonly show the first signs of ageing; jowls, folds between the nose and mouth corners, slack skin around the jawline and thinning, sagging skin around the neck. Hence it’s a common focus area for our treatments and procedures. Non surgical options for early signs of double chin/neck and jawline sagging include dermal fillers, fat dissolving injections and strategic use of muscle relaxer or fillers. Surgical options include facelift or mini facelift surgery.
Injectable fillers and muscle relaxers
Dermal filler can be placed along the jawline or cheekbones to lift and firm the early signs of jowling. The cost will depend on the amount of filler required, and usually ranges from $1200 to $2400. Muscle relaxing injections to address muscle issues costs $12.50 per unit. We use only the highest quality dermal fillers and wrinkle injections. Read more about these treatments here.
Under or ‘double’ chin fat dissolving injections
We find most patients with mild to moderate deposits of fat in this area only require 3 treatment sessions to get great results. Fat dissolving injections are not rebatable through Medicare unfortunately, as they are considered a cosmetic treatment. Click here to read more about dissolving double chins and unwanted fat deposits on your upper neck.
Facelift surgery
This procedure can range from a minor operation performed under local anaesthetic in our clinic to remove a small amount of excess skin on the lower face - through to a full facelift with neck lift, tightening the deep underlying structures of the face and repositioning fat pads that have migrated south. To read more about facelift surgery please click here.
Our facelift patients range from people in their late 30’s seeking our unique Sharp Lift technique, which firms and redefines, addressing early jowls and lower face laxity while using nano fat grafting to plump and revolumise - through to men and women in their 70’s who are looking for the natural-looking, ‘total’ facelift results. Each facelift is crafted to suit the individual patient’s anatomy and desired result.
How can I determine the best treatments for my face?
Ultimately the best decision for you will be based upon a number of factors, including:
- how much excess skin you have in this area of your face
- your natural bone structure, jawline and chin projection
- any unwanted fat deposits
- the condition of your skin
- your budget and;
- most importantly, your desired outcome
Not sure? Book a complimentary consultation with our clinician
Call us on 3202 4744 if you would like to arrange a booking – or if you have any further questions you would like to discuss with us. Our team prides itself on delivering gold standard clinical care, whether you are having non surgical treatments or surgery with us, you will always receive honest, transparent advice and plenty of information to make an informed decision about your face.
Ask us your facial ageing question!
What I wish I’d known before I had breast augmentation surgery…
Breast augmentation surgery is now one of the world’s most commonly performed cosmetic surgery procedures. There are over 60,000,000 implants currently implanted in women around the world. Despite being a popular procedure, there are some important factors and considerations to make when undergoing breast augmentation surgery. We are very up front about costs, credentials, implant benefits, risks and recovery.
We frequently receive enquiries from women who have had breast augmentation surgery elsewhere in the past and wish to have their surgery revised. We’ve collated the most common “what I wish I’d known” statements below. It’s important to ask questions and get as much information as possible (and read it carefully) the first time around, to ensure an optimal outcome:
1. What are my surgeon’s credentials?
Did you know, in Australia, any doctor can legally call themselves a ‘surgeon’ even if they haven’t undergone the Medical Board recognised training with the Royal Australasian College of Surgeons. If your doctor calls themselves a surgeon and isn’t on this list, they aren’t a qualified Specialist Plastic Surgeon. Specialist plastic surgeons undergo extensive training in surgical safety, infection prevention techniques and implant selection to ensure a low risk of infection. To further increase patient safety in breast implant surgery, a 14-Point-Plan has been developed by Specialist Plastic Surgeons to minimise the risk of bacterial contamination of an implant and improve outcomes.
Specialist Plastic Surgeons are committed to lifelong learning in breast implant surgery to update their skills and knowledge continually, ensuring they are equipped with the latest skills and technological advancements.
2. What is the safety profile of my implants and what are their warranty provisions?
Specialist Plastic Surgeons use products that are approved by the TGA. Not all implants are created equal; they carry different risks, warranty provisions (ranging from very restricted short term cover through to life long support should you have a complication). Your surgeon should be able to explain the difference between the key brands of implants currently available. It is likely your surgeon has a specific brand of implants that she or he favours, and they should be able to explain to you in detail as to why they have chosen these. The implants Dr Sharp uses come with extensive replacement and warranty provisions, offering additional peace of mind to patients.
3. What safety measures does my surgeon take when performing augmentation surgery?
In Australia, Specialist Plastic Surgeons operate in licensed hospital facilities that have excellent infection control standards to ensure the best outcomes for patients. The diligent and systematic application of antimicrobial strategies at the time of breast implant surgery has been shown to reduce the risk of implant complications. You surgeon will be able to explain the steps they take to ensure best practice standards are upheld, or exceeded.
4. What might my recovery look like and what do I need to consider when planning my recovery?
Good questions to ask might include:
- How much time will I need off work?
- When can I return to the gym (and what I can return to doing)?
- How am I going to lift my young child in and out of the car for the first 6-12 weeks?
- Do I have a special event coming up and will this impact the outfit I can wear or activities I can participate in?
- What if my recovery doesn’t go to plan or takes longer; how will that impact my income, lifestyle or finances?
5. Am I clear on what I do and don’t like about my breasts; and do I have realistic expectations?
Plastic surgery isn’t an exact science (as much as we wish it was). Each patient is unique and comes with a different body shape, chest width, skin condition and health profile. While your surgeon will do their absolute best to achieve your desired outcome it’s important to remember that this procedure is about improving - not perfecting - your breasts. If you are chasing perfection or want to look identical to someone else, you might be disappointed with your end result.
When performed by a specialist plastic surgeons with high quality implants under the right surgical conditions, breast augmentation is very safe procedure. The above information is by no means exhaustive; our patients have at least 2 consultations with Dr Sharp before their surgery and spend at least 1.5 hours in the clinic with us covering off a wide range of information before having their procedure.
Having a breast augmentation can be an exciting experience but it’s not something to rush into. See more than one surgeon, ask lots of questions and do your research!
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In the press: West End News
West End magazine has taken a look at our luxurious new clinic in this article, featuring the custom built space we recently opened in Cordelia Street, South Brisbane!
“For many people who visit our clinics, its the beginning of a new chapter in their lives – sometimes, its the first thing they’ve donee for themselves in decades. so the gravity of their time in the clinic, and what that might represent to them, is never lost on us. Every visit is special, and so we wanted a special space.”
Read more about our luxe new clinic here!
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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 seroma’. The diagnosis of the tumor is made by examining the seroma fluid.
Is BIA-ALCL breast cancer?
BIA-ALCL not breast cancer. Breast cancer affects 1 in 8 Australian women. The implants we use carry a 1 in 86,000 risk.
BIA-ALCL is a rare type of lymphoma that develops adjacent to breast implants, usually as a swelling of the breast 3-14 years after insertion. This swelling is due to fluid building up in the fibrous capsule that surrounds the implant and does not develop in the breast tissue itself. It can also present as a swelling or lump in the breast or armpit. The incidence of BIA-ALCL is very low.
How common are textured breast implants?
There are approximately 60 million textured breast prosthesis implanted in women.
All surgery carries risks and no cosmetic procedure is without potential complications. It’s important to be fully informed of your options, and weigh up these risks to make sure they are acceptable to you before undergoing surgery.
Dr Sharp is ethically and clinically committed to providing the safest available prosthesis for patients to achieve their desired results. Implants are selected in consultation with patients, with the latest data and long term safety in mind.
☎️ If you have any concerns or questions, call us on 3202 4744 or email info@drdavidsharp.com.au.
👩💻 To read more, please click on the resource links below:
- About BIA-ALCL and latest research results: https://bit.ly/2UtarRJ
- TGA Website: http://www.tga.gov.au/breast-implant-associated-anaplastic-large-cell-lymphoma-bia-alcl
5 ways to reduce bruising
A bruise appears when tiny blood vessels are damaged, through surgery, injury or puncture. Blood gets trapped under the skin, causing a bruise. Some people are more predisposed to bruising than others; blood thinning medications or certain vitamin deficiencies can increase the risk of bruising. Bruises will heal in time as the body reabsorbs the blood.
Although bruises are common after surgery and injectables treatments, there are ways to accelerate the healing process:
- Arnica: there’s a lack of scientific evidence to conclusively support arnica as a bruise reduction treatment, but anecdotally, we find arnica tablets speed up the reduction of bruising and swelling in the week after surgery; especially after facelift surgery.
- Hirudoid cream: contains MPS (mucopolysaccharides) which promotes tissue regeneration and reduction of swelling and inflammation. The cream is gently massaged into the bruised area twice daily, avoiding the incision line.
