How to Look Younger Without Surgery

If you find that you’re constantly battling the tell-tale signs of aging, rest assured that you’re not alone. People ranging in age from 30-60 are consistently on the hunt to find the solutions to remedy their aging skin, teeth, and bodies.

For some, this means going under the knife for plastic surgery procedures to nip a little here, lift a little there, and plump things up. In Australia alone, people spend $1 billion on cosmetic procedures, according to SBS.

Many of those people, using an increasing number of technologies and procedures wished to correct facial aging (specifically around the eyes), as well as to improve facial aging issues like sagging necks, deep wrinkles, and jowl formations.

But why go under the knife when there are plenty of non-surgical solutions right in front of you? Not sure what they are? We’ve laid out a few of our favourite lifestyle choices, tips, and tricks for looking younger without undergoing the stress, expense, and recovery that go hand-in-hand with surgery.

 

Exercise and Diet

These two things are going to be the most important factor when it comes to keeping your appearance youthful. When it comes to exercise, you’re not just keeping your body limber and young, you’re also circulating more nutrients and oxygen to your skin to make you appear radiant.

Exercising essentially kickstarts the collagen production process of building younger skin, which tends to automatically slow down as you age. It also can get rid of grey hairs, reduce puffy eyes, and prevent free radical damage.

Diet, too, is an important factor. Avoid too much sugar and focus on unprocessed foods with healthy fats, antioxidants, and a heavy emphasis on fruits and vegetables.

 

Skincare and Lifestyle

When you think about your lifestyle, ask yourself a few questions:

  • Am I getting enough sleep?
  • Do I take proper care of my skin?
  • Am I avoiding substances (like alcohol and tobacco) and cortisol levels that could age me prematurely?

If not, you’ve got some work to do. When it comes to skincare, ensuring that your face and body are getting the right amount of moisturization and attention are going to be key in maintaining a youthful look.

In order to maintain youthful, healthy skin, a regular regimen is important. You should apply a moisturizer every day, wear sunscreen consistently, and wash your face at least once a day, especially after sweating. Additionally, avoiding alcohol and smoking can do wonders for you and your skin – smoking speeds up how quickly your skin ages, and alcohol can dehydrate and damage your skin as well.

 

Non-Invasive Procedures

If you’re looking for more than what a great diet and a life full of exercise can do, there are non-invasive, non-surgical procedures you can turn toward to get you and your appearance to where you want to be.

When it comes to combating symptoms of aging, one of the least invasive procedures is laser skin rejuvenation. Using four powerful technologies, this specialised method can help improve the appearance of your skin in as little as sixty days.

This skin rejuvenation process uses erbium lasers for skin resurfacing and rejuvenation to help remodel your collagen and tighten up your skin. After this treatment, your fine lines, wrinkles, and discolorations – even those that you think are permanently nestled into your skin – will disappear, giving you a new, revitalized, and youthful look.

 

Conclusion

To fight back against the symptoms of aging, you’ll probably need to implement a number of different lifestyle changes and choices to get the best results. A great diet, a healthy and regular exercise regimen, ensuring you’re getting plenty of sleep, and avoiding all substances like tobacco and alcohol are going to be absolutely vital to maintaining your youthful appearance.

When that’s not enough though, simple procedures that are non-surgical and non-invasive can be helpful! Consider looking into laser rejuvenation and resurfacing when you’re thinking about how to regain your youthful appearance.

Have questions about your skin rejuvenation options? Want to find out if laser skin rejuvenation is right for you? Get in touch with our helpful team today!

Year-Round Skin Care

Nothing brings out your natural beauty quite like clear, glowing skin. To get bright, healthy, youthful looking skin, you must take care of it every day which means diligently sticking to a proper skin care routine.

Products that worked great for you in the summer, however, may not deliver the same results when the weather turns cold, and vice versa. A great skincare regimen depends upon customising your regimen and product arsenal throughout the year. This article outlines what you need to know about taking care of your skin throughout the year for the best possible results.

Exfoliate often

exfoliant

Exfoliating your skin is essential year-round, but you may find that you need it more in the winter time. Exfoliating 1-2 times per week will slough off dead skin cells and allow your moisturising products, like face oils, serums and moisturisers, to penetrate the skin more deeply.

