THE ART OF BREAST - PDF document

1 THE ART OF BREAST AUGMENTATION What you need to know about breast augmentation surgery. DR DAVID SHARP WWW.DRDAVIDSHARP.COM.AU 2 BREAST AUGMENTATION GALLERY VISIT SITE Visit our website for our full CONGRATULATIONS On starting your breast augmentation journey! The �rst stages of breast augmentation planning are very exciting; there’s so much to learn and so many questions to ask. Information is power, and your body’s health is its greatest asset, so it’s important to understand the options, surgical techniques, risks and recovery associated with this procedure. We hope this guide provides you with some answers, and poses questions you may not have thought of as yet. Our friendly team prides itself on delivering gold standard clinical care, supporting our patients through every step of their journey. We look forward to welcoming you at one of our clinics, when the time is right for you. Specialist Plastic Reconstructive and Aesthetic Surgeon Fellow of the Royal Australian College of Surgeons Member of the Australian Society of Plastic Surgeons Performed over 20,000 operations Warm regards, Dr David Sharp MBBS FRACS (Plast) DR DAVID SHARP, SURGEON 3 MY BODY. MY CHOICE. MY CONFIDENCE My breast augmentation guide 1 // Preparing for breast augmentation surgery 04 // 06 // The procedure 07 // The placement: under, above, dual plane 08 // Recovery, maintenance, replacement + risks 09 // Choosing the right surgeon for you 10 // Pregnancy, breast lift + mummy makeover 11 // Costs 12 // Preparing for your �rst consultation 13 // The Dr David sharp difference 14 4 // PREPARING FOR BREAST AUGMENTATION SURGERY DR DAVID SHARP QUICK FACTS: Breast augmentation in Australia 40,000+ augmentations are performed annually The averag

e breast augmentation patient is 30+ yrs old A doctor is a quali�ed ‘plastic surgeon’ if they are a Fellow of the Royal Australasian College of Surgeons - denoted by FRACS (Plast) after their name Quali�ed ‘plastic surgeons’ have completed about 16 years of medical and specialist surgical training, and passed rigorous testing. Performed in combination with other procedures, including abdominoplasty, breast lift or face lift surgery Australian surgeons + hospitals observe world-leading safety standards What is a breast augmentation? Breast augmentation, also known as augmentation mammoplasty, can be a cosmetic procedure - or a reconstructive procedure, in the case of breast reconstruction surgery after mastectomy or trauma. Breast augmentation can Increase fullness and projection of your breasts Improve the balance of your �gure Even up asymmetric breasts and improve deformities Reconstruct a breast after mastectomy or injury Enlarge breasts that never developed a proportionate amount of breast tissue Breast augmentation can enhance your appearance and your self- con�dence, but it won’t necessarily change your looks to match your ideal, or cause other people to treat you differently. Before you have surgery, think carefully about your expectations and discuss them with your surgeon. 5 What breast augmentation surgery alone won鉴 do Breast augmentation does not correct severely drooping breasts. If you want your breasts to look fuller and to be lifted due to sagging, a breast lift /mastopexy (pictured below) may be required as well. What does breast augmentation surgery involve? The procedure involves implants - usually silicone - being inserted beneath, or sometimes above, the breast muscle (right) . The objective of

this procedure is to increase the size of your breasts, or restore breast volume that has been lost after weight reduction or pregnancy. Dr Sharp performs this surgery under general anaesthetic, usually as a day procedure. Before + 6 weeks after combined breast augmentation + mastopexy surgery Is there a minimum age for breast implant surgery? Cosmetic surgery - that is, aesthetic surgery that is not medically required - can only be performed on patients who are over 18, unless the patient has congenital abnormalities such as tuberous breasts or breast asymmetry – and only when there has been no breast growth for at least 6 months. 6 How do I know if breast augmentation is right for me? The best candidates for breast augmentation are women who are looking for improvement, not perfection, in the way they look. Breast augmentation can be performed before or after having children. It’s important to factor in that pregnancy and breastfeeding can change your breast augmentation results, and sometimes necessitate revision surgery. If you’re physically and mentally healthy - and realistic in your expectations - you may be a good candidate for breast augmentation surgery. Breast augmentation is a highly individual procedure and may not be suitable for everyone. Breast augmentation results are often portrayed as painfully oversized, unrealistic depictions of reality; as seen in tabloid magazines (right). Most of Dr Sharp’s patients are average-sized women who are simply seeking proportion, natural balance and shape. We focus strongly on achieving a naturally beautiful look . Before you decide on breast augmentation with implants, there are some important issues to keep in mind: Breast augmentation does not correct droopy breasts Implants may not last a lifetime and future su

