FAQ

Pain and discomfort from large breasts often occurs in the shoulders, lower neck and/or back and can be at its worst during physical activity. A breast reduction reduces, and usually eliminates this pain whilst helping to enhance posture, overall appearance and self-esteem.

Yes. There is evidence that obese women (BMI* over 30) who undergo breast reduction surgery have higher complication rates and wound healing problems. *BMI is a ratio of weight in kg over height squared. Ideal female BMI is 20-25.

The goal of surgery is to reduce your breasts to a size that is in better proportion to your physique and makes you feel more comfortable.

Although scars will be present, most patients believe they are worth it due to the significant health and lifestyle benefits of having breasts that are in proportion to their physique. The scars are situated around the areolae of the nipple and under the breasts and usually become less visible over 6-12 months, especially if you comply with post surgery scar management instructions. There are however a small number of patients that have a tendency to develop thick scars which will not fade as well over time.

There is normally a slight difference in size between the breasts and this may persist following your procedure.

There will be some alteration in sensation of the nipples post surgery, but this often improves with time.

Possibly. There is still significant breast tissue remaining post surgery so it is possible for most women. A lot of large breasted women struggle to breastfeed. The evidence suggests 1/3 of women breast feed fully, 1/3 partially and 1/3 not at all and that these figures are similar after breast reduction surgery.

Breast reduction surgery is performed under general anaesthetic with a 1-3 night hospital stay followed by 1-2 weeks off work to recover. Vigorous exercise can usually be resumed after about 6 weeks.

The breasts in a patient that presents for breast lift surgery may have all or some of the following features:

• breasts have lost shape and/or volume
• breasts have a flatter, elongated shape or are pendulous
• when unsupported, nipples fall below the breast crease
• nipples and areolae point downward
• areolae have become enlarged
• one breast is lower than the other

These are just a few of the common causes:

• Pregnancy
• Breastfeeding
• Weight fluctuation
• Ageing
• Genetic factors

No – not significantly. If you want the breast to look noticeably fuller, you will require the insertion of an implant in addition to the breast lift procedure. It is quite common to combine a breast lift procedure with an augmentation.

There will be a scar around the nipple, +/- vertically down from the nipple to the lower fold of the breast and possibly in the lower fold of the breast also.

Possibly. Breast lift surgery doesn’t significantly alter the breast tissue remaining, so shouldn’t have a significant impact on ability to breastfeed.

The breast skin may stretch with pregnancy and breastfeeding and hence reverse some of the effect of the breast lift procedure.

The breast lift procedure is usually carried out in private hospital under general anaesthetic as a day procedure.

Following your procedure, dressings will be applied to the incisions and you will need to wear a support bra for 2-4 weeks to minimise swelling and support your breasts as they heal. A return to all normal activities is expected by 6 weeks.

Breast implants will normally need to be changed after 15-20 years if there have been no complications.

Breastfeeding is likely to change the shape of your breast. Once you have stopped feeding you may wish to have revision surgery to lift and/or change the implant to obtain a fuller breast.

Although scars are the inevitable results of any surgery, additional scarring from revision surgery is usually insignificant. Every effort is made to make the scars as inconspicuous as possible. Usually scars can be hidden inside natural skin creases where they are easy to conceal.

How long is my Breast Augmentation Revision surgery post recovery?

Breast augmentation revision surgery is usually performed as day surgery but sometimes requires an overnight hospital stay. Following your procedure, dressings will be applied to the incisions and you will need to wear a support bra for 2-4 weeks to minimise swelling and support your breasts as they heal. A return to all normal activities is expected by 6 weeks.

Breast reconstruction surgery is carried out in hospital under general anaesthesia with usually a 3-10 night hospital stay : the stay being usually much shorter when the least complex surgical technique is chosen . Recovery time off work is usually in the range of 4-6 weeks for most of my patients.

We most commonly use implant or more complex free tissue transfer techniques of breast reconstruction.

We use the single stage or two stage implant reconstruction depending on your situation.

The single stage implant reconstruction is usually only possible at the time of mastectomy (called immediate recon ) . This involves insertion of the implant after the breast has been removed and often requires the use of a skin substitute material placed under the chest muscle to help protect the implant.

