Celebrity Knifestyles

Lauren Pope, The Only Way Is Essex (TOWIE) beauty was fitted with potentially toxic Poly Implant Prothese implants made from industrial grade silicone. In 2005, Lauren then aged 23, got a breast augmentation and went from a 34B to a D. She recently went under the knife to replace them, but the whole experience has shocked and angered her.

Lauren had a scan that showed one of the breast implants had leaked and just wanted them out. She stated that, “It felt like it was a ticking time-bomb”. In December 2011, the horrifying news came that around 400,000 women worldwide had been given potentially toxic implants between 2001 and 2010 (none in the US). They were initially linked to nine cases of cancer, including one death, but this has been firmly discounted by medical experts in Europe.

Lauren took the initiative and had the PIP implants removed and replaced with bigger ones, going up another size to a DD with a slightly different shape. Remember, however, “bigger implants, bigger problems’. Lauren, who has also had lip fillers, a nose job, teeth veneers and Botox, admits she still isn’t confident about her looks which is a shame. She clearly is a very attractive woman and I have concerns whether or not she has Body Dysmorphic Disorder (BDD): an excessive concern about or preoccupation with a perceived defect of her physical features.

For women who unfortunately still have PIP breast implants, they would be  advised to check the details of their implant with the surgeon responsible for their care. The surgeon should have a record of the implants used (including the make and size). This information should be provided free of charge. If you are unable to access your surgeon, you should contact your general practitioner for advice regarding an alternative referral. I would recommend that you discuss your options with your surgeon first of all. The decision on whether a scan (USS/MRI) will be required will usually be made after consultation with a surgeon.

The upshot is that all silicone gel implants leak to some extent- this is called “leeching”. So it doesn’t even matter if these implants are ruptured, they still leak. In the case of the PIP implant, the gel inside there is low (industrial) grade silicone and contains even more than the usual amounts of toxins. My recommendation to all PIP implant patients is to “Take them out.” If it were my family member that had PIP implants, that’s what I would do.

Thanks for reading,

DrTim

Madonna is one of the most recognisable icons in modern pop culture. She is constantly reinventing her image allowing her to enjoy so much success not only as a singer-songwriter but as an actress too.

Madonna, I have to say, is looking remarkably fresh-faced and youthful for her 53 years of age. The singer insists she has not had any cosmetic surgery procedures and credits Kabbalah with keeping her focused on inner rather than outer beauty. However, it is my opinion that she has had a bit of a helping hand cosmetically in turning back the hands of time.

Despite being in her fifties, her face has remained very youthful and wrinkle-free:

• Her forehead, frown and crows’ feet appear very smooth and she is without any of the lines you would naturally expect in a woman her age.

• She shows signs of having had a facelift with an unnatural fold that sweeps up into the ear (it could also result from a “ribbon lift” procedure) and some volume restoration to the cheeks, perhaps using fat transfer because of the significant volumes required. The fluctuations in the fullness of Madonna’s cheeks over recent years indicate that it’s more likely due to cosmetic procedures. As we age, our cheeks deflate and sag, and the underlying facial bones resorb thus exacerbating the situation. The only way for the cheeks to reflate and be lifted again is to have temporary fillers or fat transfer injected deeply to lift the cheek pads up, giving high, rounded apple cheeks (this is in contrast to cheek implants which would lift the cheek pads to the sides) or have a face lift.

• She’s most likely had eyelid surgery on the upper and lower lids. Her eyes were much more hooded when she was younger, and now her upper lids are very tight or pristine, which is hard to achieve without surgery. She also has a peculiar crease under the eyes which travel out to the sides of the face (this isn’t an appearance you would naturally expect).

• Lips typically thin with age, but Madonna’s lips are plump which may mean that they have been filled up with fillers or fat. The wrinkles from the corner of nose to mouth (nasolabial folds) are also blunted, and are a likely result of filler injections.

• Madonna’s super-smooth, shiny skin also looks as if it has had the benefit of laser resurfacing facials which work by fractionally removing layers of skin to increase collagen production in the deeper layers.