rgery may be needed The surgery is only suitable for non smokers If you are concerned about the way you look and considering surgery to boost your con�dence, there are alternatives to consider; including padded bras or accepting your current size External pressures from the media, partners or friends can in�uence how we view our bodies. Dr Sharp doesn’t support patients having surgery for the sake of meeting anyone else鉳 expectations. If you aren’t doing it for yourself, reconsider having surgery at this point in your life. 7 Your consultation The initial consultation with Dr Sharp is a double appointment; during this time he will discuss the procedure with you, and you’ll an indication of the size and type of implant that will achieve your desired result. The fee is $220, with a $50 deposit payable upon booking, leaving $170 payable on the day of consultation. If you decided to proceed with surgery following this appointment, you will have a second – free of charge – consult with Dr Sharp prior to your surgery. Breast augmentation may be a good option for you if: One or both breasts failed to develop normally You are physically and mentally in good health You are dissatis�ed with your breasts losing shape and volume after pregnancy, weight loss, or with aging You have realistic expectations Your breasts are now fully developed Your breasts vary in size or shape You acknowledge that the natural shape and size of your breasts before surgery will outcome 8 // IMPLANT SELECTION: SIZE, COMPOSITION PROFILE + SHAPE DR DAVID SHARP Types of breast implants: composition SALINE IMPLANTS A silicone envelope �lled with varying amounts of sterile salt water (saline). This can affect the shape, shell leaks, implan

t will collapse and saline will be absorbed and naturally expelled by the body. SILICONE IMPLANTS A silicone envelope �lled with an elastic gel that feels much like natural breast tissue. If the implant leaks, the gel may remain within the implant shell or it may escape into the scar capsule (area around the implant) or even into the breast tissue. A leaking implant �lled with silicone gel may not collapse. Types of breast implants: shape ROUND BREAST IMPLANTS Round breast implants have a tendency to make breasts appear fuller. Higher pro�le options can achieve even more projection. Because round implants are the same shape all over, there is less concern about them rotating out of place. ANATOMICAL BREAST IMPLANTS Anatomical (or tear drop) breast implants main characteristics is a �atter upper breast pole and a fuller lower breast curve. An appearance that usually is associated with a youthful natural- looking female breast appearance. Types of breast implants: coating SMOOTH BREAST IMPLANTS Smooth breast implants are the softest feeling. These implants can move with the breast implant pocket, which may give more natural movement. Smooth implants may have some palpable or visible rippling. TEXTURED BREAST IMPLANTS Textured breast implants develop scar tissue to stick to the implant, making them less likely to move around inside of the breast and get repositioned. Texturing offers some advantage in diminishing the risk of a tight scar capsule. 9 Which implants does Dr Sharp use? Dr Sharp uses Mentor and Motiva smooth or micro/nanotextured silicone gel breast implants in most cases.The modern, new-generation silicone breast implants Dr Sharp uses carry some of the best safety records in the world, and have evolved to a very high standard, offering

a wide range of pro�le options, providing a more natural appearance and feel - along with a consistent health records, and manufacturer’s replacement warranties. Your implant choice is one of the most important factors in determining your end result. Dr Sharp will assist you in making the right selection for your body shape. It’s important to remember that just because a friend with the same pre-augmentation cup size as you had a certain implant shape or size, that it’s also the right one for you. The best breast implant for you should be determined after a discussion with your surgeon about your desired result, examination and measurement of your chest. Th�ngs to cons�der before hav�ng breast implants include: Composition: saline or silicone Shape: round or anatomical Projection: low, medium, high or extra high Coating: textured or smooth Silicone or saline? Saline breast implants contain sterile salt water, similar to the �uid that makes up most of the human body. They can have a textured or smooth surface - and come in moderate, moderate plus and high pro�les. If alt water will be absorbed and expelled by the body. They are less frequently used in modern plastic surgery, as advancements in silicone implants provide more options for most patients. he gel is soft and created to mimic natural breast tissue, albeit �rmer. If a silicone implant leaks, the form stable cohesive gel (also known as ‘gummy bear’) implants Dr Sharp usually uses will remain within the implant shell; it will not collapse. The consistency is often described as being somewhat like turkish delight jelly. Smooth or textured breast implants? Textured implants are predominantly used by Dr Sharp as they are associated wi