- Ice therapy: for the early stages of bruising. This can prevent the bruise from being as apparent and reduce swelling. Apply ice over the bruised area, but not over your incisions (if you’ve had surgery). Ice the bruise for 10 minutes at a time. Wait 20 minutes before reapplying.
- LED light therapy: can help speed up the breakdown of bruises.
- Conceal: use a high coverage or camouflage concealer such as Dermablend, which is available in pharmacies. This can be applied over the bruise. If you’ve had surgery, don’t apply the concealer over your incision line.
As always, what you put in your body will impact your recovery. Avoiding processed foods, salt, sugar and alcohol before and after surgery - and sticking to good water intake and healthy, whole foods - will assist with optimal healing. Incorporate fruit and vegetables that offer antioxidant and anti inflammatory benefits, such as pineapple - which is packed with bromelain - or celery which offers vitamins B6, C and K. Everything in moderation; ginger and turmeric also have anti inflammatory benefits, but very high doses can worsen bruising, so go easy on them!
If you are a patient of Dr Sharp’s and having a cosmetic or large reconstructive procedure, your black post operative bag will contain some products to assist with your recovery and bruising. Our clinics also offer complimentary Hirudoid cream for our surgical and injectables patients.
How long do bruises take to fade after surgery or injectables?
About 2 weeks; for milder or more superficial bruising (common after injectables), bruises can fade within 1 week to be almost indistinguishable. Bruising can appear immediately as a red or pink patch; within the first 2 days, the hemoglobin (the part of your blood that carries oxygen) changes and the bruise turns a blue, purple or black colour. After 5 to 10 days, the bruise turns green or yellow. Then after 10 or 14 days, it turns yellow brown or light brown colour before disappearing altogether. They can be tender to touch during this period.
How does a bruise differ from a haematoma?
A haematoma occurs when the body cannot heal the bruise as easily or quickly as a minor injury. A bruise occurs when a small amount of blood comes out of the vessel. A haematoma usually involves a larger amount of blood; this sometimes occurs after surgery when blood pools in the tissues, and the body cannot quickly process the blood as it does with a bruise. As a result, a haematoma stays the same color and firmness after several days rather than demonstrating the same aforementioned healing progress as a bruise. If you think you might have a haematoma, contact your surgeon to find out if it requires further treatment. In some cases, the haematoma can be removed through draining or surgically removing the collection of blood.
Should I be worried about my bruising?
Although they can be unsightly, bruises are not typically cause for clinical concern after surgery or injectables. They usually heal on their own. But, in some cases, a patient may need to seek medical attention for their bruising. Your bruise should not cause your limbs to become numb or lose function. This is especially the case if:
- you have recently had a dermal filler treatment and find that part of your face on or near the site of the injections has become blue, purple or black. This can be a sign of occlusion and requires urgent medical attention.
- after surgery, if you find that your bruise is firm and does not fade or change in the manner explained above. This could indicate that you have a haematoma. The location, size, and cause of the haematoma will determine how to treat it.
The information contained in this article relates to bruising after surgery or injectables and does not relates to bruising due to other trauma. The article does not constitute medical advice; if you are concerned, you should seek the advice of your doctor. If you are one of Dr Sharp’s patients, we will monitor your bruising and provide advice as your healing progresses. Any concerns regarding your bruises should be promptly raised with us.
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Lip flip vs lip lift: what is the difference?
My upper lip is very thin and curls under when I smile, showing the gum above my teeth. I’ve found that even when I have fillers, my lip still looks like it curls up and under, especially when I smile.
Can cosmetic injections help or do I need lip lift surgery to correct this?
Deborah:
Cosmetic muscle relaxing injections can be injected into the muscle above the top lip (orbicularis oris) to relax it slightly, softening a gummy smile - or rolling the lip out, giving the appearance of more volume. While both procedures cause the upper lip to ‘kick’ out more, the results of lip lift surgery differs from lip flick injections in that the injections relax the muscles around the upper lip, while surgery shortens the distance between the upper lip and the nose (philtrum). Dr Sharp explains lip lift surgery (pictured above) in more detail here.
Lip flick injections strategically and temporarily reduce repetitive muscle movements associated with the development of wrinkles around the mouth. They are often used in conjunction with dermal filler injections. The treatment takes 5 to 10 minutes, causes minimal discomfort and the results of this procedure last between 3 to 5 months.
When used alone, or in combination with fillers, muscle relaxing injections give lips a subtle pout by flipping out the lip line, rolling the lip gently outward and providing a fuller appearance.
With so many options now available thanks to modern lip enhancement techniques and procedures, it can be difficult to know which treatment works best for you. At our consultations, we will assess your face and upper lip appearance, and advise the best treatment or procedure to achieve you aesthetic goal.
Muscle relaxing lip injections
- slightly relax muscles that surround the upper lip
- reduce gummy smile
- help flick out the top lip making it look fuller
- last 3-5 months
- cost: from $25 per treatment
- takes 5-10 mins per visit
- no downtime
Dermal filler lip injections
- enhances lip volume, projection and shape
- last 10-18 months
- from $499 per treatment
- 20 mins per visit (longer if you require anaesthetic cream)
- sometimes swelling and bruising can be visible for 3-7 days
Lip lift surgery
- reduces the distance between the upper lip and the nose
- incision in crease under the nose
- flicks out the top lip making it look fuller
- long term results
- cost: from $2750
- takes 40-60 minutes
- 1 week downtime
It’s important to remember that dermal filler adds volume, which makes the lip appear larger by literally making it bigger, while anti-wrinkle injections relax muscle around the mouth and rolls the lip outward, creating the illusion of a bigger lip — without the added volume. Dermal fillers can be used in conjunction with muscle relaxing injections as well as lip lift surgery.
Ask us your lip enhancement question!
IS MODERN BREAST AUGMENTATION SURGERY SAFER THAN EVER BEFORE?
Is breast augmentation surgery considered to be a safe procedure?
Specifically, are modern breast implants safer than the implants used in the past and is there anything I can do to make sure my surgery is as safe as possible?
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. Breast augmentation surgery is a safe surgical procedure, if you use a qualified plastic surgeon, opt for high quality implants and promptly seek medical advice if you have any concerns regarding your breasts in the future.
With new-generation implant options and surgical techniques, breast augmentation today is safer than ever and can help women achieve 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 to having access to a wider range of implant options, surgeons now often utilise a spectrum of new techniques, with shorter incisions and less downtime resulting.
The use of Keller funnels and micro and nano textured implants - to reduce the risk of bacterial contamination and associated risks - has been accompanied by more long term research and scientific analysis of breast implants than ever before.
Natural looking results
We have moved away from the ‘bigger is better’ mantra; modern breast augmentation patients usually want natural looking, sustainable results. For most women, the goal of breast augmentation is to increase breast volume and improve asymmetry but to do so subtly for a very believable result. More proportionate implants, sized and positioned to suit the natural anatomy, place less strain on surrounding tissues and structures, resulting in a better long term outcome.
Breast augmentation plastic surgery specialists
Not every doctor that implants breast prosthesis in Australia is a qualified surgeon. Sadly, some of them pass themselves off as ‘surgeons’ despite not having undergone Medical Board recognised specialist plastics training. Despite widespread media regarding the potentially catastrophic consequences of choosing an unqualified surgeon to perform surgery, patients still tell us they’re confused about the difference between a ‘qualified’ and ‘unqualified’ surgeon. Choosing a RACS qualified, specialist plastic surgeon (denoted by the ‘FRACS Plast’ after their name) who understands the latest breast enhancement options, techniques and trends is the best place to start. You can locate qualified plastic surgeons in your area here. Your plastic surgeon will be an excellent resource to help you better understand the differences between implant types, and to create a customised surgical plan that is designed to meet your individual needs.
Most importantly…
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. But if you are going to embark upon breast augmentation surgery, it has to be something you feel 100% confident and safe undertaking. If you have doubts or feel anxious about the risks, I recommend waiting. Perhaps do more research, get a second or third opinion from other plastic surgeons and talk to women who have implants. Delaying surgery until you feel totally comfortable with your decision is something your surgeon will support - and something you’ll never regret!
Ask us your breast augmentation question!
How many breast augmentations are performed around the world annually?
Breast augmentation surgery is one of the most common procedures requested in our Brisbane and Ipswich clinics. Figures released by the International Society of Aesthetic Plastic Surgeons in November 2018 show that 1,677,320 breast augmentations were performed internationally in 2017.
Number of breast augmentations performed annually
- Annual Global Aesthetic Survey, ISAPS 2017
Breast augmentation continues to be the most popular plastic and cosmetic surgery procedure around the world, and in Australia. In our clinics, it is closely followed by abdominoplasty, facelift, breast reduction or breast lift and blepharoplasty surgery.
call to book a consultation with Dr Sharp
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Pre operative nerves; how to relieve anxiety before surgery
Pre surgery jitters are very normal; even if you are excited about your procedure and the changes it will bring, it can be hard not to worry about the operation, the possible risks and recovery. Whether you are having day surgery or a lengthy inpatient stay, these feelings are to be expected in the days or weeks leading up to your procedure.
