Mummy Makeovers Explained; What is a Mummy Makeover?

Motherhood can be both beautiful and terrifying, but it does not mean that you have to sacrifice your self-confidence and appearance to enjoy it.

A mummy makeover is a combination of multiple operations, particularly surgery of the breast and abdomen following pregnancy. The physical signs of pregnancy can often be surgically corrected with great success. The breasts may be lifted or augmented with an implant or both lifted and augmented. The abdomen can be repaired and sculpted with an abdominoplasty procedure (tummy tuck), with or without liposuction. It is a commonly performed procedure for mothers wanting to restore their pre-pregnancy physique and improve their self-image.

Mummy Makeover—Is It Right for Me?

Although the term ‘mummy makeover’ refers to correcting the issues that arise from pregnancy, there is no set list of procedures. What goes into the surgical combination is very personal—no two mummies are alike, so each procedure is tailored to meet the woman’s individual needs. We will help you pinpoint areas of particular concern during your consultation, and we will discuss restorative options.

Further, although mummy makeovers generally refer to women who have given birth, you don’t need to be a mummy to have a mummy makeover! It is a popular term for having breast and tummy surgery at the same time, as these two surgeries pair well together. Women who have lost a significant amount of weight can also benefit from a mummy makeover.

Your Mummy Makeover May Include

Tummy Tuck

The tummy tuck procedure is one of the most common surgeries done in Australia, second only to breast surgeries. It is no surprise why. Pregnancy, weight fluctuations and the aging process all promise excess skin and stubborn fat accumulation around our midsections. The inconvenient truth about those annoying ‘love handles’ (oh, the irony) is that there is no miracle exercise, diet or cream that can completely reclaim the firm waist of our youth.

Abdominoplasty surgery, also referred to as a ‘tummy tuck’, is a surgical procedure that successfully sculpts the midsection for a tighter, more appealing body contour. The procedure can also repair weakened and separated abdominal muscles, further tightening the stomach. Although abdominoplasty is considered a cosmetic procedure, it also improves two of the most common physical complaints experienced by women after labour and delivery—pain and incontinence. Therefore, the procedure is cosmetic and reconstructive by nature.

Patients seek tummy tuck surgery to:

  • alleviate pain and urinary incontinence
  • enhance their self-image and self-confidence
  • alleviate itching, infections and irritations caused by excess skin
  • alter the tone and shape of the abdomen, creating a flatter and firmer abdomen
  • repair structural abdominal defects such as Diastasis recti (separated abdominal muscles), hernias and other abnormalities caused by trauma, obesity, pregnancy and extensive weight loss.

Abdominoplasty surgery typically involves the surgeon making a horizontal incision along the lower abdomen so that the underlying abdominal muscle can be tightened, and the fatty tissue and excess skin can be removed. In cases where the rectus muscle has separated (divarication), the muscle will be brought back together and sutured internally along the connective tissues. The navel, or belly button, will be repositioned, and the incision will be closed with stitches, tape or clips. The incision is strategically placed along the pubic hairline to hide the scar underneath your underwear.

Ultimately, the procedure removes excess skin and fat from the abdomen and repairs loose and separated abdominal muscles. The result is a flatter, firmer and shapelier abdomen.

Liposuction

Liposuction, also referred to as lipectomy, lipoplasty and body contouring, is a cosmetic surgery that removes excess stubborn fat. Liposuction is not a magical weight-loss method; instead, it is a method that reshapes certain areas of the body by removing excess fat deposits. Liposuction is commonly used to target areas where stubborn fat that does not respond to diet and exercise collects, such as the abdomen, thighs, buttocks, arms and under the chin.

It is worth considering liposuction if:

  • You want to sculpt and reshape your body.
  • Your figure is affecting your self-image and confidence.
  • You have stubborn fatty deposits that are resistant to diet and exercise.

During the liposuction procedure, a small incision is made, and a sterile liquid is injected into the vein to prevent bleeding and trauma. Then, a cannula is inserted into your fat layers using a careful back and forth motion to break up the fat cells. The dislodged fat is then suctioned out of the body using a surgical vacuum or a large syringe attached to the cannula. The process is repeated over and over in target areas, creating a more sculpted look.

The fat cells that are removed are gone permanently. If a patient gains a little weight after liposuction, the existing cells will accumulate more fat. Thus, their figure simply becomes a larger version of their new body shape. However, if much weight is gained, new fat cells can develop.

Breast Augmentation

Breast augmentation, also referred to as augmentation mammoplasty, breast implants or a ‘boob job’, is a cosmetic surgery that involves using saline or silicone implants to enhance the size, shape and volume of your breasts. Breast augmentation is the most popular cosmetic surgery in Australia and worldwide. Generally, the breast augmentation procedure promises perkier, fuller breasts that are more symmetrical and appealing. This procedure may also restore breast volume, shape and symmetry after pregnancy or extensive weight loss.

Women seek breast augmentation to:

  • enlarge smaller breasts
  • restore asymmetrical breasts
  • balance breast and hip contours
  • enhance self-image and self-confidence
  • increase projection and fullness of breasts
  • reconstruct breasts after mastectomy or injury
  • restore breast shape after pregnancy, weight loss or breastfeeding.

There are two types of breast implants typically used in Australia: saline implants and silicone implants. Both types achieve a similar look and have been approved by the Therapeutic Goods Administration. Saline implants are silicone shells typically inserted empty and then filled with sterile salt water (saline). In the unlikely event the shell leaks, the saline implant collapses, and the saline is safely absorbed and expelled by the body. Silicone implants also have a silicone shell, but the shell is filled with a thick, sticky silicone gel that mimics the feel of breast tissue. If a silicone implant leaks, the gel often remains in the implant shell, but it can leak into the breast tissue. It is unlikely that the whole implant would collapse.

In breast augmentation surgery, the silicone or saline implant will be placed behind the breast, either between the breast tissue and the chest muscle or behind the pectoralis major (large chest muscle). Each position and type of implant has its advantages and disadvantages. Your plastic surgeon will discuss the options with you and recommend which option is most suitable for your situation.

Breast Lift

Mastopexy, also known as breast lift surgery, is a surgical procedure that firms and raises the breasts. It can correct sagging and asymmetry caused by pregnancy, breastfeeding, aging, illness or defect. The procedure will not make your breasts appear larger. Instead, it involves removing excess skin, tissue and fat, leaving breasts perkier and firmer.

A breast lift is worth considering, if:

  • Your breasts have lost shape and volume.
  • Your nipples and areolas point downward.
  • Your nipples are below your breast creases.
  • Your breasts appear to be sagging and stretched.
  • Your breasts are asymmetrical, with one falling lower.
  • Your breasts are affecting your self-image and confidence.
  • Your areolas have stretched out of proportion to your breasts.

Breast lift surgery attempts to defy gravity by removing excess skin, redistributing breast tissue and restoring the original projection of the breast. The breast tissue is commonly reshaped as well, creating a youthful, more appealing breast contour and firmness. The nipples are often repositioned and raised, and larger areolas are reduced by excising the skin at the perimeter, so the breasts appear naturally youthful. Mastopexies can be done in a single procedure or along with a breast augmentation or reduction.

Nipple & Areolas

When it comes to the breasts, the nipple and areola often draw the most attention. Women who are unhappy or embarrassed with the appearance of their nipples or areolas may undergo surgery to improve the look, size, height and symmetry. A mummy makeover typically refers to the aesthetic procedures of the nipple and areola, although it is worth mentioning there are reconstructive surgeries for those without nipples due to cancer or trauma.

You may consider nipple surgery, if:

  • Your nipples are not symmetrical.
  • Your areolas are disproportionately large or small.
  • Your nipples are exceedingly long or droopy.
  • Your nipples are affecting your self-image and confidence.

An areola reduction is where an incision is made around the areola to remove pigmented areas. This procedure creates a smaller areola circumference while also creating the size, shape and symmetry desired. Many women have this surgery along with a breast lift or augmentation so that the nipples and areola complement the new breast appearance. This procedure is also often performed on women with droopy or misshaped areolas, where some of the pigmented areas are removed or sutured, making the areolas more aesthetically appealing.

Why Choose To Have a Mummy Makeover?

Although exercise and diet may help you shift some of the ‘baby weight’ after having children, they are not always enough to regain your pre-mum body. Separated abdominal muscles, loose skin, stretch marks, stubborn fat and deflated breasts are virtually impossible to reverse naturally. A mummy makeover can ultimately help you boost your self-image and self-esteem, leaving a sexier, shapelier you. If you would like more information about mummy makeover procedures or would like to schedule an appointment with Dr Dona, please call our clinic on 1300 373 662 or email [email protected]

Mummy Makeovers; How Pregnancy Changes the Body

Giving birth and caring for your children can be one of the biggest joys in a mothers life, but pregnancy can also trigger an avalanche of changes to your body in some not-so-wonderful ways. If you are like most women, you probably have some battle scars to prove it too.

While some women’s bodies may take a while to return to the way they were, others may never completely return to the way they looked before pregnancy, and some of the unexpected changes can be difficult and overwhelming to deal with. Although these changes are natural, many women struggle to accept their postpartum body, especially those that no amount of exercise or restrictive dieting can cure. We do not believe women should have to sacrifice their body confidence after giving birth.

Whether you are pregnant and anticipating the inevitable changes pregnancy brings or want to feel more comfortable in your postpartum body, this article will explore the different ways that pregnancy can affect the body and how a mummy makeover can address some of these issues.

