We understand that choosing to undergo a cosmetic procedure can be life-changing, it can boost confidence and self-esteem but can also boost nerves. We want all of our patients to be the most confident version of themselves and aim to achieve this by answering any questions and educating on every aspect of the journey from before you step foot into the clinic. Below are our most frequently asked questions however if you have any questions that haven’t been answered please contact our friendly team on 1800 745 536 to arrange a consultation.

Breast Implants

What type of breast implant should I get?

There are two basic filling materials – silicone and saline. These are the inner substance and both types are covered by a silicone outer shell. This shell can be smooth or textured (more on this later).

There is significant scientific information to support the safety of silicone as a safe substance for breast augmentation and in fact many other body implants. The newer types of silicone gel are cohesive (meaning that the implant holds together even without its shell) and are not liquid like the first generation of implants. In the unlikely event of shell failure, there would most likely be no noticeable or significant issues with the feel or appearance of your breasts, or general health. Saline implants contain a type of salty water that causes no reaction if they leak. The problem with this type of implant is that if they do leak, they rapidly deflate and need to be replaced at another operation. The rate of deflation or leakage is higher than silicone-containing implants. They do not feel as natural as silicone and are also more prone to ‘rippling’ – a problem that can be seen or felt at the sides of the implant.

Silicone implants are a soft gel so they can be manufactured into a range of shapes that can be chosen for the particular result that a woman desires. They can be round or anatomical (teardrop/asymmetrical) in shape and are made in a wide range of sizes which vary in how far they protrude from the chest wall (projection). With saline implants, there is a much smaller selection. All types of implants can develop a problem called ‘capsular contracture’; this is when the normally soft membrane that forms around an implant hardens, making the breast feel firmer and sometimes distorting the shape of the breast. It is not known exactly why this occurs in some patients and not in others.

Below or above the muscle?

It depends on the shape of your breast, the amount or thickness of tissue that you have at the upper part of the breast and how physically active you are. In general, it is best to place an implant on top of the muscle if there is sufficient breast tissue to cover the implant at the upper part of the breast. Patients who don’t have much breast tissue in the upper part of the breast will most likely get the best result by having their implant placed under the muscle so that the implant has more tissue covering it and looks more natural. In thin patients, where the ribs at the top of the breast are visible, placing an implant behind the muscle will provide more tissue to cover the edge of the implant. This achieves a softer edge and looks more natural in terms of not seeing an obvious ‘cut-off’ line where the chest meets the implant.

When we talk about ‘behind the muscle’ we are actually referring to ‘partially behind the muscle’ as the lower half of the muscle needs to be detached from the chest wall to allow the implant to sit optimally in the breast and achieve a natural shape. This technique is called ‘dual plane’. Detaching half of the muscle weakens it; women who use their pectoralis major muscle for sport will need to weigh up the options carefully. For most women, however, they don’t notice much of a difference in normal, day-to-day activities.

Where is the best place to place the incision?

Here we shall discuss the three main sites through which to insert an implant.
Some people believe that an incision around the nipple (peri-areolar) produces the best result. This is true in some people, however, it depends on the way a person heals scar tissue, as an incision can be quite noticeable in this location and it is also a sensitive part of the breast. An incision in this area has a higher risk of reducing the sensation of the nipple and the ability to breastfeed.

Another way of inserting an implant is through an incision made in the armpit (axillary). Again, the problem with this incision occurs when the scar is prominent and thus can be seen when the woman lifts her arm. Patients with these types of scars are often unable to wear clothing which may show their armpit scar if they raise their arms – this means sleeveless items like bikinis, strapless dresses, halter neck garments and singlets.

Our preferred incision site is in the breast crease (inframammary) because the scar usually heals well and is very difficult to see. It leaves no scar on the actual breast itself and does not restrict the type of clothing that can be worn even if it still visible.

What about after the operation?

Breast augmentation is performed under a general anaesthetic in a Day Hospital. The patient can leave the hospital after a couple of hours in recovery and after a period of post-operative observation.

