Breast Implants, Textured Breast Implants & Anaplastic Large Cell Lymphoma (ALCL): A Rare form of Non-Hodgkins Lymphoma (NHL).

A Scientific Guide for patients.

Many patients in Australia and across the world have recently become aware of the risks associated with a specific make of Breast Implant, called Poly Implant Prosthese (PIP), Polyurethane Breast Implants (Furry Brazilian) or Textured Implants.

Dr. Bobby Kumar (Cosmetic Surgeon) has never used PIP Breast Implants and does not recommend textured breast Implants. He has chosen only to use breast Implants with a proven and trusted safety record, and breast Implants that are recognised and approved by the major medical authorities around the world, such as FDA (Food and drug authority of the US), TGA and NHMRC of Australia as well as UK’s Medicines and Healthcare products Regulatory Agency (MHRA).

Breast Implants that are recommended at the Bare Aesthetics Cosmetic clinics and by Dr. Bobby Kumar are Eurosilicone (It has one of the lowest rates of all breast Implants for rupture) and Mentor Breast Implants. These Implant companies provide guarantees for their Implants; Eurosilicone Implants are Insured for life to all my patients and the company will exchange for free any on their Implants that develop a spontaneous rupture and or capsular contracture.

Dr. Bobby Kumar (Cosmetic Surgeon) in his opinion has recommended that the PIP Implants be removed especially if they have ruptured; this is contrary to the recent advice provided by the TGA  and their advisors.

1. What are the concerns regarding Breast Implants and the rare ALCL tumour?

Depending on the source of scientific literature and information there are a slightly varying number of ALCL cases in women having undergone breast Implantation.

After a careful review of literature published from January 1997 through May 2010, the FDA identified 34(one study identified only 27) unique cases of ALCL in women with breast implants worldwide. In addition, the FDA has received information from other international regulatory agencies, scientific experts and breast implant manufacturers. Altogether, the agency is aware of approximately 60 cases of ALCL in women with breast implants. Most of these women are mainly in Europe and some in the USA.

However, based on all the evidence available to us at this time, the FDA believes that women with certain types of breast implants may have a very low but increased risk of developing ALCL.

Since initially publishing this article it has been recognised and established that there is a link between Textured Breast Implants, the formation of capsular contracture and ALCL by Australian researchers (Click on the following link for details: http://www.mq.edu.au/newsroom/2014/11/11/link-found-between-textured-breast-implants-and-rare-cancer/ )

2. What is Anaplastic Large Cell Lymphoma (ALCL)?

ALCL is not breast cancer. According to the National Cancer Institute (USA), ALCL is a rare malignant tumor (non-Hodgkin lymphoma) that may appear in several parts of the body including the lymph nodes, skin, bones, soft tissue, lungs or liver.

Also according to the National Cancer Institute, an estimated 1 in 500,000 women per year in the U.S. are diagnosed with ALCL. ALCL in the breast is even rarer. Approximately 3 in 100 million women per year in the U.S. are diagnosed with ALCL in the breast (with or without breast Implants).

Even though ALCL has been found in the breasts of some women with breast implants, it is not breast cancer. ALCL is a type of lymphoma, a cancer of the cells of the immune system.

In fact the type of ALCL that forms in association with some breast Implants, that is, ALCL Kinase negative, is an even rarer form of all the subtypes of ALCL.

ALCL comprises only 2% of all newly diagnosed NHL worldwide. Lymphomas occurring in the breast are even rarer, comprising only 0.04 to 0.5% of all breast cancers and approximately 1-2% of all extranodal (outside of lymph nodes) lymphomas.

The absolute risk of developing ALCL following breast augmentation is extremely small. It is estimated by de Jong et al. to have an incidence of 0.1 to 0.3 per 100,000 women with breast Implants per year.

It has been propsed that the link is associated with a bacterial infection in contact with the textured surface of the breast Implant. The infection creates a chronic inflammatory state and activates the patients Immune system and lymphocytes causing a transformation into what is now referred to as BIA-ALCL (Breast Implant Associated ALCL)

3. Symptoms associated with development of ALCL and women with Breast Implants

The main symptoms of ALCL in women with breast implants were persistent swelling or pain in the vicinity of the breast implant. These symptoms were noted to occur well after the surgical incision had healed, often years after implant placement (published articles estimate 6 months to several years after breast augmentation).

Upon evaluation, evidence of fluid collection around the breast implant (seroma) was observed. Some patient reports indicated that a palpable mass or capsular contracture (thick and noticeable scar capsule around the implant) were present.

4. Where in the breast has ALCL been found in women with breast implants?

In the case studies reported in the literature, the ALCL was found near the textured breast implant, and contained within the fibrous scar capsule. However, it was not in the breast tissue itself. The illustration below shows the location of the ALCL in these reports. In most cases, the ALCL cells were found in the effusion fluid (seroma) surrounding the implant or contained within the fibrous scar capsule.

