Tummy Tuck is surgically known as Abdominoplasty surgery. The surgery is performed for Cosmetic and legitimate medical and surgical reasons. In Sydney and Adelaide patients can claim part of the procedure on Medicare and their private health insurance. Women following child birth and if they have had a caesarian section can be left with an overhanging lower abdomen. These patients decide to have Tummy Tuck surgery to address the hanging “Pannus” of redundant skin and soft tissues.This is the case for those patients that have succeeded in losing a significant amount of weight. Consequently these patients are left with a large redundant apron of skin and subcutaneous fat and tissues which in themselves are a problem; causing skin fungal infections, aesthetically undesirable lower torso and the patient is left with having to hide the redundant mound in clothing.

Who makes the best candidate for a Tummy Tuck?

Tummy Tuck or abdominoplasty surgery is becoming a popular form of Cosmetic Surgery for men and women. It is considered by patients for a variety of reasons. The most obvious reasons are that patients have a significant redundancy of skin and tissues of the upper and lower abdomen.

The cosmetic considerations are based on patients who may have had previous surgery and or delivered babies via caesarian section and they are left with a flap or “Pannus” of skin and tissues which typically overhang their clothing. These patients often find it unsightly and difficult to find the right clothing to hide the overhanging skin and tissues. They are also reluctant to go to the beach during summertime for fear of embarrassment when wearing a bathing suit.

Some patients may have had a primary abdominal surgery which has left them with an “ugly” scar and a mound of redundant skin and tissues. Often the surgical consideration here is not only scar revision but also an abdominoplasty to refine their abdominal shape and contours.

There are those patients who have been successful in losing a tremendous amount of fat and therefore weight. These patients unfortunately find that despite their heroic weight loss their skin and residual tissues do not retract sufficiently, and so they are left with a large amount of lose hanging skin and subcutaneous tissues.

These patients find that the hanging tissues create many problems such as bacterial and fungal infections as well as discomfort due to rubbing as they continue to exercise to maintain their weight loss. It is for these reasons that massive weight loss patients seek not only a Tummy tuck, they often need to consider a total body lift.

General Cosmetic Surgical overview of Tummy Tuck Surgery

In general a Tummy Tuck will require some Liposuction and or Liposculpture to remove fatty tissues around the flanks so that tailoring the tissues and skin will produce an aesthetic result as opposed to removal by excision of skin and fatty tissues alone. Often many patients will require tightening of their abdominal muscles above and or below the umbilicus (belly button). The effect of tightening the rectus muscle is to repair the separation and weakening of the muscle with weight gain and subsequent weight loss. The tightening procedure will also produce greater definition of the underlying musculature; often referred to as the “six pack”.

Patients requiring a tummy tuck and tightening of their muscle bed may require a relocation of their umbilicus. When the abdominal flap is pulled and the redundancy of skin and fatty tissues are removed, the umbilicus becomes stretched or often displaced to a point too low on the abdomen that the final result is unappealing and unusual.

A total Body lift involves a Tummy Tuck and what is known as a Reverse Tummy Tuck, which means removing skin and tissues of the upper abdomen just below the breasts and the lower abdomen in the traditional fashion for a tummy tuck; as well as a Breast reduction, thigh lift and an arm lift.

Body lifting procedures are often performed in stages as it would be surgically and medically unsafe to perform as a single stage surgical procedure. Most patients will have an inpatient hospital stay following large procedures. Despite the likelihood of obvious scars, most patients who decide to consider body lifting procedures do so with the knowledge that whilst they will have scars, they will however, have a better body shape especially in clothing.

Tummy Tuck surgery should not be considered to be a form of weight loss surgery. Most Cosmetic Plastic surgeons discourage utilising an abdominoplasty in an attempt to facilitate a patient’s weight loss. Patients will need to be sufficiently motivated to lose weight prior to considering any surgery. When seeing their Cosmetic Surgeon they will need to have reached a stable weight loss to be a candidate for consideration of a Tummy Tuck procedure. Often the motivated patient will go on to continue to lose more weight after the Tummy Tuck and this will help with the overall success of the surgery and appearance of the patient.