Despite Madonna insisting: ‘I am not going to hold a press conference if I have plastic surgery. But I’ve said many times, I think about it and I sure don’t rule it out,” I think Madonna looks great for her age and her facial rejuvination actually suites her. Critics have been unkind calling her “puffy pillow-face” and so on  but they don’t appreciate that facelift procedures take time to heal and the initial puffiness will eventually settle down (scar tissue can take up to 12 to 18 months to mature). In the end, it really doesn’t matter what the rest of us think. What matters is whether Madonna herself is happy, and so she should be!

Thanks for reading,

DrTim

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Actress, dancer and model Nicole Austin, known more popularly as Coco, achieved a new height of fame when she married rapper and actor Ice-T. The two appear together frequently at public events, often with Coco appearing in provocative outfits.

However, Coco is more famed for concentrating her weight in her breasts and buttocks. Coco is 32 years old, 5 feet, 2 inches tall (1.57 m) and weighs 61.2 kg (135 lbs) and according to several reports she enlarged her breasts to 39DD (overall measurements are 29”-23”-40”).

In my opinion, her breast implants are disproportionately large compared to her small frame. Some people have suggested that she may have had “double stacked” breast implants. It involves using two sets of breast implants, one stacked on top of the other. Double stacking breast implants is used when a patient wants huge, fake-looking, high-profile breasts. This is a disreputable procedure that most plastic surgeons will not do.

It shouldn’t be that surprising that Coco, along with many other women, don’t exactly go for the natural look. Most women grapple with 2 desires when thinking about breast enhancement:

1) Do I go natural or do I go for the more obvious look?

The vast majority of women that I see prefer their breast augmentation not to be obvious and for as few people to know about their procedure. “…I don’t want fake boobs. I just want the natural look and for no one to know.” In contrast, younger women generally have more of a desire to be sexy, and hence, prefer their breasts to be obvious. “I want them to look bigger like the girl’s breast’s in magazines.”

2) Do my breasts need correction or do I need to create breasts?

Most women after having kids undergo significant changes to their breasts, namely loss of volume, sagging and stretch marks. They have experienced what was “normal” and want it back. “…I felt I’ve lost my boobs and they were replaced with empty sacs. I want my 20-something perky, natural look back”. Whereas, there is a subgroup of women who have never experienced the breasts that they so desire, and feel robbed of the opportunity to feel womanly and curvy. They have insecurities about their breasts, “…I would always wear padded and push-up bras to increase the size of my breasts and create some cleavage. I always felt they were smaller than my friends and inadequate”.

Recent Australian marketing research has shown that when the desires outlined above were analysed further, there were 3 clear segments that emerged:

1) Establishers: “make me a woman”

Women in this category fit into all ages. They are determined not to look fake and are the most anxious. They often feel long-term envy about other women (especially friends who are well endowed), feel masculine or inadequate, often having to hide or mask their lack of breasts with padded bras or “chicken fillets.” They often don’t want other people to know about their intentions or the surgery.

Establishers tend to have been considering enhancement since puberty, often gathering information about breast augmentation for a long time. As a consequence, they may be relatively overwhelmed and confused with the many options available out there which may then breed fear and anxiety. These women need their anxieties alleviated and encouraged or reassured about a natural looking outcome following breast augmentation.

2) Restorers: “make me a woman again”

These are determined women and they don’t want to look fake. These women have lost their self-confidence, they feel like their mother or an older version of themselves and they know what it is like to have “normal” breasts. Their sagging breasts are often a result of breast-feeding or weight loss.

Restorers are clear about “wanting their breasts back” and should be encouraged or reassured about a natural looking outcome and restoration of “original” breasts.

3) Boosters: “make me a lot more of a woman”

This group of women, usually 18-24 year-olds, are steadfastly determined and have a desire for the obvious look. Although they have similar reasons for considering breast augmentation to establishers, they feel pressured by the media/others to look a certain way eg. they want “celebrity” breasts. It is of interest that those that have had breast augmentation surgery, approximately 20% often want to have even bigger breasts.

In view of their determined mindset for the obvious look, most boosters are quick to make up their mind about breast implant size and shape, which pocket they want it placed in, which incision site they prefer and often book a date for surgery on the spot.

Thanks for reading!