The two stage implant reconstruction uses a temporary implant placed under the muscle which is gradually expanded to stretch the tissues over several months and is then exchanged for a long term implant during a second operation.

Free tissue transfer breast reconstruction techniques are where the reconstructed breast is created out of your own tissue only. This tissue is most frequently taken from the abdomen.

The tissue is detached from the body with blood vessels attached which are then repaired to blood vessels in the chest under a microscope (microsurgery). The tissue then has its own blood supply on the chest wall and can be shaped to recreate the breast.

This is known as a free flap. The flap from the abdomen is called a TRAM flap (contains some muscle) or DIEP flap (no muscle is taken).

This operation is carried out in one stage, but requires a longer stay in hospital and takes longer to recover from than an implant reconstruction.

This is where an implant is used, but it is combined with the use of some of your own tissue (autologous).

The most common tissue used is the latissimus dorsi muscle from the back. This is transferred to the mastectomy site and used to help cover an implant.

This technique would be used most frequently in patients who have had radiation treatment and do not wish to have a flap reconstruction or have had complications with previous reconstructions.

Breast reconstruction surgery is sometimes carried out on the same day as the mastectomy (called an immediate reconstruction) or once the mastectomy wound has healed (called a delayed reconstruction).

Some patients prefer immediate reconstruction as they combine the breast cancer and reconstruction surgery in one hospital stay, wake up with a breast mound already in place and don’t have to experience having no breast at all. Outcomes are reported to be better with immediate reconstruction, but this technique is not possible for all women.

If the breast reconstruction is to be delayed it can be performed at any time after breast cancer treatment is completed.

For women that have had mastectomy of one breast, they will often require surgery to the other breast to gain better symmetry of shape and volume between the two breasts.

The surgery to the other breast may be enlargement or reduction +/- breast lift as required

Although certain drugs, obesity and medical problems have been linked with male breast overdevelopment, there is no known cause in the vast majority of cases.

Gynaecomastia surgery can be very rewarding for patients who are bothered by their overdevelopment of breasts and who:

• are physically healthy and of relatively normal weight
• do not smoke or use drugs
• have realistic expectations from surgery

Adolescents may benefit from surgery, although secondary procedures may be needed in the future if breast development is not complete at the time of the procedure.

Any surgical treatment to correct gynaecomastia will require incisions and while most incision lines are concealed within natural contours of the skin, some may be visible post surgery.

Gynaecomastia surgery is performed under general anaesthetic, often in day surgery and occasionally with an overnight stay. Time off work to recover is usually 1-2 weeks and vigorous exercise can usually be resumed after 6 weeks.

CTS generally develops between the ages of 30 and 60 and is more common in women, with a female to male ratio of 3:1. Although there are many possible causes, the cause is unknown in most people. There is some evidence that people who develop CTS have a smaller carpal tunnel, explaining why it may run in some families. Other possible causes include:

• Obesity – good predictor of developing CTS
• Arthritis – inflammatory or osteoarthritis of surrounding joints
• Pregnancy – usually resolves after delivery
• Diabetes or a family history of diabetes
• Trauma – recent or old
• Increased activity, including sport or work
• Other medical conditions – underactive thyroid, kidney disease

If symptoms are mild, there may be no adverse outcome from no treatment. However, persistent and more significant symptoms may lead to permanent nerve damage, which can cause permanent loss of feeling and loss of function in the muscles that work the thumb.

Not every patient is appropriate for keyhole surgery. This will be assessed and discussed at your consultation.

Surgery to release CTS can be performed under general or local anaesthetic and is performed as day surgery in hospital. The wound usually heals quickly and symptoms are often relieved within these first few weeks. However, any altered sensation can take many months to recover if it was present night and day prior to surgery.

The dressing is kept in place for 7-10 days post surgery and patients can use their hands for gentle activities in the few weeks post surgery.

Usually Trigger Finger affects just one finger but it can affect many fingers and at different times.

Yes. We often suggest trying a combination of rest, anti – inflammatory tablets, a splint and/or a cortisone injection prior to recommending surgery.

No, it is usually a condition that can wait weeks to months for treatment.