th a reduced capsular contracture risk and the surface is intended to cause the breast tissue to adhere to the implant and prevent it from moving or rotating. 10 How to choose the right breast implant size During your consultation with Dr Sharp, you will try on implant ‘sizers’ to provide an indication of the best implant size for your body. We also offer 3D simulation technology. Dr Sharp advocates a natural-looking approach to breast augmentation surgery that takes into consideration a woman鉳 frame to achieve a beautifully enhanced, balanced outcome. The human eye sees beauty in proportion; rather than distorting or exaggerating the body, ethical cosmetic surgery aims to restore balance and harmony, producing realistic results.  Optimal results are obtained when the body is in proportion. Breast implants change the body; even if you have them removed in the future, there will be excess skin, scaring and potential complications to consider. Excessively large breast implants can cause a number of complications and functional issues: back and neck pain excessive pressure on the inframammary fold, causing it to ‘bottom out’ - whereby the implant protrudes through the internal inframammary fold that is meant to be supporting it an overall ‘heavier’ look in the upper body that can result in the patient looking as though the禒ve gained weight overly stretched skin which may need revisional surgery if the implants are downsized due to aforementioned issues in the future your chest Patients seeking an excessively large and intentionally disproportionate look from their augmentation surgery often experience costly complications and high levels of dissatisfaction. Dr Sharp encourages his patients to consider these factors before undertaking augmentation surgery. Round o

r teardrop/anatomical? The best implant shape for you will depend upon all those individual factors that make your breasts - and body shape - unique. There’s no one-size-�ts-all ideal; which is why the right implant choice is one of the most important factors that determines your end result, and should be made after lengthy consultation with an experienced plastic surgeon. Round breast implants can make the breasts appear to sit higher, and with greater volume in the upper pole (above the nipple). Round implants are less likely to change the appearance of your breast if they rotate. Anatomical breast implants are shaped rather than round. They have more projection in the lower pole (below the nipple) and are tapered towards the top. Anatomical implants are often favoured by women wanting to obtain a natural-looking, gently sloping breast silhouette. If an anatomical, or ‘teardrop’ implants rotates, it may lead to an unusual appearance of the breasts. 11 How do I know if my implant is leaking or ruptured? If your doctor believes you may have a leaking or ruptured implant, they will refer you for an ultrasound. While ultrasounds are not conclusive ways of telling if you have a leak in your implant, they can provide a helpful indication, and further tests or surgery may be organised from there, in consultation with your surgeon. If you are seeing Dr Sharp regarding a potentially ruptured implant, it is advisable to visit your general practitioner to obtain a referral and have an ultrasound organised prior to seeing him, so the results and options can be discussed in context with the ultrasound results during your consultation. Implant rupture is one of the most common breast augmentation complications, and while it requires attention, it does not usually mean you have to urgently

have the implant removed - so while it’s advisable to book a consultation promptly, it is not a medical emergency that requires urgent surgery. Which breast implant brand does Dr Sharp use - and why? Regulations prevent surgeons from publicly naming the brand of implants used, however this information can be provided upon request to the clinic, with a patient education pack featuring extensive information about the implants given to you to take home. Dr Sharp uses a range of implant types, but predominantly chooses a spec��c brand of s�l�cone �mplants for h�s pat�ents, which are manufactured in the USA and have had a safe track record for over 20 years. He has chosen this implant brand for its high quality of manufacturing, its safety history, range of sizes and pro�les; and also because it uniquely offers a lifetime replacement warranty. Why it’s important to ask about implant warranty provisions Capsular contracture and rupture are two of the most common breast augmentation complications, and require the breast implants to be removed - and if the patient wishes, replaced. If your original implants were not covered by a warranty, or if you do not have private health insurance that covers such complications, the expense of a second procedure can exceed that of the original augmentation. Due to the high quality of the implants we use, if our patients experience capsular contracture or rupture, the cost of replacing their implants is covered, and a portion of the rest of the out of pocket fees for the surgery are also reimbursed by the implant manufacturer. 12 The Australian Breast Device Registry; why we participate All breast implants used by Dr Sharp are registered with the Australian

Breast Device Registry, so our patients can always access speci�c information regarding their implants. We also retain a copy of manufacturer’s details and serial / batch codes for future reference if required. What is BIA-ALCL? BIA-ALCL (breast implant associated anaplastic large cell lymphoma) is a rare type of lymphoma that develops adjacent to breast implants. It is not breast cancer. ALCL usually presents as swelling of the breast or a lump in the breast or armpit, most commonly between 3 to 14 years after the implants are placed. Internationally, on average, the risk is believed to be around 1 in every 5,000 women who have breast implants – but due to the quality of the implant Dr Sharp uses, the risk for our patients is approximately 1 in 60,000. The Therapeutic Goods Administration has advised that of the small number of cases reported in Australia, most were cured by removal of the implant. Research shows that of the small number of ALCL cases in Australia, almost all were performed by cosmetic (unquali�ed) surgeons and used macrotextured implants – so choosing a quali�ed plastic surgeon and the right implants is the best way to avoid these risk factors. Dr Sharp performs breast augmentation surgery in accredited hospital facilities and upholds the highest standards of infection control, to reduce the risk of bacterial ‘bio�lm’ contamination associated with the disease. He is also one of the surgeons in Australia who has committed to the Macquarie University’s 14 Point Plan; created subsequently, BIA-ALCL. Read up to date information about BIA-ALCL on the news page on our website. How safe are silicone breast implants? Silicone implants have changed over the decades and the modern ‘new generation’ implants Dr S