Dr Tim -  Sydney Cosmetic Plastic Surgeon

www.cosmeticculture.com.au

www.drtim.com.au

Megan Fox is a classic Hollywood beauty, but it is common knowledge that she has had a cosmetic surgery makeover since being cast in the first ‘Transformers’. There is a dramatic change in her facial appearance that cannot totally be attributed to aging, cosmetics, or weight loss. Her nose, lips and cheeks have changed shape. But what I would like to concentrate on is her gorgeous eyebrows. They are perfect for her face and I would like to explain the basis of why this is the case.

Brow Aesthetics

In the normal brow, the inner part of the eyebrow (head) extends to the most inner part of the eye (a-e), and the outer eyebrow (tail) extends to the intersection of an imaginary line drawn from the nostrils through the most outer part of the eye (b-e).

The head of the eyebrow can begin below or at the inner eye socket. The tail of the eyebrow is positioned above the eye socket, often dropping to the same horizontal level as the head of the eyebrow.

The tail of the brow normally may be found above the horizontal line of the head of the brow (a-b). The apex of the brow arch lies immediately above the outer edge of the iris (c-d). In fashion models or iconic actors, the apex tends to be at the point dividing the inner two thirds and outer third of the brow, or sometimes even more outward, creating a stylised or more exotic appearance as in Megan’s case. In the average patient the apex of the brow often is located more centrally, but this still can produce an attractive brow.

The depth of the orbit or eye socket and the shape of the overall orbit should also be taken into account. In a patient with deep-set eyes, an overly elevated brow appears more abnormal, whereas a patient with a shallower orbit can tolerate over-elevation of the brow and still appear within normal limits.

As is seen with clothing and art, horizontal lines make long objects appear more round and vertical lines create the illusion of length in round objects. Megan has an oval shaped face which is the “ideal”. It is intrinsically balanced. The brow plays no significant role in making the face appear “more oval.” If however she had a more round face that needed to appear oval, one should apply lines that go up the face and a hgh arched brow accomplishes this. This draws the eye more up and down and stops it from going side to side. The peak is best moved out toward the end of the brow and lets the lines of the brow go up and down as much as possible. The tail should therefore be short eg. Cameron Diaz. To make a long face appear oval, one should apply horizontal lines to the face. This draws the eye from side to side and stops it from going up and down. Hence, a flat brow stops the eye from going up the face eg. Stephanie Seymor.

Other Considerations

As the face ages, the orbital shape changes from an oval or egg shape to a circular shape, caused most often by sagging of the mid face. In patients with a significant inner lower eyelid crease from mid face sagging (nasojugal crease), avoid elevating the brow as an isolated procedure, since this makes the circular shape of the orbit worse and increases the aged appearance. In this situation, consider having a facelift or mid facelift in conjunction with a brow lift. A mid facelift also can be performed in conjunction with a lower eyelid procedure.

Furthermore, noticeable asymmetry of eyebrows is present in approximately one third of patients. Often the distance from orbit to brow is the same on both sides even though the brows appear uneven. In this situation, the entire orbit on one side of the face is usually lower. The plastic surgeon must decide which approach provides a more symmetric look—raising the brow the same degree on both sides, which maintains the asymmetry of the brow, or raising the eyebrows asymmetrically, which equalises the eyebrows but may introduce a new asymmetry in distances between brows and eyes.

Lastly, remember that the brow and upper eyelid are one aesthetic unit, so look at the amount of redundant skin in the outer eye region. Significant overhanging skin near the “crow’s feet” is difficult, if not impossible, to remove with eyelid surgery alone. Elevating the outer brow may be necessary. This is one helpful indication in addressing the need for brow elevation, especially in the patient presenting with heavy upper eyelids.

Thanks for reading!

Dr Tim -  Sydney Cosmetic Plastic Surgeon

www.cosmeticculture.com.au

www.drtim.com.au

There has been a great deal written about Nicole Kidman’s breast augmentation last year, of which I would like to make one salient point: If you are thin and your ribs are easily visible, then you should always have the breast implants placed beneath the chest muscle. This picture of Nicole clearly demonstrates what happens when the implants have been placed above the muscle, because they look so round, high and unnatural.