Potential Complications for Tummy Tuck Cosmetic Surgery

Fortunately with great surgical care and selection of appropriate patients for a Tummy tuck complications are uncommon and if they occur tend to be minor and easily resolved.

Like any surgical procedure complications are always a potential risk and occurrence. Bleeding, Haematomas and Seromas can occur as the tissues are highly vascular. Male patients and smokers tend to have a slightly higher frequency or potential for this type of complication. Drains may be used to gauge bleeding and genera drainage from the wound in the acute phase of the post operative period. However; if the bleeding is significant the patient may need to be returned to the operating theatre to investigate bleeding vessels and to stop excessive bleeding or ooze.

Other complications include wound breakdown and skin and tissue loss. This can occur due to excessive tension of the tissues and vascular compromise to the abdominal flap. Infections postoperatively whilst uncommon as the patient is adequately covered by pre and postoperative antibiotics can still occur due the resistant nature of some bacterial organisms. Skin sensation can be diminished; tissues may be injured due to the lack of pain sensation. Scars are the measure of success of any operation; some patients do scar poorly and as such scar revision may be required.

Postoperative recovery following Tummy Tuck Cosmetic Surgery

Patients will be required to wear a compression garment, in my practice this maybe up to 3 months or more. The garment applies a compressive force to the elevated abdominal flap; the garment facilitates adherence of the flap to the abdomen and therefore healing of the tissues. The garment is required to be worn initially continuously for 24hours per day, and only removed for showers and to wash the garment. Patients will be restricted from carrying out some of their usual activities such as sporting activities and various work commitments. The cosmetic surgeon will discuss your postoperative care and management as the overall final result and success of a tummy tuck will be dependent on wearing the garment and care of the abdominal tissues.

As previously described, complications are low and ensuring that the patient is an appropriate candidate for a Tummy Tuck procedure will ensure success of the operation and realistic expectations of both patient and Cosmetic Surgeon.

For an experienced and skilled Cosmetic Surgeon visit www.bareaesthetics.com.au. Dr. Bobby Kumar performs Tummy Tuck surgery in Sydney and Adelaide,offering a rejuvenated body and youthful definition of your waist. For an appointment today contact us on (02) 9571 4850 or 0430 491 009.

The Top Cosmetic Surgery procedures for Men

Typically cosmetic surgery is normally associated with women having procedures such as Breast Augmentation, breast reductions and liposuction. If we discuss men having cosmetic surgery we normally think about well known male actors and celebrities such as Sylvester Stallone, Michael Jackson and Mickey Rourke. These men are not great examples of natural and aesthetic cosmetic surgery results. However; men do have great Cosmetic surgery results it is just that we hear about the extreme and ridiculous results performed on the infamous celebrities.

Statistics released in March 2011 by the American Society of Plastic Surgeons (ASPS) demonstrate that many more men are now becoming more conscious about their appearances and maintaining their appearances that they are now considering some form of Cosmetic surgery. The statistics revealed that the overall increase in cosmetic procedures in men increased by 2% in 2010 when compared to the previous year. Some procedures in particular like Facelift surgery rose by 14% and Liposuction increased by 7% in 2010.

The ASPS statistics for 2010 show that men underwent an increased number of Surgical and minimally invasive procedures; the increase in surgical procedures grew faster than the traditional minimally invasive treatments.

The increase in men having cosmetic surgery may be related to a number of factors; such as an increase in the general fashion and cosmetic industry and therefore an increase in the participation of men in requiring cosmeceuticals and that their requirements do not seem to be unusual or the domain of women. Also with the changes in workplace perceptions and socially men may feel the need to have a rejuvenated and youthful appearance as well as being fit and healthy. Men and women have shifted the age for when they are choosing to have children. As such men may feel that they are now ready, mature and financially capable enough to make the decision to have Cosmetic plastic Surgery.

Interestingly once the minimally invasive procedures such as Botox® or dermal fillers were popular with men. It is apparent that as men age, so do the tissues and the addition of gravity means that the tissues sag. Consequently a much more comprehensive surgical procedure is required and is necessary to lift and rejuvenate the body to show any significant improvement.

