Melbourne Plastic Surgery Blog

Melbourne Plastic Surgery Blog

Dr Ramin Shayan appointed Consultant Plastic Surgeon to the Victorian Melanoma Service

Thursday, November 21, 2019

Dr Ramin Shayan has recently been appointed by the Victorian Melanoma Service as one of their Consultant Plastic Surgeons.

Located at The Alfred Hospital, the Victorian Melanoma Service (VMS) is one of Australia’s largest multidisciplinary treatment services for melanoma.  It provides treatment for patients who have a biopsy proven melanoma. The clinic is accessed via a referral from a GP or medical professional.

The clinic has a number of specialists who work together to diagnose, treat and follow up on melanoma patients. Medical professionals who work at the VMS include those who specialise in anatomical pathology, dermatology, plastic surgery, general surgery, medical oncology and radiation.

Dr Shayan has specialised in melanoma and skin lesion removal at Brighton Plastic Surgery since joining the practice in 2014. This is in addition to his pioneering work in the treatment of lymphoedema.

“It is exciting to join such an expert team to ensure delivery of gold standard, cutting edge assessment and treatment of often complex melanoma patients” said Dr Shayan.To find out more about the Victorian Melanoma Service visit Alfred Health.

Inaugural Friends Of Interplast Dinner

Thursday, August 08, 2019

The Inaugural Friends of Interplast fundraising dinner was recently held at The Carousel in Albert Park.

The dinner aims to raise much needed funds for Interplast’s work in repairing bodies and rebuilding lives across the Asia Pacific Region.

As President of Interplast, Mr Mutimer spoke at the event and is pictured below alongside recently announced ambassador, and rising AFLW star, Jess Hosking.

The evening was a huge success with funds raised being used to create the 'Friends of Interplast' Program. This will involve sending a surgical team overseas where approximately 30- 50 patients will receive life changing surgery, as well as opportunities for Interplast volunteers to build capacity and provide ongoing training.

To find out more about Interplast or to donate visit: www.interplast.org.au

Latest update on textured breast implants and ALCL

Thursday, August 01, 2019

This information has been summarised from the Australasian Society of Aesthetic Plastic Surgeons recent statement on Breast Implant Associated ALCL.

Understandably, a number of patients with breast implants have been alarmed by the increase of coverage in the news regarding Breast Implant Associated-Anaplastic Large Cell Lymphoma (BIA-ALCL) following the announcement that the TGA were reviewing the safety and ongoing availability of textured breast implants in Australia.

Here's a summary of current information and what you need to know:

  • The TGA announced on 11 July 2019 that it had completed its review and laboratory assessment of textured breast implants on the Australian market.
  • The next steps are either a proposal to cancel or a proposal to suspend certain types of textured implants by specific manufacturers. 
  • You can find the full list of implants in question on the TGA’s website.
  • It is important to note that BIA-ALCL is not breast cancer. 
  • It is a rare type of lymphoma that develops adjacent to breast implants, usually as a swelling of the breast 3-14 years after insertion.  This swelling is due to fluid building up in the fibrous capsule that surrounds the implant and does not develop in the breast tissue itself.  It can also present as a swelling or lump in the breast or armpit.
  • BIA-ALCL is a rare condition, with 92 patients confirmed in Australia and New Zealand.  Due to its rarity, it's difficult to be sure about the exact level of risk of developing this disease.  The risk of developing ALCL with textured implants differs with different grades of texture from one in 2,800 to one in 80,000.  Comparatively, breast cancer occurs in one in every eight women.
  • In the case of BIA-ALCL, the key to effective treatment is early diagnosis and specialist treatment.
  • In the early stages, BIA-ALCL is slow-growing and curable by surgery alone.
  • The cause is currently unknown but Australian and New Zealand Plastic Surgeons, along with local and international research organisations are working tirelessly to find the cause.
  • BIA-ALCL can occur in both breast reconstruction cases and cosmetic cases, as well as affecting both saline and silicone implants. 
  • At this time, there is no evidence to suggest the benefit of routine removal of breast implants if you do not have symptoms of this condition.