Two types of exfoliating products exist: chemical and physical exfoliants. Chemical exfoliants use chemicals like alpha hydroxy acids (AHAs), beta hydroxy acids (BHAs), and fruit acids and enzymes to exfoliate the skin. Physical exfoliants are products which rely on physical means, like small grains, beads, or bristles to exfoliate.

Be sure to follow up with a rich, nourishing face oil or skin cream to protect your skin and prevent it from losing excess moisture.

In the summer, your skin will naturally be more hydrated, but you should still exfoliate when needed to ensure your skin can optimally absorb moisturisers. It’s best to avoid products with rough, scratchy ingredients like large fruit pits and shells, as these can cause micro-tears in and irritation to the skin.

 

Cleanse daily

skin care routine

Use the best facial wash for your skin type. Many mistakenly think they must scrub with a strong cleanser to clean properly but, in reality, using harsh products may cause irritation, dryness, and peeling which are problematic in the drier winter months.

Switch to a gentle cleanser for sensitive skin which can add moisture to your skin and will soothe any dryness. If you have problematic skin or experience irritation, stick to a fragrance-free cleanser with minimal irritants.

In the summer, you may be able to choose a lighter cleanser so you continue to have gorgeous, glowing skin.

 

Target concerns with skin treatment products

After cleansing, it’s time to apply specific products designed for your skin type; you may find that you need to use more moisturising ingredients to hydrate the skin during the dry, cold winter months.

During the hot summer months, many people find their skin can tolerate less moisture, and lighter products are appropriate.

 

Use sun protection

moisturising cream

Sun protection should be an essential step of your year-round skincare routine, as the sun’s rays are damaging even on cloudy days. Suncare is a must if you want to have youthful skin and prevent wrinkles, premature aging, and skin cancer. Apply SPF to clean, dry skin after cleansing or moisturising.

Today’s sunscreens will meld into your skin and work well under makeup. In the winter, you may opt for a combination moisturiser and sunscreen that delivers hydration and protection.

For the beach and swimming in the summer, choose a water-resistantformula with a minimum of SPF 30 and re-apply at least every two hours generously. Using a lip balm with an SPF 15 or higher will also protect your lips.

 

Apply an eye treatment

If your eye area tends to get dry in the winter, use an eye cream or concealer with a moisturising formula designed specifically for the eye area.

In the summer, you may find that a lighter gel-based or oil-free cream during the daywill offer enough moisture for the skin around your delicate eye area.

 

What’s next?

By understanding your skincare needs throughout the year’s seasonal changes, you can excellent results from your skin and enjoy the healthy complexion you deserve.

Want to learn more about getting younger looking skin?Dr Robert Goldman offers a variety of products and procedures to keep your skin looking radiant and youthful. From skin care products, to facial rejuvenation, to cosmetic injectables, Dr Goldman has everything you need for beautiful skin. Contact us today for a quote and to schedule a consultation with Dr. Robert Goldman.

Busting the 7 Biggest Bust Myths

Breasts are an important part of a woman’s anatomy and confidence. It is important to consider all factors of breast augmentation to make smart decisions.

For whatever reason you are wanting a breast augmentation, there are many myths surrounding the procedure. From replacements to breastfeeding we want to clear your cleavage confusion.

 

Myth 1: Wearing a bra prevents your breasts from sagging

Wearing a bra every day does not help your breasts to stay up. Research has been conducted to show that wearing a bra every day can actually encourage sagging by weakening breast tissue. So, every now and then jump on the #freethenip trend.

Rather, Cooper’s ligaments can be to blame for your breasts heading south. These ligaments are the connective tissue in your breasts which helps them maintain their shape. Over time, these will start to stretch out, causing you to notice your youthful perkiness disappear. This process is completely natural and every woman experiences it (although, some lucky ladies run into this later in life).

However, researchers have an exception. Wearing a supportive bra during exercise helps reduce breast bounce which slows down the breakdown of breast tissue.

 

Myth 2: Breast augmentations are only for people wanting a bigger size

Breast augmentations are conducted for many reasons including correcting asymmetry, repairing genetic breast deformities, restoring breasts following cancer surgeries, and enhancing breast shape after weight loss or pregnancy.

