Breast Augmentation

Breast augmentation or enlargement is suitable for women with small breasts, or women whose breasts have reduced in size after pregnancy, or changed over time.

 Breast Implants
We will recommend only the best quality breast implants usually containing form stable or cohesive silicone gel with a shape and projection best suited to your figure and your desired goals. Our surgeons are not prepared to compromise patient's results by using low-grade or inferior quality implants.

 Questions & Answers

·         Is breast augmentation right for me?

·         What are the first steps?

·         What does the surgery involve?

·         What is the recovery process?

·         When can I return to work/sport/gym?

·         Will my breasts look and feel natural?

·         Are there any risks involved?

·         Are there any long-term side-effects?

·         How long do implants last?

·         How do I monitor breast health after augmentation?

·         Can I still have a mammogram after augmentation?

·         How much will it cost?

Is breast augmentation right for me?
This is a question that can only be answered in consultation with your surgeon. The aim of breast augmentation is to create a pleasing, balanced appearance in proportion to your shoulders, your rib cage and hips. This plays a large part in determining which type and size of implant is appropriate.

 Women choose to have breast augmentations for a variety of reasons including:

·         Long-term dissatisfaction with their breast size.

·         Lack of proportion in their body shape

·         Wanting to regain or enhance breast size after having children or losing weight.

·         Wanting to correct uneven or malformed breasts

·         Restoring symmetry after breast cancer surgery

What are the first steps? 
Before meeting with your surgeon, you may want to take the opportunity to discuss your concerns and expectations with one of our specialist plastic surgery nurses. She will give you information about this procedure and discuss what is involved in detail, including post operative care and recovery.
As well as discussing the question of what is achievable aesthetically, your surgeon will also ask you about your medical history, examine your breasts, and photograph and measure you. Depending on your age and family history, your surgeon may recommend that you have a mammogram prior to your operation.
There are a number of factors that you and your surgeon need to take into account. What is the overall quality of your breast tissue and will a breast lift (mastopexy) also be necessary. Where should the incisions be hidden? Should the implant be positioned under or above the chest muscles? These all have an important bearing on the desired result.

What does the surgery involve?
During surgery a pocket for the implant is made under each breast. Implants are inserted into the pocket to achieve the look you desire. It is very important during the operation to check the appearance 'sitting up', as well as 'lying down'. Your surgeon will do this before completing the surgery and applying the dressings or bandages. A surgical drain is usually not necessary.

 Breast augmentation is usually performed under general anaesthesia, with local anaesthetic injected during the operation to assist with postoperative pain relief.

 What is the recovery process? 
 You will experience some swelling or discomfort as the anaesthetic wears off, which is managed with prescribed pain relief. Usually you are able to go home on the day of your operation, but in some circumstances your surgeon may recommend an overnight stay in hospital.

You will return for a check -up within the first few days after surgery. You should expect some initial swelling and firmness – this is normal. Tape is applied to the healing wounds to help reduce scar formation. You will be provided with instructions on care of your surgical site and you will need to wear your surgical support bra for three to four weeks afterwards.

Swelling normally takes up to six weeks to settle and your stitches should dissolve over three months or so. A small scar will remain either under the breast fold, in the areola, or in the natural crease under the arm. The scar’s appearance will gradually improve over three to nine months.

 When can I return to work/sport/gym?
 You should resume normal activities at a slow, gradual pace, and your return to work will depend on your occupation. Light exercise (not involving your arms) can commence after a week. Heavy lifting and strenuous exercise should be avoided for between four and six weeks.

Will my breasts look and feel natural?
Yes. It is normal that they will feel swollen and firm for the first few weeks after surgery, but they will then settle.

 Are there any risks involved?
 As with any surgery, breast augmentation carries a potential risk of complications. These include reactions to anaesthesia, infection, blood accumulation or unanticipated scarring. Fortunately the incidence of these problems is very low in healthy, cooperative patients. Your surgeon will discuss this fully with you during the consultation process and provide you with information booklets that also cover all this in detail.

Are there any long-term side-effects?
In the past there has been much speculation about potential associations of arthritis, muscle and collagen disorders and silicone-filled devices. There is no evidence that silicone-based devices cause these diseases. Several large studies have shown that women with silicone breast implants do not have significantly higher risks for connective-tissue or immune-related diseases.

How long do implants last?
Breast implants are not lifetime devices and cannot be expected to last forever. Implant failure can occur after direct trauma or injury to the chest but more often failure or rupture will be spontaneous with no obvious cause. Further surgery is necessary to remove and replace an implant that has failed, however modern implants have very low rupture rates.