harp uses are safer than ever, with reduced health risks - while maintaining a realistic and natural looking result. Silicone is derived from silicon; a naturally occurring element found in sand, crystals and quartz. It’s also found in many common household items such as polishes, cows milk, moisturising creams, suntan lotions, deodorant, soap and chewing gum. The amount of silicone released from a breast implant is very minimal; and some research shows the amount is less than what is absorbed from daily consumer products containing silicone. When modern implants ‘rupture’, the cohesive gel inside does not leak or spill into the body, rather it usually stays contained within the implant shell. Do implants impact mammogram screening? Breast implants may interfere with your mammogram results. It can make the mammography more patient. For these factors, along with the extremely small risk of implant movement or damage during mammography, Dr Sharp recommends ultrasound for breast screening after breast augmentation. It is very important to discuss any family history of breast cancer with Dr Sharp during your pre-operative consultations. 13 // BREAST AUGMENTATION: THE PROCEDURE DR DAVID SHARP A breast augmentation procedure includes the following steps: Step 1 - Anaesthesia general anaesthetic with a specialist anaesthetist, meaning you will be completely asleep and feel nothing. Step 2 - The incision Incisions are made in inconspicuous areas to minimize visible scarring. Dr Sharp routinely uses an inframammary incision as it allows good exposure and maneuverability during the surgery and also leaves a scar hidden in the breast crease. Step 3 - Inserting and placing the breast implant After the incision is made, a pocket is created for the insertion of the breast implant. The

location of the pocket can be either sub-muscular, sub- glandular or dual plane. Step 4 - Closing the incisions Incisions are closed with layered sutures in the breast tissue and with sutures, skin adhesive or surgical tape to the skin. A small thin drainage tube is sometimes left in the breast for 12-24 hrs to assist with drainage of blood or �uid. Step 5 - See the results The results of breast augmentation are immediately visible 14 Sensation changes after breast augmentation: what to expect Numbness is a normal part of any surgical procedure, and can be expected for several weeks or months after surgery, as the nerves are traumatised by surgery and may be compressed by swelling. Sensation in the breast and nipple can increase or decrease after augmentation surgery - ranging from a total loss of feeling through to tingling or sharp twinges. Most loss of feeling will resolve in 2 to 3 months, however some areas - such as the nipples and the area directly around the scar line - can take up to 2 years to resolve. The last place to regain the sensation will be directly adjacent to the incision, as the nerves make their way from the periphery to the scarline. In some cases, sensation may never return to 100% of what it felt like previously. This is slightly more likely to be the case when breast lift surgery is performed along with the augmentation. The usual signs of the nerves regenerating are itching, followed by a burning sensation and then occasional sharp pains; these are normal. Sometimes women feel hesitant to touch the numb areas of their breast as they can feel strange and separate from their body, however it is important to massage and stimulate the nerves to encourage regeneration - you can combine this with your daily scar minimisation massage. The size of the impla

nt relative to the size of your chest diameter is the most important factor that impacts sensory changes, especially numbness; which is why it is important to select an implant size that is appropriate for your body. The smaller the implant, the less dissection required relative to the base of the breast, and the lower the likelihood that nerves innervating the breast from the periphery of the breast will be disturbed. If persistent sensory changes occur, discuss this with your surgeon. What kind of anaesthetic will I have? Breast augmentations are performed under a full general selected range of medications are administered during the surgery to ensure your post- operative comfort. Dr Sharp works with a highly experienced team of anaesthetists in safe, accredited hospital facilities. 15 // BREAST IMPLANT PLACEMENT DR DAVID SHARP What is the dual plane technique for breast augmentation? The dual plane technique is a form of subpectoral - or ‘under the muscle’ - breast implant placement. There are two main kinds of implant placement: Above the muscle, whereby the implant is completely above the muscle Under the muscle, whereby the implant is placed under the pectorals muscle, in varying degrees For the dual plane placement, implant is placed under the pectoral muscle at the upper, and sometimes mid, part of the breast; the lower part of the implant is not covered by the muscle. The varying different degrees of muscle coverage over the implant depends on the patient’s current breast shape and desired result, and that’s why it’s important to choose a surgeon that is experienced in this technique, as the ratio of muscle-covered implant to uncovered implant makes subtle adjustments that impact your result. The dual plane technique is a form of under-muscle attri