Breasts

For many women, changes to the breasts are one of the earliest signs of pregnancy, and they continue to change from the first trimester through to the postpartum period.

Within weeks of conceiving, your body starts preparing for lactation by ramping up the production of pregnancy hormones like oestrogen and progesterone. These hormones are essential in preparing the breasts for lactation and are responsible for many of the changes you may experience. Oestrogen stimulates the growth of the breast duct cells and generates the secretion of prolactin, another hormone. Prolactin stimulates breast enlargement and milk production. Progesterone supports the formation and growth of milk-producing cells within the glands of the breasts. As hormone levels rise, so does blood flow, fluid retention and fatty tissue, causing your breasts to feel swollen, sore, sensitive and appear enlarged and veiny.

Increased breast size also causes the breast skin and tissue to stretch and tear, leaving obvious stretch marks behind. Stretch marks occur when the collagen and elastin in your skin stretch beyond the point of repair. If you inherited skin that is predisposed to losing its elasticity, you are more likely to develop those angry-looking purple or red lines. Though there are supposedly creams that promise to prevent them, do not expect miracles.

After you have given birth, the oestrogen and progesterone levels plummet, and prolactin levels rise, allowing lactation to commence. Some breasts naturally revert afterwards, while others appear deflated, sagging and uneven. For some, the loss of a once-buoyant chest can be difficult to accept, despite it being an inevitable process for the female body.

If you want perkier breasts after pregnancy and breastfeeding, procedures like breast augmentation, breast reduction and breast lifts can help. Breast augmentation involves placing implants behind the breast tissue or under the chest muscle. This will increase the volume, shape and placement of your breasts. Breast reduction involves removing excess fat, tissue and skin, creating a more proportionate contour and alleviating the physical discomfort associated with disproportionately large breasts. A breast lift is often accompanied by breast augmentation or breast reduction, but it can also be undertaken alone. The procedure gives the breasts a naturally lifted appearance by removing excess skin and tightening the breast contour.

Nipples & Areolae

When you become pregnant, your breasts go through changes, and your nipples are no exception. You can blame it on the hormones again.

From the first trimester, the nipples protrude more, and Montgomerys glands (the little bumps surrounding your areolae) become more prominent in preparation for breastfeeding. Progesterone and oestrogen cause the body to stimulate pigment-producing cells, so you can expect the darkening of your nipples and areolaeespecially if you already have a darker skin tone. Within a couple of months postpartum, most nipples return to their original appearance. Although, some may continue to appear a little bigger, darker and stretched out than before pregnancy.

If you are feeling self-conscious about your nipple and areolae appearances postpartum, nipple surgery can help. In most cases, the surgery simply reduces the size of the nipple, but it can also include reshaping the areolae to achieve better proportions. This procedure can be performed alone or in conjunction with other cosmetic surgery procedures such as breast augmentation, breast reduction or breast lift.

Abdominal Wall Muscle Separation—Diastasis Recti

One of the more obvious physical signs that a woman is pregnant is the ‘baby bump’, which affects the abdominal muscles.

It is common for the two muscles that run parallel down the middle of your stomach to elongate and separate to accommodate your growing baby during pregnancy. This is known as diastasis recti or divarication.

After the birth, the abdominal muscles may become weaker and appear overstretched, leaving you with a sagging or bulging stomach and stretched skin that cannot retract. Along with the stretched-out skin, excessive fatty deposits between the muscles and organs, and weakened muscles, this separation can also contribute to incontinence, lower back pain, hernias and the stubborn pooch that sticks around long after giving birth.

Studies have found that diastasis recti occurs in approximately two-thirds of women in the third trimester and one-third of women postpartum. Although diastasis recti is often correctable through core-strengthening exercises, lifestyle changes and physical therapy, in some cases, surgery is necessary. This can be corrected with a tummy tuck, which involves tightening the separated muscles. A tummy tuck will also remove excess skin and any stretch mark scarring located on the excess skin that is being removed. By bringing the muscles back together, your stomach will become firmer and flatter, and your waistline narrower.

Excess Fat Removal

Many of us expected that the extra kilos would fall off on their own after birth. While it is true that women tend to lose weight postpartum, the weight loss trajectory is not always as straightforward as we think. In fact, it is common to lose lots of weight in the first couple of weeks postpartum and then hit a frustrating babyweight plateau. This is why:

Like most weight-related issues, hormones can play a big role. Prolactin, a hormone increasingly referred to as the ‘fat-storing hormone’, is raised during pregnancy and breastfeeding. Prolactin is secreted to stimulate milk production while increasing appetite and slowing metabolic functionessentially storing fat as insurance to nourish the baby. This biological pressure to eat more, coupled with other ‘hungry hormones’ like leptin and ghrelin that prompt unsatiable cravings for sweet, salty and starchy food, make it very difficult to lose weight.

You may have heard that breastfeeding is an easy means of weight loss, but, unfortunately, that is not entirely true. You will burn some stored body fat by breastfeeding, but, as explained above, your body actually protects some fat for breastfeeding. It is unsurprising then that studies that have measured the effect of breastfeeding on weight loss have found only a very small effect. Breastfeeding mums only lost approximately 0.6kg to 2kg more weight than mums who did not breastfeed in the first year.

You may experience a build-up of stubborn fat deposits within the stomach, breasts and legs. Though exercise and diet are often enough to tame your fat deposits, many women find themselves unable to return their pre-pregnancy bodydespite how healthy they are. If you have had a baby months ago and have a belly bulge that simply will not budge, it could be a sign of diastasis rectithe separation of your abdominal muscles.

Liposuction, otherwise known as lipectomy or lipoplasty, is a procedure that removes localised excess fat deposits to slim and sculpt specific areas of the body. Liposuction is the second most popular cosmetic surgery in Australia after breast augmentation. Liposuction has a successful history of eliminating stubborn body bulges that persist when exercise and nutrition have failed.

Excess Skin & Stretch Mark Scarring

Pregnancy can bring lots of changes to your skin. A womans face, areolae, stomach and moles often darken during pregnancy, and stretch marks and scars on the stomach, hips and thighs are often an unwanted souvenir.

These telltale marks painted across the body can be one of the hardest things to eradicate postpartum. There is no miracle cream. They may fade, but the skin is unlikely to completely regenerate.

Skin is made of collagen and elastin, so it expands with weight gain. Once stretched and torn from expanding to accommodate the growing foetus, your skin may have trouble returning to its original shape.

Unfortunately, there is no diet, exercise or non-surgical treatment that can reverse permanently stretched or excess skin. One of the biggest changes postpartum is excess loose skin. This often occurs on the tummy area since the belly skin stretches a great deal to accommodate a growing baby.

In less severe cases, non-surgical treatments may lessen the appearance of stretch marks. In more severe cases, surgical options such as a tummy tuck, thigh lift or arm lift can be more effective.

The Good News?

It is no secret that pregnancy and childbirth take a huge toll on the body. The bitter truth is that no matter how much miracle cream you apply or how many prenatal yoga classes you attend, once you start carrying a baby, your body will expand and change in ways you are not quite prepared for.

Sadly, many of these physical changes can alter the way we feel about ourselves. However, it does not have to be a life sentence. You can have your beautiful baby and body too with a ‘mummy makeover’.

A mummy makeover is a combination of plastic surgery procedures that restores your body to its pre-pregnancy stateand sometimes even better! The procedure typically involves a tummy tuck (abdominoplasty), breast surgery (including breast augmentation, breast reduction and breast lift) and body contouring (liposuction). However, many additional treatments, such as a thigh lift or cosmetic injections, can be performed during a mummy makeover, depending on your specific concerns.

A mummy makeover is a way to regain your figure and confidence in your postpartum body. For more information or to book a consultation with Dr Dona, please contact our clinic on 1300 373 662 or email [email protected].

How Much Does A Tummy Tuck Cost?

One of the most common questions we receive about tummy tuck surgery at our clinic is how much the surgery costs. Unlike more standard fee procedures such as breast augmentation, tummy tuck surgery pricing depends much more on the patients body. Larger tummy tucks could take up to five hours, whereas a tummy tuck procedure on a smaller patient may only take two hours, resulting in a lower surgical cost. Every patients body is unique, so it is difficult to provide a precise cost estimation without an initial consultation. Every tummy tuck procedure performed by Dr Dona is tailored to the patient’s individual body and is not a standard cookie-cutter procedure. Several other factors come into play, such as whether you are eligible for a Medicare rebate and your level of private health cover. Although we discuss the factors affecting the cost of a tummy tuck procedure in-depth in this article, the best way to obtain an exact price for your tummy tuck surgery is to book a consultation with Dr Dona so he can assess your situation. To book your consultation, please call us on 1300 373 663.

What is a Tummy Tuck?

Abdominoplasty, more commonly known as a tummy tuck procedure, is designed to remove and tighten excess skin around the abdominal region; this excess skin could result from several factors, such as post-pregnancy or extreme fat loss. During the procedure, an incision is made below the bikini line resulting in your scar being nicely hidden away. This is also the optimal position for improving abdominal shape. There will also be a scar around the belly button, as it will be relocated at the end of the procedure to its new home. A tummy tuck will also remove most abdominal scarring and stretch marks, including any caesarean scars. Other abdominal issues such as muscle separation and abdominal wall hernias can be resolved during a tummy tuck procedure performed by an experienced specialist plastic surgeon such as Dr Dona.