Top Ten Cosmetic Procedures for Men (as an increase in percentage)

The list comprises the fastest growing cosmetic procedures between 2009 and 2010.

1. Facelift – 14% increase

2. Otoplasty (Ear Surgery) – 11% increase

3. Dermal Fillers – 10% increase

4. Botox® – 9% increase

5. Liposuction – 7% increase

6. Male breast reduction (Gynaecomastia) – 6% increase

7. Eyelid surgery (Blepharoplasty) – 4% increase

8. Dermabrasion – 4% increase

9. Laser hair removal -4% increase

10. Laser vein treatment – 4% increase

Top Ten Cosmetic Procedures for Men in 2010 (By Volume)

The top 5 Cosmetic Surgical Procedures (Invasive)

1) Rhinoplasty (Nose surgery) - 64,000
2) Eyelid Surgery (Blepharoplasty) – 31,000
3) Liposuction/Liposculpture – 24,000
4) Male Breast Reduction (Gynaecomastia surgery) – 18,000
5) Hair Transplantation – 13,000

The Top Five Cosmetic Minimally-Invasive Procedures

1) Botox ® – 337,000
2) Laser Hair Removal – 165,000
3) Microdermabrasion – 158,000
4) Chemical Peel – 90,000
5) Dermal Fillers – 78,000

The majority of cosmetic surgery clinics show that whilst there are high profile men having cosmetic surgery, clearly many more men are “average” males who are looking to improve their looks and therefore to look as good as they feel. Many of these men are normally seen as tough male role models such as firemen, plumbers and bricklayers.

There are the men who are still quite physically active, perhaps approaching retirement who still wish to have a rejuvenated appearance to go along with their active lifestyle. It is not unusual in my practice to perform a combined Facelift, neck lift as well as an eyelid lift for mature men seeking to reverse the effects of the sun, genetic aging and gravity and to create a rejuvenated face and neck.

After having performed the cosmetic surgery procedure, it is not uncommon to observe a new invigorated male patient. The procedure itself appears to have provided a greater sense of self confidence; male breast reduction is such an example. Many males with large breasts commonly known as “man boobs” are often reluctant to go to the beach or engage in any social activity where they need to remove their shirt.

Following male breast reduction surgery most patients are motivated to join gyms to improve their general health, wellbeing and fitness levels. They have an increased desire to lose weight and build muscle to match their improved chest/breast area.

Many of these men have very supporting partners often of similar age, which is contrary to the popular perception that these are men with much younger partners. In my practice many of these women will not have had any cosmetic procedures or surgery, and so this has not been a natural or expected transition for their male partner to consider cosmetic surgery. It is a choice that these men make to help them maintain a rejuvenated, natural and aesthetically pleasing appearance for themselves and sometimes for their partners as well.

If you are looking for an experienced and skilled Cosmetic Surgeon who performs male cosmetic surgery procedures and non-invasive procedures such as Botox® and dermal fillers then contact Dr. Bobby Kumar today on (02) 9571 4850 or 0430 491 009 for an appointment at the Bareaesthetics Cosmetic Surgery clinics (Sydney,Port Macquarie or Adelaide).

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.

Actual Tummy Tuck Patient

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 board 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

Breast Lift with Breast Implants

A woman’s breasts often define her femininity, and with the vast differences in shape, size, and appearance, breasts further help to define a woman’s individualism. The breasts undergo changes in response to factors such as genetics, aging, pregnancy and breast feeding, weight gain or loss, and hormonal fluctuations. All of these factors can cause the breast size and shape to change. These changes can be dissatisfying and can make women feel as if they are losing some of their femininity and youthful vitality.

Breast augmentation alone cannot restore the shape of the breasts for those women who have significantly “droopy” breasts. For those women who would like to have a breast enlargement to increase the size of their breasts as well as restore a firm, more upright position, a breast augmentation in combination with a breast lift can improve body contours and revitalize their appearance.

Incisions for the breast lift and breast augmentation are typically around the Nipple, or the Nipple and down the vertical part of the lower breast.

Mastopexy augmentation, or a breast lift augmentation, tightens the breast skin, lifts the nipple to a better height and increases the size for better upper chest fullness. My preference is a partial sub pectoral implant plane so the recovery from this surgery is a bit lengthier than just a breast lift. Most patients are able to return to work after two weeks and to the gym after 6-8 weeks.