Breast Implants and ALCL tumours

5. Prognosis

ALCL disease occurring in women with breast Implants is a clinically indolent disease with a favourable prognosis, as distinct from the systemic ALCL disease type.

Management consists of removal of the involved breast Implant and capsule, which likely on current evidence will prevent local reoccurrence (evaluation for other disease sites needs to be performed).

With capsule confined disease, adjuvant chemotherapy and radiotherapy is not necessarily required; however this decision is made by a medical oncology team.

6. Conclusion

Whilst ALCL of the breast and in particular in women with breast Implants is rare, it is recognosed now that there is a positive association between BIA-ALCL and textured breast Implants. There is a causal link  between textured breast Implants , bacterial infection and developing BIA-ALCL.

Textured Implant range include PIP Implants, Micro textured breast Implants & Poly Urethane breast Implants (Commonly referred to as ‘PURE’ or ‘Furry Brazilian’).

The scientists have suggested that smooth breast Implant surfaces potentially have a lower or no risk of developing ALCL. 

The expert panel also believes that there is evidence of an increased risk of developing ALCL in women that have breast augmentation in the Subglandular plane (under the breast) compared to those women with Subpectoral breast augmentation (under the pectoral muscle).

The treatment is removal of the textured breast Implant and fibrous capsule. It is not clear whether there is still a long term risk of developing ALCL despite removal of the affected breast Implant and capsule.

7. So what are the issues with the PIP breast Implants?

The media and the PIP manufacturing company have released a statement suggesting that PIP Implants have a higher than expected spontaneous rupture rate, at least approximately 4x greater than other types of breast Implants. There is a greater risk of Capsular Contracture and now a suggestion that this particular breast Implant is implicated in the formation of a rare form of NHL tumour (BIA-ALCL) of the scar tissue(Capsule) surrounding the Implant.

Of particular concern are textured PIP breast Implants as well as textured titanium coated breast Implants.

8. Consequently Poly Implant Prosthese(PIP) has advised that patients should consider removal of their PIP breast Implants.

This has caused significant concern amongst patients with PIP Implants or in fact with any breast Implant, as evidenced by the number of calls received at Bare Aesthetics Cosmetic Surgery Clinics. In Australia PIP breast Implants were used largely by Surgeons in South Australia (State where the parent Importing Company of PIP breast Implants resided) and Queensland.

PIP breast Implants were banned for use in Breast Augmentation in the USA by the FDA in the year 2000 when it became evident that there were significant spontaneous rupture rates and capsular contractures. It was also recognised that PIP manufacturing company were using Industrial strength Silicone, not authorised or appropriate for use in medical breast augmentation.

Despite the FDA findings the Australian TGA only banned PIP breast Implants in approximately 2010, when similar concerns were raised by Australian patients reporting adverse outcomes.

To reiterate Bare Aesthetics Cosmetic Surgery Clinics and Dr. Bobby Kumar have received many enquiries regarding what to do from patients having had PIP breast Implants by another surgeon. Dr. Bobby Kumar (Cosmetic Surgeon) in his opinion has recommended that the PIP Implants be removed especially if they have ruptured; this is contrary to the recent TGA advice.

Patients with PIP breast Implants are naturally distressed and anxious about developing ALCL and removal of the affected breast Implants which then entails increased risk or morbidity of having further surgery and anaesthesia, especially as it will take longer than a standard breast augmentation. Also there is consideration of cost; it is unclear who will finance further surgery for the removal of the affected PIP Implants.

At this stage patients are expected to finance further surgery, although international authorities are suggesting the government finance patients in cases where breast augmentation with PIP Implants followed corrective surgery for breast cancer; or it be financed by the private clinics and or Surgeons that performed the breast augmentation with PIP breast Implants.

Dr. Bobby Kumar is a Cosmetic Surgeon, experienced and qualified to perform Breast Augmentation or Breast Enlargement surgery. For advice regarding Breast Implants and PIP Implant related issues, please contact us at www.bareaesthetics.com.au or call 1300 676 003 or 0430 491 009.


Written by Dr. Bobby Arun Kumar on Monday the 7th of September, 2015. Currently No Comments »

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How does Dr. Bobby Kumar, Cosmetic Surgeon, decide which Breast Implants are best suited to you?

Breast Augmentation surgery is the most common Cosmetic Surgery sought by women in Australia today. Planning for breast augmentation surgery requires choices about breast implants, including,

saline vs silicone

size/volume of breast implant

shape of breast implant (round vs anatomical)

projection of  implant (eg high vs very high)

the outer layer of the implant (textured vs smooth)

placement of the implant (Subglandular or Subpectoral)

So how do you know which type of  implant is best for you and will achieve the results you desire?