Nicole is known for her slim, statuesque figure with low body fat and anyone who has seen the actress wear next to nothing in movies like “Eyes Wide Shut,” will know that she is typically around an A-cup. Following her breast augmentation, she is now more of a full B-C cup which makes her look more proportional ie. the breast augmentation “marries” the chest to her hips. Although the volume selected may have been correct, the pocket in which the implant was placed was not. A much better and more natural result would have resulted if the implants were placed under the muscle, because the muscle acts as an extra padding or has a “doona effect” that camouflages the borders of the implant so that it blends into the surrounding chest tissues seamlessly.

Other factors that may have contributed to her breast implants looking like “play-doh” are that the pocket that the implant was placed in may have been inadequate or there was development of excess scar tissue (capsular contracture) that distorted the breast implants to make them look rounder and less natural. Unfortunately for Nicole, I feel that on this occasion, she has made the wrong decision with regards to  pocket selection. Regardless, she is still a very classy lady and an extraordinarily talented actress and I wish her well.

Thanks for reading!

Dr Tim -  Sydney Cosmetic Plastic Surgeon

www.cosmeticculture.com.au

www.drtim.com.au

Kim Kardashian has placed butt augmentation very high on the cosmetic culture radar by strutting her  curvaceous, rounded behind on the celebrity circuit. As a result, many admirers have began to follow suit. The question, however, still remains “Has she had a butt augmentation?”
While her butt does appear to be quite projected, this may, in fact, be hereditary. However, previous butt augmentation surgery cannot be excluded. The fact remains that despite her butt being large, it is also quite “square” in shape which makes her look “bottom heavy” or a better term may be “Modiglianiish”. This in my opinion detracts from the actual beauty of the butt which should be round shaped. Let’s examine this further.
There is a fundamental difference between women and men when it comes to the buttocks. Women have curvy, shapely lines and round volumes, while men are characterised by straight lines and square volumes. Generally speaking, the shape of butts fall into 4 groups:  “A-shape”, “V-shape”, “square” and “round”.  According to Brazilian plastic surgeon Dr Raul Gonzalez, an expert in buttock reshaping, the major feature of a beautiful butt is the round shape. There are several characteristics which he feels  contribute  to keeping the buttock permanently round-shaped. These include:
a) Butt  projection. The greatest projection should be at the upper 2/3 or in the middle 1/3 of the buttock
b) Butt crease. There should be no crease, or if there is one, it should not go beyond the thigh’s midline
c) Outer thigh bone (trochanteric) depression. There should be no trochanteric depression, if there is. it should be very shallow
d) Firmness of the buttock fat
e) Muscle firmness and tone. Muscle volume provides the round protruberance that shapes the buttocks
Having now educated ourselves that a beautiful butt is round-shaped and firm, regardless of the position and angle, let’s now look at what  techniques are currently available for  butt augmentation.

1) FILLERS
a) Fat Injections (”The Brazilian Butt Lift”)

This method is becoming the gold standard for butt augmentation and/or  reshaping. Plastic surgeons will remove fat from areas of the body where it is more plentiful (the flanks, hips, lower back, thighs or tummy) with liposuction. This excess fat is then purified and re-injected it into your backside. In other words, you get 2  procedures in 1. Note that butt implants can’t help shape the lower part of the buttock (see below) whereas fat injections can. Fat injections may also be used in other areas of the buttocks to sculpt, contour and project the buttocks.

Approximately 30% of the injected fat dissolves, meaning that the procedure may need to be repeated several months later. This procedure is best suited for overweight patients, or patients who wear size 8-12 dresses. There is < 1% chance of complications arising from fat injections including: skin irregularities, fluid collection (seroma), skin discolouration and fat reabsorption. Obviously, fat grafting for butt augmentation cannot be performed in very thin women unless they decide to put on substantial amounts of weight. If this was not an option, that is where butt implants come into their own.
b) Synthetic products
These fillers are being used overseas are not currently approved in Australia or the USA for butt augmentation.  The attractiveness of these types of butt fillers is due to the fact that they are cheaper than fat grafting or butt implant surgery, and offer no downtime. Some of these products include silicone, hydrogel, aquagel and PMMP (polymethylmethacrilate microspheres). Many patients may look quite good in the short term but in the long term (say 5-10 years) they may get  disfigurement problems resulting from foreign body reaction.  However, the most dreaded complications from synthetic fillers include: lung or heart attack (if synthetic fillers are not injected correctly, the product may go into the artery or the veins which can then  travel to the lungs (embolism) and  lead to death (which is what happened to former Miss Argentina Solange Magnano late last year)) and infection (this is exactly what happened to Latin pop star Alejandra Guzman who was hospitalized following injections to the buttock that became infected, and she ended up in the intensive care unit)