bute. The ‘dual’ in ‘dual plane’ actually refers to the fact that the surgeon dissects (or cuts) a pocket out for the breast implant under the muscle, but also dissects off a portion of the breast tissue that’s connected above the muscle. So a dual plane augmentation involves dissection under the muscle, and above the muscle. The purpose of this dual dissection is to detach part of the muscle from the overlying breast tissue, so the breast implant and muscles can relax into a natural shape without holding it to the position of the upper breast tissue, areola/nipple and skin. During the post operative healing period, the pectoral muscle and implant is allowed to �nd their own natural resting position, relative to the overlying breast tissue. That’s why the �nal result of dual plane breast augmentations can take some time to reveal themselves, as these tissues go through various healing stages during the post operative period until they settle into place. 16 Is the dual plane technique right for me? This technique was developed for women with low grade breast droop, or ptosis - as well as those desiring a more natural, lower fullness in their �nal result. This is seen most commonly in women who have lost weight, breastfed or found that ageing lead to excess lower breast (called ‘lower pole’) skin. Patients who have constricted breast deformity, technique. After assessing your breasts and discussing your desired result, your surgeon will explain whether the dual plane technique is right for you. Does the dual plane method replace the need for a breast lift? Not if you have true breast ptosis. The dual plane breast pole in women who might have ‘borderline’ ptosis, or pseudoptosis. For women with actual ptosis, the dual plane techniqu

e will not replace the need for a breast lift. Breast implant incisions and scars Scars are an inevitable part of surgery, however places them along natural skin lines and creases to make the scars as discreet as possible. Dr Sharp and your post operative support nurse will endeavor to minimise scarring and to keep your his team offer a unique pre and post operative skin optimisation program that supports you in maintaining healthy skin quality throughout, and after, your breast augmentation journey, to help reducing long term scarring. If you have concerns about scarring, please discuss this with Dr Sharp or your support nurse. 17 // BREAST AUGMENTATION RECOVERY, CARE REPLACEMENT + RISKS DR DAVID SHARP Breast augmentation recovery Immediately after your surgery, you will be taken into a recovery area to be closely monitored following surgery. Dr Sharp will have put your support bra on during the surgery, so this will be in place when you wake up, helping to minimise swelling and support the breasts as they heal. Usually patients don’t require drains, but - depending on your speci�c case – Dr Sharp may decide you would bene�t from having drains in place after your procedure. These are very small tubes, which drain excess blood into a canister. Most patients have this procedure as a day case, meaning they go home a few hours after surgery. If you have drains in place, your post operative nurse will check on these within 48 hours after your surgery, and remove them when indicated. After a post-surgical breast augmentation recovery period of 24 to 48 hours and an additional reduced- activity period of a few days, you will likely experience soreness and swelling for a few weeks. During this time, you will have support of our post operative care nurse, w

ho is available to take your calls 24/7, should you have any concerns. Dr Sharp and your post operative care nurse will give you speci�c instructions on ongoing wound care, to achieve optimal healing and results. These instructions include: How to care for your surgical site/s following surgery Medications to apply or take to aid healing and reduce risk of infection site/s or in your general health Dressings, wound care and when to resume normal activities You will also go home with a special post operative bag, featuring our favourite products for optimal post op recovery and care. aow much t�me should e take o� work? Most people return to work, particularly if it involves sedentary activity, after 1-2 weeks. For jobs that require heavy lifting, 6 wks may be required Avoid strenuous activity for up to six weeks after a breast augmentation. After this time, gently and slowly reintroduce heavier lifting and activities, being cautious to avoid pulling/tearing or painful sensations. 18 How to maintain your breast augmentation results Breast augmentation results are immediately visible. Over time, post-surgical swelling will subside and incision lines will fade. Satisfaction with your new image should continue to grow as you fully recover from surgery. Everyone’s body responds differently to surgery. In some cases, post-operative revision surgery might be required. Some factors, such as weight, lifestyle or health problems can increase the chance of a complication or unsatisfactory results occurring. Dr Sharp will take time to learn about your potential risk factors during your pre operative consultations, and will determine if they are relevant to your surgery. Do I need to lose weight before augmentation surgery? As with all surgery, you