What should you do if you are concerned?

  • If your surgery was performed at Brighton Plastic Surgery, please ring us and we can inform you about what implants you have, and we can guide you through the clinical review process. If your surgery was conducted elsewhere and you are unsure of the type of breast implant used in your surgery, details will be in your original surgeon's medical files, and they will be able to inform you if it is a textured implant.
  • If you are unable to contact your original surgeon, please see your GP who can get you in contact with a Specialist Plastic Surgeon for a full clinical evaluation.  It would be recommended that this occur in any patient with breast implants, who are exhibiting symptoms of this condition.

We recommend that you click here to read the full statement from the Australasian Society of Aesthetic Plastic Surgeons.

Considering Ear Surgery (Otoplasty)?

Thursday, May 09, 2019

Ears are usually not the most noticed feature of the face but for people with prominent ears, they can find this upsetting, especially for children or people who wear their hair short.  Ear plastic surgery, also known as Otoplasty is designed to correct protruding ears. It can also be used to make ears more symmetrical or to correct ears that droop to low.

Ear surgery involves a surgeon pinning the patient’s ears back closer to the head, thus making them less prominent.

There are many benefits associated with undergoing surgical otoplasty. These include:

  • Low risk – the procedure is considered very safe with minimal risks involved (see important considerations below)
  • Minimal scarring once healed
  • Enhanced confidence and self esteem
  • Natural looking results

Ear surgery – important considerations

There are several key considerations for those exploring the option of ear surgery (otoplasty).

1) Timing (for young patients) – a person’s ears reach full development by the age of 4-5 therefore ear pinning surgery should not be performed until AFTER this age.

2)  Recovery time – overall recovery from otoplasty surgery is generally quick. There may be some discomfort in the first 1-2 days but this generally settles quickly.

3)  There will be some swelling and bruising post-surgery. Usually the bruising and discolouration is gone within 3 weeks. Swelling will diminish over the course of the first 6 weeks, however some minor swelling may continue for up to 2-3 months.

4)  It is important to note that a patient can only sleep semi-reclined on their back during the initially recovery period (generally for the first 2-3 week/s).

5)  Complications are generally minimal for otoplasty however as with any surgery risks can include bleeding, slow healing time, numbness and thickened scarring behind the ear. 

6)  One of the most problematic complications with ear surgery is if the ear is pulled on or knocked before adequate healing has occurred. If this happens the shape can be altered. Absolute care should be taken to avoid this and if this does occur you should reach out to your surgeon straight away to receive further advice.

Parents with a child who opts to undergo otoplasty will often find the first several weeks challenging, assisting the child to follow all instructions provided to ensure an optimal recovery. This includes keeping their head bandaged, ensuring they don’t scratch the ear area if itchy, minimising physical activity so as to not knock the ears etc. Knowing this in advance allows for pre-planning and makes it all very manageable.

If you are considering ear plastic surgery we recommend booking a consultation with a specialist plastic surgeon in Melbourne who will be able to discuss the intended procedure, perform a full suitability assessment, 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.



Interplast 35th Anniversary Celebrations

Wednesday, April 03, 2019

Last week Mr Mutimer had the pleasure of attending and addressing attendees of Interplast’s 35th Anniversary Celebrations.

 In attendance was Her Excellency the Honourable Linda Dessau AC, Governor of Victoria and Mr Anthony Howard AM QC who kindly hosted the reception at Government House. The Governor praised the work of Interplast in repairing bodies and rebuilding lives across 17 countries in the Asia Pacific region, as well as acknowledged the wonderful contribution of volunteers and donors.

The event was attended by over 120 Interplast supporters including Board members & staff, volunteers, corporate partners and donors.

To find out more about Interplast or to make a donation visit www.interplast.org.au

What is lip lift surgery?