Breast Lift and Breast Enlargement

Breast Lift/ Mastopexy Surgery (No Breast Implants)

Many patients complain to me about the droopiness of their breasts. Some are happy with the overall volume or size of their breasts, but feel they tend to wrinkle and fold in a bra. Mastopexy, or breast lift surgery, can reduce the skin excess and lift the saggy nipple to a more acceptable level. No breast implant is necessary if a patient is happy with her overall size. The surgery takes about 2-3 hours to perform and the recovery is about one week off from work.

Breast Reduction Surgery

Many women complain of back, shoulder and neck discomfort due to the large size of their breasts. Most Medical Insurance companies will cover some if not most of the cost of breast reduction surgery. I use my judgment along with the patient’s request to come up with the most proportional breast size.

Reduction mammaplasty can improve the shape and size of the breasts allowing one to wear lighter bras and camisoles. I prefer the Hall Findlay modification of a vertical scar breast reduction as I feel it gives the best projection and shape of the breast. Standard anchor reduction mammaplasty procedures result in flattening (“bottoming out”) and widening of the breast with time. I have found the vertical breast reduction retains a better shape over the years.

The surgery takes me about 3 hours to perform under general anesthesia. I usually combine some liposuction of the lateral chest to reduce the width of the breasts as well. The recovery is about one to 2 weeks off from work and 6-8 weeks away from the gym. The size change is apparent immediately; however postoperative swelling can take 6-8 weeks to settle after which patients can shop for a bra appropriate to their new breast size.

Breast Reduction Hall Findlay Vertical Reduction Technique

Male Breast Reduction/ Gynaecomastia Surgery

Some boys and men are bothered by excess fat and breast tissue known as Gynaecomastia. They are frequently very self conscious and will not take off their shirts at the beach. A solution is male breast reduction surgery, or subcutaneous mastectomy, a procedure that removes extra breast tissue and fat to give a more sculpted look to the male chest.

There are several techniques used such as liposuction alone, direct areolar tissue reduction surgery with a short peri areolar scar (Scar around the Nipple only), and full breast reduction surgery with scars around the nipple and along the chest (for very droopy breasts such as those in massive weight loss patients).

The full result is usually seen in a few weeks however scars take 6-12 months to completely mature and fade with time.

Male Breast Reduction Surgery (Gynaecomastia)

Cosmetic Surgeon Dr. Bobby Kumar performs all of these procedures. For a Consultation today in Sydney, Adelaide or Port Macquarie Contact us on (02) 9571 4850 or 0430 491 009. Otherwise visit www.bareaesthetics.com.au for more details.

Bare Aesthetic Cosmetic Surgery Clinics in Sydney, Adelaide and Port Macquarie

A person’s body has become such a talked about and noticed thing. One cannot look in the mirror without thinking of something wrong with their body. Those patients considering Augmentation, enhancement, rejuvenation or correction of their body there is Cosmetic Surgery.

Cosmetic Surgery offers the ability to produce aesthetic and natural results; however, patients need to have realistic goals and expectations and to remember that it  is “Real Surgery” and by being Cosmetic Surgery in no way diminishes the seriousness of the surgery, its outcomes and potential complications.

Several Cosmetic Surgery procedures are included in the “body contouring” procedures list. These include such procedures as Liposuction or Liposculpture, Tummy Tuck or Abdominoplasty, Arm Lift or Brachioplasty, Thigh Lift, Calf and Pectoral Augmentation, and Male Breast Reduction or Male Gynaecomastia Surgery.

Also known as suction lipectomy, liposuction will slim, sculpture and reshape specific areas of a person’s body by removing extra fat deposits. This will improve both the contours and proportion of the body. Ultimately, this Cosmetic Surgery procedure will enhance the self-image of any patient.

Tummy tuck surgery often referred to as Abdominoplasty will remove the excess fat like liposuction, but will also remove the excess skin. In most cases this procedure will restore separated or weakened muscles and will create an abdominal profile that is both firmer and smoother than before. After a person has lost a large amount of weight, they will likely need what many people call a “full body lift.” This surgery, or set of procedures will improve the tone and shape of a person’s underlying tissues that support skin and fat. A full body lift will also remove extra fat and skin.