 

Myth 3: Breast implants look fake

Don’t want your breasts to look like Dolly Parton’s? Don’t worry. If done correctly, breast augmentations look natural and in proportion meaning your family and friends might not even notice.

TIP: Listen to your doctor’s recommendations, your frame and skin elasticity needs to be taken into account.

 

Myth 4: Your family/friend’s experience will be the same as yours

You and your friends have different muscles, breast tissue, and frames so refer to your surgeon’s recommendations.

Breast implants aren’t a “one size fits all” solution. Although you can have a goal in mind, remember that bringing in your favourite photo of Emily Ratajkowski will just be a guide, not something you should expect to be an exact result.

Pain is also something that varies. You may know of someone who had unbearable pain after the surgery whereas you might experience little to absolutely zero pain.

Myth 5: You can’t breastfeed after an augmentation

Just because you haven’t had kids doesn’t mean you can’t get an augmentation. There are 2 areas where your implant can be inserted, in front of or behind the muscle. When placed in front of your breast muscle, the implants can cause pressure on your glandular tissue. This can cause a decrease in your milk production resulting in needing substitutes for your child.

Under the muscle implants are equally likely to cause disturbance to your milk production. If difficulties do occur, it is likely that this issue was a factor before your augmentation, not a result of it.

Breastfeeding can and does occur with implants. Remember, 1/3 of normal women ( without implants) an naturally unable to breastfeed, If you have had a breast augmentation and are then unable to breastfeed, the implants a very likely NOIT to blame.

Always make sure to let your surgeon know whether you’ve had kids or would like to have them.

 

Myth 6: Once you have an augmentation, you can’t get mammograms

Implants don’t reduce the risk of cancer, nor do they interfere with regular screenings. Although it is safe for women with implants, there can be a minute chance that the pressure of the mammogram can cause the implant to rupture or break. However, the important thing is that this is very unlikely.

If you are concerned about cancer screening, consult your surgeon – it’s always better to be safe than sorry.

 

Myth 7: You need to get your implants replaced every 10 years

This is a widespread myth due to many implants having a 10-year manufacturer’s warranty. If your implants haven’t ruptured, you haven’t experienced any unusual pain and you are happy with your shape, there is no need for a replacement.

However, if you have a baby, lose weight or are unhappy with your results, you may need an adjustment.

 

So, what now?

Breast augmentations may seem daunting, however, it is one of the most common cosmetic procedures in the world. Close to 100% of women are satisfied with their results and in many cases, your surgeon will correct any issues you have.

Check out a locally qualified specialist cosmetic surgeon and think twice before travelling overseas to get a cheap boob job. Make sure you are comfortable with your doctor and always ask questions.

Dr. Goldman is happy to answer any questions you may have about the procedure during your consultation and will offer extensive reading and educational material to take home to assist you in the education and decision-making process. Contact us today

What You Need To Know About Liposuction In 2017

Since I last discussed the differences between liposuction (traditional) and liposculpture (more refined and accurate), new information has appeared together with newer technology for dealing with body fat.

In this context, the concept of non-invasive body contouring has appeared. This involves altering the nature and composition of fat in order to speed up metabolism and aid in the elimination of excess adipose tissue. The 2 common technologies used to alter metabolism and eliminate bulk are cooling (Coolsculpt) and ultrasound (Accent Ultra).

The practice of ultrasound-assisted non-invasive contouring is better understood than cooling mechanisms. These methods are only suitable for mild to moderate and localized fat deposits. Depending on the person and situation, the results of these procedures may not always be ideal.

To actually eliminate the fat completely, the only surefire method is liposuction. The differences between liposuction and liposculpture are explained below. However, I would like to expand on this by first explaining the differences between traditional techniques and modern, state-of-the-art systems.

Differences between liposuction and liposculpture

Traditional liposuction is a 2-stage surgical procedure. The first stage involves the infiltration of the adipose tissue layer with a saline solution in order to waterlog the fat. This facilitates the suction process. The second phase is the actual suction of the waterlogged fat out of your body.

The suction pressure required to remove the waterlogged fat from your body is high. Traditional liposuction does not have the ability to distinguish between adipose tissue or the small blood vessels and nerves that pass through the layer.