Tummy Tuck Initial Consultation

Your initial consultation includes a minor contributing fee to your total surgical costs, and you will not be charged for follow-up appointments during the first 12 months of postoperative care (after your surgery).

Your initial consultation with Dr Dona will include:

  • a physical examination of your abdominal area
  • an assessment and discussion together about your concerns, such as excess skin, muscle separation or abdominal wall hernia issues
  • asking several questions about your medical history, specifically relating to any previous abdominal surgery
  • Dr Dona answering any questions you may have regarding the operation.

After Dr Dona has assessed whether you are suitable for a tummy tuck procedure, a surgical plan will be created to provide you with the desired outcome. This will also include a discussion about the realistic results achievable from your surgery.

Dr Dona will also discuss your expected recovery time and any potential risks or complications to help you make an informed decision about your tummy tuck surgery.

After your consultation, one of our registered nurses will be happy to further discuss the costs with you and check possible surgery dates. Planning the right time to have your tummy tuck is essential since you will need to take things easy for a minimum of three weeks following the surgery.

Variations in Tummy Tuck Procedures

We touched on this earlier, but there are several reasons why someone may consider having a tummy tuck procedure. This procedure addresses the issue of overhanging or excess skin around the belly, which, in most cases, is caused by the abdominal area shrinking back down in size after weight loss or pregnancy. Although your body has shrunk, the skin does not completely shrink back down to fit your new shape. It is hard to help this further using natural solutions such as diet or exercise because the skin itself can only tighten to a certain point.

This is when the skin needs to be resized to fit your new body shape, which is done by removing the excess skin. Just like people come in all shapes and sizes, so do tummy tuck procedures. Every tummy tuck procedure is tailored to the individual; some people may have lost a significant amount of weight, resulting in a great deal of overhanging skin that can create functional and skin irritation issues. These larger tummy tuck procedures generally take a lot longer to perform than a tummy tuck on a smaller individual. That means that the surgical fees can differ based on the size and time required for each individual. However, Medicare rebates are available for those in surgical need of a tummy tuck and can significantly reduce outofpocket costs. If you are eligible for the Medicare rebate for a tummy tuck procedure, you will also likely be eligible for part of your fees to be covered by your private health insurer (this will depend on your health insurance provider and the level of cover you have).

Tummy Tuck Hospital Fees

Abdominoplasty (tummy tuck) procedures are not performed in public hospitals, which means part of the total outofpocket cost for your surgery will include private hospital fees. Hospital fees make up a significant portion of the total outofpocket costs for a tummy tuck procedure, especially if your private health insurance provider does not cover part of your

  • hospital expenses.
  • Your hospital fees will cover:
  • operating theatre costs
  • hospital accommodation for postoperative care.

After the operation, most patients will spend two days in hospital to recover from surgery before being discharged. Within the 48 hours after your surgery, you will be cared for and monitored by the hospital staff until you are ready to be discharged and go home.

Tummy Tuck Anaesthetist Fees

The anaesthetist’s role is a crucial part of any surgical procedure. Their role is to properly administer anaesthesia so that you are not awake during the operation. They will then carefully monitor your vital function signs throughout the surgery. An anaesthetist is a fully qualified medical doctor who, after obtaining their medical degree, has spent at least two years working in the hospital system before completing a further five years of training to specialise in anaesthesia (Australian Society of Anaesthetists). If necessary, they will also play a role in your postoperative comfort and pain management. Unfortunately, there is no set pricing that you can expect to pay an anaesthetist. The cost of your anaesthetist will vary depending on the length of your procedure.

Mini Tummy Tuck Cost

A mini tummy tuck is smaller than a traditional tummy tuck and is, therefore, a less expensive procedure. During a mini tummy tuck procedure, the incision made along the lower abdomen is much shorter than the hip to hip incision of a traditional tummy tuck. It is performed below the belly button; the belly button remains in its original position (unlike a full tummy tuck, which involves relocating the belly button).

The mini tummy tuck is an ideal option for women who only have a small amount of overhanging belly skin that they would like to correct to achieve a flat stomach. Another advantage of a mini tummy tuck is a faster recovery time than a traditional tummy tuck. It is important to note that only a small group of women benefit from this type of tummy tuck.

Can I Get a Medicare Rebate for a Tummy Tuck?

A tummy tuck procedure can be required not just for aesthetic reasons but for functional reasons as well.

Generally, patients who have a higher volume of excess skin may experience or suffer from one or more concerns, including:

  • skin integrity issues
  • sweat rash
  • ulceration within the belly button and abdominal folds
  • a fatty apron
  • a low hanging pubic area
  • hygiene issues.

These are all real issues that can affect a patient in surgical need of a tummy tuck. Medicare may provide you with a rebate towards your procedures, providing you meet certain criteria.

Does Private Health Insurance Cover My Tummy Tuck Surgery?

Whether your private health insurance will contribute to your tummy tuck surgery depends on your health insurance provider and the level of private health cover you have. However, if you are eligible for the Medicare rebate, you may also be able to claim some (if not all) of the hospital and anaesthetist fees.

If you are not eligible for the Medicare rebate towards your tummy tuck, it is likely that your private health insurance provider will not contribute to your total surgery costs.

Determining your eligibility for Medicare and your health fund can only be determined with a face-to-face consultation with Dr Dona.

FollowUp Appointment Costs

We like to see all our patients back in our clinic for several followup appointments within the first 12 months after the tummy tuck procedure. This is important so that we can check in and see how they are progressing through their recovery.

We ask our patients to come in for postoperative milestone appointments after:

  • one week
  • three weeks
  • six weeks
  • three months
  • six months.

This schedule may vary, and Dr Dona will discuss this with you. We are also happy to see you anytime between these visits if necessary. You will not need to pay for any of your

followup visits within the first 12 months after your surgery, as they are included in your surgery fee.

Many of our patients travel interstate for their surgical procedures, and for these patients, we help make provisions and arrangements for them to stay in touch following their surgery. You are more than welcome to pop into our clinics anytime when you are travelling through Sydneyjust let our clinic know ahead of time, and we will make sure to fit you in for a follow-up appointment.

How Much Will My Tummy Tuck Cost?

Tummy tuck procedures are exceptionally tailored procedures and cannot be precisely quoted without an in-person consultation. This article has endeavoured to guide you through the basic aspects of the procedure and its cost breakdown. If you would like an exact quote for your potential surgery, please book a consultation with Dr Dona for an assessment.

Your quote will include the total outofpocket cost with no hidden expenses for your specific surgery, taking into consideration your private health insurance status and eligibility for the Medicare rebate. At the end of your initial consultation, you will have a clear picture of your surgical options and the financial impact of your potential procedure.

If you have any further questions or queries regarding tummy tuck surgery or any other procedures offered by Dr Dona, please do not hesitate to call our clinic on 1300 373 662 or email [email protected].

Got questions about Tummy Tucks? (FAQ)

We frequently get all sorts of questions when patients first inquire about Abdominoplasty surgery, more commonly known as a Tummy Tuck. In this Q&A article, we will be answering many of the questions you might have regarding tummy tuck surgery. Of Course, if you are considering having a tummy tuck, the best way to answer all of your specific questions is to book a consultation with Dr Dona. Everyone’s body is different, and every tummy tuck procedure can differ depending on the person. During your consultation, Dr Dona will provide you with all the relevant information for your specific tummy tuck procedure and answer any questions you have. There is also a complimenting video if you would prefer to watch Dr Dona answer all of the below questions in video format. For more information, please call us on 1300 373 662 or email us at [email protected], and we will be happy to answer any further queries that you may have.

Tummy Tuck Frequently Asked Questions

How much does Tummy Tuck surgery cost?

Unlike more standardised fee operations, such as breast augmentation. We do not have a standard fee for tummy tuck procedures since there are so many variables that need to be taken into account. The time taken to perform a tummy tuck for Dr Dona can vary anywhere from 2 to 5 hours, depending on the individual. Of course the more complex procedures will cost more. Secondly, the total costs can vary significantly whether you have private health cover and if they will cover your hospital costs. Which is a substantial part of the total out of pocket costs for a tummy tuck. Unfortunately, without assessing someone with an in-person consultation, we are unable to provide them with a precise quote. By booking a formal consultation, Dr Dona can assess your specific situation to provide you with an exact cost for your tummy tuck surgery based on your body and private health insurance status. There is also a medicare rebate available providing that you meet their specific criteria. For more information regarding the cost of tummy tuck surgery, please take a look at our article on Tummy Tuck Pricing.

Can you have a tummy tuck if you have other scars on your tummy? (e.g. caesarean scar, other tummy surgery)

Post-pregnancy is one of the most common reasons why a patient may want a tummy tuck. Dr Dona removes the caesarean scar by making the incision along or below the scar when performing a tummy tuck. Many people have asked Dr Dona if having a caesarean scar complicates the surgery. Scar tissue makes the surgery a fraction more difficult but will not complicate the surgery. The same is for any other scars along the belly, such as those from previous abdominal surgeries. Removing these unappealing scars is also a great bonus to a having tummy tuck.

What is the difference between a tummy tuck and liposuction? Which is better?

There is no better, they both have different applications. A tummy tuck removes excess skin and the associated excess fatty tissue. Liposuction is classically known as liposculpture, which is used surgically for removing stubborn pockets of fat. Liposuction can be very beneficial, providing that it does not create an excess skin problem. Dr Dona often makes the analogy of tummy tuck surgery like tailoring a dress. “When your body goes through a change such as pregnancy or extreme weight loss. Your skin does not always shrink back down to your new shape, leaving you with excess skin. We tailor your skin to suit your new body by removing the excess skin just like you would tailoring a dress or a suit”.