Monday, December 03, 2018

A lip lift is a procedure designed to lift the top lip in people who have a thin upper lip. It is a permanent solution  and is most beneficial for those wishing to improve the perceived volume of their lips and aesthetic of their smile and facial proportions. A lip lift can also reduce the signs of ageing often prevalent around the mouth.

Lip lift surgery involves a surgeon carefully removing a small amount of skin under the nose in order to “lift” the upper lip.  The procedure is performed as day surgery, usually under local anaesthetic.  The procedure generally takes less than an hour. Lip lift surgery is tailored to each individual to ensure natural looking results are achieved.

It is worth noting that a lip lift is only performed on the top lip.  Often lip fillers are also used in the bottom lip to create balanced, voluminous lips.

Interested to find out more or book a lip lift consult? Feel free to call us on 03 9592 0522 or submit a confidential enquiry via our website.

What is best for me - a tummy tuck or liposuction?

Tuesday, October 02, 2018

Many of our patients seeking a flatter stomach come armed with one question – what is right for me – a  tummy tuck (abdominoplasty) or liposuction (body contouring)??

These two procedures are very different and the best option for you will depend on your specific circumstances and what you are trying to achieve. Skin and muscle laxity play an important role in determining the best approach, as do your individual goals/aspirations.

We asked Mr Mutimer, a well respected Melbourne Plastic Surgeon to explain the key differences and considerations:

LIPOSUCTION:

Liposuction is good for people who generally have good skin and muscle tone, and who want to remove localised fatty tissue and stubborn excess fat. Localised fat deposits may sometimes be an inherited trait and typically do not respond to dieting or exercise.

Liposuction will not eliminate extra skin, stretch marks or issues stemming from loose abdominal muscles.

Liposuction can be used on other areas of the body such as the arms, legs or bottom. Whilst both procedures require a general anaesthetic, liposuction is less invasive than a tummy tuck which involves a surgical incision and a longer recovery time.

TUMMY TUCK:

As mentioned above abdominoplasty (tummy tuck) is a more invasive procedure with a longer recovery time. It is generally recommended for patients who have stretched skin and/or loose stomach muscles (not excess fat).

This procedure uses an incision within the lower abdomen to remove the excess tissue and tighten associated muscles.  It is because of the abdominal wall muscle reconstruction that a longer recovery time is required. Tummy tucks are often considered by people who have had significant weight loss or have abdominal issues following pregnancy.

It’s also important to know that some patients have a combination of excess fat, stretched skin and /or muscle laxity. In these situations people often opt for a combination procedure, having an abdominoplasty with liposuction at the same time. 

WHICH PROCEDURE IS BEST FOR ME?

It is important to determine what specific issues you are faced with in order to then recommend which procedure is right for you. We recommend a consultation with a Specialist Plastic Surgeon who will be able to assess your issues and advise the best course of action.

Generally, if you have localised areas of fat liposuction is the best course of action. For loose stomach muscles and/or sagging skin – a tummy tuck would likely be recommended.

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


Preparing for a facelift

Tuesday, August 07, 2018

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

Thursday, June 28, 2018

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

Friday, May 18, 2018


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.


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Dr Ramin Shayan appointed Consultant Plastic Surgeon to the Victorian Melanoma Service

Dr Ramin Shayan has recently been appointed by ..

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Dr Ramin Shayan has recently been appointed by the Victorian Melanoma Service as one of their Consultant Plastic Surgeons.

Located at The Alfred Hospital, the Victorian Melanoma Service (VMS) is one of Australia’s largest multidisciplinary treatment services for melanoma.  It provides treatment for patients who have a biopsy proven melanoma. The clinic is accessed via a referral from a GP or medical professional.

The clinic has a number of specialists who work together to diagnose, treat and follow up on melanoma patients. Medical professionals who work at the VMS include those who specialise in anatomical pathology, dermatology, plastic surgery, general surgery, medical oncology and radiation.