Usually, pain is manageable and can be controlled with pain relief. Drains are not routinely used and dressings are minimal so a shower can be taken the day after surgery. Our surgeons use the Rapid Recovery technique, which reduces bleeding and for most patients enabling them to be up and about after 24 hours. The majority of patients can drive a car and go down the local shops the next day. After about 5 to 7 days most patients can return to work provided that they do not need to raise their arms or need to do any heavy lifting as this can be uncomfortable (particularly if the implant is under the muscle). All sutures are dissolving so there is no need to have them removed, but we do like to see patients at the one week stage to check on their recovery. A nurse will review the wounds and provide you with a scar-reducing silicone gel to use.

In the first few weeks, there is usually some swelling as the tissues heal. This settles gradually and is usually minimal by about a month after the operation. The size of the breasts at the one month stage is what they will be long term. By the 2 – 3 month stage they will soften and thus continue to improve for about a year. For the first 4 weeks, no bra should be worn and no activities undertaken that bounce the breasts (like aerobics or jogging). After this time patients are free to gradually resume normal activities. Pools and spas should be avoided in the first month to reduce the risk of wound infection.

Breast implants should not affect breastfeeding, whether the implant is above or below the muscle. There is no increase in breast cancer risk for those patients who have implants and mammography, ultrasound and MRI can be performed normally. Normal breast screening recommendations apply and should be followed. Implants should be considered permanent and do not need to be removed by a certain time or date unless there are medical reasons to do so.

Breast Lift

What type of scars could I expect to have?

A vertical scar down from the bottom of the areolar/nipple toward the crease under the breast.

All of these scars usually heal very well and fade to a pale, fine line over a year or so. Some patients do have dark, raised and wide scars – this is unpredictable in general but can often be revised and improved after a few months.

Is there a long recovery? Is it painful?

Breast lifts are performed under a general anaesthetic in a Day Surgery centre. The patient can go home a couple of hours after the operation if she’s feeling alright, after a period of observation.

Usually, pain is manageable and can be controlled with standard pain relievers. Drains are not routinely used and dressings are minimal so a shower can be taken the day after surgery. Sutures are dissolving so do not need to be removed.

After about a week most women can return to work provided that they feel comfortable.

In the first few weeks, there is usually swelling and bruising as the tissues heal. This settles gradually and is usually minimal by about a month after the operation.

For the first four weeks, a support bra should be worn and no activities undertaken that bounce the breast (like aerobics or jogging). After this time women are free to gradually resume normal activities.

Is this a risky operation?

In general, it is not a particularly risky operation, but it does present the same types of potential complications as any operation – bleeding, infection, scarring, reaction to the anaesthetic or medications, asymmetry, cosmetic result and pain.

The vast majority of patients are very happy with the result. Some need to have one or more further operations to improve the end result, as with any operation.

It is normal to have a difference between sides of the body – we are all asymmetrical and imperfect before any operation and this will be the case afterwards.

Who is this operation suitable for?

Mastopexy (lifting) is usually sought by women who have had children and feel that their breasts have sagged too much. For these women, the aim is to lift the breast and reshape it into a more youthful position.

Is there a Medicare rebate?

For some women there may be a Medicare rebate applicable; this can be determined during your consultation with Dr Topchian.

What if I have more questions?

If you would like to make an appointment for a consultation, please contact us on 1800 745 536.

Breast Reduction

What type of scars could I expect to have?

A vertical scar down from the bottom of the areolar/nipple toward the crease under the breast.

All of these scars usually heal very well and fade to a pale, fine line over a year or so. Some patients do have dark, raised and wide scars – this is unpredictable in general but can often be revised and improved after a few months.

Is there a long recovery? Is it painful?

Breast reduction is performed under a general anaesthetic in a Day Surgery centre. The patient can go home a couple of hours after the operation if she’s feeling alright, after a period of observation.