Tummy Tuck

Liposuction and Abdominoplasty surgery is not meant to replace a healthy diet and exercise when attempting to lose weight or have a healthy weight. Typically most patients seeking this form of Cosmetic Surgery have tried everything and may have redundant fat, skin or both and they are finding it difficult to lose the redundant pockets of fat and tighten the excess skin.

Cosmetic Arm surgery is referred to by many names. Arm tuck, Brachioplasty, and Arm Lift and “Tuck shop Arm surgery” are the most common. The surgery is designed to remove flabby, redundant, and sagging skin folds in a person’s upper arms. Hanging arm skin folds are not just unsightly, but also will interfere with one’s ability to fit into a sleeved top. It will also cause underarm skin rash and irritation.

Arm Lift

Patients seeking Arm Lift surgery realise that they will have a long scar often from the armpit to the elbow on the inside of their arm. The scar will fade and be a fine line; despite this patients seeking this Surgery do so to improve the functional and aesthetic appearance of their arms.

A Thigh Lift procedure will reshape the thighs by reducing the excess skin, and in some cases fat. This will result in smoother skin and a better-proportioned contour of the lower body and thighs. There are various cosmetic surgery procedures that are available to those who would like to have fuller, perky, youthful buttocks with a more sensual body profile. The procedure for augmentation and enhancement of the buttock specifically varies depending on what is the actual deficiency and what is missing.

Calf augmentation is a Cosmetic Surgery procedure that is designed to enhance the appearance of one’s calves. It is also capable of enlarging the size of one’s calves as well as making them appear more proportionate in shape and size to the rest of the lower extremity of the body. In this procedure, calf implants of various contours, shapes, and sizes will be inserted over the existing calf muscles. This will achieve a fuller and better shape and contour to one’s calves.

Pectoral augmentation, often just called “Pec” implant surgery, is a procedure that is designed to add fullness, shape, and size to a male’s chest. The procedure involves inserting an implant into a space created under the pectoral muscles in a similar fashion to performing an Axillary approach Breast Augmentation or Breast Enlargement in females.

Pectoral Implants

Male Breast Reduction may be one of the most beneficial body contouring procedures. Gynaecomastia (female-like breasts in men) is a common problem that may affect only one or both breasts. There is no known cause in most cases. Surgery is the only known physical remedy for the problem. In the case of obesity, weight loss can alter the condition, but for many, it will not eliminate it.

Male Breast Reduction

For more details and a consultation with our experienced Cosmetic Surgeon Dr. Bobby A. Kumar MB,BS(UNSW)  BSc(UNSW) FACCS, call today for all appointments in Sydney, Port Macquarie and Adelaide on           (02) 9571 4850 or 0430 491 009. Alternatively visit www.bareaesthetics.com.au

Breast Augmentation

Cosmetic surgery packaged style overseas holidays are popular at this time of year, often because of the misconception that they are cheap and safe. There are the occasional stories of patients having had a reasonable result from Breast Augmentation overseas.

However, as an experienced Cosmetic Surgeon it is not unusual to have to deal with the multitude of mishaps and poor results from overseas surgeries.

As Breast Augmentation is one of the most popular Cosmetic Surgeries performed in Adelaide and Sydney . It is not surprising to find patients that have sought an overseas opinions. Often the advising person responding to the their email request for Breast Augmentation surgery will recommend additional and unnecessary unrelated cosmetic surgery procedures such as a Tummy Tuck or Liposuction.

Patients ultimately pay more for these unexpected procedures, and with additional surgeries there are associated additional surgical risks and complications.

Breast Augmentation results should be natural and suit the patient’s anatomy, body shape and size, chest and breast dimensions. Typically this is determined during an appropriate consultation with your Cosmetic Surgeon; Not over the Internet with an unknown person in another country. Patients have no ability to check the credentials of the person performing the operation,and  least of all how many of the procedures they have performed; their complication rates and how they will deal with complications.