The finger can be moved immediately after surgery and the hand can be used as it feels comfortable to do so.

The finger can be moved immediately after surgery. The dressing is removed at the first appointment and usually recovery is complete within 2-3 weeks. No splints are required.

Ganglion Cysts are most commonly present on the back or the front of the wrist and on the bone or end joint or the finger.

Ganglions usually arise due to some degeneration in the lining of a joint in the hand or wrist.

Although most ganglions can be diagnosed by examination alone, an x-ray is useful if arthritis or other joint problems are suspected. Often a request for an ultrasound is required to assist with diagnosis and possibly for a steroid injection at the same time.

No. If a Ganglion is causing you no pain then there is no need to treat it – unless of course you are concerned due to its appearance.

Yes. Usually Ganglions can be treated with a steroid injection prior to considering surgery as this sometimes helps to reduce and eliminate the Ganglion.

Surgery to excise Ganglion Cysts can be performed under general or local anaesthetic and is performed as day surgery in hospital. The wound usually heals quickly and symptoms are often relieved within the first few weeks.

The dressing is kept in place for 5-7 days post surgery and patients can use their hands for gentle activities in the few weeks post surgery.

The average risk of return of a Ganglion after surgical removal is around 10%.

The initial lumps may produce discomfort that usually resolves itself, but Dupuytren’s Disease is not typically painful.

Surgery for Dupuytren’s disease will usually be carried out as day surgery in a hospital. A dressing will be worn for a few weeks post surgery and will also need hand therapy to assist with movement and to help prevent further contracture. Most patients will need to wear a splint at night for six weeks up to three months.

Despite surgery, the disease process may progress or present in other areas of the hands causing further contractures. This is usually a slow process occurring over years.

Surgery is usually performed as day surgery and normal use of the hand can usually be resumed within a few weeks. There is some pain during the recovery period. No splint is required.

Rest and elevation of the hand is important and will also help reduce discomfort. If fitted with a sling, take your arm out of the sling hourly to exercise your shoulder and elbow so they do not become stiff. If your fingers and thumb are not in the splint, they should be moved as well. At night sleep with your arm propped up on pillows next to you.

Surgery should be considered after one year of age as occasionally the condition resolves itself spontaneously up until the age of one, but this is very unlikely to occur after the age of one.

No. Although Trigger Thumb is often called congenital, evidence suggests that it does not appear at birth.

Approximately one quarter of infants who have trigger thumb have it in both hands.

The vast majority of infants make a quick recovery and complications are unusual.

The procedure is usually performed in hospital as a day surgery under general anaesthetic.A bulky dressing is applied after surgery which is usually left intact for up to 2 weeks. No splints are required.

A resumption of triggering after surgery is very unusual.

Sometimes. The medicare description requires that the upper lids are sufficiently lax and excess to be within the field of view in normal vision. We will assess if this is the case at the time of your consultation.

The major concern most patients have regarding the outcome of blepharoplasty is scarring. Although scarring is the inevitable result of any surgery, we are usually able to keep this to a minimum by making careful incisions along natural skin lines and creases where scars usually fade with time and become barely noticeable.

Yes, this is possible for upper blepharoplasty only. This procedure can be performed with local anaesthetic alone and thus can sometimes be undertaken in the rooms.

Blepharoplasty reduces wrinkles in the eyelids and also partially the crows feet area. It does not affect wrinkles anywhere else .

Blepharoplasty is usually performed as a day case under local or general anaesthesia. We will review your recovery and remove any surface stitches 5-7 days post surgery. A return to work is usually possible after 7-10 days but note that bruising and swelling for up to 3 weeks can be expected.

From a surgical point of view the ideal age for otoplasty in children is at the age of 7 or 8 years and not before 4 years of age. The operation is often performed at the age of 5 or 6 years i.e. before the child is about to start school, when parents consider he or she may become embarrassed and withdrawn because of their perceived difference from their classmates.

Emotional stability is the primary factor to be considered before any aesthetic surgery is performed – and this is especially important when performing the operation on children. Some children are able to grow up happily with prominent ears with little related self-consciousness from them. Other children benefit greatly from the operation as anxiety is reduced and self-confidence increased.