Modern procedures, on the other hand, protect and preserve these blood vessels and nerves. For liposculpture and other modern fat removal processes, the procedure is a 3-stage process. The first stage is the same as with liposuction; the infiltration of the fat layer with a saline solution.

However, the second stage involves the application of either ultrasound (Vaser) or laser (Alma Lasers LipoLife). This process involves the liquefaction and emulsification of the fat before it is suctioned.

The results here are more accurate and offer gentler preservation of the nerves and blood vessels that pass through the layer of adipose tissue. In Addition, the post-surgery pain and discomfort tends to be less with modern methods than with traditional liposuction. Overall, the return to normal activities is quicker as well.

Both Vaser and laser liposculpture result in significant skin tightening but there is a 4-6 month lag phase between the surgery and the skin tightening. Dr Goldman will only discuss the final results after this time.

The refinement of these methods has resulted in the development and patenting of high definition muscle sculpting, which will be discussed in more detail later.

With laser liposculpture, lasering occurs immediately before the suctioning as one step and is therefore significantly faster than the Vaser ultrasound system. Thus, more fat can be removed in a shorter time than with Vaser. This has a cost benefit, as the shorter the procedure, the less the total hospital charges are.

Dr Goldman only performs Vaser procedures in hospital under full general anaesthetic with all the required safety monitoring as he believes your safety is paramount.

Before heading into further detail about both Vaser liposculpture and hi-definition Liposculpture, we would like to address four commonly asked questions about the procedures:

What Is The Difference Between “Liposuction” and “Liposculpture”?

In the professional world of cosmetic surgery, “liposuction” and “liposculpture” are often used interchangeably. We don’t strictly agree with this as we see liposculpture as a more advanced procedure than liposuction.

The term “liposculpture” first appeared in 1991 and was described as a technique that “shapes the body by removing fat cells in areas where there is excess and/or adding cells to areas where additional padding is desired”. This procedure is far more advanced than standard liposuction and is highly dependent on the skill and artistic eye of the cosmetic surgeon. Knowing what to remove and what to leave makes all the difference in the final result.

Because Dr Goldman exclusively uses the Vaser system for all of his liposuction and liposculpture cases, and because this system offers advanced sculpting techniques in the removal of pockets of excess fat from the body, we generally prefer to use the term “liposculpture” over “liposuction”.

What Is Vaser Liposculpture (Liposuction) And Why Do We Consider It The Best Procedure Available For Body Sculpting?

Vaser Liposculpture is an advanced body contouring procedure that selectively removes unwanted body bulk. An alternative to the harsh techniques of traditional liposuction, Vaser Liposculpture uses state of the art ultrasound technology designed to gently reshape your body. What distinguishes Vaser Liposculpture is its ability to differentiate targeted fat from other important tissues – such as nerves, blood vessels and connective tissues. Innovative Vaser technology breaks up fat while preserving these other important tissues, which promotes smooth results and rapid healing.

What Is The Difference Between Vaser Liposculpture (Liposuction) And Vaser Hi-Def Liposculpture?

Both Vaser Liposculpture and Vaser Hi-Def Liposculpture use the latest ultrasound technology to selectively break down adipose tissue deposits for easier removal.

Vaser Hi-Def is a recent breakthrough in fat removal. It is a body sculpting technique developed by plastic surgeons for men and women who desire a more sculpted, muscular appearance. The technique focuses on the precise removal of superficial and deep adipose tissue around muscle groups in order to enhance the visibility of the underlying musculature. It is designed to be a sculpting procedure rather than a debulking technique. The procedure is intended for generally fit men and women who have good muscle tone without excessive amounts of fat or excess skin. The typical patient maintains a healthy lifestyle through diet and exercise but is unable to achieve the desired definition.

Vaser liposculpture is the best option for men and women who are frustrated by the resistance of certain body areas to diet and exercise. If you are healthy and seeking a fast, low-pain option for losing stubborn fat deposits, the Vaser liposculpture technique is likely to prove the best solution. Therefore, Vaser liposculpture is intended for men and women who are seeking the removal of bulkier, stubborn adipose tissue deposits, rather than focusing in on the precise removal of smaller amounts of fat to enhance muscular visibility.