Will you get liposuction at the same time as your tummy tuck?

For many tummy tuck procedures, Dr Dona uses liposuction along the sides of the stomach to help sculpt and enhance the waste line. Dr Dona usually will apply minimal liposuction along the front of the belly during a tummy tuck procedure. Performing liposuction too close to an incision can damage the blood vessel needed to support the wound in the healing process and significantly increases the risk of postoperative wound complications. After six months, it is perfectly safe to further enhance the sculpting from the tummy tuck procedure using liposuction.

Are stretch marks removed with a tummy tuck?

Stretch marks are scars caused by the skin being stretched faster than what it can keep up with. Stretch mark scarring is often a result of pregnancy or weight gain. Depending on their genetic makeup, some women can gain a moderate amount of weight and may not experience any stretch mark scarring. Whereas some women may get stretch marks from only amount small weight gain. A tummy tuck procedure will remove many, if not all stretch mark scarring around the abdominal area.

Will a tummy tuck correct muscle separation (Diastasis recti)?

Tightening the abdominal muscles is a routine part of most tummy tuck procedures. During pregnancy, the abdominal muscles are forced apart, and they don’t always spring back together post-pregnancy. During your operation, the abdominal muscles will be brought together and tightened from top to bottom. In some cases, the sides will also be tightened up. Tightening the abdominal muscles will help flatten the belly and tighten the waistline.

When repairing muscle separation, how tight can you make it?

While Dr Dona does tighten up the abdominal muscles quite tightly with several layers of internal stitching, there is a limit to how much the abdominal muscles can be tightened safely. Large amounts of visceral fat, which is the internal fat around your internal organs in the abdominal area, can restrict the amount of muscle tightening that can be performed. The only way to lose visceral fat is through exercise and healthy eating.

Can a hernia be repaired during tummy tuck surgery?

Abdominal wall hernias, especially around or within the belly button are extremely common. In most cases, they are noted before surgery. Dr Dona will repair any abdominal wall hernias during surgery by closing up the hernia and tightening the muscles around it.

Should you get a belly button hernia repaired before a tummy tuck?

In most cases, Dr Dona will recommend against getting a hernia repaired beforehand if you are planning to have tummy tuck surgery. The most common way that a general surgeon repairs a hernia can significantly increase the risk of a belly button not surviving a tummy tuck procedure. We would recommend that Dr Dona repairs your hernia during your tummy tuck procedure.

What is the ideal weight before having a tummy tuck?

The ideal weight for a tummy tuck is the weight that you are. Given that your weight is stable and not going to fluctuate. When a larger person has extra weight and a more prominent fatty apron, this can be a debilitating medical problem. They need to be treated and surgically reconstructed accordingly to resolve the issue. It does need to be considered that performing surgery on someone with a heavier weight can increase the risk of anesthetic and surgical complications. Dr Dona will not reject or make a larger patient go off and lose a bunch of weight before performing surgery if they are in surgical need of a tummy tuck procedure. There is no “perfect” weight for tummy tuck surgery.

Why do some people still have a “big belly” after a Tummy Tuck?

One of the most common reasons why someone might still have a “big belly”, especially around the top of the stomach, is that they still have quite a lot of visceral fat. Visceral fat is the internal fat around the organs in the abdominal area. Unfortunately, this fat can only be lost through lifestyle changes such as healthier eating and exercise. Whilst a tummy tuck procedure will make a significant difference to the top and bottom of the abdominal area. Heavier patients may still have quite a lot of visceral fat. This can result in the top of the belly still looking larger. Before & After surgery, it is also important to maintain posture and exercise your abdominal wall muscles to achieve the best look from your tummy tuck procedure.

Is the pubic area lifted during a Tummy Tuck (Men & Women)?

Lifting the pubic area is a standard part of most tummy tuck procedures. Having a lot of excess fatty tissue can cause the genitals to sag down relatively low in both men and women. A tummy tuck procedure will also pull up your genital area (Penis or Vagina) back up to where it is supposed to be in its prominent position.

Will you go home with drains after a Tummy Tuck?

No! You won’t be going home from hospital with any drains still attached. When you wake up from surgery, there will be two plastic tubes going into your abdominal wall, which are drains.

What is the pain like after a tummy tuck?

Tummy tuck operations are a major procedure. Like any major procedure, you will experience a moderate amount of pain postoperative. Whilst you are in hospital, you will be monitored and given as much medication as required to keep on top of the pain. When you go home, you will be given some strong prescription medication to keep you as comfortable as possible in the early stages of the recovery process.

What is the recovery like post-tummy tuck?

You will go home two to three days after surgery with waterproof bandages protecting the incision wound and wearing a compression garment. Since everything has been tightened, including the abdominal muscles. You will find that you are pretty hunched over for the first few weeks after surgery. You can expect to be resting around the house for the first two to three weeks, but by six weeks, life will be starting to return to normal. At six months, life will have returned to normal, and you will be able to enjoy your transformed body completely.

When can you start driving after a tummy tuck?

Unfortunately, you won’t be driving anytime in the first two weeks following your procedure. After two weeks following your tummy tuck surgery, you will be able to start driving again if you feel safe to do so. You may still be quite hunched over at this point, so it might take an extra week or two.

When can you get back to work after a tummy tuck?

If you are doing light office duties, you will be able to return to work after three weeks. You will need to wait at least six weeks for more strenuous workloads. After six weeks, your body will have settled into its new form more, and you will be able to attempt most things. Likely, you will still experience some pain at this stage, but you will be able to test the waters to determine what you are able and unable to do. After some more time and gradual progression, you will be able to return to a more strenuous workload. Dr Dona will advise you when you should return to work depending on the level of strenuous activity you undertake.

When can you start exercising/sport after a tummy tuck?

You will need to wait at least six weeks before returning to exercise, besides light walking. At the six week mark, you will be able to begin returning to exercise by starting slowly and gradually building up intensity week by week.

When can you have sex after a tummy tuck?

One of the biggest questions that everyone is curious to know but too shy to ask is how long after surgery can you have sex again? You can have sex again whenever you like. But for the first six weeks following surgery you will need to avoid any active movements involving your abdominal muscles or having your abdominal area grabbed/touched. This means that you will need to be taking a very passive role in sex during the first six weeks.

How long does swelling last after a tummy tuck?

Swelling after surgery is completely normal, especially after a major operation such as a tummy tuck. This will take a while to go down. You will be wearing a compression garment for the first six weeks, which will assist in reducing swelling. From three to six months following surgery, you will have a degree of swelling which will go down with time.

Why do some patients (from other surgeons) end up with ugly belly buttons after a tummy tuck?

Getting a belly button to look natural after a tummy tuck can be quite challenging for many surgeons. There are some techniques that other surgeons may use which result in the belly button looking fake or deformed. Dr Dona has perfected his own technique to achieve a natural-looking belly button during tummy tuck procedures. While saying this, a small number of patients may scar badly or have issues with the wounds healing around the belly button. With Dr Dona’s technique, the vast majority of patients Dr Dona has performed surgery on over the years have ended up with a great looking belly button.

Happy Anniversary & About Dr Dona 🎉

On the 29 June 2009, I proudly opened my private plastic surgery clinic in the Sydney suburb of Bella Vista. So today we celebrate 11 amazing years! During that time, my clinic has basically been my home and the only place where people can come and have a formal consultation with me. I have patients travel from all over Australia to see me for treatment, and this is where they come for that all important first consultation and subsequent care.

So today I thought I’d use this moment to answer some of the questions about myself I’m frequently asked.

I was born, raised, educated and trained in Sydney.

I graduated in Medicine from the university of Sydney and became I doctor in 1996. I thenspent a further 11 years of training until I finally became a specialist plastic surgeon in January 2007.

I often get asked about my background – where does “Dona” come from? It’s a Lebanese surname with both my parents originating from Lebanon. In fact, I was the very first doctor of Lebanese heritage in NSW, and possibly Australia, to become a specialist plastic surgeon! With my background, including attending Public Schools in Sydney’s western suburbs, it was quite a challenge to be the first to try and get onto the plastic surgical training programme where the hierarchy back then was primarily anglo-saxon or private school boys surgeons – but I did!

And whilst my name has been used by a number of clinics since 2007, here in Bella Vista is the only clinic that I have owned, it is the only clinic that I’ve ever run, it is my name, it is my life, and I manage it to the high standards that my private patients deserve.

As a specialist plastic surgeon, I operate out of several private hospitals around Sydney.

Despite running a busy private plastic surgery clinic, I still dedicate part of my time to one of Sydney’s largest teaching public hospitals. It is here that I often look after all the non-cosmetic plastic surgery problems such as hand and skin cancer surgery, including trauma and reconstructive microsurgery. It is also here that I provide training and mentoring to the future generation of plastic surgeons. And over the years I have provided training to over 50 plastic surgeons. I’ve also provided some training to many other doctors including those practicing cosmetic surgery.

Over the last 5 years I have established Australia’s leading plastic surgery YouTube channel. It is here that I happily showcase all manner of plastic surgery cases including extensive explanatory videos. This is primarily designed for the general public to help better understand plastic surgery and appreciate what it can achieve. However, it is also used as an educational platform for the numerous surgeon followers to help them up-skill.