When planning Breast Augmentation surgery, Dr. Bobby Kumar does not take a “one type suits all” approach when recommending breast implants. There are several factors that he considers when evaluating which breast implants to recommend to any given patient, including:

Existing features:

Volume of existing breast tissue (ie the amount of breast tissue/size of breasts)

Skin thickness, quality, quantity and elasticity – these features affect the placement of the breast implants of above or below the muscle (Subglandular or Subpectoral) and potentially the size of breast implant. For example, a woman with thin skin seeking a natural result may be best suited to breast implant placement below the muscle to allow for coverage of the implant and to avoid the edges of the implant showing through the skin. The quantity of skin is also taken into consideration as the desired outcome is to fill the skin adequately with the breast implant. An implant that is too small to adequately fill the skin results in an unnatural appearance.

Chest diameter – the width of the chest and breast diameter affect the width of breast implants that can be accommodated. For example, a large breast implant may not be able to be accommodated by a small diameter breast, or conversely a smaller breast implant in a breast with a large diameter may result in poor breast augmentation.

Shape/position of existing breasts – for some women, their breasts have developed a degree of droop with age, changes in weight, and/or pregnancy and breastfeeding. A mild degree of droop can be addressed with certain types of breast implants. Most women seek upper pole fullness and the ability to create cleavage. This, for example, cannot be achieved with anatomical breast implants that are teardrop shaped.

Desired result/outcome:

                The result that each woman wants to achieve with breast augmentation surgery can differ. For example, some women seek an implanted look whilst others want a natural fullness. Some women seek to be a couple of “sizes” bigger, whilst others want to be significantly larger. Trends have changed when it comes to what is considered desirable – currently the most popular look amongst women seeking breast augmentation surgery is full, natural breasts with upper pole fullness and cleavage. Typically women who seek breast augmentation surgery after having children are aiming to restore their breasts to their pre children appearance, seeking to restore volume, shape and proportion to their body shape. 

Other factors:

      Size and development of pectoral muscles

      Height

      Weight

      Pregnancies/breast feeding, weight gain/loss – these factors results in changes over time in the size and shape of the breasts and the stretch of the skin, for example.

The manufacturer and supplier of the breast implants:

               Dr. Bobby Kumar actively stays informed regarding the breast implants available on the market and ongoing research into continued product development in order to maximise the safety and wellbeing of every woman who is seeking breast augmentation surgery. For example, Dr. Bobby Kumar chose not to ever use the now very well publicised PIP implants due to his knowledge of the history and concerns regarding the implants and the manufacturers themselves.

These are all factors that Dr. Bobby Kumar, Cosmetic Surgeon, considers comprehensively in a consultation when discussing the types of breast implants available and which breast implants would be best suited to any given woman seeking breast augmentation surgery.

Make an apointment today for a consultation by calling 1300 676 003 or contacting Wendy on 0430 491 009. Alternatively visit our website at www.bareaesthetics.com.au

 


Written by Dr. Bobby Arun Kumar on Monday the 22nd of April, 2013. Currently No Comments »

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       Women Considering a Mummy Makeover:

“I just want my body back…I’ve had my kids and now I want something just for me, to get my body back to something like the way it was…I maybe considering Breast Implants or a Tummy Tuck ?”

This is the most common phrase I hear from women seeking breast augmentation surgery, abdominoplasty (tummy tuck sydney) surgery, or both together.  Typically these women have had children and see the lasting effects on their bodies every day; loss of volume and shape in their breasts and residual excess skin and tissue on their tummy that doesn’t respond to diet or exercise.  So what are their Cosmetic Surgery options?

Breast Augmentation Surgery:

Breast Augmentation surgery involves the insertion of breast implants into the breasts to increase and/or restore their size. Many women seek breast augmentation surgery to enhance their overall body shape, contours and proportions.  For women who have breast fed their children or lost weight, sometimes a breast lift will be combined with breast augmentation in order to address sagginess or droop of the breasts.

Usually women seeking breast augmentation seek to achieve larger breasts, but retain a natural appearance. Most women don’t want to look “implanted”. A natural look can be easily achieved with the right advice from your Cosmetic Surgeon as to what size, style, shape, projection and volume suits your shape and body type and will achieve the look you are seeking.

Abdominoplasty Surgery (Tummy tuck):

Many women who have had children are unhappy with the residual excess skin and tissue at the base of their tummy that is unresponsive to diet and exercise. (This is also common in both men and women who have achieved significant weight loss). Tummy tuck surgery involves the excision of the excess skin and tissue on the tummy, often with tightening of the underlying tummy muscles, to achieve a smooth and defined tummy. This should in no way be considered a means of weight loss; your Cosmetic Surgeon will advise you to be within your optimal weight range prior to surgery to achieve the best and most lasting result. Tummy tuck surgery is often combined with Liposuction or Liposculpture, where fat is removed through incisions will a metal tube and suction device, in order to achieve a smoother, contoured and natural appearance.

Performing Breast Augmentation and Abdominoplasty surgery (Tummy Tuck Sydney) at the same time is appropriate for some women. The priority of the Cosmetic Surgeon is your safety and minimising your surgical risks; this may mean that the surgeries should be performed on separate occasions if by performing them together your operating time is at a length of operating time that poses increased risk to your safety. This is obviously something that you should discuss in consultation with your Cosmetic Surgeon.