Usually, pain is manageable and can be controlled with standard pain relievers. Drains are not routinely used and dressings are minimal so a shower can be taken the day after surgery. Sutures are dissolving so do not need to be removed.

After about a week most women can return to work provided that they feel comfortable.

In the first few weeks, there is usually swelling and bruising as the tissues heal. This settles gradually and is usually minimal by about a month after the operation.

For the first four weeks, a support bra should be worn and no activities undertaken that bounce the breast (like aerobics or jogging). After this time women are free to gradually resume normal activities.

Is this a risky operation?

In general, it is not a particularly risky operation, but it does present the same types of potential complications as any operation – bleeding, infection, scarring, reaction to the anaesthetic or medications, asymmetry, cosmetic result and pain.

The vast majority of patients are very happy with the result. Some need to have one or more further operations to improve the end result, as with any operation.

It is normal to have a difference between sides of the body – we are all asymmetrical and imperfect before any operation and this will be the case afterwards.

Who is this operation suitable for?

Provided that overall health is good, breast reduction is generally performed for women who have large breasts and want them reduced in size. It can occur before or after having children, but it may reduce a woman’s ability to breastfeed.

Is there a Medicare rebate?

For some women there may be a Medicare rebate applicable; this can be determined during your consultation with Dr Topchian.

What if I have more questions?

If you would like to make an appointment for a consultation, please contact us on 1800 745 536.

Male Breast Reduction

Which operation is the best one for me?

There are two types of operation performed for this problem depending on the anatomical problem:

1. Excessive fat – if no firm, glandular tissue can be felt behind the nipples and the chest feels soft then most likely the problem is one of too much fat tissue. Liposculpture of the chest can improve the shape.

2. Excessive glandular tissue – firm tissue behind the nipples. A surgical procedure is required to remove the enlarged breast tissue.

In some men, both problems exist, and if this is the case can be addressed at the same operation.

What to expect in the procedure?

Performed under a general anaesthetic, the excess fat is removed using a liposculpture technique. Through small 3mm incisions, a cannula is passed under the skin to extract fat under negative pressure.

For men with overgrowth of glandular tissue as the main problem, an incision is made at the lower half of the nipple and the glandular tissue is removed. Sutures are used to close the incision, which generally heals well.

The procedure usually takes around an hour and patients can go home after a period of observation.

Recovery time?

Most patients feel a little sore for 2 or 3 days and can usually return to work after about 5 days.

A compressive garment is worn for 4 weeks to promote healing. If sutures are used, they are removed at the one week stage. Antibiotics are taken to reduce the chance of an infection.

Pain is manageable with simple medication; patients are encouraged to commence gentle activity the day after their procedure and can usually get back to normal exercise after 3 to 4 weeks.

Are there visible scars?

For most people, the scars are nearly invisible and cannot be seen after a few months of healing and remodelling of the tissues in the area.

Fat Transfer Face

Who is a candidate for this operation?

A wide range of people may benefit from fat transfer. Those who are undergoing normal ageing and dislike like the hollow, deflated appearance that parts of the face can take.

The cheek bone area and tissues around the mouth are frequently the most obvious areas of fat loss and therefore of advancing years. The skin sags partly because of a reduction in fat holding it out and up, causing deflation. The lost volume can be replaced with fat from another part of the body.

Under sedation and local anaesthetic, the area to be harvested is injected with a special solution that makes the fat easier to remove.

A 2mm incision is made in the area through which a cannula is inserted and used to remove the fat. The harvested fat is concentrated and then injected into the desired treatment areas. The procedure usually takes around an hour and patients can go home soon afterwards.

Recovery time?

Most patients have swelling in the area (especially the face) for 2 or 3 days but can usually return to work after 5 to 7 days.

No special dressings or sutures are necessary.

How long do the results last?

Some of the fat injected is absorbed by the body. The amount that remains varies between individuals but on average about half of the injected fat remains in the long term (after 3 months), after that time the volume that remains is permanent.
Because the amount of fat retained by the body varies, some people need 2 or 3 treatment sessions to get the effect they desire.