Natural and Aesthetic Breast Augmentation

Beautiful Breast Augmentation

The complications that I as a Cosmetic Surgeon encounter with overseas performed Breast Enlargement surgery are;

Significant numbers of Capsular Contracture rates: Capsular contracture is the scar tissue that naturally forms around any Breast Implant. The scar becomes thick and contracts causing the Implant and breast to become deformed, painful and requiring further corrective surgery. Further surgery incurs greater cost and morbidity for these patients.

Capsular contracture is as a result of any process that causes increased inflammatory activity of the scar tissue. This is usually as a result of post-operative bleeding and intra-operative trauma of the tissues, poor sterility control of the procedure and handling of the Breast Implant, and often use of the wrong type of Implant or as in several cases a product not intended as a Breast Implant.

Before & After Image of Capsular Contracture

Deformed breasts by Capsular Contracture

Capsular Thickening

Capsular Contracture

Infections: This complication is not uncommon with patients having any form of surgery overseas, not withstanding Breast Enlargement surgery. The problem stems from inadequate sterility and handling of the Breast Implant which should be sterile as should the dissected breast pocket be at the time of Breast Augmentation surgery.

Infected Breast Implant

Defects and Abnormally Shaped Breasts after “holiday” Breast Augmentation Surgery:

Complications of this type occur because the breast pocket dissected is in the wrong plane, over dissected causing Synmastia (“uniboob”), Breast Implants being placed in two different planes (Subglandular and Subpectoral), excessive release of the pectoral muscle resulting in “window shading”  and rupture of the Breast Implant during Breast Enlargement surgery.

Synmastia

Synmastia - This is a difficult problem to correct

Distorted Breasts

Distorted Breasts after Enlargement

Incorrectly performed Breast Augmentation

Breast Augmentation surgery should be considered significant surgery. In our Adelaide and Sydney rooms we spend a significant amount of time discussing your concerns, your realistic options and what you should expect by having the surgery performed in either Adelaide or Sydney.

A frank and thorough discussion about potential complications is had with all our patients, as well as, their post-operative recovery. Each patient is provided with a step by step guide and every patient has frequent follow up and aftercare.

Unfortunately patients seeking Cosmetic Surgery and in particular Breast Augmentation overseas do not have these services provided to or for them by the often non medical operator of these trips or the person performing the surgery in the country that they have  travelled to for their surgery.

When problems arise from overseas cosmetic surgery trips and they are encountered by me in Adelaide or Sydney there is often no recourse for the patient. That is patients may have to travel back overseas to have corrective surgery if they trust the expertise of those performing this surgery, and patients will find that they are Not covered by Medicare or their Insurance (Private health or travel) company.

It is essential for patients to consider the overwhelming risk to their health and finances of overseas based “Cosmetic Surgery Holidays”. You should consider the training of the person performing the Breast Augmentation surgery, the relevant professional organisations that they belong to (Australasian College of Cosmetic Surgery or the American Academy of Cosmetic Surgery) and their experience with performing a wide range and variety of Breast Augmentations.

Cosmetic Surgeon Dr. Bobby A Kumar is a Fellow and member of the professional institutions listed above.

Contact us for more details on (02) 9571 4850 or 0430 491 009.

Before surgery

As with any surgical procedure, the certified Cosmetic Surgeon will see you for a consultation to evaluate your needs and goals. This includes a physical examination and a thorough review of your medical history and status. In your consultation, your Cosmetic Surgeon will discuss and describe the appropriate technique and plan for you. The amount of skin and fatty tissue requiring removal and underlying muscle weakness can be determined through a physical examination. The Matarasso Classification is used to identify the types of tummy tuck required. The presence of underlying hernias may also be investigated with referral for an ultrasound. An ideal and stable weight is desirable prior to surgery with a history of a healthy diet and regular exercise. Tummy tuck surgery should not be viewed as a weight loss strategy.

During the surgery

Tummy tucks are performed by a certified Cosmetic Surgeon under general anaesthetic. The incision will be made a few inches below the belly button; for women an old caesarian incision can be utilized. Excess skin and fatty tissue between the incision and the belly button is then removed. To produce a tighter appearance, the muscle from each side of the tummy will be pulled and stitched together. Depending on the amount of skin and fatty tissue removed, the belly button may be reshaped and created to fit the newly tightened stomach. The tummy tuck procedure can take between 2 and 4 hours depending on the complexity and extent of the surgery.