Finally, I want to take this opportunity to thank all my patients that have chosen me as their surgeon. I seriously do consider it a privilege when someone chooses me to look after them. I’m always grateful and humbled by every patient that has placed their health and well-being in my hands.

Myself, along with my team at our Bella Vista clinic will always strive to do our very best to deliver you the very best of care. Ensuring you have a smooth, stress free transformation journey and treating everyone like a WORKofART is what we love to do. Hopefully, we’ll be able to continue doing exactly that for at least another 11 years.

Breast Surgery Q&A time – Dr Dona answers all your questions

Breast augmentation, mammoplasty or the colloquial ‘boob job’, is the most sought-after cosmetic procedure in Australia and one of the most common procedures worldwide. If you are thinking about joining the 20,000 Australian women undergoing breast augmentation annually, you probably have many burning questions. Here are answers to the most common questions about the procedure.
If you are considering having breast augmentation surgery and would like more information, the best way to have all your questions answered is to book a consultation with Dr Dona. Please call us on 1300 373 662 or email us at [email protected] We would love to speak with you about the breast augmentation procedure.

Breast Augmentation Frequently Asked Questions

How-Much-Does-a-Breast-Augmentation-Cost?

Our standard fee for breast augmentation is $11,00. This all-inclusive price covers the plastic surgeon’s fee, the anaesthetist’s fee, all hospital and theatre fees, the cost of your implants and 12 months of postoperative care. Additional costs may apply depending on the complexity of the procedure, but $11,000 is our standard fee.

Is the Cost of Breast Augmentation Covered by Medicare or Insurance?

Medicare does not cover elective surgical procedures completed purely for cosmetic purposes. Breast augmentation is primarily a cosmetic procedure, but it may be medically necessary, and in such cases, you may be eligible for a Medicare rebate. If your breasts are causing chronic discomfort or distress, you may be eligible for a rebate. The best option is to speak with your general practitioner and get a referral for a plastic surgery consultation. Without a referral, a claim cannot be made even if you are eligible.
Whether your private health insurance covers breast augmentation largely depends on your policy. If you have private health insurance with hospital cover, you may be eligible to have the hospital and anaesthetic components subsidised. Please clarify with your health insurance fund what will be covered before you book the surgery.

What Is the Difference between Saline & Silicone Breast Implants?

Silicone implants are silicone pockets filled with a thick silicone gel that mimics the look and feel of breast tissue. Saline implants have silicone shells filled with a sterilised saltwater solution. Saline implants are more likely to show rippling and may cause slight sloshing when you move. We use silicone implants almost exclusively because they look and feel more like natural breasts. Depending on which factors are most important to you, we may sometimes recommend saline implants.

Should I Choose Teardrop or Round Implants?

Round implants are a compressed circular sphere of either saline or silicone. Teardrop implants, also known as anatomical implants, are shaped to imitate the asymmetric appearance of natural breasts. The implant is thinner at the top and gently slopes down into a fuller, more rounded base; hence, the teardrop shape. There is a common misconception that round implants always create round unnatural breasts and that teardrop implants always create natural-looking breasts. The truth is that both types of implants can look natural and beautiful, providing they are the correct size, shape and profile for the patient. The key to achieving the best results is to have a surgeon who understands the best choice based on your body type and desired results.

Do Implants Need To Be Changed Every 10 Years?

Many women mistakenly believe that breast implants must be replaced every 10 years. The truth is, there is no expiry date on implants! Although the average life span of a breast implant is typically 10–15 years, breast implants only need to be replaced if you have an issue such as implant rupture or capsular contracture or your aesthetic preference has changed. Unfortunately, your body changes over time and breasts are no exception. Weight fluctuations, pregnancy, breastfeeding and natural aging are likely to affect the appearance of your breasts and replacing implants may correct these changes in appearance.

Which Breast Implant Pocket Is Best?

The implant pocket refers to the placement of an implant in comparison to the pectoralis muscle. The pectoralis muscle is the chest muscle that covers the collar bone, outlines the breastbone border and stretches along the ribs near the lower breasts. A breast implant can be placed in three primary pockets. Placing the implant above the pectoralis muscle and underneath the breast mound is called a subglandular or prepectoral placement. Placing the implant underneath the muscle is considered a submuscular or subpectoral placement, which can be further distinguished by placement entirely under the muscle (totally submuscular) or partially under the muscle (dual plane). There are advantages and disadvantages of each pocket location, and after making an assessment, your surgeon will recommend a pocket placement that considers your individual anatomy, lifestyle preferences and desired look.

How Long Does It Take To Recover from Breast Augmentation Surgery?

Although the breast augmentation procedure may only take a couple of hours and be done without an overnight stay, recovery will take up to six weeks. It is important to understand that recovery can take time and is different for everyone, but here is what you can expect. After the procedure, you will be sent home with a waterproof dressing, surgical bra, pain medication and antibiotics. Typically, the first week is the most uncomfortable, and you will likely experience some swelling and bruising. After a week, you will return to us for review, when we will change your dressings and check your wounds. Then, with your surgeon’s approval, you may gradually ease into daily activities, such as walking and light office work. The discomfort should be reduced at this point, but labour-intensive jobs and any strenuous physical activity, such as going to the gym, should be avoided. You will see us again at six weeks for another review; this time, we will take your dressings off permanently and discuss scar management. Most of your swelling should be gone at six weeks, and you can engage in most activities with caution. Complete healing can take up to six months; your breast will have settled and softened by then. For the first 12 months, your surgeon will examine you at each milestone, examining the incision, breast fold and scar tissue and ensuring that they are healing correctly. The six-month appointment is when you will have the opportunity to discuss the results of the procedure.

Can You Breastfeed with Implants?

Most women can breastfeed with implants. Whether the implants go under or over the muscle during breast augmentation surgery, they do not interfere with the breast ducts or mammary glands from which milk is excreted. Hence, breast augmentation does not affect your milk quality or ability to breastfeed.

Can You Breastfeed after a Breast Lift or Reduction?

Although it is possible to breastfeed after a breast lift or reduction, your ability to produce milk may be compromised. A breast reduction is more invasive than a breast lift as it removes significant amounts of glandular tissue. Many breast lift and breast reduction surgery patients can breastfeed without any issues, but there is an increased risk from these surgeries that breastfeeding may be affected.

Will Having Children Ruin My Breast Implants?

Pregnancy and breastfeeding will not affect the integrity of the implants; however, pregnancy and breastfeeding may affect the breasts’ appearance. Your breasts will continue to change throughout your pregnancy, thanks to surging hormones such as estrogen and progesterone. The breasts swell in preparation for milk production and continue to remain engorged throughout breastfeeding. When the nursing period ends, the breasts typically shrink to their near-original size. The breasts may then appear to be deflated, stretched and sagging. The skin may also have lost elasticity, and it may struggle to contract completely around your smaller breasts. In this situation, you may wish to have further surgery. However, in some women, there may be little to no difference in breast appearance. Because pregnancy does not affect the integrity of the implants, you can focus on having a safe and healthy pregnancy before correcting the potential aesthetic issues that may arise. Just be prepared for the possibility of corrective surgery to restore your breasts’ appearance.

Will I Lose Nipple Sensation If I Have a Breast Augmentation?

Changes in nipple sensation are very common after breast augmentation surgery, including under or overly sensitive nipples. The good news is that neural pathways can heal and re-establish themselves, meaning normal nipple sensation should fully return in most patients. This process can take a couple of months to a year to complete. Unfortunately, in approximately 10 per cent of patients, nipple sensation may be permanently lost. It can be difficult to predict which women will have lasting sensation loss after a breast augmentation, so it is important to be aware of the risk.

Do Breast Implants Cause Cancer?

Breast implants do not cause breast cancer. Studies have found no difference in breast cancer severity, aggression or survival rates between women with and without implants. Implants do not affect the ability to detect changes in your breasts, and breast cancer can still be detected early in women with breast implants. While breast implants do not cause breast cancer, a possible association between women with breast implants and anaplastic large-cell lymphoma (ALCL) has been found. ALCL is a type of non-Hodgkin’s lymphoma that is a cancer of the scar tissue capsule. It is very rare and associated with textured, not smooth, implants. Approximately 1 in 86 thousand women are diagnosed with ALCL depending on the type of implants, and the cancer can be treated effectively if it is detected early. We advise patients to continue with monthly breast self-examinations and annual mammograms, just as they did before receiving implants. Look for lumps, distortions or swelling in the breasts and armpits that warrant further investigation. If you find a change in your breast, see your doctor without delay.

Can You Have a Mammogram with Breast Implants?

Yes, most women with implants can and should have regular mammogram screenings. Mammograms may be less effective for some women with implants because the implant can obscure some of the breast tissue. However, studies suggest that mammograms are still very effective in screening for breast cancer in women with breast implants. We advise you to find a clinic where the radiologists are experienced in performing mammograms on women with implants and interpreting the results; tell the staff that you have implants.

What Bra Should I Wear after Breast Augmentation?

After surgery, you will be given a surgical compression bra that is not underwired. Although these bras are not attractive or appealing, they are essential for avoiding infection and allowing your breasts to heal post-operation. They are designed to support your breasts comfortably while assisting with swelling, inflammation and healing. You will wear the surgical bras day and night for the first six weeks. After six weeks, you will no longer need to wear the bra at night-time; however, you can continue to wear it overnight if you find it more comfortable. You may also go and buy some new bras. A very supportive sports bra that minimises breast movement is recommended for the first couple of months.

Can I Go Bra-Less after a Breast Augmentation?