Severe anxiety can cause unpleasant symptoms and stress. Typical symptoms include a pounding heart, a racing heart, irregular heartbeat, nausea or stomach cramps, shortness of breath and sleep problems.
Anxiety can make pain worse, as well as making it harder to cope with the pain. It also becomes a problem if it makes it harder to understand and remember important things you are told about the operation, such as advice about your recovery afterwards.
It’s important to make sure that anxiety doesn’t become too overwhelming before your surgery, or impact negatively on your headspace or emotional preparation. Although there is not much research on strategies for managing pre surgery anxiety, some evidence suggests that certain measures can help:
- Learn how your pre operative nerves are affecting you. Anxiety increases your heart rate, blood pressure and keeps you awake. Over time, most people learn how to manage their anxiety and frightening situations. They develop suitable strategies to cope with what is causing the anxiety. Going into the hospital and having an operation is often a completely new situation, so you might emotional and practical support from friends and family too.
- Talk to other people. People cope with pre operative anxiety in different ways. Some try to prevent it by obtaining information and talking with other people about their concerns. Others use distraction techniques such as reading, exercise or deep breathing. Several studies have suggested that listening to music before surgery can relieve anxiety.
- Let your surgeon and hospital staff know how you are feeling. You won’t be the first person to come to hospital feeling anxious and a good surgical team will be skilled in techniques to put patients at ease and make them feel comfortable.
- Utilise relaxation techniques such as breathing exercises, meditation or muscle relaxation. Massages, acupuncture, homeopathy, aromatherapy or hypnosis aren’t scientifically proven anxiety treatments - but many patients find them beneficial in the lead up to surgery.
- Medication can assist. Benzodiazepines are often used for the purpose of relaxing patients and reducing anxiety. They might also make you feel drowsy. It is important to tell your surgeon or anaesthetist if you already took a sedative before arriving at the hospital.
Smoking before surgery! Many people who smoke tend to smoke even more when they’re feeling worried. But smoking during the lead up to surgery can increase the risk of post operative complications, delayed wound healing and unfavourable scarring. Stop smoking at least 6 weeks before surgery and talk to your GP about obtaining support to break the habit while dealing with pre operative nerves.
Have questions regarding surgery? Call our friendly team on 3202 4744, we’d love to assist.
The information contained in this article in general in nature and does not constitute medical advice.
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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 a surgeon uses when they are researching the right surgeon for them.
- Before your surgery, ask your surgeon why s/he choses those implants
- We chose these implants because they are high quality prosthesis with sound science behind their design and warranty provisions; they are backed by reputable manufacturers. Secondary to this, they also provide a more natural feel and better result than other implants, in our opinion.
- Ensure you are aware of the implant’s warranty provisions and safety record
- With Medicare and private health insurers no longer covering implant replacement surgery, warranty provisions for rupture and capsular contracture are very important - not just because they save you money if you need to have the implants replaced, but it also signifies that the manufacturer takes responsibility for its product’s performance.
- Ask your surgeon if they have taken the 14 Point Plan Pledge
- Dr Sharp follows the 14 Point Plan. You can read more about why this improves the safety of our breast augmentation surgery here.
- Ask your surgeon if they register their implants with the Australian Breast Device Registry
- We do. After your surgery, you will receive your implant details. These are also saved to your electronic chart in our practice, and a copy is sent to the ABDR, so you have 3 ways of identifying your implants should you need to in the future. The data collected by the ABDR also unable us to track the long term performance of breast devices, and identify best surgical practices to ensure optimal patient health outcomes.
Are all textured breast implants the same?
No. The coating of the implants we use are calling ‘micro’ textured or ‘nano’ textured and differ significantly from those recalled; adhering to the highest implant quality standards. The safety of our implants is supported by clinical data, with our micro textured implants in particular being examined by three, 10-year prospective clinical trials. The risk of developing BIA-ALCL differs between different textured prosthesis and has been shown to be rare with the kind of breast implants we use; about one in 86,000 according to the most recent risk assessment published in the Plastic and Reconstructive Surgery Journal. Other implants carry a 1 in 2,800 risk, demonstrating that when it comes to safety, all implants are not created equal.
Read more about BIA-ALCL here.
Do I need to have my implants removed and replaced?
Currently there are no recommendations to have implants ‘preventatively’ removed. If your implants are causing you concerns - or if you are encountering a complication such as rupture or capsular contracture - see your GP as a first course of action. Seek the advice of your GP if you are experiencing:
- swelling
- distortion
- changes in shape or size
- pain or discomfort
- discharge
- firmness / hardness
- lumps
- rash
The GP will examine your breasts - and they might refer you for an ultrasound or MRI, along with a referral to a plastic surgeon. If you have a copy of your implant details, please bring them along to your consultation.
View before and after photos and read more about implant revision, which includes removal and replacement surgery, here.
BIA-ALCL: fast facts
• The incidence of BIA-ALCL remains rare.
• Most seromas are not BIA-ALCL
• As of September 30, 2018, the FDA had received a total of 660 medical device reports (MDRs) of BIA ALCL worldwide, including the death of nine patients. In Australia and New Zealand, 94 patients have been identified, a further two being worked up. This includes four women who have died. To put this number into context, in 2017 the International Society of Aesthetic Plastic Surgeons estimated that approximately 1,600,000 breast augmentations were performed that year alone.
• Diligent and systematic application of antimicrobial strategies at the time of breast implant surgery has been shown to be beneficial; that’s why Dr Sharp follows the Macquarie University 14 Point Plan.
• To date, although there are hypotheses, no one can claim to know the exact cause of BIA-ALCL. The hypotheses with most scientific support involve textured implants, the presence of bacteria, host genetic predisposition, chronic T-cell response with eventual monoclonal proliferation and transformation into lymphoma
• Updated Australian and New Zealand figures show that 70% of ANZ cases are diagnosed in stage 1 of the disease. In these cases, complete surgical removal is curative with enbloc capsulectomy and implant removal.
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This article does not constitute individual medical advice; if you have any concerns, please see your GP for referral to a specialist plastic surgeon to receive advice specific to you and your implants.
Ask us your breast augmentation question!
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 work with an experienced personal trainer to create customised workouts during the months after surgery, so talk to us if you’d like to discuss the options available to you, with a carefully selected workout routine.
It is important to emphasise that it’s still possible to do damage during this period, placing strain on the supporting structures and new scar tissue in your breast, which can have long term impact on your results! So the short term frustration of ‘taking it easy’ is worth it in the long run - and something worth committing to prior to undergoing breast augmentation surgery.
If you use exercise to manage your mental wellbeing, it’s important to discuss this openly with your surgeon prior to surgery, so s/he can discuss the impact that your recovery period could have, and weight up the challenges you might encounter.
Ask us your breast augmentation question!
What to expect during your first consult
Your first visit to a surgeon can be both exciting, and scary. It’s very normal to experience a mix of nerves, eagerness and uncertainty. To ensure that your visit is as stress free as possible, prior to your first visit, our patient care team will email to you:
- a link to complete our patient registration form online (please complete this at least 24 hours prior to your consult)
- a list of any referral letters, tests or reports to bring along
- directions to our free patient carpark
During your first visit to us for a cosmetic or reconstructive procedure, you will be greeted by our friendly patient care team, who will take your referral letter or reports, and give you a white folder containing your procedure information pack.
Please enjoy a tea or coffee while you wait, and peruse the information contained in your white folder.
We don’t expect you to speed read all the information in this folder before you go in to see Dr Sharp, but some of the key points on the back page of the brochure might help you formulate questions you hadn’t already thought of.
At the end of your consult you will take this folder home; we understand there’s a lot of information to take in during you first consultation, so don’t hesitate to ask questions or request that Dr Sharp elaborate on any information you don’t understand.
During your consult with Dr Sharp he will discuss your concerns - or the areas you’d like to improve. He will examine and assess the area, and take any necessary clinical measurements. You will then step through the surgical options available together. Once you have decided upon your desired procedure in consultation with Dr Sharp, he will step through the surgical process involved - as well as the expected outcomes, risks, recovery period and any considerations he’d like you to make when weighing up the procedure’s pros and cons.
Dr Sharp is very approachable and most patients comment that they quickly feel relaxed and at ease with him - but he also appreciates that talking about your concerns or being examined isn’t something people do every day, and so you might feel uncomfortable; this is very normal. Please let Dr Sharp know if you would like a friend, family member or female observer to be present during your consult. Sometimes it can be difficult to take in all the information discussed during the first consultation and so having a second set of ears present can also be helpful when recalling the procedure/s you discussed. As standard procedure, we always require a friend, family member or female member of our team to be present during genital examinations.
