SURGERY

Eyelid Surgery/Blepharoplasty | Breast Surgery | Tummy tuck/Abdominoplasty | Liposuction/Liposculpture | Fat transfer

 

EYELID SURGERY OR BLEPHAROPLASTY

What is a Blepharoplasty?

The eyelids are the first parts of our face to age. They can make us look tired and old even after a good nights sleep. An Eyelid Reduction (Blepharoplasty) is a procedure to remove excess fat and skin from the eyelids. This is a simple procedure performed under local anaesthetic. Some people prefer sedation.

Does it hurt?


There is no pain. Some people get bruising that lasts up to two weeks, but you can still get around and do most things.


Will I need to take time off work?

No time off work is required but some people get bruising. You may prefer to take some time off work. The bruising should resolve within two weeks.


Will I have scars?

The scar is made in the depths of the folds of the eyelids and it is not visible except in some cases where it may be seen at the lateral edge of the eye. However, the incisions fade quickly and are barely noticeable after a few weeks. Makeup can be applied a few days after surgery.


Is it a safe procedure?

With a lower eyelid blepharoplasty, one person in 45,000 patients bleed into the orbit causing pain and blindness. Any pain after this procedure should be reported to us immediately to prevent this happening. While there are risks with any surgery, this is a relatively minor and safe procedure with instant improvement.

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Breast Surgery

What is a Breast Reduction?

Large breasts can pull the neck and shoulders forward causing pain in the spine and shoulders. Breast reduction procedure to alleviate this may qualify for a Medicare rebate.
The classical breast reduction removes volume and some skin to tighten and lift. This results in an anchor shaped scar and often loss of nipple sensation.

Removing skin around the areola results in a breast lift with a scar on the border of the areola only. The associated purse string pleating reduces over the ensuing months and can leave a very satisfactory result.

Liposuction of the breast has the advantage of no scars, no cutting but does not lift the breast. The breasts will be the same shape but 50% smaller.


What is a Breast Augmentation?


Breasts can be enlarged using silicone or saline. Silicone implants have a very natural feel. The 'allergic' and metabolic 'problems' thought to be caused by them have not been shown to be caused by silicone. The problems of silicone implants relate to the rubbing between the implant and the surrounding breast. This causes an irritation, which can result in scarring forming a hard capsule around the implant. This needs to be broken up and may need surgical removal. Fifteen percent of implants are associated with loss of sensation around the nipple. The other problems of implants are common to all surgical procedures - infection, scars, etc.


Saline implants are not as soft. They are easier to feel through the skin and feel less natural.

All augmentations are limited by the amount of droop present. If droop is too great some skin will need to be removed.

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Tummy Tuck or Abdominoplasty

A protruding abdomen is a result of weak abdominal muscles, weight gain or pregnancy.  It is a condition that causes distress to thousands of people.  This condition does not respond well to diet or exercise because the skin and underlying muscles have been stretched.  Today, a remarkable procedure called abdominoplasty has been designed to flatten a protruding abdomen through the tightening of abdominal wall muscles and removal of excess fatty tissue and skin.

Abdominoplasty is not a substitute for weight loss.  The objective of the surgery is to improve the contour of the body by flattening and narrowing the abdomen.  The best candidate for the surgery is the individual who is of normal weight but who has weak abdominal muscles and excess skin and fat.  Age, obesity and smoking habits are some of the factors the physician considers when evaluating a candidate for this procedure.

Prior to surgery, a complete medical history is taken in order to evaluate the general health of the patient.  A careful examination is also conducted.  The physician and patient discuss together what can realistically be expected.  Photographs may be taken before and after surgery to evaluate the amount of improvement.  The type of anesthesia to be used, the procedure, and possible risks and complications are also discussed.  Pre-operative instructions may include the elimination of certain drugs which contain aspirin in order to minimize the possibility of excess bleeding.  Antibiotics may be prescribed prior to surgery to prevent infection.  The patient may also be advised to bathe with an antiseptic soap for several days prior to surgery.

Abdominoplasty is usually performed in a hospital setting under general anaesthesia with the patient asleep.  Pre-medication may be administered to relax the patient.  Although there are several procedures from which to choose, the one most frequently used by physicians involves a ‘u’ shaped incision made below one hip bone and across the pubic area to under the other hip bone.  A second incision is made around the navel.  The skin is then separated from the abdominal wall and lifted up to the breast bone exposing the loose tissue that covers the abdominal muscle.  Often lax abdominal muscles are sutured in order to tighten loose or stretched out muscles.  The skin is then lowered over the abdomen and excess skin and fat is removed.  Before the incisions are closed with small sutures, the navel is constructed and usually drains are inserted to eliminate fluid build-up.  Firm elastic bandages are then applied to the area.