2) BUTT  IMPLANTS
This typically involves an incision made between the midline of the buttocks. The plastic surgeon creates a pocket for the silicone implant and inserts it through this incision. The implant is positioned between muscle and fat or within the main buttock  muscle.  This area will form scar tissue that should help keep the implant in place. Butt implants come in different sizes and shapes, and can even be customised. In general, these natural-feeling implants help round out the upper and outer parts of the buttocks; but not the lower parts. This procedure is suitable in thin patients who wear size 2-4 dresses where fat grafting is not possible because they do not have any fat to spare.
Butt implants are performed under general anaesthesia, typically as an overnight stay in hospital. After placing the implants, the plastic surgeon must assure that both buttocks are symmetrical and look natural before stitching up the incisions. The procedure usually takes about 2-3 hours to complete. Sometimes butt implants are paired with buttock lifts and liposuction of the lower back to yield more balanced results. Other times, liposuction with fat injections are used to shape and contour the entire buttock area. The latter procedure should not be done at the same time as buttock implant insertion because the fat injections can contaminate the implant, resulting in infection. Furthermore, the pressure from the implant can destroy the fat.
In the early days, butt implant augmentation had a 30% complication rate which has now reduced to < 5% by largely refining our techniques, choosing the right patients, and learning how to select the correct implant shape, size and texture. The main complications that can arise from butt implants are: wounds opening up (dehiscence), implant infections that may require intravenous antibiotics or , at worse,  removal of the implants, the implant my become hard (capsular contracture), the implant may shift  over time, the implant may be rejected (extrude), the patient may develop fluid around the implant (seroma) and the buttocks may look asymmetrical.
Remember that butt implants stretch the tissues, which can be painful, especially if the implants are placed within the muscle. Your plastic surgeon will prescribe an antibiotic and anti-inflammatory medication to reduce the risk of infection and help with the pain. Some plastic surgeons use temporary drains to remove excess fluid buildup during recovery. You will also need to wear a compression garment for support for a few days after your buttock surgery.

3) BUTT LIFT SURGERY
A butt lift removes excess skin and fat that may cause sagging buttocks to add contour to the waist, hips and back of the thighs. The incision is made along the lower back, spanning from hip to hip. The plastic surgeon then pulls the excess skin below the incision to lift the buttocks and outer thighs. The extra skin is then removed. Sometimes, the skin only is removed and the fat is left attached to the underlying muscle but moved lower in the butt for added butt projection.
A butt lift is often part of a total body lift, which is common after weight loss (bariatric) surgery. It can take about 2-3 hours to perform by itself, under general anaesthesia.  Most people who have butt lifts go home 2-3 days, however, the hospital stay may be longer if other procedures are performed simultaneously. Swelling may last for up to 3-6  months, and the full cosmetic results are visible within a year. The main complications concerning butt lifts are: asymmetry, infection, unsatisfactory cosmetic results, excessive bleeding, anaesthesia problems and the need for revision surgery

4) LIPOSUCTION
Another way  to enhance the buttocks, is to do liposuction to the hips and thighs around it. This essentially makes everything around it smaller, and can indirectly make the buttocks look bigger and rounder compared to the rest of the body.The main benefits are decreased surgical time, fewer complications, and the fact that  the patient can sit down immediately.

Needless to say, choosing the correct plastic surgeon can play a major role in your satisfaction with the results of your buttock surgery. The plastic surgeon should be a member of the Australian Society of Plastic Surgeons. This ensures that they have extensive training and are up-to-date on new technology and techniques. Also, consider viewing before-and-after photos of a potential surgeon’s previous buttock surgery patients for a better idea of what you can expect.

Thanks for reading!