r post operative healing and chances of attaining an optimal result will be improved if you have a healthy diet and active lifestyle - and maintain a stable weight within your body shape’s ideal range. What happens if I loose weight after my breast augmentation? Minor weight loss will not impact on the appearance of your implants. However, signi�cant weight loss may change their appearance, creating wrinkles or a ‘crêpey’ appearance where underlying fat once supported the skin - and potentially sagging or changes to the position of the breasts on the chest wall. It is ideal to maintain a steady and sustainable weight prior, during and after surgery, to achieve the best long term outcome. Am I ready for the care and maintenance required? Breast implants are low maintenance - they’re very easy to take care of, but that doesn’t mean they don’t require any maintenance at all! Following your surgery, you will receive information about how to monitor your implants, these include: Self examination: once you’re healed, you’ll need to become familiar with your new breasts. If you feel an irregularity or change in your breasts, don鉴 presume it’s just your implants; make a prompt appointment with your GP. if you’re at the age where you require screening, or have a family history that makes you a candidate for early screening, don’t overlook this important detection tool. Watch for changes: ruptures are uncommon with modern implants, but they do happen. If you to your breast shape and position - or experience discomfort, ask your GP to examine them and refer you for imaging, and if applicable, back to your surgeon. Breast implant replacement It’s important to know that breast implants may not last a lifetime. Your implants may

need to be replaced. Over time, your breasts can change due and gravity. If, after a period of years, you become dissatis�ed with the appearance of your breasts, you may choose to undergo a breast lift or implant exchange to restore a more youthful contour. 19 How long do breast implants last? Breast implants last for a very long time, but not forever; chances are if you are having a breast augmentation in your 20’s, you will outlive your implants, and they will need to be replaced at some stage. The lifespan of breast implants differs from woman to woman, but most commonly spans 10-20 years. The most frequent reason for implants to be removed and replaced is that women wish to change them for a different shape, size or position. Medically-required replacements are usually for complications such as capsular contracture, infection or migration of the implant. Breast augmentation risks and complications Like any surgery, you must weigh up whether the bene�ts out way the risks for you. While breast augmentation surgery is very common, it also carries risks. Your pre-operative consults with Dr Sharp will enable him to discuss potential complications with you. Possible breast augmentation surgery risks include: Anesthesia risks Bleeding and infection Changes in sensation Poor scarring Implant malposition, leak, rupture The formation of tight scar tissue Fluid accumulation (seroma) Wrinkling of the skin Pain, which may persist Possibility of revisional surgery Complications are rare, and Dr Sharp and his team manage each of these risks with the upmost care to further reduce the likelihood of them occurring. In the event they do occur, most can be treated quickly and easily with prompt intervention. 20 // CHOOSING THE RIGHT SURGEON FOR YOU DR

DAVID SHARP Putt�ng your health and safety �rst: how to select a surgeon Breast augmentation surgery changes your body forever; it’s a big decision, and your relationship with your surgeon should be enjoyable, and life- long. The priority when selecting a surgeon should never be how cheap they are, what credit plans they offer or how quickly they can do the surgery; none of these are the key factors that predict a good surgical outcome. Choose a surgeon that you’ll want to stay in touch with for ongoing care and concerns into the future; one that is RACS quali�ed - and who is approachable and respectful throughout the consultation process (it’s a good sign of the compassion and care you’ll receive during, and after, surgery). Every surgeon has a different personality, approach and practice ethos so we encourage Qual��cat�ons and tra�n�ng: what to look for by a quali�ed plastic surgeon who is registered as a Fellow of the Royal Australasian College of Surgeons. You can con�rm your surgeon’s credentials on the RACS website’s Surgeon Finder directory. Unfortunately, due to lack of regulations in Australia, many doctors who perform breast augmentation patients are not aware of the differences between a RACS quali�ed surgeon, and someone who has only completed medical school and wants to operate on people. A quali�ed plastic surgeon will have the letters ‘FRACS Plast’ after their name, meaning that they are a Fellow of the Royal Australasian College of Surgeons. Communicating with your surgeon You should feel comfortable and at ease when discussion your procedure. Your surgeon should provide a relaxed and safe environment to expres