If you are in any way unsure as to which Vaser liposculpture (liposuction) technique is best suited for you, Dr Goldman will assist you at your consultation in defining the best solution so that you can fulfill your sculpting aspirations.

Tummy Tucks 3-Minute Guide

Often, women who have experienced pregnancy or weight gain find that returning to their previous body shape through natural means is difficult.

Abdominal muscles lose elasticity and stretched out skin in the midsection typically remains loose and cannot be repaired naturally. This is why many women opt to undergo tummy tuck (abdominoplasty) surgery.

Tummy Tuck Candidacy

Abdominoplasty candidates should have healthy expectations of the surgery to be discussed with their surgeon, be in good general health, and be willing to commit to maintaining the results with a stable diet and regular exercise.

Abdominoplasty candidates should not have serious medical conditions, plan to become pregnant or feel pressured into the procedure by another person.

Ideally, a suitable candidate is close to their ideal body weight with an abdomen that has not responded to natural methods.

Full tummy tuck vs mini tummy tuck

Abdominoplasties are broken down into a full tummy tuck and mini tummy tuck.

Full tummy tuck

A full tummy tuck is a more invasive procedure for more extreme cases like post-pregnancy or getting back to your desired shape after a sizable weight loss.

Mini tummy tuck

A mini tummy tuck is focused more directly below the navel and aims to remove the loose skin. It’s best suited for women who don’t need significant reduction of extra tissue. Your cosmetic surgeon will determine what is the best procedure for you to give you your desired results.

Other considerations

Liposculpture / Liposuction could be a suitable alternative as it is a less invasive procedure with minimal scarring, making it more suitable for younger patients with good skin elasticity.

The procedure


Abdominoplasty is a surgical procedure that entails separating the skin from the underlying muscles to tighten them and remove excess skin.

View our full 3-minute animation

Tummy tuck recovery & results

Though it varies from person to person, recovering from the surgery typically takes 3-6 weeks. Dr Goldman and his caring team of professionals will make sure your recovery process goes as smoothly as possible.

Women often expect their tummy tuck results to be permanent, but the outcome often hinges on the patient’s choices after surgery. Maintaining a healthy diet and exercise will enable patients to enjoy longer lasting results, especially when combined with liposuction.

Not having another pregnancy should also prohibit your body from stretching out to the position it was in before the tummy tuck. As the ageing process continues things will loosen up over time, but that is a natural part of ageing.

Tummy tuck scars

It is important to realise that the incision lines will be permanently visible. Certain individuals may have incision lines that are more noticeable, but in some instances, they will eventually be only faint lines. Most often, the scars heal well and over time slowly and progressively mature and fade. It usually takes 9-12 months for the scar to fade.

There are some modern scar management systems and processes to speed this journey, but these should not be used until 12 weeks after the surgery. Dr Goldman will discuss this with you at the time.

Fortunately, the scars from your tummy tuck surgery are usually in locations concealed by most undergarments.

Costs

The costs involved in an abdominoplasty can be broken into surgeon’s fees, anaesthetist’s fees, hospital/theatre costs, and the cost of compression support garments.

Prices vary depending on your starting point and desired results which Dr Goldman will discuss during your initial consultation.

You may find that your health fund may cover all or a portion of your surgery depending on your level of cover. You may also be eligible for the Early Release of Superannuation for Surgery.

Before proceeding with the operation, it’s essential to clarify with your insurance fund what exactly is and is not covered.

Are you considering a tummy tuck or have questions about tummy tucks? Contact Dr Goldman now!

Medical Tourism: What You Need to Know

Each year, thousands of Australians board planes to have cosmetic enhancement procedures performed in other countries – the most prominent of which is Thailand.

For those wanting tummy tucks, liposuction or breast augmentation, the benefits of medical tourism seem blatantly obvious. Who wouldn’t want pay up to 30-40 percent less [source] than they’d pay in Australia while sipping a cocktail by the pool?

But there’s more to the story. When taking a closer look at medical tourism, many realise that the benefits associated with it are greatly outweighed by the risks.

In this post, we will explore medical tourism with a strong focus on cosmetic enhancement to ascertain what it is, why people do it and the risks taken when having procedures performed overseas.