Otoplasty is usually performed as a day procedure in hospital under general anaesthetic. Following surgery, a bulky bandage will be placed over the ears to protect them for one week. After removal of this dressing a head band is worn just at night for a further five weeks. Patients usually return to work/school after one week i.e. when the bandages no longer need to be worn in the daytime.

The final shape and contour of the ears becomes evident after about 2-4 weeks. Contact sports and activities that may bend the ears can usually be resumed after 6 weeks. Complete healing may take up to one year.

Patients who benefit the most from a tummy tuck are bothered by the feeling that their tummy is too large, but are realistic about their expectations from surgery. They are physically fit and healthy with a stable weight and are non-smokers or have stopped smoking.

If you may fall pregnant in future or plan to lose a lot of weight you should delay the procedure until your weight is likely to remain stable in the long term.

A tummy tuck is not a substitute for weight loss or an exercise program and we do point out to candidates to consider that whilst the results of the procedure are technically permanent, any result would be greatly diminished by significant future fluctuations in weight.

Patients who present with good abdominal tone and only moderate fat excess in the lower abdomen only, do not usually need a full tummy tuck as the abdominal muscles do not require repair.

A mini tummy tuck is less extensive than the full tummy tuck as the upper abdomen and abdominal muscles are not operated on and the belly button does not need repositioning.

Recovery periods and the scar are much shorter than for the full tummy tuck, but note that this procedure is not an option for most patients.

Although scars are the inevitable result of any surgery, every effort is made to make the scars as inconspicuous as possible. Usually scars can be hidden inside the bikini line where they are easy to conceal.

Drains are plastic tubes sometimes inserted at the time of surgery to decrease the chance of fluid or blood collection in the wound post surgery. We don’t usually use drains for tummy tuck surgery. We have found that with meticulous control of bleeding at the time of surgery drains are not required. When used, drains are uncomfortable and can be a contributing factor to increased stay in hospital.

Not necessarily. If your tummy tuck is considered medically necessary it will attract a medicare item number and then your health fund may provide cover for it. We can help you working this out once you have had your consultation.

Yes. You will be provided with a girdle to wear for approximately six weeks post surgery.

Abdominoplasty surgery is performed under general anaesthetic, usually with a few nights in hospital followed by two to four weeks’ recovery time off work. Wearing a supporting girdle during the recovery period helps optimise results and most patients are able to return to vigorous exercise after about six weeks.

Note that there is often a feeling of tightness in the lower abdomen and there is usually an area of diminished sensation for several months after surgery.

Liposuction can improve your overall body appearance by reducing and recontouring localised collections of fat. Surgical lipectomy, which involves removal of excess skin, as well as fat, may be advised instead of, or in addition to suction lipectomy.

Liposuction is ideal for patients who have bulges which persist after diet and exercise. It is not a substitute for weight loss. Usually the overlying skin will contract following liposuction, however in some circumstances a further procedure to remove excess skin may also be required.

Patients are advised that scars are the inevitable result of any surgery. However, because the incisions with liposuction are small at usually around 1 cm, the scars are not usually significant.

At your consultation, time is spent counselling all patients to make sure they understand that liposuction can be a major surgical procedure often taking many hours to perform, is not an effective weight-loss technique and does not reduce stretch marks or improve the appearance of cellulite.

Liposuction is usually performed as day surgery under general anaesthesia. Post surgery dressings are usually kept intact for 1-2 weeks and strenuous activity is restricted in this time when bruising and swelling are likely to occur. A return to all normal activities is expected by 6 weeks. A post-op pressure garment is worn for 2- 3 months to decrease swelling and encourage the skin to contract to the new shape.

The best candidates for Labiaplasty are women with marked prominence of the labia minora such that they suffer from irritation with splitting/cracking of the skin and potentially bleeding.

In addition, women with significant cosmetic concern can also benefit from the surgery.

Although scars are the inevitable results of any surgery, the incisions are very inconspicuous and will leave little noticeable scarring. Every effort is made to make the scars as inconspicuous as possible.

Labiaplasty surgery is performed as a day procedure in hospital under general anaesthetic. Following surgery, antibiotic ointment is applied to the wounds and pads are used for the small amount of bleeding expected.