Dr Tim -  Sydney Cosmetic Plastic Surgeon

www.cosmeticculture.com.au

www.drtim.com.au

I recently had a look at First Lady Michelle Obama and noticed that she had a problem with her left lower eyelid, termed scleral show, meaning that you can see the “white of the eye” beneath the pupil, which is abnormal. Whenever one discusses the lower eyelid, the cheek should be mentioned as well, as they are intimately related or “married” to each other.

As you age, there are certain things that happen in this lid-cheek junction, as well as, to the rest of the face:

1) Deflation. Fat melts away in the cheek (end up with excess skin-think of sucking the beans from a bean bag).
2) Descent. Gravity takes effect and skin sags.
3) Deterioration. Skin is damaged from sun, stress, smoking, pollution, sleepless nights, sugars etc. End up with mottled, porous and scaly skin.
4) Dissolution. The underlying facial bones melt away on their surface, so the soft tissues sag even further (think of the sand on the shore line when a wave comes in and then flows out again).

All these factors play a role in the lid-cheek junction that can result in dark circles under the eyes, flat cheeks, deep skin folds that run from each side of the nose to the corners of the mouth, and scleral show.

Scleral show is a common condition with a number of causes. The lower eyelid is composed of 3 layers (say like a sandwich containing a filler), any one of which may result in the eyelid position being lowered. Eyelid surgery (for cosmesis or corrective purposes) or facial paralysis (eg. stroke) can increase the looseness of the skin and structures of the eyelid, resulting in droopy and weakened eyelids. Other causes with much the same effect are thyroid eye disease, amyloidosis, and scarring eg. due to sun damage or burns. Patients may also develop dry eyes from poor tear flow as well.

Fortunately, many options exist to correct the problem. Suturing and pulling up the eyelid is the simplest method. Sometimes it’s necessary to tighten the lower lid by shortening it, like “tightening up a belt buckle”. Scleral show from scarring may be managed by cutting the scar and placing either your own soft tissue or a synthetic patch to make the eyelid more mobile. Lastly, lifting the cheek or supporting it with fat grafting may be necessary to help lift up the eyelid and prevent relapse of scleral show.

These various surgical methods have their pros and cons so you need to consult with a plastic surgeon who can perform a comprehensive examination and determine which exact procedure may be most appropriate for you. It should be noted that one eyelid procedure cannot treat all the causes of scleral show.

Thanks for reading!

Dr Tim -  Sydney Cosmetic Plastic Surgeon

www.cosmeticculture.com.au

www.drtim.com.au

Now we all know Britney Spears is a very talented singer and performer who has attracted a lot of attention in the past for her outlandish behaviour. However, I would like to draw your attention to her chest today to make a point: her nipples appear to be at different heights and her breasts are asymmetrical, the left one appearing fuller than the right. This is all very normal!

The 28 year-old mother of 2 boys has just gone through the ravages of motherhood which usually involve the severe physical trauma of pregnancy, childbirth and breast feeding. I don’t want to make it sound like a pathological condition but these things have profound negative effects on women and causes them to lose their hour-glass figure. Cosmetic surgery in these instances is used to 1) hoist slackened skin; 2) decrease stretch marks; and 3) decrease pregnancy fat.

Britney is a good example of what happens to breasts following childbirth. The  breasts tend to lose upper pole volume, they sag and lose their shape, and sometimes manifest themselves with unsightly stretch marks. We know that breasts tend to be asymmetrical to start off with in the majority of women. Sometimes, one breast may enlarge more than the other during puberty or pregnancy/breast feeding. This is what I assume has happened to Britney. What are her options?

The first thing to decide is whether she is done with having kids or not. Further pregnancies will only create the same scenario for her. The next issue is whether she requires a nipple lift or a formal breast lift with or without insertion of breast implants and that really depends on the patient’s wants (desires), her breast tissues (reality), and the surgeon’s experience. What do I mean by this?

If breast volume is not a problem and there is minimal sagging, then nipple repositioning is a simple, safe and effective method of equalising the heights of the nipples so they look symmetrical. This results in a scar that is either crescentic or round in shape and is usually well camouflaged. Special care has to be taken in a small proportion (<1%) of African-Americans, Hispanic and Asians who may get raised scars (keloid or hypertrophic scars) and hyper- or hypopigmented scars.