This information will also be contained within the information pack you will take home on the day, along with the consent form explaining the elements of the procedure you need to consider before committing to surgery. If you are considering breast augmentation surgery, Dr Sharp will also provide a sports bra and implant ‘sizers’ to try on.
This enables you to put your own top on (or we have tops available for you to use) and view the different implant sizers in a mirror. You are welcome to take photos of your anticipated breast appearance in clothing, as this can be helpful when considering your implant size selection at home later on.
After your consultation with Dr Sharp, clinical pre operative photos will be taken of the area you are having treated. These photos are securely stored and used as a reference tool by Dr Sharp when planning surgery, and sometimes intraoperatively. 3D simulation technology is also available in our clinic, and if you are having breast augmentation surgery, one of our patient care team members will complete the scan and upload your simulation results to peruse at home.
At the conclusion of your consultation with Dr Sharp he will advise our patient care team of the procedure you are considering and any potential item numbers involved. This will enable us to check if any Medicare or private health insurance rebates apply, and compile an estimate of fees for you. This takes 5-10 minutes, so we thank you in advance for your patience while we collate the different costs for your procedure.
Before you leave the clinic, we will step through the estimate of fees with you and answer any queries you might have regarding costs, as well as providing you with potential surgery dates at your preferred hospital/s.
After your initial consultation if you wish to proceed with surgery, our patient care team will schedule the procedure for you and accept any deposits required. If you are having a cosmetic procedure, we will organise a second - complimentary - pre operative consultation with Dr Sharp. We ask patients to bring their patient information folder back with them for this consultation, as it contains important consent documentation which needs to be signed with Dr Sharp.
We also offer video consultations for regional or overseas patients who wish to see Dr Sharp. Usually at least one of the two consultations is conducted face to face prior to surgery, with the other consult via video (FaceTime or Skype).
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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 pay a higher excess to reduce their premiums. This means they might choose a policy that costs less throughout the year, but will incur a larger excess payment if they do go to hospital.
When will the changes happen?
The changes will start to happen from 1 April 2019. By 1 April 2020, every private health insurance policy will have changed to the new system. Your insurance policy may not change straight away, but if you are planning surgery, we recommend that you call your fund to discuss their changeover date.
I’m planning surgery; should I change my policy before the 1st of April?
Choice recommends that - unless your fund has advised that you will lose cover for an essential item - you don’t need to switch funds or policies before 1 April. They recommend waiting until your fund advises the switch over date, and whether or not they’ll close old policies and move members to a new one. Also, Choice advises that it could be difficult to find the right policy before April 1 as many policies are changing, and will be released after that date.
Finding the right policy to switch to before 1 April might be difficult, because many policies are changing and new ones will be released on that date. If you haven’t already, you’ll receive a letter from your health fund telling you what they’re going to do with your policy; read this handy guide to help you understand the letter from your fund.
If you’re planning surgery, ask your surgeon if item numbers apply. If so, contact your fund and ask whether the item numbers specific to your surgery will be covered in the tier that your policy will be on. If not, ask them if you can select a higher tier - and whether they’ll waive any waiting periods.
Is this a good thing, or a bad thing?
Like all private health insurance policy changes, only time will tell! The government believes the new tiers will make it easier for patients to understand what each policy type covers, and to shop around for the best private health insurance deals. Conversely, there are concerns that consumers will have difficulty understanding the new categories, and ensuring continuity of cover.
We welcome any private health insurance reforms that deliver clearer, fairer and more cost effective options for patients.
While we are not permitted to recommend any specific funds to our patients, our practice manager Carol is able assist you with questions to ask your fund to ensure you are covered for any item number eligible procedures you may be considering in the future. Email Carol any questions at manager@drdavidsharp.com.au
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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 these procedures have lifted; they are also easier to access now, thanks to lower costs. Some of the procedures can also be claimed through private health insurance such as breast reduction, abdominoplasty or rhinoplasty, if they are considered to be medically required.
We are definitely seeing more demand for breast augmentations and facelifts than we have in the past. This could be due to a greater awareness of the options available; facelift surgery techniques have evolved to offer a procedure that provides a very naturally rejuvenated look – not the stretched, pulled-back appearance. We’re also seeing smaller facial procedures, such as minifacelifts and lip-lift surgery, grow in popularity as we can perform some of these under local anaesthetic.
The “new generation”, high quality breast implants I use also look and feel more natural than ever before, and along with fat grafting, it means we can tailor the augmentation result to the patient’s unique anatomy. In terms of breast augmentation, the popularity of this procedure has skyrocketed over the past 10 years in general.
Misconceptions about cosmetic surgery
There is still a concerning lack of understanding around credentials. We still speak to a lot of patients who didn’t realise there’s a difference between a doctor that has done 7-10 years of additional training and supervision to become a surgeon, as opposed to a doctor who wants to call themselves a surgeon, and opens up a cosmetic clinic. I encourage patients to check their doctor’s qualifications on the Royal Australasian College of Surgeon’s website’s ‘surgeon finder’; if they aren’t there, they aren’t an accredited Specialist Plastic Surgeon. Meaning, they will not be covered by the same training, hospital operating rights or insurance provisions. The same applies to cosmetic injectables; when you can get a TGA-regulated injection in a hairdressing salon or beauty clinic with no medical professional in sight; we need to ask why patients’ best interests and safety are not being considered.
Four steps patients should take before undertaking cosmetic surgery
1. Look at lots of websites, choose a shortlist of two or three surgeons and check their credentials on the Royal Australasian College of Surgeons’ website (https://www.surgeons.org/ find-a-surgeon/) to ensure the surgeon you choose in in fact a Specialist Surgeon and accredited by the Australian Health Practitioners Regulation Agency.
2. Book a consultation with more than one; it’s a big decision and you need to choose a surgeon that you resonate with and feel comfortable around.
3. Have at least two consultations before your surgery to ensure you’ve had the time to ask all of your questions and that you fully understand the potential complications and how long your recovery is going to take.
4. Have realistic expectations; plastic surgery is about making improvements – not about achieving perfection
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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 the cheek or jawlines.
After the scarring has settled, scars can soften and loosen up with time – and if this doesn’t occur satisfactorily, Fraxel laser and dermal fillers can be used in small doses to help plump and improve the appearance of the skin in the area. Lasers can commence from week 6 post op, and fillers can be utilised a bit further down the track, once the initial healing period is complete.
During this period you will have routine post op consults booked, but we welcome you to come in and see us for a checkup - or to consult with Deborah, who is experienced with non surgical scar optimisation strategies. I hope this information assists during your healing process.
Ask us your scar question!
How many cosmetic wrinkle injections are performed each year?
Cosmetic wrinkle injections are the most commonly performed aesthetic treatments in the world, according to figures released by the International Society of Aesthetic Plastic Surgeons in November 2018. In our Brisbane and Ipswich cosmetic clinics, muscle relaxing cosmetic injectables have been performed on a daily basis for many years - and continue to be one of our most rapidly growing procedures, with crows feet, frown lines and hyperhidrosis for excessive sweating three of the most common treatment areas.
Number of wrinkle injection treatments performed annually
- Annual Global Aesthetic Survey, ISAPS 2017
Wrinkle injection treatments work by safely and temporarily reducing muscle activity, smoothing existing wrinkles and preventing more from forming. The effects last 3-4 months and so the 10-20 minute treatment is usually performed 3-4 times a year.
Priced from $12.50 per unit, we use the world’s most reputable wrinkle injection product (which can’t be named here due to TGA regulations) under the clinical supervision of our plastic surgeon Dr Sharp.
call to book a consultation with Dr Sharp
Modern injecting techniques deliver a soft, natural look - rather than the frozen, overly smooth appearance once synonymous with this treatment.
In addition to reducing wrinkles in the upper face, muscle relaxing injections can also reduce the appearance of a ‘gummy smile’ whereby the upper lip curles up, exposing the upper gums - as well as excessive sweating in the armpits, hands, scalp and feet, which is called hyperhidrosis. With its excellent safety record and broad application, it’s not difficult to see why it is literally the world’s most popular cosmetic treatment!
To book a complimentary wrinkle injection consultation, call us on 3202 4744.
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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.
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. (Pictured above: liposuction results for Dr Sharp’s patient at 6 months post surgery).
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!
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?
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 there to find the most suitable time for their surgery.
When planning your breast augmentation, remember that you will probably have 2 consultations with your surgeon, a few weeks or even months apart.
Also keep in mind that most plastic surgeons in Brisbane or Ipswich will have anywhere from a 3 to 8 week wait at various times of year; sometimes longer.