It is usually 2 weeks before you can return to physical activity and 6 weeks before you feel fully recovered.

This varies for different patients, but is generally between 2 and 6 weeks post surgery.

At the initial consultation we discuss your concerns and reasons leading to consideration for Labiaplasty. An examination will be required, but this is performed only when you feel comfortable to proceed and always in the presence of a female chaperone (nurse).

The examination is not absolutely necessary at the first consultation, but will be required prior to any procedure.

Pictures will also be taken prior to any procedure, these are taken by the nurse in a private room and treated as confidential.

The treatment requires multiple injections. While the needles are very fine it is still uncomfortable and sometimes painful, particularly in the palms or soles of the feet. We use local anaesthetic blocks for treatment of the hands or feet and topical anaesthetic for the armpits to help decrease the pain.

It takes 3 to 7 days days following treatment for the noticeable improvement. A slow return to sweating approximately 7-8 months following the hyperhidrosis treatment is usual but it is not uncommon to get 12 months of relief. The treatment can then be repeated.

A good scar management routine usually involves a combination of applying silicone gel, massaging with bio oil, using tape on the wound and keeping the area out of the sun for several months’ post surgery. The exact routine prescribed will depend on the procedure performed, the area of the body and your age and skin type.

Diligent adherence to the routine is your best chance to minimise scarring.

We recommend a silicone based scar gel as there is strong scientific evidence that silicone improves scar outcomes.

Massaging the scar daily can help reduce sensitivity and pain – scars can be uncomfortable and painful for the first month after surgery as they heal.

The sun does not technically make the scar worse, however your scar will be more susceptible to sun damage than undamaged skin. Hence it is important to wear sun protection daily on the scar.

The scar healing process will generally take between 9-12 months after which point it will become a mature, pale scar if it has healed well.

A cortisone injection can be useful in treating hypertrophic and keloid scars as it can help to dissolve excess collagen and create a flattened appearance.

If you develop a complication such as stretching, keloid or hypertrophic scarring, this will normally be evident by the 6 month mark, which is a good time to consider scar revision surgery.

No scar can be completely eradicated, however every effort is taken to significantly improve its appearance.

If Scar revision surgery is required, your sutures are usually removed 5-14 days post surgery. At this appointment our practice nurse will advise you on when and how to start your scar management protocol at home.

If you have a Skin Lesion then review by your GP or at a skin cancer clinic or dermatologist is warranted. If the doctor is concerned then they may suggest a biopsy, this is where some or all of the lesion is cut out and sent to the lab to be visualised under a microscope. The diagnosis is then made and treatment can be planned.

Some lesions are very typical of certain skin cancers and in these cases the doctor may recommend to excise the lesion without a prior biopsy being required.

This is very difficult to say without seeing the lesion. Your doctor will help you make this decision. Generally if the skin lesion is not growing or changing with time then it is much less likely to be a cancer.

Most patients seek to visit a Plastic Surgeon to remove a lesion if it is important to them to obtain the best cosmetic outcome i.e. minimal scarring. This is more likely to be for lesions on the face or neck than say on the thigh.

A Plastic Surgeon is also required for larger lesions and more complex cancers requiring some form of reconstruction.

Once the wound has healed, we will prescribe a scar management regime for you to follow to attain the best scar outcome. This is likely to involve a combination of wearing a skin coloured tape to the scar, application of a silicone scar cream, massage and sun protection.

Most patients can return to normal activities the day following their procedure with some restrictions depending on the location of the lesion removed and the complexity of the surgery performed.

Following surgery, a dressing will be applied which will need to be kept clean and dry for 48 hours and a sample of your lesion will be sent to our pathologist for examination.

Your wound will be reviewed and stitches removed between 5 – 7 days for an excision on the face and 7 – 14 days for anywhere else on the body. At this time the pathologist report will be available and discussed with you.

If you are in good health, you may be able to have a consultation and procedure on the same day. This is never necessary but often requested by patients to save their time and limit the number of visits required. Staff will ask you a series of questions to ascertain if you are eligible for this at the time of booking your consultation.