s your concerns, fears - and ask those questions you might worry are silly (there are no silly questions when it comes to considering surgery)! They will provide you with best practice advice and guidance based upon what it best for you, even if it is not always what you want to hear. Their honesty will ensure you have realistic expectations as to what your surgery can achieve, and a full understanding of your options and potential outcomes. Pre and post operative support Having surgery is more than just a consultation appointment and hospital visit. Your surgeon will provide as many pre operative consultations as you require to make a considered and informed decision. They may ask you not to make a decision on the day, and to go home and review your options, coming back at a later date to discuss it further. Their team will support you before your procedure with ample opportunities to ask questions and receive resources and information about your surgery. After your surgery, you should be provided with 24/7 support, post operative appointments and follow up care should you have any concerns, complications or questions. 21 // PREGNANCY, BREAST LIFT + MUMMY MAKEOVER DR DAVID SHARP Dr Sharp has a spec�al �nterest �n post-pregnancy transformat�ons - also known as ‘mummy makeov敲’ surgery. Visit our website to read more about tummy tuck and breast surgery options for restoring pre-pregnancy body shape and condition Combined breast augmentation, tummy tuck or breast lift Dr Sharp often performs breast augmentation surgery alongside abdominoplasty and/or liposuction. He also performs breast augmentation and lift surgery. Advantages of combining procedures include the aesthetic bene�t of having These combined procedures are oft

en popular amongst women who have �nished having children and wish to lift sagging breasts, replace lost volume, remove excess stomach skin or repair rectus divarication. Peruse our website to �nd out more. Breast augmentation + pregnancy Breast augmentation can be safely performed before you have children, and is not considered to affect breastfeeding in most cases as Dr Sharp uses an incision and implant placement that does not damage the mammary ducts. However, pregnancy will cause signi�cant changes in your breasts, and if you have had a breast augmentation prior to having children, you may �nd that your results are different afterwards. For some women, this results in a more softer, natural post- augmentation result. For others, a repeat breast augmentation is required, and the cost of this should be considered before undertaking primary breast augmentation before having children. If you are planning future pregnancies, speak to Dr Sharp about the pros and cons of proceeding, or delaying, surgery. 22 How do I know if I need a lift with my augmentation? If your breasts are small or have lost volume — for example, after pregnancy — breast implants inserted in conjunction with a breast lift can increase both their A breast lift, also known as mastopexy, is a procedure that raises and �rms the breasts. Excess skin is removed to tighten the surrounding tissue and to reshape and support the new breast contour. For women with breast ptosis - whereby the nipple sits below the inframammary fold, or points down, a mastopexy results in the nipple sitting higher on the breast. Sometimes the areola (the darker skin around the nipple) becomes enlarged over time, and a breast lift will reduce this as well. W�ll the

�mplant g�ve me a l�ft (aka ‘scarless’ l�ft)? It will depend upon your level of ptosis, and ‘ideal’ �nal result. Sometimes, if you have ‘boarderline’ or psudeoptosis, it may be possible to achieve a small uplift of the breast tissue with strategic placement of the right type of implant. It may still be necessary for you to have further surgery in the future as your breasts continue to age – in order to achieve an optimal result – but for some women, who like their breast implants to sit lower on their chest – this can be a solution. Dr Sharp will advise if this is suitable for you upon examination. Do breast augmentations remove stretch marks? A breast augmentation does not correct stretch marks. Dr Sharp’s clinic offers a range of safe, skin therapies that have been scienti�cally proven to reduce stretch marks – without surgery, needles or down time. If you are concerned about stretch marks, book in with our dermal clinician. 23 // BREAST AUGMENTATION COSTS DR DAVID SHARP How much do breast augmentations cost? Potential costs include: Dr Sharp’s fee Costs of implants Anaesthetist’s fee Assistant’s fee Theatre costs Support garments Inclusive of all above factors, most breast augmentation procedures in day surgery with Dr Sharp cost approximately $9,850. This is broken down into: + $7,000: Surgeon, implants, surgeon assistant, bra, post op appts for 12 mths + $1,450: Theatre and hospital (day surgery) + $1,400: Anaesthetist The cost of combined breast augmentation + lift If you have a breast lift (mastopexy) at the same time as your augmentation, the additional costs total approximately $4,500. However, some of these costs may be rebatable if you have sagging

breasts (nipple ptosis) and have had a baby in the past 7 years. At your �rst consultation we will be able to ascertain if this applies, and the total value of Medicare rebates or private health fund coverage. Medicare rebates and private health insurance Breast augmentation for cosmetic reasons is not covered by most private health insurers. However, in some cases - such as post-mastectomy or in classi�ed as reconstructive, and therefore has a Medicare item number. If so, you will be eligible to claim a rebate from Medicare, as well as your private health fund. Other costs to consider It is important to understand that, in the case of complications or revision surgery, the cost of your breast augmentation might extend to future surgical procedures and hospitalisations. It’s common for patients to think that their surgeon can easily have these costs waived – however in most cases, this is not possible, and the patient may be further out of pocket. In addition to considering the physical and emotional impact of complications or revisional surgery, we encourage patients to think about how they would fund further treatment beyond the immediate costs expected. 24 :ons�der�ng a cut-pr�ce augmentat�on w�th an unqual��ed - or overseas - surgeon? Surgery is an investment in your health, wellbeing and long term appearance. Sadly, we often see the distressing complications caused by cosmetic tourism, whereby patients choose to have their surgery overseas in order to save money. Sometimes it goes well, but when it doesn’t, the lack of post op care means results can be disastrous. TIP: If cost is the most important factor in choosing a surgeon, please reconsider whether or not right now

