Melbourne Plastic Surgery Blog

Melbourne Plastic Surgery Blog

How To Ensure Your Plastic Surgery Is Safe

Monday, October 02, 2017

This blog post was originally published on the American Society of Plastic Surgeons website.  Some content has been changed to reflect equivalent certifying bodies in Australia.

Not all physicians are created equally: this is an essential consideration when looking for a plastic surgeon in Melbourne, or any other location for that matter. How do you choose a plastic surgeon? Ensuring safety throughout your plastic surgery journey is just as important as the procedure you want and the desired result. To ensure a safe surgery with an expert in the field, we have outlined a 10-point checklist below to help you in selecting a plastic surgeon, what to ask, and qualities for which to look.

  • Your prospective surgeon should be certified by the appropriate specialty group for the procedure you are contemplating. With a multitude of medical practices throughout the country, you can immediately narrow your search down to doctors who are certified by the Royal Australasian College of Surgeons (RACS), this means they are a fellow of the College and will have FRACS after their name. In addition, the peak body in Australia for Specialist Plastic Surgeons (both reconstructive and cosmetic) is ASPS - check online that your surgeon is a member of ASPS. Do you want an occasional plastic surgeon or someone who has gone the extra mile to attain and maintain credentialing? RACS has a rigorous qualification, examination, and recertification process that ensures your plastic surgeon is qualified and an expert in their field.
  • Find references you can trust. Ask people you trust, i.e. your GP, friends, and people you know in healthcare to give you recommendations on plastic surgeons they may know or of whom they have heard. Also, reach out to people you know who have had plastic surgery, ask about their experience, and if they are happy with the results. Lastly, go online: review sites can be great places to see what people are talking about with a plastic surgeon. Remember, though, online reviews are not vetted so they might not be as authentic as they appear. A good guide for truth vs fiction is a rating site that has as many good and some not so good ratings. This is more realistic and truthful than someone who has a thousand great ratings and no negative ones. That is a red flag for fake reviews.
  • Examine your prospective surgeon's website. First look at the biography section of the plastic surgeon, this will give you information about their experience as well as certification. If there is no biography listed, ask yourself why. A great plastic surgeon will have nothing to hide. A well-organised website, with great design, and detailed information can tell you a lot about a prospective surgeon. Remember, also, that everyone can be famous on their own website, so, when referencing credentials, make sure also to research what each certification means, how is it obtained, how is it maintained, and what qualifications one must have to get that certification.
  • Verify that your prospective surgeon has hospital privileges. "Hospital privileges" refers to the right of a surgeon to use the equipment and facilities at a given hospital. Even though you might have your procedure at a Day Hospital rather than an overnight hospital, hospital privileges indicate that your surgeon has been vetted by their peers and by a hospital committee. It should be a red flag if your prospective plastic surgeon does not have hospital operating privileges.
  • Enquire about your surgeon's specific experience. You have the right to make sure the surgeon is right for you, possessing the experience and expertise they claim. A qualified plastic surgeon will be more than happy to explain his experience and expertise. If not, that should be a red flag. Make sure to ask if the procedure you are seeking is something they do at least once a week and is it in their top three procedures performed.
  • Ask your prospective surgeon to clarify all potential benefits, risks, and complications. If your prospective surgeon answers questions with "everything will be fine," or "you will not feel a thing," this should be a red flag that your surgeon is not being honest with you. Plastic surgery, as relatively safe as it is, can have complications and each patient's medical history can present different risks. Your plastic surgeon should be readily forthcoming with information about risks and potential complications.
  • When it comes time for surgery, if you don’t have to stay overnight, it should be performed in an accredited Day Hospital. Accredited Day Hospitals are subject to internal and external inspection by credentialing agencies, thus must maintain a facility that operates in such a manner. This type of facility will also have the emergency equipment and training necessary to respond to an emergency if the need arises. Check your Day Hospital is licensed and accredited.
  • A great surgeon will employ a carefully selected and certified anaesthetist. The person administering your anaesthesia is pivotal to ensuring a relaxing and comfortable procedure. A reputable plastic surgeon will only engage anaesthetists that deliver the same quality of care that they deliver.
  • Discuss your recovery period with your prospective surgeon. Understanding the recovery process and what to expect especially in the first 24-48 hours is crucial to maintaining safety. Every surgical recovery is unique, and your surgeon should explain in detail what to expect and how to get in touch with his or her staff if necessary.
  • Get additional opinions from appropriate professionals, if needed or desired. Remember: This is your body, and you are the boss. Choosing a plastic surgeon is a very personal decision. Selecting a plastic surgeon is an interview process, and sometimes 2 or 3 consultations with different surgeons are necessary to find one that meets your criteria and makes you feel comfortable.