Are there visible scars?

For most people the scars from the removal process heal very well and cannot be seen after a few months of healing as remodelling of the tissues in the area takes place. The small injection site wounds heal after approximately a week.

Are any special blood tests required?

For most healthy people no blood tests are required.

Eyelid Surgery

What is Blepharoplasty?

Blepharoplasty is a surgical procedure to remove excess skin and muscle from the upper eyelids. Blepharoplasty can improve drooping skin and bagginess. It can help improve vision in older patients who have hooding of their upper eyelids. Although it can add an upper eyelid crease to the Asian eyelid, it will not erase evidence of one’s racial or ethnic heritage. Blepharoplasty will not remove “crow’s feet” or other wrinkles, eliminate dark circles under the eyes, or lift sagging eyebrows. Eyelid surgery cannot stop the process of ageing. It can however, diminish the look of loose skin and bagginess in the eyelid region.

Alternative treatments?

Alternative forms of management include not treating the skin laxness and bagginess in the eyelids by surgery. Improvement of skin laxness, fatty deposits and skin wrinkles may be accomplished by other treatments or surgery such as a brow lift when indicated. Other forms of eyelid surgery may be needed should you have disorders affecting the function of the eyelid such as drooping eyelids from muscle problems (eyelid ptosis) or looseness between the eyelid and eyeball (ectropion). Minor skin wrinkling may be improved through chemical skin-peels, laser resurfacing, or other skin treatments. Risks and potential complications are associated with alternative surgical forms of treatment.

Long-Term Results?

Subsequent alterations in eyelid appearance may occur as the result of ageing, weight loss or gain, sun exposure, pregnancy, menopause, or other circumstances not related to blepharoplasty surgery. Future surgery or other treatments may be necessary to maintain the results of blepharoplasty.

Further information?

Not all patients are suitable for this procedure, and a consultation is required to assess your suitability, medical history and general health & fitness, and to allow you discuss the procedure including risks and complications with Dr David Topchian.

If you would like to make an appointment for a consultation, please contact us on 1800 745 536.

Liposuction

Why is Vaser Liposuction different?

A machine generates ultrasound waves that are transmitted through the tip of a cannula so that the energy is delivered right to the fat cells, liquifying them. Other tissue is not affected, unlike standard liposuction.

The cannulas used are more gentle than standard ones; this makes it easier to remove the liquified fat cells which in turn means less bleeding and a faster recovery.

Because the fat cells are easy to ‘vacuum up’, the results are smoother too.

An added benefit is the greater contraction of skin, stimulated by the heat produced by the ultrasonic waves.

How is Hi Def Vaser Liposuction different to Standard Vaser Liposuction?

Cannulas used in vaser liposuction have multiple openings to allow even collection of fat cells in the layer of fat that sits on top of the muscle, for hi definition liposuction a second cannula is used with a single opening which enables the fat cells to be removed closer to the surface to allow for visual muscle definition.

Who is this operation for?

Ideally, liposuction is for people who are happy with their overall size and shape – other than one or two areas that have disproportionately more fat. Mostly these are people in good health who exercise and eat a high-quality diet but just can’t seem to shift difficult areas. They have found that focal fat reduction (for example, doing sit-ups to reduce abdominal fat) does not work.

For those patients who are generally overweight, liposuction to the abdomen and inner thighs can help to really motivate them to start exercising more and to improve their lifestyle once they have seen a rapid improvement in their shape. However, it is not a weight loss technique and is not recommended for large volume reductions.

If you have a prominent abdomen you may have fat within the abdominal cavity (behind the muscle); this type of problem responds best to exercise and eating well, and cannot be improved with liposuction. Only the fat in front of the muscle can be reduced with liposuction.

What is the recovery time?

Most patients feel sore for 2 or 3 days, they can usually return to work after about 4 or 5 days. Special support garments need to be worn for 4 weeks. These are firm supportive elastic outfits that help to speed recovery and improve the contour and are very important to achieving a good result.