Start contacting your short list of surgeons for available appointments about 4-6 months ahead of your ideal surgery time frame, so you get your pick of preferred dates, and also so you don’t feel like the consultation and surgery booking process is rushed or compromised. It’s an exciting and important process, so give yourself lots of planning time!
Ask us your breast augmentation question!
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.
Considering surgery in 2019? The best results are planned ahead! Contact us to take the first step...
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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 patients are prone to keloid or hypertrophic scarring which can be prominent, but steps can be taken post operatively if your post op surgical team is made aware of this - using tape, dressings, topical treatments and possibly laser or fractionated needling therapy. Most patients do not require any scar intervention, but if you want to give your scars the best chance of healing well, follow these 3 steps:
- Read the post op instructions your surgeon has provided, and follow them closely.
- When your post op care team indicates the time is right, start massaging your scars daily with the gel provided by Dr Sharp in your post op care bag.
- Keep your tapes on and wear your clinical support garment as per your post op instructions.
- Don’t stretch, over-extend or place pressure on your incision lines; they are under the tension and weight of an implant, so give them support and lots of care!
Read more about our approach to breast augmentation surgery in our Ultimate Breast Augmentation Guide.
above: before and five months after breast augmentation surgery with Dr Sharp
call to book a consultation with Dr Sharp
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How many liposuction procedures are performed around the world each year?
Liposuction is a commonly-requested procedure in our Brisbane and Ipswich clinics, with patients often pairing it with facelift, breast and abdominal surgery. Liposuction can also form part of gynaecomastia, gender confirmation and thigh lift procedures. Figures released by the International Society of Aesthetic Plastic Surgeons in November 2018 show that 1,573,680 breast augmentations were performed internationally in 2017.
Number of liposuction procedures performed annually
- Annual Global Aesthetic Survey, ISAPS 2017
This makes liposuction the second most performed procedure in the world during 2017, closely behind breast augmentation surgery which was performed 1,677,320 times. Liposuction is suitable for people who have achieved their ideal weight and just have pockets of stubborn fat that don’t respond to diet or exercise.
Commonly treated areas include the abdomen, flanks, under-bra area, upper arms and double chin.
call to book a consultation with Dr Sharp
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.
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 may leave the implant, but will usually be contained within the natural scar tissue capsule that forms a few weeks after the implant is placed.
That means you might not notice an immediate difference in your breast. If you do notice a change in your breast, it might be a shape our outline/profile alteration. You might notice some persistent discomfort in the area. As silicone gel is biologically inert, it does not react with your tissues and research shows that when modern cohesive gel implants rupture, they don’t pose an immediate risk to your health.
If you think you might have a rupture:
- Visit your GP; they will assess your breast (and symptoms) and may refer you to have a scan. Ask for a referral to see your plastic surgeon; a referral from your GP will enable you to receive a Medicare rebate on your specialist consultation fee.
- If you aren’t going back to see your original surgeon, and you don’t have the implant details that were given to you at the time of your augmentation, contact your surgeon to obtain these. This will help you ascertain the type of implants (cohesive gel, saline etc) and the manufacturer’s warranty provisions. Knowing your warranty provisions will help you ascertain the out of pocket costs of any potential revision surgery.
Implants do not last forever; I have seen patients with first-generation implants that have been in place for over 40 years, while other patients have required replacement due to capsular contracture, rupture or migration after 8-10 years.
The good news for women who wish to undergo breast augmentation with modern high quality silicone gel implants is that they are generally very safe and ruptures are rare. When they do occur, they are usually contained within the capsule and easily removed and replaced.
For more information, read our checklist for caring for your breast implants , which includes:
- Self-examination
- Screening when you reach the age where screening is recommend - or if you have a family history that makes you a candidate for early screening
- Watching for changes
Have breast implant questions?
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.
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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?
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 fat always dies off when being grafted to the new site - this can range anywhere from 5% up to 40%. Fat grafting has been around for a long time, but it’s widespread use is a very recent thing and modern medicine is still adapting ways to help reduce the number of fat cells that die when grafted. If large amounts of fat don’t survive the process, fat necrosis can occur. This usually resolves with time, but can cause pain and sensitivity in the area as well as contour deformities and pockets of firmness that are sometimes visible to the eye. Successful fat grafting is a combination of good surgical technique, good fat selection and a good candidate. Patients need to be non smokers, follow a nutrient-rich diet low in processed foods, stay within a normal weight range and closely follow post operative instructions to ensure best possible results.
When I perform fat grafting to subtly enhance parts of the face or body, I use a special fat harvesting kit to strategically extract small quantities of good quality fat, with minimal disruption to the fat cells themselves. In the case of facial fat grafting, the fat is then carefully put through a process that creates tiny ‘nano’ fat that can be injected into the face.
Fat grafting can improve the appearance of an ageing face, but it won’t address all aspects of facial aging, and depending on how much skin laxity you have, you may find that a facelift is unavoidable if you wish to restore your underlying facial structure and skin tightness. It is possible to have liposuction to reduce your unwanted fat deposits, breast augmentation using implants and fat grafting to achieve a fuller breast (a mastopexy may be required if you have significant amounts of sagging breast skin or ptosis) and facial fat grafting with or without a facelift. These procedures can be performed in the one operation, or over separate surgeries. The first step is to consult 2 or 3 plastic surgeons to obtain their opinion about the best procedures and techniques for you and your individual aesthetic goals, so you understand all of your options and the benefits, risks and cost associated with each of these.
Ask us your fat grafting question!
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?
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 you still meet the MBS criteria for a ‘medically required’ blepharoplasty, Medicare will rebate a portion of your surgeon’s and anaesthetic fee, and you will be 100% out of pocket for your hospital fee. If this is the case, the procedure will cost you about $3,500-$4,000 out of pocket (after rebates). If you don’t meet the new criteria, your costs will total around $5,000.
If you have private health insurance:
If you still meet the MBS criteria for a ‘medically required’ blepharoplasty, Medicare and your private fund will cover your hospital fees (minus any excess payable on your policy) and will rebate part of the surgeon’s and anaesthetic fees. The procedure will cost you about $2,300-$3,000 out of pocket (after rebates). If you don’t meet the new criteria, your costs will total around $5,000.
Should a blepharoplasty be performed in hospital under general anaesthetic, or in surgeon’s rooms under local anaesthetic?
I mostly perform this procedure under general anaesthesia in hospital. This ensures that the patient is not subjected to any unnecessary discomfort, and more extensive blepharoplasty techniques (where muscle or fat can be repositioned) can be utilised without compromising your operative experience. That said, some blepharoplasties can be comfortably performed under local anaesthetic, and this is certainly a possibility for some patients. It’s one of the considerations we discuss together during the initial consultation.
Blepharoplasty under local anaesthetic in your surgeon’s rooms might sound like a convenient, cost effective solution, but it comes with its own risks. The best location for your surgery should be a multifactorial decision made between you and your surgeon, based on your individual circumstances and procedure.
If you’re considering blepharoplasty surgery and want to know how the MBS item number changes specifically impact your procedure, please call our helpful patient care team on 3202 4744.
Please note: the fees provided in this article are only indicative and may vary. When you book a consultation with Dr Sharp, we will check your eligibility for this procedure with your health fund, so if you qualify for the item number coverage, we will be able to supply you with a complete quote (inclusive of all rebates) at the time of your consultation.
Ask us your blepharoplasty question!
Question of the week: facelift scars
Where are facelift scars located, and can they be positioned so that they are invisible to the eye?
Dr Sharp:
I customise each facelift procedure to the individual patient’s anatomy and their age, degree of skin laxity and hair line. Most standard facelifts usually involve an incision inside the hairline adjacent to the temple, down the earlobe and around the back of the ear, tracking along the hairline down to the nape of the neck (as shown below by the dotted line).
Sometimes the incision is shorter, especially in my shorter-scar Sharp Lift procedure, more common among people in their late 30’s and 40’s who want to redefine their jawline and remove early jowls.
Wherever possible, incisions are placed within the hair or along the hairline, although this can be dependent upon the thickness of the hair, the position of the hairline (some people have receding hairlines, while others sit forward on the face) and how much skin is removed.
How you scar is largely dependent upon your body’s natural predispositions; your ethnicity and genetics play a role in scar colour and texture. Due to neck movement and the pressure on incisions when lying down or turning your head, sometimes the scars behind the ears and along the hairline of the neck can be thicker and wider for the first 24 months, but once you reach the 2 year mark post operatively, most patients find their scars no longer look or feel prominent.
We understand that scars are one of the most common aspects of facelift surgery that deter people from undergoing the procedure. It’s one of the first questions that patients raise; however, post operatively, we find it’s rarely a source of concern. We take a very proactive approach to scar reduction; all of our patients have Fraxel scar reduction laser as a complimentary component of their facelift post operative care with us. Along with daily massage using the scar reduction gel suppled in our facelift post op support bags, Fraxel laser speeds up the scar maturation process, optimising their appearance and helping to reduce their visibility as quickly as possible.