Generally speaking, you should not be bra-less for at least six weeks after breast augmentation—potentially longer, depending on your surgeon’s recommendation. Your breasts need to be thoroughly supported to ensure optimal healing and results. After six weeks, you may occasionally go bra-less for special occasions, but do not make this a habit.

Will Breast Implants Affect My Areola Size?

In most patients, the areolas do not dramatically enlarge after breast augmentation. They may stretch slightly because of the larger volume of the breasts, but it is uncommon for them to become substantially bigger. Often, the areolas appear much smaller relative to the larger breasts. Many women want their breasts enlarged and their areolas reduced in the same surgery, but this combination is not advisable. During breast augmentation surgery, the breasts are under much tension. Making the areolas smaller is counterproductive because it becomes a tug of war between the thick breast skin and the weaker areola skin. Inevitably, the areolas naturally stretch back out. It is best to wait until after the breasts have softened and healed, which will be approximately six months after augmentation, and if you are still concerned about the areola size, we can surgically reduce their size.

Is a Scar-Less Breast Lift Possible?

Although the term ‘scar-less’ breast lift gives the impression that there will be no scarring, all invasive surgery guarantees some scarring. Scars may lessen in intensity and be strategically placed to minimise visibility or cleverly concealed. With a well-planned and well-performed breast augmentation, a significant lift can be created without causing scars on the breast mound. This procedure is generally referred to as a scar-less breast lift, although it is technically a breast augmentation where the scar is hidden in the breast instead of the mound. In more extreme cases of sagging, breast lift scars may be unavoidable without compromising results. A breast lift incision typically outlines the areola and traces down from the bottom of the areola to the crease below the breast. This scar naturally resembles a lollipop. In the beginning, the scars will be raised with a reddish-pink appearance. As they heal, the scars will eventually flatten and fade. The scars from a breast lift may not be as noticeable or as scary as you might think.

What If My Implant Pockets Stretch Too Big?

During implant surgery, your surgeon creates an appropriately sized pocket to hold the implant firmly, ensuring that the implant is secure. Sometimes, the implant moves around the pocket too much. There are two reasons movement may occur. First, an inexperienced surgeon might have created a pocket that is too large for the implant. More likely, however, there is a weakness and a lack of elasticity in the breast tissue. So, even though the pocket was an appropriate size at surgery, the implant continues to affect the envelope by stretching it out. Weakness and a lack of elasticity in the breast tissue can be caused by genetics, pregnancy, breastfeeding and weight fluctuation. Whatever the underlying cause, the implant pocket needs to be surgically corrected to make it smaller. Correction involves operating along the same scar, typically to suture and tighten up the pocket. If the cause of the problem was weak tissue, smaller implants, more supportive bras or implant removal may be advised.

Can Breast Implants Come Out of Their Pocket?

Breast implants can shift or become displaced from the desired and original position. Displacement can be caused by capsular contracture, healing and surgical issues, weight fluctuations and trauma to the breast. Larger implants are more likely to be displaced than smaller implants. The implants may migrate to your armpits (lateral displacement), towards the midline of your chest (symmastia) and downwards, which is referred to as ‘bottoming out’. Revision breast augmentation surgery may be needed to reposition the implant; surgery usually involves tightening up the pocket around the implant. Wearing an appropriate and supportive bra and attending all postoperative appointments can reduce the likelihood of implant displacement.

Can Breast Implants Burst?

Breast implants are very resilient and do not rupture easily. Although unlikely, implants can rupture due to intense physical trauma to the breast, intense compression during a mammogram, accidental perforation during a breast biopsy and other exceptional circumstances. Symptoms such as an abrupt loss in breast volume, ongoing breast ache or pain or misshapen and lumpy breasts may indicate a ruptured or collapsed implant. If your breast implant has ruptured, you will need corrective surgery to remove or replace the breast implant.

Do You Accept Interstate Patients?

Surgery is commonly performed on interstate patients. That being said, it is essential that you have access to your surgeon in the first couple of days of recovery. You can fly home two or three days after surgery, but it is important to maintain contact at regular intervals to ensure that you are hitting recovery milestones. Some, but not all reviews can be facilitated virtually.

Can Overweight Women Undergo Breast Augmentation?

If you are overweight but in good overall health, you absolutely can undergo breast augmentation surgery. Given that there is a much higher complication risk for overweight breast surgery patients, it is important that you discuss your suitability for surgery with your doctor and that you are aware of the potential risks. Nevertheless, if you have a fuller figure, it is possible to have breast augmentation surgery.

How Long Do I Have To Wait after Breast Augmentation To Have Another Surgery?

After breast augmentation, your breast tissue needs time to heal and adjust to the presence of a breast implant before you can fully appreciate the final results. At your six-month postoperative appointment, your surgeon will examine, discuss and critically review your results. Here, you will have the opportunity to approve or suggest further surgery, such as an areola adjustment or the insertion of bigger or smaller implants.

Can I Transfer Fat to My Breasts?

Fat transfer, commonly referred to as fat grafting, is an emerging technique that involves transferring fat from your troublesome areas via liposuction and injecting the fat into the breast. While I do offer fat transfer, I do not recommend it often. The issue is that fat grafting is less effective, more unpredictable and less reversible than breast implants. When fat cells are injected into a new location, they are not guaranteed to take. The body breaks down much the fat, and only a small percentage of fat cells receive enough blood supply to survive. It is difficult to predict the size and symmetry of the breasts after a fat transfer, so you may require several follow-up procedures to achieve the desired result. Although many surgeons feel that fat grafting provides the most natural-looking result, in successful procedures it typically increases the breast by only a single cup size.

What is Capsular Contracture & How Is It Treated?

Capsular contracture occurs when the scar tissue that normally forms around the implant becomes abnormally thick and tight, contracting around the implant. The scar tissue capsule is essential, as it holds the breast implant in place and prevents slippage, but if the scar tissue contracts too tightly, it can cause the breasts to become hard, distorted and even painful. When capsular contracture begins to present visible distortion or causes discomfort, corrective surgery to remove the capsule and replace the implant is necessary. You can minimise the risk of capsular contracture by wearing a supportive compression bra and ensuring your breast incision sites are clean. Having textured implants inserted can also help to avoid the implants moving.

What Is the Difference between Textured & Round Implants?

Textured implants have a rough surface, similar to sandpaper, that adheres to the breast tissue. The texture stabilises the implant in position and reduces the risk of capsular contracture. Anatomically shaped implants, also known as teardrop implants, are textured to avoid rotation and typically feel firmer than smooth implants. Round implants, however, can be textured or smooth. A smooth breast implant shell is thinner than a textured shell, which can make the breast feel softer and more natural.

Can You Be Allergic To Breast Implants?

Breast implants are made of silicone and sometimes filled with a sterilised saline solution. These are biocompatible materials that are suitable for living tissue and pose no risk of injury or rejection by the immune system. Silicones can be found in everyday items, such as antiperspirants, shaving creams, shampoos, cooking utensils, soaps, laundry detergents, fabric conditioners and contact lenses, so you have likely already been in contact with silicone. If you have experienced allergy symptoms post-surgery, it is more likely due to the medications or adhesives used during the surgery.

Is Breast Implant Illness Real?

Breast implant illness, commonly referred to as BII, is a term that some women and medical professionals use to refer to a wide variety of symptoms that appear to have developed after breast augmentation surgery. In some but not all cases, women who have had their breast implants removed have reported improved symptoms. BII is a very difficult topic as it is not currently recognised as an official medical diagnosis, and there is no scientific evidence proving an association between medical grade silicone breast implants and chronic illness. However, where does that leave women who are experiencing symptoms? The only treatment that surgeons can offer is to remove the implants, but there is no guarantee that the symptoms will disappear.

Plastic Surgery After Massive Weight Loss

Although plastic surgery has many subspecialties—including craniofacial and maxillofacial surgery, microsurgery, reconstructive surgery, cosmetic surgery and surgery that address issues of burns and skin cancers—a large subspecialty is the plastic surgery required after massive weight loss. The term ‘reconstructive surgery’ applies to all the subspecialty within plastic surgery, including some ‘cosmetic surgery’ procedures. In Australia, all plastic surgeons are classified as Plastic and Reconstructive surgeons. Personally, I am a member of the Australian Society of Plastic Surgeons, whose motto is Corpore Mens Melior Refecto (‘the mind is better when the body has been restored’). Reconstruction means to restore to a state or to create a state that is ‘normal’; ‘normal’ means something that is functional or acceptable to an individual’s race, sex and age. ‘Normal’ is also in the eye of the beholder and the mathematical definition of average cannot be applied to the human form when defining normal.

The most common cause of massive weight change is pregnancy. Another common occurrence of massive weight loss exists in individuals who are carrying a great deal extra weight and who lose weight through diet and exercise. Finally, individuals who require surgical assistance to lose weight—such as lap band, gastric sleeve and gastric bypass surgery—represent another common occurrence of massive weight loss. No matter the cause, individuals who have lost a massive amount of weight experience the same issue—their bodies become smaller but their skin does not. Skin does not contract, shrink or wrap around a smaller body. Metaphorically, excess skin represents the former self—or an old dress. Individuals who have lost a massive amount of weight become smaller, fitter and healthier but they are essentially wearing a dress that is too big. The bigger the loss, the baggier the dress.