If breast volume is not a problem and there is moderate to severe sagging, then a breast lift is appropriate. This is were you are trading excess skin for a scar. The scars may come in different patterns such as round (around the areola which is the pigmented skin around the nipple), a lollipop (around the areola and in front of the breast) and as an anchor (around the areola, the front of the breast, and in the breast fold). The quality of the scar largely depends on your genetics, age, sun exposure and whether you smoke or have medical problems like diabetes etc.

If breast volume and sagging are both a problem then a breast lift and insertion of breast implants is the way to go. But this breast “combo” is the most difficult breast procedure to perform. Just think for a second: you’re inserting breast implants to give you volume esp. in the upper pole, so tissues are stretched leading to pressure outwards; then, you are lifting and tightening breast tissues, which cause pressure inwards. This interplay makes it difficult to predict what the final outcome will look like, and if you add pre-existing stretch marks into the picture, then it becomes almost impossible to do so. I caution my patients never to go too big with the breast implants esp. on a background of stretch marks (you don’t want them to look like the “rock in the sock” in 5 years time). Furthermore, I always tell my patients that there is a ~20% revision rate with such procedures, usually involving tidying up of loose skin or excess scar tissue.

If breast volume is too much, then breast reduction would be a better option. This not only removes excess breast tissue, it lifts and shapes the breast, at the same time, repositioning the nipples to lie at or just above the breast fold. The scars are generally the same as for a breast lift. The best thing that patients tell me after this procedure is how much better they feel without the pains in their neck, shoulders and upper back, not to mention, relief from the bra strap causing shoulder grooving.

Talk to or visit your plastic surgeon whose knowledge and experience will help you decide what procedure is appropriate for you.

Thanks for reading!

Dr Tim -  Sydney Cosmetic Plastic Surgeon

www.cosmeticculture.com.au

www.drtim.com.au

Much has been written and discussed on whether Heidi Montag’s cosmetic surgery sojourn was worth it or not and whether somebody at her tender age of 23 should be having so many procedures in the first place. This is my personal take on things.

Firstly, one has to understand that this is not anti-aging cosmetic surgery. This is “moneytization” surgery. This has been one of the best PR coups that has been meticulously crafted and staged to get the most recognition possible for a “B-listed” reality show star. She will now try and use her enhanced assets to catapult her career in Hollywood even further. Heidi admitted it herself that she’s in the entertainment industry and she needs her assets to ply her trade.

Secondly, anyone who has 10 procedures (not in the same area) by a plastic surgeon in one sitting, regardless whether they are young or fit, is doing themselves more harm than good. In my opinion, it would be akin to being involved in a  motor vehicle accident (unrestrained) and coming out alive,  battered and bruised. It takes a longer time to get over the accident, and sometimes, things may never return back to normal. A surgical assault on different parts of the body at the one time has the same effect. The inflammatory response one gets from multiple injured sites increases exponentially your risks and complications such as blood clots and infections.

Lastly, my only caution and advice to Heidi would be that you can’t put all your self-esteem into your physical attributes. Remember, beauty is youth and youth is temporary (look at your high school reunions for confirmation!). Heidi may look good today but the day will come when she will look wrinkled and saggy. There will be other beauties who will come along and steal her limelight. However, you can still grow old and be attractive in other ways such as staying fit, having a charismatic personality and being self-confident. We are constantly evolving or if you like “under construction” throughout our lives and have to first find peace within before we are comfortable finding beauty on the outside.

The moral of the story is that it’s all right to fix up minor deficiencies at a young age but multiple cosmetic surgeries in one sitting won’t make up for psychological deficiencies or guarantee success in ones chosen career. In the end, Heidi is an adult who has made an informed decision, accepted the risks and complications, and decided to move ahead with her program of self-improvement. I hope for her sake that she has found happiness in doing so. But I am reminded of yesterday’s icons who have tried to remain eternally youthful only to have been crushed by the ever scrutinizing media once they’ve aged. They have been cast from the pedestal to the waste bin along with a lot of psychological issues. Let’s hope that it’s not the same scenario for Heidi Montag.

Thanks for reading!

Dr Tim -  Sydney Cosmetic Plastic Surgeon

www.cosmeticculture.com.au

www.drtim.com.au