Ultimately when deciding on a RACS qualified plastic surgeon, you must find someone who has experience, who is an expert in the desired field, and who can show you proof of exceptional results. Deciding to undergo surgery to alter your appearance is a big decision and should not be taken lightly. As an educated consumer, you must do your part to determine what you want, do your homework, and seek expert consultation. By following the above steps, you can rest assured that you are making a well-informed decision.


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Preparing for a facelift

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Deciding to undergo facelift surgery is a big decision, one requiring careful consideration after consultation with a Specialist Plastic Surgeon.

Referred to as “rhytidectomy” a facelift is designed to smoothen loose skin and wrinkles on the face and neck, tighten underlying tissues which have become lax with age, and gets rid of fatty facial issue. As a result a patient undergoing facelift surgery can expect the face to appear firmer and more youthful.

Choosing the right Specialist Plastic Surgeon for your facelift is important and you should ensure that you are comfortable with the specialist chosen, have checked their credentials, feel satisfied with their level of expertise in performing facial surgery and that, after consultation, you both have realistic expectations on what can be achieved.

Choosing the right surgeon aside, preparing for your surgery, and post-surgical care are both important factors to ensure you do everything you can to get the best outcome.

Patients who elect to undergo face lift surgery at Brighton Plastic Surgery are given a comprehensive list of pre and post-surgical instructions. This post aims to summarise some of this information, providing an overview of what you should expect when undergoing this type of plastic surgery.

Two Weeks Before Your Face Lift Surgery

Two weeks before your scheduled surgery you should expect to meet with your Specialist Plastic Surgeon for a final consultation. Any administrative matters are generally tended to at this point and you will be given detailed instructions on pre and post-operative care.

You should cease smoking at least 2 weeks prior to undergoing facelift surgery. Smoking is known to impede the healing process. If continued, blood flow, which carries all the healing properties to your wounds is significantly reduced and will cause delays in your recovery or could cause wound breakdown. Better still why not use your upcoming surgery as a catalyst to stop smoking all together!?

Aspirin and other medications known for their blood thinning properties should be avoided at this point.  Other medications to cease 2 weeks prior to surgery include anti-inflammatory drugs, vitamins or herbal/complementary medicines.

It is critical that you discuss any medications you take with your Surgeon at both your initial Consultation, and when you meet with them 2 weeks before your procedure.  They will advise what you need to stop taking and what you may need to start taking. To ensure a successful surgical outcome it is important that you follow your surgeon’s directions without deviation.

48 Hours Before Facelift Surgery

You should refrain from drinking alcohol 48 hours before your facelift procedure.  Alcohol will dehydrate you and prolong your recovery period. You should follow any additional instructions provided to you by your Surgeon at this time including taking any additional medications required.

The Day of Your Face Lift Surgery

Have a good shower and thoroughly wash your hair on the morning of surgery. Do not put any hair products in your hair, including hairspray.

Bring comfortable loose clothing with you on the day of your surgery. Tops should be buttoned or zipped down the front, so nothing will pull at your wounds. This should also be the case for sleeping attire. Easy to slip on shoes are essential to avoid bending over after surgery.

Facelift surgery usually takes between 3-6 hours depending on each patient’s specific needs.  Facelift surgery is performed as an inpatient procedure  and is performed under general anaesthesia. You can expect to be in hospital for 1-2 nights after your surgery.

You will need to ensure that you have pre-organised a responsible adult to pick you up from hospital and have them stay with you day and night for the first 48 hours after you are discharged.

Face Lift – Post Operative Care

There will be many specific instructions provided to you to follow post-surgery. It is important that these are strictly adhered to in order to facilitate the best surgical outcome.

After your surgery you should expect some post-operative swelling, bruising and/or numbness for some time - this can continue for a matter of weeks or months.  All incisions and dressings should be kept dry until your Surgeon indicates that showering or bathing is ok.

It is important to keep your head elevated for the first few weeks after your surgery. We suggest sleeping semi reclined on 2-3 pillows, on your back. This will aid your recovery.

You should aim to keep a light schedule in the weeks following your surgery to allow for adequate healing time.  Extra rest is important to promote proper healing. Refrain from physical activity (i.e. exercise) for first 2 weeks, after which time you may gradually increase activity. No strenuous exercise or activity is recommended for 6 weeks after surgery (gym, yoga etc).

Deciding to undergo face lift surgery is a decision that should not be taken lightly.  If it is something that you are considering we recommend booking a consultation with Mr Mutimer, a Melbourne based Specialist Plastic Surgeon. He’ll be able to inform you on all aspects of the surgery, perform a full assessment of your suitability, discuss expected outcomes and answer any questions that you may have,

For more information or to book a facelift surgery consultation feel free to call us on 03 9592 0522 or submit an enquiry via our website.

Information regarding breast implant associated Anaplastic Large Cell Lymphoma

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Following renewed media interest regarding the correlation between breast implants and an increased risk of developing Non-Hodgkin’s Lymphoma Mr Mutimer thought the timing pertinent to outline key information related to BIA-ALCL.  