This can often cause or contribute to ‘yo-yo’ dieting habits—a vicious cycle of weight loss and weight gain. Individuals who lose massive amounts of weight do so through discipline, diet and exercise. However, when they look in the mirror they often still view themselves negatively due to the excess skin that hangs from their bodies. This can lead to individuals not only giving up and reverting to their old dietary habits but also developing a more concerning issue—depression. So, what do you do when you have a dress that is too big for you? You cannot throw away your skin but you can have it tailored. As your surgeon, I can tailor your skin to fit your body.

I like to compare the surgery required after massive weight loss to dressmaking. In dressmaking, you remove material and run a seam; in surgery, you remove skin and create scars. Creating scars improves contours. Therefore, creating more scars can create better contours. Of course, reconstruction involves far more than skin, but this is the simple way in which I explain reconstructive surgery to my patients—that surgeons tailor their patients’ skin to fit their body.

Actual tailoring involves materials that do not have much stretch. When you purchase a custom-made dress, you typically have a fitting so adjustments can be made to ensure that the dress fits perfectly. Although surgery after massive weight loss can be compared to dressmaking, it is much more complex. Skin and tissues are not rigid—they swell, stretch, shrink and sag. Additionally, the body beneath the skin also changes, which is especially true during the first few months after surgery. Therefore, as a surgeon, I craft, sculpt and reshape things that are 3D, and not static. I also ensure that I do not make things too tight because that can result in serious problems with how a wound heals and breaks down. After the initial post-surgery swelling starts to decrease and the skin settles into position, it is normal for your skin to not feel as tight as it did initially. Therefore, it is not uncommon to require further minor surgery to fine-tune the results.

Although massive weight loss affects skin in every area of the body, the four common areas are the arms, the breasts and chest area, the stomach and the thighs. However, there is a limit to how much can be achieved in one day so you typically cannot have every procedure done at one time. Combinations that can occur in the same surgery are the breasts and stomach and the breasts and the arms. For some individuals, I might combine the arms, the breasts and the stomach. However, operating on the thighs is something I never combine with another area because it is a big operation with its own potential and significant issues. Basically, we start with the areas that most concern an individual and then we continue in stages depending on the degree of concern and other considerations such as lifestyle and financial constraints. The minimum time period between each surgery is three months.

My job is to educate my patients. We have real discussions about what they are dealing with and what needs to happen to ensure they reach their goals. I have a YouTube channel with an extensive video library showcasing all my surgeries. Many of my patients have observed my surgeries and followed my YouTube channel for a long period so they are familiar with the surgeries and know what is involved. I also never trivialise an operation. Although it would be easy to simply show before and after pictures, every surgery carries risks that patients need to understand. Regarding consenting, although all operations have similar post-op course issues and potential complications, each operation has a unique post-op course and potential complications that I must bring to my patients’ attention, which are things we discuss during our consultation. I also clarify any issues they may have.

Do patients who have lost a massive amount of weight experience medical or cosmetic issues? Although there are explicitly physical problems associated with having excess skin, other issues are implicitly physical. Can psychological problems be physical? The body and mind are intertwined and while psychology and psychiatry are large fields of medicine, where is the distinction? When do we say that the surgery to address these concerns is purely cosmetic? Referring to my earlier definition of ‘reconstruction’, all surgery required to address these patients’ concerns is without question reconstructive surgery. As a secondary benefit, they are going to look better. However, the primary purpose of the surgery is not cosmetic but reconstructive.

Any form of reconstructive surgery is complex and carries risks. However, to compound these risks, the skin and tissue quality of many of these patients is poor, which increases the potential for issues such as poor wound healing. This leads to a higher risk of wounds breaking down with skin and tissue loss. Therefore, there is a high risk of further surgery being required in the postoperative stage to address these issues. Higher-risk patients must accept the possibility of experiencing wound healing issues that will warrant further surgeries and downtime. This is all part of the consent process discussed at length prior to surgery.

Overall, the surgery required to address the issues experienced by patients who have undergone massive weight loss is total-body reconstruction. For a surgeon to succeed at this type of surgery, they must appreciate anatomy and ‘normal’ aesthetics. However, many surgeons avoid these patients because they are considered difficult and ‘not worth the risk’. Such surgeons typically chose ‘easy’ surgical problems to address. Additionally, many surgeons lack the technical and artistic skill set to manage these patients, which is another reason why they choose to not treat them. Any surgeon can cut and sew. However, to be a master reconstructive surgeon requires an artistic flare to sculpt, reshape, restore and reconstruct a living work of art.

 

BREAST LIFTS Part 3 – Combined Breast Lift-Augmentation Surgery

This is part three of my series of breast lift surgery videos where I’m going to discuss breast lift/augmentation surgery.

A combined breast lift/augmentation surgery (which means performing a breast lift and inserting implants during the same operation) is far more complex than either one of the procedures done separately. It is the most difficult of all cosmetic breast surgery procedures performed and because of this many plastic surgeons choose not to do them.

And whilst some are much easier than others, in general they are extremely challenging.

So prior to undergoing surgery patients need to be made aware of the complexity of this combination procedure, have realistic expectations, and understand that additional surgery (along with the additional recovery time, time off work, stress, expenses etc) may be necessary in the short or long-term.

So why is it so complex?

There are numerous things that a surgeon must (or at least should) assess and consider before contemplating and planning a surgical breast lift (with or without an augmentation).

They include:

  • Skin quality
  • Degree of sag
  • The nipple direction
  • The skin distance from the nipple to the lower breast fold
  • Nipple areolar size
  • Breast tissue quality
  • Breast tissue volume
  • How “detached” the breast tissue is from the chest wall muscles
  • The patients’ desired look
  • And finally, Time, and how that will impact on the results.

A concept that one needs to understand is that a breast lift/augmentation surgery requires the surgeon to increase the breast size with breast implants, whilst at the same time reducing the breast envelope (that is, removing skin and breast tissue in order to achieve the breast lift). These two potentially counterproductive actions must be balanced as perfectly as possible in order to achieve the desired results.

Ultimately, the surgeon needs to lift the nipple and breast tissue to ensure a uniform and “tight” distribution of the natural breast tissue over the chosen implant to create a uniform appearing and feeling breast mound.

During breast lift procedures the nipples remain attached to their blood and nerve supply while they are repositioned. Some of the technical difficulties and limitations of a breast lift surgery is related to ensuring that you surgically don’t completely cut off all the blood supply to the nipple, which would basically mean the nipple would literally die and fall off!

Performing a breast lift without an implant allows the surgeon to apply more surgical “manoeuvres” designed to lift up the breast tissue to maximise the chance of the breast tissue remaining high. Every surgical step involved in a breast lift does to some degree cut off part of the blood supply to the nipple. When an implant is added to the equation, many of the steps involved in creating a pocket for the implant, and the pressure effect from the implant, further compromises the blood supply to the nipple. Therefore, the surgeon often needs to limit the “manoeuvres” required to maximally lift the breast tissue. They also need to reduce the “maximal size” of the implant that could otherwise be used for a simple breast augmentation. These limitations can add to the potential issue of the breast tissue re-sagging early after surgery.

The potential for “re-sagging” is even greater with breast tissue problems such as:

– large volumes

– breast tissue that is very soft and lost its elasticity

– breast tissue that is “detached” from the underlying muscle and slides around

– skin that is thin and has lost its elasticity

Given that women wanting a breast lift typically have one or more of these problems, then you can appreciate that one of the main issues with a breast lift/augmentations is that the breast tissue doesn’t stay where we want it to stay.

Essentially the patient is needing a breast lift because they have weak and soft breast tissue quality which has sagged – yet that same breast tissue and skin still exists after surgery, and it’s therefore still wanting to sag. No surgery and no surgeon can change the quality or consistency of the breast tissue and skin. All the surgeon can do is try to reposition and sculpt the breast tissue.

In addition to breast tissue that doesn’t necessarily stay where it’s meant too, breast implants don’t necessarily stay where we wish they would. Therefore, breast implant related problems such as positioning (too low, lateral slide etc.) can occur and may be a reason for returning to the operating room for further surgery. This is especially the case in those women needing a breast lift because there breast tissue envelope is typically soft without any structural support so it easily stretches again resulting in a very mobile implant.

In the end, often the “full perky” look that many women want is simply not achievable due to the persons chest wall shape, breast footprint, and nature of the persons natural breast tissue.

If you need a breast lift and also want implants, then the surgical options I’ll recommend will depend on the state of your pre-existing breasts and the look you’re after. The two possible options include: the single combined lift/augmentation operation, or two separate operations.

The single operation approach basically means having a combined breast lift and augmentation. Many variables are considered before I decide who is suitable for this, and it is decided on a case by case basis. As a very general guide the ideal candidate for this is someone who has minimal breast tissue, mild to moderate sag and still has relativity firm tissue and elasticity. However, even in the ideal candidate, I would quote about a 20% chance of the patient requiring further surgery to “fine tune” the results.

The Two Staged (or two operations) Approach means performing a breast lift first, and an augmentation as the second operation at a later date. This is the option taken for those when I believe it is too risky to attempt a combined lift augmentation. Who that may be is decided on a case by case basis, but generally speaking the typical patient who is offered this option has significant sagging and/or has a large volume of soft breast tissue. Trying to do a lift and augment in one operation for this group of patients would be risky and has a high chance of significant complications and a much greater chance (more than 50%) of requiring further surgery. That is, whilst you could offer a single combined lift augmentation operation to this group of women, more often than not a second unplanned surgery is required to fix problems.