After the surgery

Recovery from tummy tuck surgery usually takes up to 6 to 8 weeks. Usually patients take a couple of weeks off work. It is important to rest following surgery. It is also important not to place the incision and stitches under any tension or pressure. The wound and tummy may be painful and tight (often described as if you had just done a thousand sit ups) and cause the patient to bend at the hips to sleep and walk. It may take a couple of weeks for this pain to subside and the patient to feel comfortable standing up straight. Following surgery, a compression garment is to be worn for 6 to 8 weeks (or more) to provide support to the tummy and provide maximum adherence of the skin and underlying tissue; this facilitates a successful result. The incision scars are placed in areas usually covered by underwear. Eventually these scars will lighten.

Typically patients who have had a tummy tuck describe a high degree of satisfaction with their new body shape and tone, giving them increased confidence in their appearance and choosing flattering clothes.

For more information, contact a certified Cosmetic Surgeon.

The most appropriate candidates for Abdominoplasty are men or women who are close to an optimal and stable weight with residual and excess skin and/or tissue that does not respond to diet and exercise. Typically these patients have already lost a significant amount of weight or for women, have had several pregnancies and desire for their tummy area to return to the pre-pregnancy shape.

In your consultation with the certified Cosmetic Surgeon, the surgeon will take a thorough medical history and will usually require you to have a range of blood tests, potentially ruling out underlying reasons for weight gain. You will be advised to reach a stable and appropriate weight prior to surgery. Abdominoplasty should not be seen as a weight loss strategy.

Abdominoplasty surgery involves a general anaesthetic and can typically take between 2 and 4 hours to complete depending on the complexity and extent of the surgery. In preparation for surgery, the Cosmetic Surgeon will mark the abdomen and the estimated skin and tissue to be removed. The initial incision is made across the lower abdomen; for women this incision can incorporate a caesarian scar. The skin and tissue excised and removed is typically between the pubic area and the belly button, with the remaining skin redraped and stretched over the tummy to create an optimal contour. Loose abdominal muscles are tightened through a process of stitching. Finally the incision is closed with sutures.

The recovery period following Abdominoplasty varies between individuals and the complexity and degree of the surgery performed. Patients are usually up and about the day after surgery and able to go home. The feeling following surgery has been likened to having done a thousand sit ups; patients need to rest and take care not to be in a position that puts any strain on the incision site and stitches. Within a few days, it is easier to straighten up. For 6 to 8 weeks following surgery, patients are required to wear a compression garment. This is to be worn to protect and support the incision site and promote adherence of the underlying tissues. Swelling can take up to 3 months to resolve. Straining of the abdominal muscles needs to be avoided; hence patients are required to avoid strenuous activity including lifting and have adequate rest.

As with any surgical procedure, there are risks associated with Abdominoplasty, such as bleeding, infection, blood clots, asymmetry, and loss of skin sensitivity or swelling. These risks and other complications should be discussed thoroughly by the certified Cosmetic Surgeon prior to your surgery.

Patients who have undergone Abdominoplasty surgery typically describe satisfaction with their body shape, contour and body proportion with the benefits of comfort and confidence to wear a range of clothes.

Skin changes with age in the following ways:

• the skin becomes thinner, making it more fragile and vulnerable to damage and irritation from environmental factors
• the skin loses strength and elasticity due to the breakdown of collagen and elastin
• the skin’s ability to hold moisture reduces resulting in skin becoming drier and looser
• the skin loses underlying fat, reducing skin tone and smoothness
• blood vessels decrease, causing a loss in colour and glow
• sebaceous glands are less active, reducing the skin’s natural protective oily layer and making it more dry

How your skin ages is related to your genetics, your repetitive facial movements and gravity. The skins aging process is also caused and exacerbated by a number of environmental factors, including:

• sun and UV radiation exposure
• cigarette smoking
• stress
• poor nutrition
• extreme changes in temperature

Most premature aging is caused by sun exposure, with visible signs including wrinkles, freckles, age spots, spider veins, rough and leathery skin, loose skin and a blotchy complexion. Cigarette smoking causes biochemical changes in the body that accelerate aging, increasing the development of wrinkles, leathery skin and a yellowish complexion. Smokers often have tell-tale signs of their habit written on their face, including increased and deep lines around the mouth.