The following information has been sourced from the Australasian Society of Aesthetic Plastic Surgeon’s website and summarises what we know to date:

FACTS ASSOCIATED WITH BIA-ALCL

  1. It is a cancer of lymphatic cells and a form of Non-Hodgkin’s Lymphoma.
  2. It is not a breast cancer.
  3. It occurs in association with breast implants and to date exclusively with exposure to textured implants (i.e. No case has been reported with exposure to smooth implants alone).
  4. It occurs in women who have had implants for both cosmetic and reconstructive indications.
  5. It takes an average of 7-10 years after implant insertion before it develops.
  6. The commonest presentation is a fluid swelling around the breast implant and in the space between the implant and breast implant capsule – late seroma. The diagnosis of the condition is made by examination of the seroma fluid.
  7. Early stage disease is curative with surgery alone.
  8. Disease which has spread through the capsule, forming a mass or which has spread to local lymph glands carries a worse prognosis.

RISK 

The most accurate assessment of risk published to date is from a detailed study of numerator and denominator in Australia and New Zealand. This showed that the risk for implants with high surface area texture (biocell, Alllergan and polyurethane, Silimed) were around 10 times higher (1 in 4,000 to 1 in 7,000) compared with implants with lower surface area texture (1 in 60000 for siltex Mentor). The risk was calculated only for companies that complied with a request for provision of sales data.

We did see ALCL arising from other implant manufacturers, but were not able to calculate risk due to their refusal to supply data for analysis.

The study also identified clusters of multiple cases arising from the same practice. These clusters are currently under investigation, with the consent of the centre and/or surgeon, and there is insufficient evidence presently

to comment as to likely causative factors.


CAUSATION

Recent media stories suggested that there is a link with cut-price providers. No such link that has been established to date by analysis of the evidence.

A unifying theory was proposed by the ANZ epidemiology paper and has become widely accepted worldwide as the best explanation for factors that cause BIA-ALCL.

The unifying theory cites four inter-related factors:

  1. Textured implants (with a higher risk for high surface area textures)
  2. Bacterial contamination at the time of surgery to reach a threshold to cause inflammation
  3. Patient genetic predisposition
  4. Time - for the process to develop.
Bacteria have been identified in association with these tumours, similar to the association between gastric lymphoma and Helicobacter pylori.

I'VE HAD BREAST IMPLANTS OR AM CONSIDERING SURGERY - WHAT SHOULD I DO NEXT? 

If you currently have breast implants and are concerned you should consult with a Specialist Plastic Surgeon who will determine what type of implants you have and address your concerns.

Similarly if you are considering breast implant surgery it is important to schedule a consultation with a Specialist Plastic Surgeon to discuss the risks and benefits, including the risk of BIA-ALCL. There are different types of implants available and selection needs to take into account the risks and benefits of specific choices.

For more information or to book a Consultation with Mr Keith Mutimer – Specialist Plastic Surgeon phone 03 9592 0522 or submit a confidential enquiry via our website.

 

Why Winter Is An Ideal Time To Have Plastic Surgery

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A common question posed by clients looking to undergo plastic surgery in Melbourne is “when is the best time to have this procedure?”.  Whilst timing may not be an important factor for some, and there really is no right or wrong time to schedule in your surgery, winter most definitely has its benefits.

We always recommend doing what works best for you however some considerations for why winter could be a more favourable time include:

  • A more comfortable recovery: your recovery time will be the same regardless of when you have plastic surgery however winter generally poses more favourable conditions for a comfortable recovery.  The cool weather during winter means you are more likely to be wearing bulkier clothing, making it easier to cover up any swelling, dressings or compression garments.  
  • Sweat less: you will sweat less in winter making any post-surgical dressings or garments generally more comfortable to wear.
  • Easier to avoid sun exposure: exposing scars to the sun can cause permanent damage and should be avoided at all costs. For those who have lived through (and survived) a Melbourne winter you will know that generally over-exposure to sun won’t be an issue at this time of year!
  • You won’t miss out on water activities: swimming, especially in pools, is often prohibited post-surgery so again undergoing plastic surgery in winter means you won’t be left sitting on the sidelines while others enjoy the water.
  • Not showering may be easier to manage: no one likes to think about not showering regularly, however after your procedure you may be instructed to refrain from showering for several days –generally much easier to manage in the cooler months.
  • You’ll be summer ready: opting for plastic surgery in the cooler months mean you will have recovered and be ready to put your best foot forward in summer.

If you are considering plastic surgery we recommend booking a consultation with a specialist plastic surgeon in Melbourne who will be able to discuss your intended procedure, perform a full assessment of your suitability, discuss expected outcomes and answer any questions you may have, including when may be the best time to have the procedure. 

For more information or to book a consultation feel free to call us on 03 9592 0522 or submit an enquiry via our website.