Dr Shayan has specialised in melanoma and skin lesion removal at Brighton Plastic Surgery since joining the practice in 2014. This is in addition to his pioneering work in the treatment of lymphoedema.

“It is exciting to join such an expert team to ensure delivery of gold standard, cutting edge assessment and treatment of often complex melanoma patients” said Dr Shayan.To find out more about the Victorian Melanoma Service visit Alfred Health.

Inaugural Friends Of Interplast Dinner

The Inaugural Friends of Interplast (https://w ..

Read more

The Inaugural Friends of Interplast fundraising dinner was recently held at The Carousel in Albert Park.

The dinner aims to raise much needed funds for Interplast’s work in repairing bodies and rebuilding lives across the Asia Pacific Region.

As President of Interplast, Mr Mutimer spoke at the event and is pictured below alongside recently announced ambassador, and rising AFLW star, Jess Hosking.

The evening was a huge success with funds raised being used to create the 'Friends of Interplast' Program. This will involve sending a surgical team overseas where approximately 30- 50 patients will receive life changing surgery, as well as opportunities for Interplast volunteers to build capacity and provide ongoing training.

To find out more about Interplast or to donate visit: www.interplast.org.au

Latest update on textured breast implants and ALCL

This information has been summarised from the  ..

Read more

This information has been summarised from the Australasian Society of Aesthetic Plastic Surgeons recent statement on Breast Implant Associated ALCL.

Understandably, a number of patients with breast implants have been alarmed by the increase of coverage in the news regarding Breast Implant Associated-Anaplastic Large Cell Lymphoma (BIA-ALCL) following the announcement that the TGA were reviewing the safety and ongoing availability of textured breast implants in Australia.

Here's a summary of current information and what you need to know:

  • The TGA announced on 11 July 2019 that it had completed its review and laboratory assessment of textured breast implants on the Australian market.
  • The next steps are either a proposal to cancel or a proposal to suspend certain types of textured implants by specific manufacturers. 
  • You can find the full list of implants in question on the TGA’s website.
  • It is important to note that BIA-ALCL is not breast cancer. 
  • It is a rare type of lymphoma that develops adjacent to breast implants, usually as a swelling of the breast 3-14 years after insertion.  This swelling is due to fluid building up in the fibrous capsule that surrounds the implant and does not develop in the breast tissue itself.  It can also present as a swelling or lump in the breast or armpit.
  • BIA-ALCL is a rare condition, with 92 patients confirmed in Australia and New Zealand.  Due to its rarity, it's difficult to be sure about the exact level of risk of developing this disease.  The risk of developing ALCL with textured implants differs with different grades of texture from one in 2,800 to one in 80,000.  Comparatively, breast cancer occurs in one in every eight women.
  • In the case of BIA-ALCL, the key to effective treatment is early diagnosis and specialist treatment.
  • In the early stages, BIA-ALCL is slow-growing and curable by surgery alone.
  • The cause is currently unknown but Australian and New Zealand Plastic Surgeons, along with local and international research organisations are working tirelessly to find the cause.
  • BIA-ALCL can occur in both breast reconstruction cases and cosmetic cases, as well as affecting both saline and silicone implants. 
  • At this time, there is no evidence to suggest the benefit of routine removal of breast implants if you do not have symptoms of this condition.

What should you do if you are concerned?

  • If your surgery was performed at Brighton Plastic Surgery, please ring us and we can inform you about what implants you have, and we can guide you through the clinical review process. If your surgery was conducted elsewhere and you are unsure of the type of breast implant used in your surgery, details will be in your original surgeon's medical files, and they will be able to inform you if it is a textured implant.
  • If you are unable to contact your original surgeon, please see your GP who can get you in contact with a Specialist Plastic Surgeon for a full clinical evaluation.  It would be recommended that this occur in any patient with breast implants, who are exhibiting symptoms of this condition.

We recommend that you click here to read the full statement from the Australasian Society of Aesthetic Plastic Surgeons.