For women and men wanting to address the visible signs of aging, there are a range of treatments available. These range from short term treatments using products such as Botox ® and dermal fillers, (such as Juvederm® and Restylane®) to more longer lasting results from Cosmetic Surgery such as Facelift, Necklift, Browlift or Blepharoplasty (eyelid surgery).

Botox ® is used to smooth mild to moderate lines and wrinkles, such as glabellar lines (vertical frown lines between the eyebrows that look like the number “11”), crowsfeet (wrinkles around the outer corners of the eyes) or forehead worry lines. Botox ® works by inhibiting the activity of a given muscle by blocking nerve impulses that cause the muscle to contract and create a wrinkle, resulting in a smoother appearance. Optimal results are usually visible within 2 weeks of treatment and last up to 4 months.

The exact number of units of Botox ® required varies from person to person, as well as, being a male or female. It is not unusual for adjustment doses after the 2 week period as there is no exact formula when injecting Botox ®.

Dermal fillers, such as Juvederm® and Restylane®, are also used to reverse the effects of aging by adding volume to specific areas to either eliminate wrinkles or enhance features. Many women and men choose to have Juvederm® and Restylane® to smooth and soften the nasolabial folds, the creases that extend from the edges of the nose to the corners of the mouth. Alternatively, people choose to enhance features, such as their lips or cheek bones. Dermal fillers may also be used under the eye area to address a gaunt appearance due to fat or tissue loss by using thicker forms of Juvederm® and Restylane® . Dermal fillers work by lifting and adding volume to an area, therefore lifting and smoothing lines and wrinkles.

For longer lasting results, many women and men choose a surgical option, such as Face lift, Neck lift, Brow lift and/or Blepharoplasty (eyelid surgery). These Cosmetic Surgery procedures essentially seek to create a more youthful appearance by addressing wrinkles, lines and loose skin and underlying soft tissue.

You can help to prevent the visible signs of aging by avoiding sun and UV damage by always wearing sun protection and wearing a hat, and avoiding cigarette smoking.

Cosmetic Surgery can address these issues. An Abdominoplasty, more commonly referred to as a ‘tummy tuck’, is the surgery that removes excess skin and tissue, restoring the stomach to a flat, smooth and toned shape. A good Cosmetic Surgeon will aim to hide incisions in an area covered by underwear. The extent of an Abdominoplasty depends on the patient; for example, how much excess skin and tissue requires removal or whether the underlying muscle also needs tightening. These issues are discussed in a consultation with the Cosmetic Surgeon. A Tummy Tuck should not be perceived as an option to achieve weight loss.

Liposuction is surgery that can literally suck fat away. This should never be seen as a way to lose weight. In actual fact, a good Cosmetic Surgeon will advise you to achieve your optimal weight prior to having surgery. Liposuction can address those stubborn areas of fat that aren’t resolved through diet and exercise. Again incision sites are usually hidden by the Cosmetic Surgeon.

Following Abdominoplasty or Liposuction, the patient needs to wear a compression garment for a minimum of 6 to 8 weeks. This is really important to make sure you achieve the optimal results from your surgery, allowing the skin and underlying tissues to shrink to the new shape. Depending on the individual, the Cosmetic Surgeon may recommend continued use of the garment beyond 8 weeks, for example 4-6 hours a day for another couple of months.

Men and women who have had a Tummy Tuck or Liposuction typically describe the area affected as feeling tight after surgery. A woman who had an Abdominoplasty described the feeling post surgery as if she had done 1000 sit ups, however did not require more than a simple pain relief tablet such as paracetamol or digesic.

Often Liposuction is a part of Tummy Tuck surgery, giving the Cosmetic Surgeon the ability to refine and shape the abdomen and flanks to achieve a toned and shapely result.