Cosmetic Surgery offers options to women who have reached a point in their life where they want to do something for themselves, take steps to restore and rejuvenate their body’s appearance and re-gain a sense of self confidence. For an appointment for Breast Implants and/or Tummy Tuck Sydney today, contact an accredited and experienced  Cosmetic Surgeon Dr. Bobby Kumar on 1300 676 003 or 0430 491 006.


Written by Dr. Bobby Arun Kumar on Wednesday the 27th of February, 2013. Currently No Comments »

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Written by Dr. Bobby Arun Kumar on Tuesday the 16th of October, 2012. Currently No Comments »

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Adelaide Breast Augmentation, Enlargement or Breast Implant Cosmetic Surgeon

Breast Implant surgery is one of the most common Cosmetic Surgery procedures performed in Australia. Many women are choosing breast augmentation to enhance their breast shape and size, body proportions and contours. Some women have always felt uncomfortable with smaller or uneven breasts; other women seek to restore their breast size and shape after pregnancies and breast feeding or significant weight loss. Whatever your motivation, it is important to research the procedure and seek the opinion of a qualified and experienced Cosmetic Surgeon.

Dr. Bobby Kumar produces natural,beautiful and aesthetics Breast Enlargement results

High Profile Breast Implants

Dr. Bobby Kumar, Cosmetic Surgeon, has been performing Breast Enlargement surgery in Sydney for many years and is now offering his considerable skills and experience to patients in Adelaide. Dr. Bobby Kumar performs patient consultations and breast enlargement surgery in Adelaide on a regular basis. He is experienced in a range of Cosmetic Surgery Procedures, including breast augmentation or breast implants cosmetic surgery; tummy tucks or abdominoplasty, face lifts, breast reduction and breast lift surgery.

Breast augmentation involves the use of implants to enhance breast size and shape. There are two main types of breast implants, saline or silicone. Silicone implants have become more popular due to their natural feel. They consist of an outer silicone shell containing silicone gel. The silicone gel stays intact in the rare event that an implant ruptures or breaks. Saline implants also have an outer silicone shell, but are filled with saline, a fluid based on water and salt similar to that naturally occurring in our bodies.

The Size Shape and Style of breast Implant selection is discussed in your Consultation with Dr. Bobby Kumar

Breast Implant Size

Recently in Adelaide there have been well publicised issues with a particular commonly used brand of breast implant that were manufactured in France. There were reported cases and an increased incidence of breast implants rupturing and leaking. Dr. Bobby Kumar has never used this particular type of implant due to his own concerns and research regarding their negative outcomes. The breast implants he chooses to use come from a manufacturer and supplier that is TGA approved and has the lowest incidence of complications.

Breast implants also vary in their size, shape and volume. The most suitable breast implant to achieve the results you desire will be discussed between you and Dr. Bobby Kumar based on your physical examination and measurements. A breast implant that is suitable for one woman may not be appropriate for another, depending on features such as existing breast tissue, shape or droop of the breast, size of the chest, and body proportions. These issues will all be discussed at length with you by Dr. Bobby Kumar so you are in the best position to make an informed decision about what is right for you.  Many women do not want to have an ‘implanted’ look and Dr. Bobby Kumar strives to achieve the most natural looking results.

The first step in the breast augmentation process is to have a consultation with Dr. Bobby Kumar in Adelaide to discuss your options and obtain all the information you require about breast surgery. If you want to proceed with surgery, there are a few things to bear in mind. Breast surgery is usually performed as a day procedure under either twilight sedation or general anaesthetic. Most women return to work within 1 – 2 weeks depending on their type of work. Heavy lifting is to be avoided after surgery, in order to allow the chest tissues to heal and the implants to settle into position. Usually women are back into their normal routine, including exercise, at about 6 weeks after surgery.

Women who have had breast augmentation typically report a high level of satisfaction with the results including the enhancement to their overall body shape and proportions and often experience a boost in their self confidence.

Bare Aesthetics and Breast Augmentation,Breast Enlargement in Sydney,Adelaide and Port Macquarie

Natural Breast Augmentation results by Dr Bobby Kumar

Cosmetic Surgeon Dr. Bobby Kumar is an experienced and trusted Breast Augmentation and Breast Enlargement surgeon offering natural and beautiful results for women seeking Breast Implant surgery in Adelaide. For more information visit www.bareaesthetics.com.au or contact for all appointments in Sydney, Port Macquarie and Adelaide today on (02) 9571 4850 or 0430 491 009.

Click on link below to find out more about a Breast Augmentation Consultation in Sydney, Port Macquarie or Adelaide at the Bare Aesthetics Cosmetic Surgery clinics with cosmetic surgeon Dr. Bobby Kumar.