By the end of the first month, most people feel back to normal as most of the swelling has gone down. There may still be some bruising and numbness which last for another few weeks.

The final result is usually seen at around the 3-month stage when all the swelling should have settled and the skin contracted. The small incisions still continue to improve for a year or two, and for most people become a barely visible blemish.

Pain is usually manageable with analgesics. Lymphatic drainage massage can speed the recovery process and will be discussed if this is appropriate for you.

Is fat removal permanent?

Some people are concerned that the body can produce more fat, or that the fat can move. This is not the case. The removal of fat is permanent.

Once you have a new shape it will remain. But if you are in a positive energy balance (eat too much or exercise too little) then you will gain weight again and be a larger version of your new shape. The opposite is also true.

For some patients, it is worthwhile seeing a doctor who specialises in Bioidentical Hormone Balancing as the balance between hormones may be a contributing factor in enlarging some fat deposits more than others.

Which areas can liposculpture be performed on?

The technique can be used in most areas, but some respond better than others:

  • arms, thighs, knees, calves, hips, back – commonly operated on with good outcome
  • abdomen – responds well in the right patient; can be a good alternative to a ‘tummy tuck’
  • chin – responds very well in most people and heals quickly
  • suprapubic/mons – an area that responds well. Can cause genital bruising for a few weeks but resolves
  • breasts – liposculpture can be used as an alternative to surgical breast reduction in women want to reduce by approximately one cup size
  • buttocks – can be slightly improved but will not tolerate large volume removal
Which areas can hi definition liposuction be performed on?
  • Abdomen / obliques
  • Arms / Triceps / Deltoids
  • Chest in male patients
  • Back
Are there visible scars?

For most people, the scars are nearly invisible and cannot be seen after a few months of healing. For people with dark skin the incision sites may darken for a few months, but usually, do return to a more normal shade.

Will my skin shrink back once the volume is reduced?

One of the challenges of this operation from a surgeon’s perspective is knowing when the right amount of fat has been removed from an area. If too much is removed then the skin might be too loose and not contract enough.

Younger patients with more elastic skin are more likely to have skin that contracts well. Patients who are older, have sun damage, loose skin or have lost significant weight before the procedure are more likely to have loose skin after liposuction. With the use of the Vaser ultrasonic machine, the retraction of skin is enhanced.

Are any special blood tests required?

For most healthy people no blood tests are required. Special tests may be required if there are medications or past medical history which may affect the operation or anaesthetic.

Labiaplasty

Who is this operation for?

There is a very wide variation in normal anatomy, and this is particularly true for the external female genitalia.

For some women their labia are large and can be a problem when doing sports like bike riding or horse riding; for others it can be uncomfortable to wear certain clothing or even precludes the wearing of swim wear; some women feel very self conscious about their large labia and this can interfere in their intimate relationships and with intercourse.

For some women only one side is too large and this side is simply reduced to match the smaller side.

The procedure?

Under a light sedation and local anaesthetic the excess skin is removed and sutures used to close the incisions made.

The procedure usually takes around an hour and patients can go home soon afterwards.

Recovery time?

Most patients feel a little sore for 2 or 3 days and can usually return to work after that time provided they don’t do a lot of walking.

A pad is worn to absorb any exudate. The sutures are dissolving and for most women don’t need to be taken out.

Pain is usually minimal and controlled with simple analgesics; salt baths help to sooth the area and keep it clean.

How long before I can get back to sex?

For most women it is somewhere around a month after the operation if healing is normal.

Are there visible scars?

For most people the scars are virtually invisible and cannot be seen after a few months of healing and remodelling of the tissues in the area.

Book a Face-To-Face or Online Consultation

To learn more about the procedures offered, please complete the form below with the procedure you are interested in. Alternatively, you can contact our clinic on 1800 745 536.

Given the current circumstances surrounding Covid 19 we also understand if people in the current climate would prefer a consultation from their home, you can now do this via an online consultation at a time that suits you.

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