After Surgery

Patients often remain in the hospital for one to three days.  Occasionally this procedure is done as an outpatient surgery.  If drains are used, they may be removed prior to discharge from the hospital or may remain in place for 3 to 7 days until fluid levels decrease.  Pain or discomfort from the surgery is controlled with oral medication.  Sutures are removed approximately one week after surgery and bandages are applied.  Bandages are later replaced with an abdominal support garment which is worn for several weeks.  During this time, patients must refrain from heavy lifting, straining or over-activity.  Although patients are usually up and around the day of surgery, the physician decides when normal activities may be resumed.  This decision is based upon the extent of surgery and the patient’s progress.  Bruising and swelling which occur around the treated area will disappear within a few weeks.  Scars from the procedure remain but fade significantly in time.

Each year, thousands of abdominoplasties are successfully performed.  The amount of improvement is individual and depends upon the extent of surgery and the patient’s skin tone, body, build and healing process. Complications connected with the procedure are rare, however there are inherent risks connected with every surgical procedure.  Possible risks and complications should be thoroughly discussed with the physician prior to surgery.  Patient can minimize complications by carefully following directions given by the physician.

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Liposuction or Liposculpture

What is Tumescent Liposculpture?

Tumescent Liposculpture is the advanced technique of permanently removing fat from areas that are resistant to diet and exercise using local tumescent anaesthesia. Tumescent means "to swell". The fat is swollen with a local anaesthetic solution. This allows "sculpting" of the body to a more pleasing shape.

By the end of puberty we will have developed our total number of fat cells and they will be in their final distribution. As we gain or lose weight fat cells enlarge or shrink but do not change in number. Some areas of the body will have more fat cells than we want. These can become problem areas if they resist diet and exercise. These areas may be inherited. Tumescent Liposculpture may be the only reliable way to correct these problem areas.
Tumescent Liposculpture allows the physician to tunnel directly into the fatty layers of the body in a crisscross pattern with fine cannulas, suctioning out the fat. A compression garment is worn after surgery to help the tunnels to collapse and the skin to contour to its new shape.

Is Liposuction permanent?

Liposculpture is permanent because the cells that contain the fat have been removed. We do not grow new fat cells, the remaining fat cells will get larger and smaller as we gain and lose weight. The new shape that has been produced by Liposculpture will remain in proportion.

While Liposculpture can remove as much as 10 percent of the body fat it should not be regarded as a weight loss technique. The best candidates for Liposuction are of normal weight with localised areas of excess fat. Megaliposuction is needed for people who are overweight.

Will Liposculpture help me?

The pinch test will tell you if you have enough fat in any particular area to be helped by Liposculpture. Hold the skin and fat between the thumb and forefinger. Unless there is more than one inch, Liposculpture may not be very useful. Poor muscle tone can contribute to a sagging appearance. If you think this may be a problem then the pinch test should be applied while you are tensing the muscle.

Patients with severe heart, kidney, bleeding or liver problems may not be suitable for Liposculpture.

How long does the procedure take?

Liposuction is a day only procedure done under local anaesthetic. Sedation is available if you require it.

How soon can I go back to work?

We advise people to take 4 days off work and then return to light duties. Full duties are possible after 2 weeks.

What other benefits are there?

Dr Hoppichler reported at the 11th European Congress on obesity, that while liposuction usually is performed for cosmetic reasons it can significantly change a person's cholesterol level.

Dr Hoppichler said the 8 patients who took part in his study lost about 2.80 kilos of body fat each and had significant decreases in total cholesterol levels.

Liposuction not only removes excess fat from the hips, abdomen, bottom and thighs, it can also help to improve cholesterol levels.

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FAT TRANSFER

What is Fat Transfer?

As we age we lose fat from our face, breasts and hands. We also tend to accumulate fatty deposits in areas that we don't want such as the stomach, thighs, arms, chin and back. Fat Transfer is the process of removing fat cells and re-injecting them into areas where we have lost fat, restoring a more youthful appearance.

The use of your own fat in this procedure means that allergic reactions and side effects caused by the introduction of foreign materials is avoided.

Can Fat Transfer help me?

Fat transfer can be used to correct cheek depressions and contour deformities, fill in deep laughter lines and facial wrinkles and enhance the hands, lips and cheeks. Fat transplantation is used mainly to fill deep lines and folds. Superficial wrinkles still need to be treated with chemical peeling, laser or fillers such as hyaluronic acid.

How much fat survives the transplant?

When the fat is harvested for fat transplantation care is taken to collect the fat cells with some surrounding blood vessels and connective tissue in filaments rather than as individual fat cells. This significantly increases the survival rate of the fat cells. As with all grafts, in the first three days following implantation are the most critical and determine the number of cells that will grow a new blood supply and survive. Once the new blood supply is well established the fat cells will live as long as the fat cells that they have replaced.

The survival rate for fat grafting varies from 30 to 100 percent. The proportion of transferred fat cells that survive varies from one area of the body to another. The fat injection can be repeated to counter any re-absorption of transplanted fat cells. Areas such as the cheek usually need to be injected 3 times to maximise the increase in fullness.

How long does the procedure take?

Fat Transfer is a day only procedure done under local anaesthetic. Sedation is available if you require it.

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