Breast augmentation or Breast enlargement what to expect in your consultation with cosmetic surgeon Dr Bobby Kumar


Written by Dr. Bobby Arun Kumar on Wednesday the 13th of July, 2011. Currently No Comments »

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Breast Augmentation or Breast Enlargement – Frequently Asked Questions during your Consultation at Bareaesthetics Cosmetic Surgery Clinics

These are the most common questions asked by women in Sydney, Port Macquarie  and Coffs Harbour who are considering Breast Augmentation Surgery:

1. How long does Breast Augmentation surgery take?

Breast Augmentation surgery in total takes between 1.5 and 2 hours

2. Under what type of anaesthetic is Breast Augmentation performed?

Breast Augmentation can be performed under either sedation anaesthesia or general anaesthesia; general anaesthesia is more common.

3.  How do I know what size implants to choose?

At the time of your consultation, you will have the opportunity to view different types of breast implants and “try” them for size. You need to make sure you are wearing a bra that will tolerate the breast implants being placed in the cup and wearing a plain t-shirt top helps to give you the best impression of sizing.

Every woman is different with regard to choosing breast implant size – the size of breast implant in one woman may give a significantly different result in another woman. This is one reason why viewing images of breast augmentation before and after photos should be done bearing in mind that each woman’s result is individual to her.

When choosing breast implant size, there are several factors to take into account, such as existing breast tissue, chest diameter, height and weight, overall body proportions and position of the breasts on the chest wall. The Cosmetic Surgeon will be able to recommend an appropriate breast implant size for you depending on the above factors and your goals and desired result.

Size Shape and Style of breast Implant selection is discussed in your Consultation

Breast Implant Size

 

4. What happens in a consultation with the Cosmetic Surgeon Dr. Bobby Kumar?

On arrival for your consultation, you will be required to complete a questionnaire asking you information about your medical history and reasons for considering Cosmetic Breast Augmentation Surgery. In your consultation, the Cosmetic Surgeon will discuss your medical history, conduct a thorough medical examination, take measurements and photos of the chest area and discuss in detail breast augmentation surgery. The Cosmetic Surgeon will also discuss what types of breast implants are available and make recommendations as to what type and size of breast implant will achieve the results you desire. As previously mentioned, you will be able to view and try a range of breast implants.

5. How long is recovery time from Breast Augmentation?

Most women take between 1 and 2 weeks off work (depending on the type of work they do) to recover from Breast Augmentation surgery. Any upper body activity, including exercise, lifting or bending over, needs to be avoided for at least 6 weeks to allow for the tissues to heal, swelling to resolve and the breast implants to settle into position. Driving needs to be avoided for 2 weeks after breast augmentation and flying should be avoided for approximately 6-8 weeks due to the breast surgery’s proximity to the chest wall and therefore the lungs.

6. What preparation do I need to do for Breast Augmentation surgery?

The first step is to have a consultation with a fully qualified and experienced Cosmetic Surgeon. From there you are in a position to schedule breast augmentation surgery. Once your surgery is booked, you may want to have a second sizing of breast implants to be sure of the size you want. Prior to your surgery, you will be required to undergo a range of routine blood tests to provide the Cosmetic Surgeon with information necessary about your health status. You will also be required to take antibiotics for approxiamtley 7-10 days after your surgery; this will help to reduce the risk of infection.

Payment for your breast augmentation surgery is usually required in full prior to your surgery.

7. Where is the incision made for the breast implants?

The most common incision site for insertion of breast implants is in the crease under the breast where the scar can be hidden. Other less common locations for the incision are either around the nipples or under the armpits both of which are more complicated and carry more risks. Crease under the Breast is the most common site for an Incision

8. Do you recommend saline or silicone breast implants?

There are two main types of breast implants; saline and silicone. Saline breast implants are essentially an outer silicone shell filled with a saline fluid. These used to be the most common type of breast implant used but have become less liked due to the literal feeling of a “bag of water” rather than natural breast tissue. Silicone breast implants consist of an outer silicone shell containing a silicone gel; these are now more common due to their natural feel similar to breast tissue. In the uncommon event that a silicone breast implant ruptures, the silicone gel stays intact rather than spilling into the surrounding breast tissue.

The Cosmetic Surgeon will discuss both types of breast implants with you, outlining the advantages and disadvantages of each to allow you to make an informed decision.

9. I’ve heard of “furry Brazilian” breast implants – what are these?

The shell of silicone breast implants come in two types; smooth or textured. “Furry Brazilian” or P-URE for PolyUREthane breast implants originated from Brazil and are a textured layer on the outer surface of the breast implant. Breast implants are not a one type suits all; for some women a smooth breast implant will be the best option, for other women a textured breast implant will be the more suitable option. Again, this is something the Cosmetic Surgeon will discuss with you in detail so you can make an informed choice.

10. Will I still be able to breast feed after breast augmentation surgery?

Breast feeding can vary from female to female, irrespective of whether you have surgery for Breast augmentation or not. The instances where breast feeding may be affected is if the Incision is through the armpit or around the nipple areolar complex. Otherwise if the Incision is under the crease of the breast there is no Impact on the breast ductal structures or nerves supplying the, therefore most women should have the same chances of breast feeding as those women not having had the surgery.

11.Can breast cancer still be detected after breast augmentation surgery?