Ask us your facelift question!
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...
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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?
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 bear.
The cross linking of the silicone in these implants can vary, creating different levels of cohesiveness and firmness. Your surgeon will discuss the appropriate implant for you. New generation implants are able to balance the benefits of form stable silicone with the goal of creating a softer, more natural feel. The implant brands I use do this particularly well, while maintaining an excellent safety record and lower complication rate than other, cheaper, implants - so doing your research and asking your surgeon which brand she or he uses is also important! Experienced surgeons will be attracted to certain implants or deterred from using others, so ask your surgeon how they decided upon their preferred implant type.
Ask us your breast augmentation question!
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?
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 smooth, texture, high profile, low profile, round and anatomical implants to be guided into their ideal position, rather than inserted solely by hand.
Smaller breast augmentation incision and scar
One end of the funnel is large (to allow the implant to be inserted) and the other end is where the implant is squeezed through; narrow enough to ensure the surgeon can make a smaller incision - meaning that we don’t have to make a large cut in the patient’s skin in order to insert the funnel and deliver the implant. This produces the shorter scar synonymous with my breast augmentation technique.
I use the Keller funnel for breast augmentation procedures when deemed suitable for the patient, type of procedure and implant. Patients are not required to purchase the funnel separately as we stock them in all hospitals that I operate at - nor are patients charged extra for the funnel.
Macquarie University has pioneered the 14 Point Plan to help reduce some of the risks associated with breast implant surgery. You can read more about the plan here and specifically about the 14 Point Plan Pledge I have taken here.
Each week we share one of the questions Dr Sharp has received from patients; to submit a question please email info@drdavidsharp.com.au or use the form below.
Ask us your breast augmentation question!
What is lip lift surgery?
The skin between the upper lip and nostrils is called the philtrum, and by slightly reducing its height, the upper lip is flipped out - without the ‘duck pout’ appearance that fillers sometime achieve while chasing this look.
Lip lift surgery involves an incision in the fold under the nose and can be performed under local anaesthetic.
As celebrities kiss goodbye to the over-inflated lip look, opting for more subtle pouts, we are finding that women are moving away from the high-projection filled look, and are looking at their entire oral region - seeking ideal proportions and a natural shape.
Lip lift surgery is also popular in men who have previously concealed a disproportionately long philtrum with a mustache. Operating on this area in men requires an astute understanding of ideal male anatomy to ensure the procedure make the face more youthful and masculine.
If demand in our Brisbane and Ipswich clinics is any indication, ‘lip lift’ surgery is growing in popularity among women and men 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.
Lip lift performed under local anaesthetic is priced from $2,750.
Results can be as subtle or dramatic as the patient wishes. The above results are shown at 6 months post surgery. In our clinics, lip lift surgery is also sometimes teamed with rhinoplasty, facelift surgery or chin augmentation surgery, to harmoniously rebalance facial features.
For patients who experience an over-exposure of gum when smiling (often called ‘gummy smile’), a small amount of muscle relaxing product can be injected into the muscle above the lip, bringing the lip down and helping it project outwards more. This is a non surgical treatment that lasts 3-5 months and is called a lip flick. It is sometimes confused with lip lift surgery, but the two are very different and achieve different things for the upper lip.
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 makeup. Having lip lift surgery isn’t akin to having lip injections; while dermal fillers can dissolve in a relatively short time, lip lift results are more permanent. When unfavourable scarring occurs, a combination of laser and topical skin treatments might be recommended, to optimise healing and speed up scar maturation.
While lip lift is not a new procedure, a resurgence in lip lift surgery’s popularity is being noted across the world, with women in their 20’s and 30’s primarily seeking a lip augmenting effect, while mature aged patients often find that the ageing process causes their upper lip to thin and elongate - with lip lift surgery creating small, flattering adjustments that can reverse unwanted changes. As the philtrum drops as we age, the top teeth become hidden and ‘mouth frown’ can occur.
Lip liners and dermal fillers play a useful role in improving the appearance of aged, thinning lips, but trying to using these tools to turn a curled-under lip out - or to reduce the length of the philtrum - can create an over-filled, heavy ‘duck bill’ appearance. In this way, dermal fillers are often over-used, as injectors try to shorten the appearance of the philtrum or achieve the rolled-out lip look, when surgery is actually required.
As a lip lift can be performed under local or general anaesthetic, the total cost can vary significantly, as hospital admission and general anaesthetic adds to the costs. If you are considering this procedure, talk to a qualified plastic and reconstructive surgeon that is a Fellow of the Royal Australasian College of Surgeons (denoted by the letters FRACS after their name) to obtain a full facial assessment and ascertain if it is right for you.
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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?
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 is the virtually pain-free for most patients. Our clinic was the first plastic surgeon lead practice in Brisbane to offer Fraxel laser, and we chose it specifically because it is a very high quality, medical grade laser that delivers measurable results without unnecessary discomfort. Most of our team members have had the treatment, so if you want to talk to someone first hand who has undergone Fraxel don’t hesitate to call us on 3202 4744 and ask!
Ask us your Fraxel questions!
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!
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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 included 214 women undergoing abdominoplasty in Australia, with an average age of 42 and a history of two or more pregnancies. Before tummy tuck surgery, half of the patients reported moderate to severe disability from back pain, while urinary incontinence was a concern for 42.5%.
At six weeks and six months post surgery, only 2% of the abdominoplasty patients said urinary incontinence remained a significant problem, while only 9% still reported moderate disability from back pain.The study’s findings renewed calls earlier this year to add abdominoplasty to the MBS for women suffering from chronic postpartum medical issues, which would see the procedure subsidised by Medicare - and rebatable through private health insurance - if the women met the MBS criteria for medically requiring the surgery.
There are many operations performed for the relief of chronic pain and it is the Royal Australasian College of Surgeon and Australian Society of Plastic Surgeon’s position that women should not be excluded from having abdominoplasty surgery to address medical problems; it should be considered as a procedure that fixes core strength and pelvic floor instability and addresses function or pain issues.
Postpartum abdominoplasty facts:
- Approximately 1.6 million Australian women are currently suffering with chronic back pain as a result of giving birth
More than 3 million Australian women experience discomfort, functional problems and social concerns that relate to stress incontinence
Tummy tuck surgery can improve back pain and urinary incontinence after pregnancy or childbirth
For more information about how abdominoplasty surgery helps repair pregnancy related abdominal wall defects, hernias and excess skin call 3202 4744 or contact us via the form below.
Ask us about abdominoplasty
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In the media: Style Magazine’s list of Brisbane’s best breast augmentation surgeons
Style Magazines has released its list of Brisbane’s best breast augmentation surgeons.
Dr Sharp was honoured to make the cut (hehe) along with some of Brisbane’s esteemed specialist plastic surgeons, discussing his approach to breast augmentation surgery and some of the things to consider if you are looking at having this procedure.
The magazine drew particular attention to the importance of researching your breast augmentation surgeon thoroughly, to ensure they are qualified as a specialist plastic surgeon:
No matter your reason for considering the treatment, it’s important to make sure you’re going to a qualified expert who can take the vision you have in your mind and make it a reality.
If you’ve been thinking about breast augmentation – “Is it right for me? What’s the procedure like? Where do I start?” – then prepare to breathe a deep sigh of relief, because we’re helping you take your next step with confidence. Here’s our guide to some of the most trusted breast augmentation specialists in Brisbane.
Read the feature in full here!
Have a question about breast augmentation surgery? Contact our friendly team!
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Spring skin treatments
Did you know that after a collagen-stimulating treatment, it takes about 6 weeks to start to see the results? That means now is the perfect time to start planning for summer holidays, skin-baring dresses and your party season glow!
Begin by removing pigmentation and dead, lacklustre skin cells while strategically stimulating collagen with our rejuvenating medical skin treatments:
- FRAXEL LASER
- DERMAPEN MICRONEEDLING
- REVOLUMISING DERMAL FILLERS
- WRINKLE INJECTIONS
- LIP ENHANCEMENT
Kick start your summer skin with a proactive approach to healthy ageing and natural-looking results.
Book a complimentary skin assessment consultation with Deborah for a treatment plan tailored to your skin goals by calling 3202 4744.
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CLINIC NEWS
25% OFF LIP ENHANCEMENT INJECTIONS
Rejuvenate thin, dry or lined lips with our high quality dermal filler injections, using techniques that produce beautiful, natural-looking results. Topical anaesthetic is provided at no cost, for extra comfort. See in clinic for terms & conditions.