How do I monitor breast health after augmentation? 
It is important to understand that there is no connection between breast augmentation and breast cancer. The implant is not placed within the breast but rather beneath it, and usually beneath the muscle on the chest wall.
However, new breast health baselines must be established by you and your doctor after surgery. Breast cancer can still be detected in the augmented breast and routine clinical or physical examination should not be hindered by the presence of a breast prosthesis. However, breasts with implants will feel different during breast self-examinations so it is very important that you discuss this with your surgeon and know what you are feeling for.
In addition to your monthly breast self-examinations, you should have a professional breast examination by your GP or surgeon annually.

Can I still have a mammogram after augmentation?
Yes, however it is very important that tell the radiologist you have breast implants before the mammogram procedure. There have been several reports of implants rupturing when the breast is compressed for mammography. It’s important to visit a radiologist who is familiar with mammography of augmented breasts. Your surgeon can suggest a suitable specialist.

How much will it cost?
Costs vary according to the severity of the condition, the combination of procedures undertaken, the amount of surgical time involved and the facility at which the procedure is carried out. We cannot offer an accurate cost estimate without seeing you. However we do offer complimentary no-obligation nursing consultations as a first step towards helping you understand your options and the approximate costs involved.
A more accurate costing will be made after the first consultation.

Brow-lift

Brow-lift (foreheadplasty) can create a brighter, friendlier look to the face by raising drooping eyebrows and eliminating frown lines. The skin of the forehead is smoothed and the muscles that cause wrinkles are adjusted.

Worry lines, wrinkling of the forehead and a drooping eyebrow position are all common signs of aging that, for some people, can result in a sad, tired, or angry appearance which doesn't really reflect what's on the inside.

Questions and answers

What are the first steps? 
What does the surgery involve?
What is the recovery process? 
How much will it cost? 

·     What are the first steps?

Before meeting with our surgeon, you may want to discuss your expectations and concerns with our consultants. We will give you information about this procedure and discuss what is involved in detail including post operative care and recovery. We will also inform you of the potential risks, complications and side effects associated with these procedures.

As well as examining your brow, your surgeon also will discuss the degree of elevation desired, the activity of the brow muscles, and the status of your upper eyelids, which often require excess skin removed in conjunction with a brow-lift.

Photographs will be taken before and after your surgery to plan the procedure and to record your results.

·     What does the surgery involve?

Most modern brow-lift surgery is performed endoscopically. Three to five small incisions are placed in the hairline. The brow tissue is then raised through the small incisions, so that it becomes fully mobile. With the assistance of a surgical telescope (endoscope) the nerves to the scalp are visualized and protected and appropriate muscle modification is carried out. The brow is then fixed in its new position.

Removal of excess skin in the upper eyelid may be necessary once the brow has been repositioned. Sometimes your surgeon may decide to correct the eyelids at the same time as your brow-lift, or he may delay the removal of upper eyelid skin until the brow has settled. If so, this operation can be performed under a local anaesthetic on an outpatient basis.

An endoscopic brow-lift is usually done as a day case under general anaesthesia. However, if it is part of a more comprehensive facial rejuvenation, your surgeon may recommend an overnight stay in hospital.

·     What is the recovery process?

After surgery you will have cold packs on your eyes and will be nursed in a semi-upright position – this is to minimise the amount of swelling and bruising of the eyelids. A head bandage may be in place overnight.

A small drain may be placed during the operation and is usually taken out the next day. Surgical staples are removed around the eighth day. Although a brow-lift isn’t usually painful, you can take mild pain-relieving medication if necessary.

Bruising is maximal in the first 72 hours after surgery. There could be minor bruising for up to a week, so cover makeup may be necessary.

It is important to restrict your normal activities in the first week following a brow-lift. Detailed work such as sewing or other handcrafts, excessive reading, writing, or computer work should be avoided, as your eyes will become very tired.

It is quite common for some numbness or itchiness to be present on the forehead and scalp following surgery, which can take some months to fully settle.

·     How much will it cost?

Costs vary according to the severity of the condition, the combination of procedures undertaken, the amount of surgical time involved and the facility at which the procedure is carried out. We cannot offer an accurate cost estimate without seeing you. However we do offer complimentary no-obligation nursing consultations as a first step towards helping you understand your options and the approximate costs involved.