Yes. Various studies have been conducted and no evidence has been found that breast implants increase a woman’s risk of developing breast cancer. However, as the breast tissue volume thins under the influence of the breast Implant it has been found that breast cancer detection may be delayed by about 3 months. This does not change the overall prognosis of breast cancer once detected compared with women never having had breast augmentation surgery.

Whilst MRI scans are recommended in the USA every 2 years for women having had breast Implant surgery, this is not the case for women in Australia. Women are advised to perform routine self breast examinations, and carry out the required radiological investigations such as MRI, mammogram or ultrasound of their breasts. Any unusual lumps or findings should be brought to the attention of your cosmetic surgeon or at the least your family doctor for further Investigation.

Breast Augmentation Sydney Bare Aesthetics Video ( Requires Real Player media player)

Consultations with experienced breast augmentation Cosmetic Surgeon Dr. Bobby Kumar in Sydney, Coffs Harbour or Port Macquarie; contact us on 1300 676 003 or 0430 491 009.


Written by Dr. Bobby Arun Kumar on Tuesday the 7th of June, 2011. Currently No Comments »

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Written by Dr. Bobby Arun Kumar on Tuesday the 31st of May, 2011. Currently No Comments »

Read related subjects to this article from Bare Aesthetics on breast augmentation or breast augmentation adelaide or breast augmentation sydney or Breast Enlargement or Breast implant or breast lift or Breast Reduction or Cosmetic Plastic Surgeon or Cosmetic Plastic Surgery or Cosmetic Surgery or Tummy Tuck.


Tummy Tucks in Adelaide, Sydney & Port Macquarie

More and more patients in Adelaide, Sydney & Port Macquarie are seeking Tummy Tuck surgery (known medically as an Abdominoplasty) to address their concerns regarding their tummy area. Tummy tuck surgery is available to women and men and usually involves removing excess skin and tissue on the abdomen to achieve a flatter, tighter and more toned tummy. Many people feel self conscious about the tummy area and feel restricted in the type of clothes they can wear. Quite often patients are women who after pregnancy have a residual area or pocket of tissue and fat in the lower abdomen that does not respond to diet and exercise. Other common reasons for seeking Abdominoplasty surgery are patients who have lost a significant amount of weight and have residual excess skin and tissue.

Typically patients enquiring about tummy tucks in Adelaide, Sydney & Port Macquarie want an estimate of how much the procedure will cost. It is important to understand that there are different types of tummy tucks according to the size of the area, the amount of tissue and fat that requires removal and whether the underlying muscle also requires tightening. The complexity of the tummy tuck procedure has a bearing on the time taken to perform the procedure; this then also affects the costs involved, for example a longer operation incurs more theatre and anaesthetic costs. Tummy tuck surgery can take anywhere from 2.5 hours to 4.5 hours depending on the individual procedure and is usually performed under a general anaesthetic.

If you are considering tummy tuck surgery, the best course of action is to have a consultation with a Cosmetic Surgeon who will discuss with you your concerns, goals and your surgical options. The Cosmetic Surgeon will also discuss the incision site (usually placed in the lower abdomen so it can be concealed by underwear) and whether you may require a complimentary procedure, such as liposuction/liposculpture, to fine tune your contours and shape. The Cosmetic Surgeon will provide you with the costs for your procedure, including surgical fees, theatre/hospital fees and anaesthetic fees.

Tummy tuck surgery can be done as a day only surgery, without the need to stay overnight in hospital. Patients are typically up and walking within hours of surgery, though care must be taken not to stand up too straight and stretch or put pressure on the incision site. Patients typically describe feeling like they’ve done a thousand sit ups and quite tight across the abdomen. Usually over the counter pain relief is sufficient and may only be needed for the first couple of days after Abdominoplasty.Most patients choose to take a couple of weeks off work. It is important to avoid any exercise or activity (e.g. lifting) that places the Incision area under any stress. Following surgery patients are required to wear a compression garment for anywhere up to 3 months; this promotes healing and adhering of the tissues for an optimal result.

It is important that tummy tuck surgery not be seen as a weight loss solution. Tummy tuck surgery is most successful when you are close to your optimal and stable weight and want to address residual skin or tissue that is not responsive to diet and exercise. The Cosmetic Surgeon is likely to recommend you lose excess weight prior to surgery with an appropriate diet and exercise plan.

As with any type of surgery, tummy tuck surgery comes with risks (such as infection, bleeding or swelling, skin and tissue loss and scarring) that need to be weighed against the benefits of surgery. The Cosmetic Surgeon will discuss these with you in detail so you can make an informed decision as to whether tummy tuck surgery is right for you.

Dr. Bobby A Kumar is a certified Cosmetic Surgeon experienced in performing Mini Tummy Tucks to complete Body Lifts following significant weight loss. For more information visit www.bareaesthetics.com.au or call today for an appointment on (02) 9571 4850 or 0430 491 009 for Sydney,Adelaide and Port Macquarie.