The rationale for a two staged approach in such women is simple:

  • The breast lift alone is designed to create an improved breast shape with the nipples sitting at the correct level. Then approximately 6 months later a well planned breast augmentation is performed as it is easy to make what is now a good breast shape into a bigger good breast shape. However, many patients don’t proceed with this augmentation as they are just happy to have a good breast shape!

An important aspect of the breast lift alone is that such patients will most likely not achieve a long-lasting upper pole fullness as the breast tissue will settle into a lower position. Hence most of these women do want augments to address this problem. 

I will briefly mention here that upper pole fullness can also be achieved to a lesser degree with fat transfers but that’s a separate topic that I’ll cover another day.

So basically you opt to do two well scheduled and well planned operations – a lift first then an augmentation later – to have the best chance of achieving a great long term result. This is far better than doing one planned operation, a combined lift augmentation, where we have a high chance of needing further unplanned surgery to try fix problems, patients not happy, surgeons not happy and we are less likely to get the best long term outcome.

Basically, we want to choose the best pathway, safest pathway, least potential problems pathway to achieve the best long term results, and if that means two planned operations, then that’s how it needs to be.

And finally, with a planned two stage approach, the surgeon could potentially, and safely, use a larger implant than would otherwise be possible with a combined lift augmentation.

Anyway, I hope you’ve enjoyed my 3 part breast lift series  (see part 1 and part 2), and that it’s shed some light on the complexity of breast lift surgery.

In the end, do your homework, always consider second opinions, and if you want my opinion, give my office a call to schedule a one on one consultation with myself.

BREAST LIFTS Part 2 – THE SURGERY with or without implants

A breast lift procedure simply means lifting up the breast tissue and nipple area to create a better breast shape. This can be done with or without the use of an implant.

Whether an implant is required or not, there are three types of scar patterns that can be used for breast lift surgery.

Circumareolar or “doughnut” technique  or Benelli technique – this involves a circular incision made around the areola. This technique is a minimally invasive procedure that achieves a small degree of lift. It results in a scar around the areolar and is also suitable for reducing the size of the areolar. However there is a limit to how much the areolar can be reduced as they typically tend to stretch back out again especially when implants are also used. It can also create a very flat looking breast.

Vertical or lollipop technique – this is named a lollipop because of the type of scar it leaves. It results in a scar that extends around the areola and down the midline of the breast to the lower breast fold. Although this procedure is slightly more invasive, it achieves a larger degree of lift with some slight reduction in natural breast tissue volume.

Anchor technique – involves an anchor-shaped scar that extends around the areola, down the lower midline of the breast and along the lower breast fold. This is required in those who require a significant lift and possibly need a reduction in natural breast tissue volume.

Often extra volume is required as well as a lift of the breast tissue – therefore implants are used.

When performing a breast lift with implants, the basic principle means that the surgeon must use the correct technique for that patient to ensure that the breast tissue is lifted in such a way that there is a uniform distribution of breast tissue over the implant to create a uniform breast shape.

There are a number of options available when someone needs a breast lift and also desires extra volume. These include:

First option – if a mild or borderline sagging problem exists, sometimes a good result can be achieved with an appropriately planned augmentation alone. In other words, no formal breast lift scar, just a routine augmentation scar. Of course once things have settled and if the results are not ideal, then you can still proceed with a lift at a later date.

The second option is to perform a combined breast lift and Augmentation* – The ideal candidate for this is someone who has minimal breast tissue. However, there are some technical limitations with the implant size that can be used with such an operation. Furthermore, even in the ideal candidate, I would typically quote around a 20% chance of patients requiring further surgery to “fine tune” the results. However, you would need to wait a minimum of 6 months to allow the results to settle before contemplating and planning this.

*Specialist Surgery – it is important to note that a combined breast lift with implants, otherwise known as mastopexy augmentations, is the most difficult cosmetic breast surgical procedures to perform. Therefore they should only be performed by specialist plastic surgeons that have an expertise in these cases.
However, many plastic surgeons opt to not perform this operation because of the inherent difficulties in doing it.

The third and final option for those needing a lift and wanting extra volume is to have a two staged approach – in other words, two planned operations. This typically means performing a breast lift first, and an augmentation as the second operation at a later date. There are a number of issues that I use to determine is this is the best option, however the typical patient who is offered this is someone who has a significant amount of natural breast tissue that has softened and sagged. Trying to do a lift and augment in one operation in these patients generally has a greater risk of complications and a very high chance (often greater than 50%) of requiring further surgery. That is, whilst only one combined breast lift augmentation surgery is planned, more often than not a second unplanned surgery is required to fix problems and improve the results.

Therefore, in these patients a two planned surgeries approach is preferred. The first operation is to perform a lift and create a good breast shape. The second operation, performed a minimum of 6 months after the first, is to make that new good breast shape larger with a carefully planned augmentation. However, many patients don’t proceed with this augmentation as they are just happy to have a better breast shape with the nipples sitting at a better level.

Not to confuse the issue, but some surgeons may opt to do the two stage approach in reverse – doing an augmentation first, and then performing the lift at a later date and there is nothing wrong with this approach.

Finally, many women who need a lift don’t want to pay the additional costs and/or have the scarring associated with a breast lift. Therefore, they only want an augmentation so that they have the fullness they desire in lingerie and clothing. And whilst they will not look great naked with breast tissue hanging from an implant type look, this is not a concern to them because they simply state that everyone sees them in clothing and extremely few people see them naked. Of course, if at a later date it does bother them, then they can have a formal lift then with no problems.

In Part 3 of my Breast Lift Surgery series I’ll discuss the technical aspects and reasoning behind some of the surgical decision making in more detail.

BREAST LIFTS Part 1 – The Assessment

This is Part 1 of 3 in my series covering breast lift surgery. In Part 1 I’m going to discuss the assessment and things I need to consider when planning your surgery. 

A breast lift, especially if combined with an implant, is the most difficult cosmetic breast procedure to perform and junior or inexperienced surgeons have troubles performing this surgery well because there are so many issues, or variables, that need to be considered. And the greater the number of variables you have in an equation, then the greater the difficulty in solving that problem.

A breast lift procedure simply means lifting up the breast tissue and nipple area to create a better breast shape. This can be done with or without the use of an implant.

There are numerous things that I must consider before contemplating and planning a surgical breast lift. In addition to all the planning typically required for a breast augmentation, other vital issues need to be considered to determine how to work with those variables to give you the best result, and to determine what results are realistically possible.

Breast issues:

  • Your Skin quality– is the skin loose with many stretch marks or thick and firm without stretch marks. Often the skin in someone requiring a lift has lost much of its elasticity. Thin skin with loss of elasticity means things have a much greater risk of re sagging
  • Degree of sagging of the breast and how much does the nipple need to be lifted. Is it sitting below the level of the lower breast fold and by how much? The lower they are sitting, the greater the degree of difficulty in lifting it and keeping it up.
  • The nipple direction – is it pointing downwards or just droopy but still pointing forwards.
  • The skin distance from the nipple to the lower breast fold – if it’s too long that’s a slight problem. But if it’s very short then that’s potentially a greater problem.
  • Nipple areolar size – a very large areolar size can be a potential problem with surgery.
  • Breast tissue quality – is it firm or soft. Soft breast tissue is very difficult to handle and typically always wants to sag! Another extremely important thing to understand is that soft breast tissue will always be soft – nothing can be done to make soft breast tissue firm again. Surgery simply redistributes or repositions the breast tissue. Even with an implant it will still be soft, and it has a much greater risk of re-sagging.
  • Breast tissue volume– the greater the amount of natural breast tissue the greater the degree of difficulty with the surgery. Lifting a large volume of breast tissue and trying to keep it up is difficult and indeed often not possible. The more natural weight the more that gravity is going to affect it!

Furthermore, the greater the amount of natural breast tissue the greater the amount of changes that occur over time. Having a lot of breast tissue can be considered a blessing when it’s all sitting right, but over time it’s going to change far more compared to those with minimal breast tissue.

  • How “detached” your breast tissue is from the chest wall muscles is another issue that’s often difficult to explain. Sometimes the breast tissue is very mobile with loose attachments to the underlying muscle and effectively your breast tissue is sliding around over your chest wall. This makes the breast tissue extremely difficult to handle and therefore difficult to effectively lift.
  • Your desires – what look is the person wanting?
  • Time – the final variable which is impossible to work with is time. How much your natural breast tissue changes after surgery based on your genetics and personal circumstances is impossible to know. Often times women will achieve an excellent result early after surgery, but within a relatively short period of time their breast have continued to sag or change. This can be due to natural breast tissue volume fluctuations, weight changes, hormonal changes etc, and these things will negatively affect the results.

As stated previously, the greater the number of variables an equation has, the harder it is to solve the problem, and that is why the problem of breast lift surgery is so very difficult.

Perhaps the hardest thing for patients to accept is that they are needing a breast lift because they have weak and poor-quality breast tissue which has sagged – yet that same breast tissue and skin still exists after surgery, and it’s therefore still wanting to sag. No surgery and no surgeon can change the quality or consistency of the breast tissue and skin. All the surgeon can do is try to reposition and sculpt the breast tissue on that day of surgery.

As you can appreciate, there are numerous natural anatomical variables that I must assess and work with when planning your breast lift surgery. Of course, due to the persons pre-existing breast state, it’s often not possible to achieve the results that person desires. This is when painting a clear picture of realistic expectations is required.

In Part 2 of my Breast Lift Series, I’ll cover the different types of surgical options available.