Facelift

Living a healthy lifestyle, staying fit and eating well all play an important role in reducing the impact of aging on your body. Yet, no matter how fit and healthy you are, it's your face which people notice first. Your face projects an image to people about who you are.

Over time the process of tissue degeneration results in the loss of elasticity and facial features undergo gradual changes that can result in a tired, old, or depressed look, which may not project the way you actually feel.

Although cosmetic surgery cannot stop the ageing process, modern facial rejuvenation surgery can make you look years younger, without changing your natural expression or the facial characteristics that make you uniquely you.

Questions and answers

·         Is this for me?

·         What are the first steps?

·         What does the surgery involve?

·         What is the recovery process?

·         When can I return to my normal activities?

·         Will people guess I've had a facelift?

·         How much will it cost?

·     Is this for me?

There is no specific age that is best for facelift surgery although most candidates are in their mid-thirties upwards. There are many factors that determine the overall result, but on average you can expect the positive results of your facelift surgery to last six to ten years on average.

Your appearance will look fresh, with a smoother improved facial contour. And of course it can also work wonders for your self-esteem and confidence.

·     What are the first steps?

Before meeting with our surgeon, you may want to discuss your expectations and concerns with our consultants. We will give you information about this procedure and discuss what is involved in detail including post operative care and recovery. We will also inform you of the potential risks, complications and side effects associated with these procedures.

Photographs will be taken before and after your surgery to plan the operation and to record your results.

Our surgeon may ask to study photos of you when you were younger. This can be an important aid to surgical planning since each person and each face is unique.

Following the evaluation, a surgical plan will be designed that may include a combination of facial procedures.

·     What does the surgery involve?

While the standard facelift addresses the lower two thirds of the face and upper neck, it is often combined with additional procedures such as eyelid surgery, a forehead or Brow-lift, liplift, suction liposculpture to remove fat (especially in the upper neck), nose reshaping, removal of skin blemishes, dermabrasion or chemical peel treatment of the skin, laser resurfacing and lipostructure (or fat grafting) to areas of facial fat atrophy and hollowing.

Results can also be enhanced and prolonged with the use of dermal fillers and Botox.

Newer techniques have been developed over recent years to produce a more natural look and avoid excess skin tension. These use similar skin incisions and involve the dissection and tightening of the suspensory supporting soft tissue structure of the face and neck (the SMAS), as well as tightening muscles and their attachments to the bony skeleton. A further advance is the endoscopic brow-lift avoids the traditional long scars of open Brow-lift. Short scar techniques, sometimes known as mini facelifts, S-lifts or MACS lifts are sometimes recommended for younger patients or for those unsuitable for more extensive surgery or requiring a minimum of post operative recovery time.

Fatty tissue, especially in the neck, can be removed through a small transverse incision hidden under the chin, or by suction-assisted liposculpture. (SAL).

Using these techniques, the deeper supporting structures of the face and neck are tightened and the skin is gently redraped to give a natural, fresh, rejuvenated appearance with normal facial expression and a smooth, more youthful jaw line without jowls.

These procedures give a longer lasting result, but require a high degree of specialized surgical skill and are more time demanding. Depending on the individual situation, either a general anaesthetic or sedative anaesthesia is used. The anaesthetist will talk to you prior to the operation and explain what is best.

Simple operations can be done as a day case, but patients usually stay one or two nights in hospital.

·     What is the recovery process?

After a facelift, it is best to plan about three weeks of time off to recover.

Upon leaving hospital, an appointment will be made for you to visit our office for removal of sutures at about five days. By the end of 12 to 14 days, all sutures or staples will be taken out.

The amount of swelling and bruising varies and is at its maximum in the first 3-4 days, gradually settling over the next 2-3 weeks. Average healing time for skin and soft tissue is about three months, during which time your scars will go through the usual healing processes.

You will have temporary numbness in the cheeks and upper neck immediately after surgery, which returns to normal over 6-8 weeks. Mild to moderate pain experienced in any other parts of the face can be easily relieved by mild analgesics.

Our postoperative nurses will support you after surgery, and a complimentary appointment will be made for you at Prescription Skin Care. Our specialist skincare nurse will advise you on camouflage for bruising, as well as future skincare. She will also liaise with your beauty therapist and hairstylist as appropriate.

Subtle improvements will continue in your appearance over six months to a year. All facelifts can be optimized with minor fine-tuning procedures six months or so later. Very loose necks and cheeks need a second stage procedure after six months to a year to give you an optimum, lasting result.

·     When can I return to my normal activities?