Click here for a YouTube Video on Tummy Tuck

Tummy Tucks by Cosmetic Surgeon Dr Bobby Kumar


Written by Dr. Bobby Arun Kumar on Tuesday the 19th of April, 2011. Currently No Comments »

Read related subjects to this article from Bare Aesthetics on breast augmentation or breast augmentation adelaide or breast augmentation sydney or Breast Enlargement or Breast implant or Breast Reduction or Cosmetic Plastic Surgeon or Cosmetic Plastic Surgery or Cosmetic Surgery or Liposuction or Tummy Tuck.


Breast Augmentation or Breast Enlargement Cosmetic Surgery options to consider:

Once a woman has decided to undergo Breast Augmentation, there are several decisions she needs to make. First is selecting a Cosmetic Surgeon with the appropriate qualifications, training and experience. Next is choosing the right size and type of Breast Implant. The main decision regarding Breast Implants has previously been saline vs silicone, however now there are many other options to consider regarding shape and size. Your Cosmetic Surgeon is the best person to work with you to select the Breast Implant that suits your goals, body type and medical history. However, it is always sensible to be an educated consumer, research Breast Augmentation and go to your consultation ready with the questions you need answered. Here is some information to get you started on your research.

Components of a Breast Implant

The main components of a Breast Implant are the shell, the filler and the patch. The shell, also known as the lumen or the envelope, is made of silicone. The filler is the material contained in the shell and may be either saline or silicone. The patch covers where the filler was inserted in the shell.

Silicone Breast Implant - Round

Silicone Breast Implant – Round

Saline vs Silicone Breast Implants

Saline is sterile saltwater solution similar to the fluid that is naturally present in the body. Saline implants are generally known for being filled during surgery. This means the initial incision can be smaller, and some implants even allow for the volume to be adjusted after surgery through a valve in the implant. In other cases, saline implants come pre-filled at a given size from the manufacturer.

Criticism of saline Breast Implants includes the unnatural feel like a ‘bag of water’ and in some instances the ‘sloshing’ noise once it becomes a part of the body.

Silicone is an organic polymer that has a variety of medical uses including as Breast Implants. Silicone Breast Implants have become increasingly popular due to their resemblance in feel to natural breast tissue. The newer generations of silicone Breast Implants contain silicone that is designed to retain its integrity if the shell ruptures, therefore having less risk of spilling into surrounding tissue.

Polyurethane Breast Implants are also Silicone Implants except they have an outer “furry” coating made of polyurethane which helps with reducing capsular contractures.

Shape

Breast Implants vary in their size, shape and profile. Your Cosmetic Surgeon will discuss with you your goals and expectations, take measurements of your chest and bust, and make recommendations as to what type of Breast Implant will best meet your needs. For women with a smaller frame, Breast Implants with a narrower base may be most appropriate, as opposed to a wider base implant that would be appropriate for a woman with a wider chest. The profile of a Breast Implant impacts on projection and overall shape. You may also have heard of anatomical or teardrop shaped Breast Implants – these are designed to have more volume in the lower portion of the breast like a natural breast. Whilst a textured outside surface is designed to keep an anatomical implant in the right position, they often rotate and then require corrective surgery. Round implants are as they sound, with the same appearance from any angle even if their position changes. However; round Breast Implants can have a tear drop shape if placed under the muscle.

This is just some brief information about Breast Implants. For more thorough information, see our website at www.bareaesthetics.com.au or contact us to make a consultation on 1300 676 003 or 0430 491 009.

Dr. Bobby A Kumar is an experienced Cosmetic Surgeon who is experienced in performing Breast Augmentations or Breast Enlargement surgery.

Breast Augmentation by Dr. Bobby A Kumar Cosmetic Surgeon

Breast Augmentation by Dr. Bobby A Kumar Cosmetic Surgeon


Written by Dr. Bobby Arun Kumar on Monday the 4th of April, 2011. Currently No Comments »

Read related subjects to this article from Bare Aesthetics on breast augmentation or breast augmentation adelaide or breast augmentation sydney or Breast Enlargement or Breast implant or breast lift or Breast Reduction or Cosmetic Surgery.


Breast Augmentation or Breast Enlargement is the most frequently performed Cosmetic surgery on women in Australia and the U.S. today. Over 300,000 women undergo breast augmentation every year, with the popularity of the procedure ever increasing, especially amongst female body builders.

Breast implants are most commonly used as an aesthetic enhancement in an individual who is lacking in natural breast tissue due to genetically predisposition or environmentally induced factors. Because breast tissue is primarily composed of fat cells, physicians in the past have attempted to inject fat (obtained through liposuction) into the breast. However, today, this is completely unacceptable due to calcification (complete hardening of the breast). Hormonal therapy may increase the natural breast size, slightly, but not enough for the majority of women.

Currently, the most common procedure to increase breast size is via breast implants. A breast implant is a sac of silicone elastomer that is either filled with saline or silicone, and is surgically implanted under the breast tissue. The proportion of the breast to body height and weight is taken into consideration, as is the chest width, location of nipple/areola complex, and cleavage. Because the concepts of aesthetics are constantly changing, there are many factors such as implant type, size, and site that should be tailored to the individuals’ specificity.