is the right time for you to have surgery. Consider the following factors when evaluating surgery options: The surgeon鉳 credentials, training standards, expertise and record What happens if something goes wrong at 1 week, 6 weeks or 6 years post surgery; who takes responsibility helping you? What are the national compliance requirements for hospital facilities in the country you are having the operation in? Will you have a quali�ed anaesthetist present at all times, and what training and accreditation have they undergone? If you have complications after surgery, is your surgeon credentialed, and insured, to perform emergency or revisional surgery in a hospital near you? What costs will you incur if you require revisional surgery? If you have a painful complication such as rupture or contracture, and can’t have your original surgeon correct this locally, will you need to wait on a public hospital list in Australia to have the surgery corrected, and how long might you have to wait? 25 // PREPARING FOR YOUR FIRST CONSULT DR DAVID SHARP 1. If you are seeing the surgeon for a cosmetic augmentation, you don’t need a referral from your GP, as no Medicare item numbers - or rebates - apply. 2. If you are seeing a surgeon regarding reconstruction, asymmetry or correction of a deformity, obtain a referral as Medicare item numbers - and rebates - may apply. 3. Consider what you expect to achieve by having breast augmentation surgery. This will be one of the �rst questions your surgeon asks you. Your surgeon wants you to love your breasts after your surgery, and they also need to ensure you are realistic. Every woman, and every pair of breasts, is different - and so your results will be too. Your original breast shape, nipple position, droo

p, natural asymmetry etc will impact your end outcome. Do you expect the surgery to address self esteem or anxiety issues; and have you considered how your self esteem will feel if the results don’t live up to the ‘dream’ breasts you imagine? Thinking about these questions pre operatively is the best way to ensure your satisfaction after surgery. 4. Is achieving a speci�c cup size the most important thing? In a world that measures women’s breasts in cup sizes, it’s easy to obsess over the ‘dream’ cup size you want to achieve. But the best thing you can do before your augmentation surgery is to focus more on your ultimate post-surgery ‘look’ rather than a speci�c cup size. What do you want your overall appearance and proportions to look like after breast augmentation? Which implant size will best suit your current breast shape and chest width? During the consultation process your surgeon will measure your chest. This will give you both an idea of the standardised ‘ideal’ breast implant size range for your body. Bigger is not always better, and cup size can be deceptive. 5. Consider your time frames and discuss these with your surgeon. While you’ll notice an immediate difference in their appearance straight after surgery - in the months following your surgery, your implants will settle into position; it can take up to a year for you to see your �nal result. So patience is vital! 6. Bring a friend or support person. Having a second set of ears will help if you forget something the surgeon has said later on. 7. If you would like a female chaperone for your examination with the surgeon, mention this to the patient care team when you arrive for your consult. 8. There’s no such thing as a silly question; if your surgeon di

smisses, ignores or is irritated by your questions, see someone else. It’s your body, and you should be encouraged to ask lots of questions about your surgery! 26 // THE SHARP DIFFERENCE Dr Sharp is specialist plastic surgeon; a Fellow of the Royal Australasian College of Surgeons, and a member of the Australian Society of Plastic Surgeons and Australian Society of Aesthetic Plastic Surgeons. He advocates a customised approach to achieving a natural-looking breast augmentation, tailored to each patient to attain superb results. His friendly team provides the highest quality post operative care and compassionate support; from your �rst enquiry, through the consulting and surgery process and your �nal post operative visit. OUR TEAM + CLINIC ETHOS Founded by director Liz Washington, our clinics offer a premium surgical service, underpinned by transparent communication and unparalleled patient support. Cutting edge techniques to minimise scaring and optmise results Our goal is to restore balance and harmony, producing realistic natural-looking results that suit your unique body shape and individual lifestyle Ethics before pro�t – we don’t tell our patients what they want to hear; we provide the kind of honest advice and respectful medical care that we’d want for one of our own family members We keep in touch with our patients throughout - and long after - their surgery; when we perform a breast augmentation, we see it as a life long commitment to providing care and support Treating you as a whole person - not just a body part - our care is holistic, ensuring maximum longevity for your augmentation WHERE YOU WILL FIND US Dr Sharp’s clinics are located in Both clinics are discreetly located, with plenty of parking directly in fron