In the first week after surgery you should restrict your normal activities, increasing these gradually over the following few weeks. At six weeks you should be able to resume a normal routine.

·     Will people guess I've had a facelift?

In the past facelifts often produced an unnatural doll-like appearance, with thickened scars. The modern facelift is tailored to the individual, and although it can accomplish a change in appearance, the end result is a fresh, rejuvenated look that preserves your normal facial expression and those characteristics that are unique to you.

After a week or two chances are people won’t guess that you have had surgery, it’s much more likely that they will tell you how well you look, or ask you if you’ve been on holiday.

·     How much will it cost?

Costs vary according to the severity of the condition, the combination of procedures undertaken, the amount of surgical time involved and the facility at which the procedure is carried out. We cannot offer an accurate cost estimate without seeing you. However we do offer complimentary no-obligation nursing consultations as a first step towards helping you understand your options and the approximate costs involved. 

This page provides an overview. More detailed information can be obtained during a consultation with one of our plastic surgeons. Please contact us for a consultation.

Rhinoplasty

If you are unhappy with the size or shape of your nose, rhinoplasty (commonly referred to as nose reshaping or nose job) can greatly improve your appearance and boost your self-esteem. Surgery may be undertaken at any age, from late teenage years onward. Rhinoplasty can also be a useful adjunct to other forms of facial rejuvenation surgery such as facelift, brow lift and eyelid surgery.

Questions and answers

What are the first steps?

What does the surgery involve?

What is the recovery process?

When will I be able to return to work/ normal activities?

How much will it cost?

·     What are the first steps?

Before meeting with our surgeon, you may want to take the opportunity to discuss your concerns and expectations with one of our specialist nurses. She will give you information about this procedure and discuss what is involved in detail including post operative care and recovery. 

The best rhinoplasties are those where the nose is in harmony with the face. Our surgeon will consider the overall balance of your appearance during your consultation. (For example, a strong nose may be overemphasized by a weak chin, and therefore improved by surgery to the chin.)

Our surgeon will examine your nose and check the airway. (Sometimes a consultation with an Ear, Nose and Throat specialist will be advised where there is a history of airway problems or allergies.) Photographs will be taken before and after your surgery to plan the procedure and to record your results, and occasionally X-rays or CT scans will be requested.

It is important that we obtain a full history of any trauma or surgery you may have had to your nose, as well as your general medical history and a list of medications.

·     What does the surgery involve?

Most rhinoplasties are performed under general anaesthetic. Incisions are made inside the nose to gain access to the bone and cartilage structure. Often a small incision is also made across the columella – the strip of skin between the nostrils. The exact technique used will be tailored to meet your particular needs.

If there is a hump, a combination of bone and cartilage is removed to make the bridge straighter and lower. The cartilages of the tip can be trimmed or reshaped to alter a bulbous or drooping tip. Sometimes grafts of cartilage are required, which are taken from inside the nose or occasionally from the ears or ribs. (If you have breathing difficulties, the inside of the nose may be straightened to improve the airway.)

Incisions are closed with fine dissolving stitches inside the nose and fine removable sutures, when required, outside the nose. A splint is usually applied for one to two weeks and the nose may be packed for several days postoperatively.

Sometimes splints are required inside the nose if the airway is very distorted. These are usually removed after one week.

Generally you will stay in hospital overnight, but for less involved rhinoplasties you may be able to go home the same day. If this is the case, make sure there is someone at home to look after you.

·     What is the recovery process?

Rhinoplasty is generally not a painful procedure. You will experience some postoperative discomfort and a temporary feeling of heaviness and stuffiness in the face, which can be managed with routine analgesics. There may be some bloodstained discharge from the nose for a few days after the operation.

Your splint will be removed around one week after surgery. There may be some bruising around the face and eyes, which will settle after 7-14 days. Most of your swelling will settle over three weeks, but there will be subtle changes for up to a year postoperatively.

·     When wil I be able to return to work/normal activities?

In general, it is advisable to stay away from work or school for two weeks, and avoid strenuous activity for three weeks.

·     How much will it cost?

Costs vary according to the severity of the condition, the combination of procedures undertaken, the amount of surgical time involved and the facility at which the procedure is carried out. We cannot offer an accurate cost estimate without seeing you. However we do offer complimentary no-obligation nursing consultations as a first step towards helping you understand your options and the approximate costs involved.

This page provides an overview. More detailed information can be obtained during a consultation with one of our plastic surgeons. Please contact us for a consultation.

To be Updated