TYPE OF BREAST IMPLANT (Saline,Silicone or “Furry Brazilian”):
Silicone vs. saline? This discussion is going to remain for many years. The advantage of silicone implants is that it is softer and appears more natural. However, leaks may be found in secondary tissue. Generally, saline is a bit firmer, but it is without the supposed health risks because a leak is simply absorbed by the body. There has recently been the use of another type of Silicone Implant known as the “Furry Brazilian” or Polyurethane Implant. These Breast Implants are specifically designed for a small group of women. The decision should be made after consultation with an experienced Cosmetic surgeon.

LOCATION OF BREAST IMPLANT:
The breast implant can be placed either under the pectoralis major muscle (sub muscular) or on top of the muscle and under the breast glands (sub glandular). Sub muscular implants are more popular because they are less palpable, have lower risk of capsular contracture, and do not inhibit mammography. However, it requires more invasive surgery and longer healing time. Bodybuilders prefer sub-glandular insertion because the heavily developed pectoralis muscle might flatten the implant and there will be less projection of the breast. Women with sagging or drooping breasts may opt for a sub glandular placement to utilise the increased projection. Disadvantages of sub glandular implants include impairment of adequate mammography and an increased risk of capsular contraction.

Subglandular or Subpectoral

Subglandular or Subpectoral

LOCATION OF INCISIONS:
There are four areas of incision:

1. Periareolar (lower part of areola 1-1/2 inches)

2. Inframammary (on the lower breast crease)

3. Axillary (armpits)

4. Transumbilical (from the bellybutton)

Each has advantages and disadvantages but the preferred incision is Inframammary because it is less noticeable. Arguments against the other approaches are that they are harder to perform; there is decreased sensation of the areola and violation of the breast tissue when approached via the Periareolar technique, there is increased risk of rupture, Infection and Capsular contracture with these other techniques.

SHAPE OF THE BREAST IMPLANT:
Most surgeons have experience with teardrop (natural implants) and with the round implants. Preference is toward the round implant because it appears more natural. Previously, there were high profile implants (which projected more) and low profile implants (less projection). Recently, medium profile implants were introduced.

HOW LONG DO BREAST IMPLANTS LAST:
There is no expiration date for implants. You should be checked by your Cosmetic Surgeon if there are any symptoms or changes that are not expected including deflation, infection, change of location, etc. Mammography, ultrasound, or MRI should be performed if any of these symptoms or signs occurs. Patients over the age of 50 years of age should have their standard Breast checks. Typically many women will consider replacing their Implants or having revisional surgery for breast changes that have occurred by 10-12 years; such as breast droop or a change in Implant size.

RISKS (not common but possible):
1. Capsular contraction: Scar tissue forms around the implant to form a hard shell. There are several steps to prevent it, such as, size and location of the implant.

2.Infection.

3. Shifting (moving) of the implant. The pocket for the implant should be adjusted for the patient (this will usually, prevent shifting).

4. Scars: Less conspicuous in the Inframammary incision.

5. Sensation: May be initially decreased. Usually 90% of sensation will return within 1-2 years of surgery.

6. Breast Feeding: About 50% of women won’t be able to successfully breast feed, particularly those with Periareolar incision.

7. Synmastia (also known as “kissing breast”), sometimes related to technique.

Synmastia or Uni boob

Synmastia or "Uni boob"

In general complications occur less when using an experienced and certified Cosmetic surgeon.

RESULTS:
Cosmetic Surgery is an art form in combination with science. Each patient and surgeon has a different sense of what is aesthetically pleasing (although the basics are common). During a consultation with a Cosmetic Surgeon, the goals of both the patient and surgeon should coincide and be realistic. The results are not entirely dependent on the surgeon. It is important to understand that everybody starts with differing anatomical breasts (some patients are better candidates than others) and there are always unforeseen factors.

Dr. Bobby A Kumar is a board certified cosmetic surgeon and he specialises in Breast Augmentation surgery. He has used all types of Breast Implants and is skilled in choosing the appropriate Implant to provide the optimal and aesthetically pleasing result for each patient and therefore does not prescribe to the “one size fits all” approach.

Bare Aesthetic Cosmetic Surgery Clinics are located in Sydney,Port Macquarie and Adelaide. For an appointment today contact our friendly practice manager Wendy on (02) 9571 4850 or 0430 491 009.

Bare Aesthetics Cosmetic Surgery Clinics

Bare Aesthetics Cosmetic Surgery Clinics


Written by Dr. Bobby Arun Kumar on Friday the 4th of March, 2011. Currently No Comments »

Read related subjects to this article from Bare Aesthetics on Antiwrinkle Injections or breast augmentation or breast augmentation adelaide or breast augmentation sydney or Breast Enlargement or Breast implant or breast lift or Breast Reduction or Cosmetic Surgery.


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