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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 criteria, costs will increase by approximately $5,500 - $8,000 (depending on inpatient stay and whether your original implants were covered by a replacement warranty)
lipectomy procedures (abdominoplasty, thigh reduction, arm reduction etc): even if you meet the criteria for these procedures individually, Medicare and private health funds won’t pay any rebates or cover hospital fees if certain lipectomy procedures are performed together as a combined procedure. For example, abdominoplasty and arm lift will be 100% out of pocket, even if you meet the MBS item number criteria, if performed together. But if you meet the criteria and have an abdominoplasty and arm lift performed as two separate operations, they will still be eligible for rebates/cover.
I have surgery booked after the 1st of November; what do I need to do?
If you have item numbers listed on your estimate of fees, the item numbers for your procedure may not be one of those impacted at all by these changes, and even if they are, you may find that you still meet the updated criteria. If you are having surgery after the 1st of November and you have item numbers on your informed financial consent document that are included in the list of those changed, our practice manager Carol and patient liaison Katy will identify this and will contact you regarding any estimate revisions required. In some cases, Dr Sharp will be able to ascertain whether you meet the updated criteria prior to your surgery - in other cases, due to the new requirements, this will need to be determined post operatively using intraoperative photography and other assessments.
I don’t have private health insurance; will this impact me?
If your surgery is currently covered by an item number (eg removal and replacement of breast implants due to complications), at the moment you’d receive a rebate on some of your surgeon’s and anaesthetist’s fees from Medicare. If you no longer meet the new criteria, you won’t be eligible to receive any rebates. If you do meet the new criteria, rebates will still apply for your surgeon’s and anaesthetist’s fees. Private hospital fees are never covered by Medicare, so these remain unaffected for uninsured patients.
I have private health insurance; how will this impact me?
Patients who are privately insured may be significantly impacted by these changes. If your private health insurance policy covers you for an MBS item number - and your surgeon and Medicare deems that you meet that criteria - your fund and Medicare pay a rebate on your surgeon’s and anaesthetist’s fees, and your fund covers your hospital fees (minus any excess or exclusions). These changes mean that we need to ascertain if you meet the amended MBS criteria for your procedure; if not, your fund and Medicare will not provide any rebates - so you would be out of pocket 100% for your surgeon, anaesthetist and hospital stay. Again, this only applies if the changes impact your specific item numbers, and you will receive notification from us if this is the case for you.
Why are changes occurring - and will there be more?
The government made these changes because they believe some MBS item numbers are being used for procedures that Medicare perceive to be ‘cosmetic’ rather than ‘medical’. Representatives from the plastic surgery community were involved in the taskforce that contributed to these changes, but not all of their requests and recommendations were implemented or observed in the resulting criteria amendments. Changes to MBS item numbers that impact plastic surgery have been a focus of government cost-cutting in recent years and this may continue. It’s important to remember that when you receive an informed financial consent document, it is based upon the information available to your surgeon, anaesthetist, hospital and health fund at the time; if the government decides to make changes to the item numbers and rebates after your estimate is provided, they are able to do so, and are not required to provide a grace period for people who have already received quotes.
I haven’t booked my surgery yet; is there still time to have surgery before the changes occur?
Out of pocket fees are understandably an important component of your surgical decision making process, however costs alone should not be a reason to rush into elective surgery before you are ready. Currently Dr Sharp’s theatre lists are fully booked beyond the 1st of November at all hospitals, so while we’re able to place you on a waiting list for surgery before this date (if you’ve already had your initial consultation with Dr Sharp and had time to consider your informed consent documents), there is no guarantee your surgery can be performed by the 31st of October 2018.
Please contact Carol at manager@drdavidsharp.com.au if you have any queries or concerns.
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THE $50 LIP INJECTION THAT BOOSTS YOUR POUT
Muscle relaxing or anti ageing wrinkle injections have long been used to smooth lines and soften wrinkles in the upper face, but they’re now also being strategically used to enhance upper lips, in a quick and cost effective treatment that’s being called the ‘lip flick’.
How a lip flick works
Wrinkle injections can be used to create a poutier look, by rolling the lip gently outward, giving the appearance of a fuller upper lip.
Cosmetic muscle relaxing injections are placed into muscle around the mouth (orbicularis oris), targeting only the surface layers of the muscles around the side of the lips. This relaxes muscle fibres enough to flip the lip outward. Another benefit of the lip flip is that it can address gummy smiles, where the lip exposes the gums.
How is the lip flick different to lip fillers?
Lip augmentation is performed with dermal fillers - a hydrous gel that’s created from a naturally occurring sugar, which draws water to the lip to increase its size, shape and projection. But some people also still find their lip curls under, and that’s where the lip flick comes in.
How much does lip flick treatments cost?
Like all muscle relaxing injection treatments, the lip flick is tailored to suit your anatomy and muscle activity, but in most cases the cost ranges from $25-$50. Results are usually visible within 2-7 days and last 3-5 months.
call to book a consultation with Deborah
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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 discuss whether or not post pregnancy abdominoplasty surgery might be right for you.
Contact us
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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 of complications, these factors have all been shown to help lower the risk.
The Macquarie University 14 Point Plan:
- Use intravenous antibiotic prophylaxis at the time of anaesthetic induction
- Avoid peri-areolar incisions
- Use nipple shields to prevent spillage of bacteria into the pocket
- Perform careful atraumatic dissection to minimize devascularised tissue
- Perform careful hemostasis
- Avoid dissection into the breast parenchyma.
- A dual plane pocket has anatomic advantages
- Perform pocket irrigation with correct proven triple antibiotic solution or betadine
- Minimise skin-implant contamination
- Minimise the time of implant opening, reposition and replacement of implant
- Change surgical gloves prior to handling the implant. Use clean or new instruments that were not used in the pocket dissection
- Avoid using a drainage tube, where possible
- Use a layered closure
- Use antibiotic prophylaxis to cover subsequent dental or surgical procedures that produce bacteremia, and have lifelong follow-up
To ensure your surgeon is following best practice it’s important to:
- check they are a qualified specialist plastic surgeon using the RACS Find A Surgeon portal
- confirm they are a member of the Australian Society of Plastic Surgeons
- see if they have taken the 14 Point Plan pledge
want to know more about Dr Sharp's approach to breast augmentation?
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GOOD THINGS TAKE TIME
There are some inconvenient truths when it comes to plastic and cosmetic surgery that should be part of the decision making process when considering surgery. Behind the exciting before and after photos - and happy outcomes - there’s a massive amount of discipline, patience and consideration that goes into each procedure. Healing takes time. Scarring doesn’t always behave as we want it to; in each body it can evolve, change and mature differently. Recovery can be painful. Friends and family can be judgemental. Surgery can trigger anxiety. And if you are aiming for perfection, you will always be disappointed (in life, and in surgery).
Some patients find it easy. We had a visit this week from one of our beautiful patients, who had undergone a breast reduction with Dr Sharp three months ago. She wanted to let us know she’d breezed through the entire process - felt great after surgery, bounced in for all of her post op appointments and patiently waited for her results to settle in. But the same procedure for another patient can be a difficult journey overwhelmed by anxiety and uncertainty - which is why it’s important to embark upon surgery with an open mind and an understanding that the process can be a marathon rather than a sprint.
Over the years we’ve noticed some commonality between patients who enjoy the process of surgery, and the results they achieve in the end:
They have reasonable expectations
They have sensible expectations of how their body will heal and recover from surgery. If their bodies don’t behave exactly as they imagined it would after surgery, they nurture it and are patient with their bodies, rather than engaging in negative self-talk. Likewise, they have reasonable expectations of their outcomes. Absolute perfection is a myth; if you are considering surgery in order to look ‘perfect’, you will always feel disappointed. Discuss your honest expectations with your surgeon - and likewise let them know that you expect honest feedback and guidance by them. It’s important for your surgeon to understand the key reasons why you wish to have the procedure, and the outcome you are hoping to achieve. Dr Sharp’s pre operative consultation process is very detailed and covers an exhaustive list of risks, complications and potential outcomes. If you are having a cosmetic procedure, you will have at least two of these consultations before your procedure. Even after these consults, if you have any doubts, ask for another pre operative consultation to discuss any concerns - they are free of charge, as we want to encourage patients to have as many as they need in order to feel fully informed!
They understand the uniqueness of each body
The advent of online surgery forums has in most part been a wonderful thing for patients, enabling them to find information and first-hand accounts that were never accessible in the past to people considering surgery. However, the flip side of this is that there’s a lot of misleading, inaccurate (and sometimes, dangerous) medical information shared between users. Every single body is beautifully unique, and what worked for one forum member might not work for another, for many reasons. In addition to starting off with different anatomy, proportions or disease progression, how your body responds to surgery after the procedure can be totally different to the next person on the forum. Some people are unlucky to be more prone to swelling, infection or suboptimal scar healing. While forums are a great way of doing ground work, it’s important to understand that everyone will have different outcomes.
They adhere to post op instructions
Your recovery is a team effort, often involving you, Dr Sharp, our post op care nurse and - sometimes if you live regionally - your local general practitioner. Before surgery, your informed consent process will include two written documents that clearly outline what to expect after your procedure; it is important to go through these with Dr Sharp and then go home and read through them again at least twice! Particularly observe the post operative information, risks and potential complications. This greatly assists patients in understanding what to anticipate from their procedure. On the day of your surgery you will receive a post operative care envelope containing your post op instructions and another copy of the appointment schedule you will have received earlier. Your post op instructions can’t cover off every possible scenario, they also rely on common sense - such as, if you have had surgery on your right ear today, don’t lie on that side when you go to bed tonight. Keep your support garment on for as long as Dr Sharp recommends after surgery (and even longer if you can), even when its cramping your style and you think you’ve healed enough to stop wearing it. Use your judgement and if you are unsure, call your post operative care nurse on the number we provide you with on your day of surgery; she’s available to talk to you anytime. There’s no such thing as a silly question when it come to post operative care - so stay in touch! Most importantly, if you haven’t adhered to your post op instructions and something has gone wrong, don’t be too nervous to get in touch and tell us; we aren’t here to berate you, we just want the best result possible for you - and the sooner you ask for help, the better your outcome will be.
They attend their post operative appointments
Our post op appointments with Dr Sharp are free of charge for twelve months after surgery - to encourage patients to come back in and receive optimal post op care and support with us. Before you undergo surgery, we will schedule your post operative appointments with you. In our experience, patients who attend their post operative appointments are more satisfied with their outcomes in the long term. Attending these free sessions ensures your healing progression is monitored, keeping healthy lines of communication with your surgeon open and enabling your care team to observe your results and support you through the recovery process.
They are patient!
It’s very understandable for you to want to cast off your dressings or support garments and see a swelling-free, scarless result smiling back at you. It’s also understandable to wish that your bruising, swelling, scars or irregularities would just spontaneously disappear tomorrow. The reality is, time is a wonderful healer, and patience is incredibly important. Some procedures are more prone to having more high risk or lengthy recovery periods that others. The amount of swelling you accumulate can vary greatly, depending on your body. And it can take longer to subside, depending on your body and your post operative activities. Scars can heal at breakneck speed, and they can also grumble along and develop nuances, discolouration, puckering and tethering. Have faith that your body will heal over time, with the ongoing monitoring and care from our surgical team and our post operative recommendations. Follow Dr Sharp’s instructions - and know that we feel just as invested as you are, in your end result - whether that be a journey of weeks, months or years.
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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?
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 bacteria that is extracted using a fermentation process. Anti-wrinkle injections also contain 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 to treat migraines, muscular disorders and excessive sweating.
To ensure patient safety, the injections should be administered in a clinical environment (not a home, hair salon or beauty salon) and by a doctor - or a skilled nurse who is under the supervision of a trusted qualified doctor. The main risks of wrinkle injections exist with injector error, which is why it’s important to choose the right clinician.
Side effects are usually limited to a small mosquito-bump like lump over the injection site, which subsides within 15 minutes – or small bruise at the injection site. Sometimes patients report a mild headache after having the injections. Misplaced wrinkle injections can cause droopy eyelids or overly-arched eyebrows, a crooked smile or drooling. It’s important that injections be placed precisely in order to avoid side effects.
Ask us your cosmetic injectables question!
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?
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 take steps to mitigate this, but it’s important to weigh this up against your desire for a larger implant. Your breasts will look bigger in clothes, but they may not look as you’d hoped, when naked.
- Increasing your implant size may cause your breasts to sit higher on your chest, and create a more unnatural appearance. Some women like this look, but it is important to decide if this is something that may bother you in the future.
- A larger implant will place additional strain on your supportive tissues and stretch your skin; this is something to consider down the track, as breast lift (mastopexy) surgery may be required if you wish to downsize or remove your implants in the future.
- Larger implants can impede on physical activities, sports and even sleeping positions; discuss this with your surgeon.
- Anecdotally, we find that the larger the implant size, the greater risk of revisional surgery; it’s important to consider if your budget and lifestyle will be able to accommodate this if the need arises in the future.
These considerations are not intended to sound negative or foreboding, but it’s far better to let them run through your mind before having surgery, than after!
Part of a surgeon’s job is to counsel patients to make sustainable, sensible decisions about surgery – this should be explained at length during the pre-operative process. Simply putting in oversized implants might please patients in the short term, but in the long term we know this is not always the ethical choice. Sometimes that means the end result is a compromise in the middle between what a patient wants, and what is safely achievable.
During the pre operative consultation process, your surgeon will take your individual chest measurements and use the clinical guidelines based upon these to arrive at the ideal implant size ‘range’. This guideline determines the maximum implant size that your breast base anatomically will accommodate; it protects patients from potentially long term implant complication, and based on this, your surgeon will work closely with you to formulate an effective plan to achieve optimal breast augmentation results.
If you live in or near the Brisbane or Ipswich areas, or if you are considering traveling to these cities to receive treatment for breast augmentation revision, Dr Sharp would be more than happy to speak with you about your various options and help you make the correct decision for your unique situation. To book a consultation, please call 3202 4744.
Ask us your breast augmentation question!
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.
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 be recommended as part of your surgical plan. Mastopexy removes skin, lifts the nipple and reshapes the breast; there are various techniques for mastopexy and it’s important to ask your surgeon to explain and show you a picture of their recommended approach, and scar placement, so you know what to expect. My typical incision placement is shown in the first set of before and after images below.
Patients often wish to avoid a mastopexy for understandable reasons, and shop around for surgeons to find one willing to do the augmentation without a lift. However, if your specialist plastic surgeon has advised you that a lift is indicated to achieve a good result, it’s because they’ve seen enough to know that both you, and your surgeon, will eventually be disappointed with the outcome of an augmentation alone. While your scars will always be visible, if you are concerned about scarring after a mastopexy, ask your surgeon to create a scar reduction plan for you to commence straight after your surgery. Our mastopexy patients receive a scar reduction treatment plan included as part of their surgery with us, however many indicate that they don’t even feel the need to utilise the full program, as they’re satisfied with how their scars have matured and faded with just the use of topical scar reduction products, massage and time.
A final note about ‘borderline’ or ‘pseudoptosis’ - whereby the nipples/areola is sitting lower on the breast, but not entirely below the inframammary fold. After discussing the pros and cons, your surgeon may be able to use a well-chosen implant and pocket placement to utilise the augmentation for a slight lift of the nipple/areola, instead of performing a mastopexy. In these cases, it’s important for the patient to understand that they may require a mastopexy further down the track if the ageing process or weight fluctuations cause more sagging.
These photos show a patient who had clinical ptosis and wanted a fuller breast with a higher-sitting nipple/area complex. She underwent a breast augmentation mastopexy as a combined procedure, with a typical ‘lollypop’ scar. Photos show results at 6 weeks post surgery.
Ask us your breast augmentation and breast lift question!
A Contemporary Approach to Breast Reduction Surgery
Excessively large breasts create both physical and psychological problems, including severe neck and back pain, bra strap indentations, skin irritations and embarrassment. Today, breast reduction surgery is widely accepted as a solution to treat ‘macromastia’; but our mature-aged patients tell us it was not alway so. Previously, breast reduction surgery was considered taboo and embarrassing, and often hidden from family and friends. [Left, before and after breast reduction with Dr Sharp].
Thankfully times have changed, and the social environment in which women undergo plastic surgery has evolved. Although it offers cosmetic improvements, breast reduction surgery also follows reconstructive principles and techniques, involving flaps and medical indications - that is, it is considered medically required due to the health benefits it brings.
This means that the procedure is listed on the Medicare Benefits Schedule and in most cases, an item number applies to the procedure. Women are able to claim a rebate on some of their costs, both via Medicare and their health fund, if applicable.
This has been one of many contributing factors that have seen breast reduction surgery rates increase significantly. As these rates have increased, surgical techniques have been refined and improved.
Dr Sharp is skilled in modern breast reduction techniques, enabling him to treat breasts of all sizes. By employing advanced techniques, Dr Sharp is able to help patients achieve physical relief from the weight of exceptionally heavy breasts, while creating a natural looking, rejuvenated overall appearance.
Breast reduction surgery requires an astute aesthetic eye as well as extensive expertise in both cosmetic and reconstructive breast surgery. Dr Sharp takes pride in being able to offer this procedure to patients seeking to alleviate the physical and psychological impact of disproportionately large breasts. [Right, before and after breast reduction with Dr Sharp].
Want to learn more about breast reduction? Call to book a consultation with Dr Sharp
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