Read more

Financing Your Cosmetic Surgery

There is a broad range of options and procedures available to individuals in Australia but any medical procedure is a serious undertaking. It’s important to get the best results and care, not to have to stress about the cost.

Read more

The true costs of medical tourism in Thailand

Are you thinking about having cosmetic surgery in Thailand?

Here are some facts and things to consider before taking the plunge.

I will take you through all the issues relating to undergoing cosmetic surgery in Thailand vs in Australia.

Disclosure: I am a registered specialist surgeon (breast and abdominal) in Australia. I have never performed surgery in Thailand and do not know anything about their healthcare system. Do you?

Read more

Mummy Makeover: Your Complete Guide to Post Pregnancy Surgery

Mummy Makeover is a new term. Its use has suddenly evolved over the last few years but importantly, this is not an accurate nor defined medical or surgical term. “Mummy Makeover” is, in fact, merely a marketing term used to categorize a series of non-cosmetic and cosmetic procedures whose purpose is to attempt to restore a woman’s body to its pre-pregnancy state.

Pregnancy is a very natural process, as are normal vaginal deliveries. However, there are defined hormonal changes that occur from the time of conception and throughout the pregnancy, including changes before and during delivery all the way to the completion of lactation and breast feeding.

pregnant stomach

It is only some months (3-6) after lactation has ceased that the normal, pre-pregnancy hormone profile returns to normal.

So, the changes to your body that result from this very natural process are significant and unfortunately are permanent. Your pre-baby body is gone forever!

In discussing the concept of the “mummy makeover,” 2 situations will arise: firstly, what I call the desired outcome: a post-pregnancy weight (body fat content) that is close to or equals the pre-pregnancy weight (body fat content).

Secondly, what I will call the undesired outcome: a situation that has resulted in a large change in the post-pregnancy weight (body fat content), where the woman has noticeably increased her body fat content during her pregnancy (eating for 2!).

The reason for this separation into 2 groups of women is important. The body changes are different and, therefore, the surgery to improve and enhance the common areas of concern will also be different.

Women with significant weight gain will usually need more complex operations but even more importantly, will usually require more operations on more body areas.

I will first discuss the different areas of the body that women commonly wish to improve/enhance, next the specific operations that can be performed and finally, the options for the women who have gained significant weight during their pregnancy.

The 2 areas that women most frequently request to improve/repair are the abdomen and breasts. For more information on this, check out our article on breast changes with pregnancy.

Areas To Improve After Pregnancy

THE ABDOMEN

As your baby grows, your uterus enlarges, causing your abdomen to change. With the hormone changes that occur from the time of conception to the preparation for delivery and breast feeding, oestrogen causes a degree of softening and laxity of the body’s tissues. This mainly impacts muscles, ligaments and tendons but also affects the skin.

As the baby grows and the uterus expands, outward pressure starts to be exerted in the muscle layer of the abdomen. This results in a stretch of the abdominal muscles and, because of the effects of the hormone changes, the main ligament that joins the right and left sides of the muscles in the middle of the abdomen will also start to stretch.

It is also important to point out that the belly button (umbilicus) is situated within this abdominal ligament and is a natural scar. However, with the stretch of this central ligament, the belly button also stretches with the evolving pregnancy.

The result of this is the separation of the abdominal muscles but also, a number of women will develop an umbilical hernia. This manifests a protruding belly button (an “outy” instead of an “inny”).

The skin overstretches and the outcome is loose, lax skin with stretch-marks that initially are red-pink but fade with time to become silvery-white.

If your baby is born by Caesarean section, then the scar together with the aforementioned skin changes results in the “overhang” of loose skin over the c/s scar. Twins or multiple pregnancies and excessive weight gain make this problem worse.

THE BREASTS

Regardless of their size, non-pregnant breasts consist mainly of fat with a much smaller breast gland component. With the hormonal changes, the breast gland component dramatically expands at the expense of the breast fat.

These are the early changes that ultimately result in milk production (lactation). The end result of these hormonal changes is very enlarged, uncomfortable, heavy breasts. After delivery and after breast feeding, the hormonal profile returns to your pre-pregnancy state.

As a result, breast gland components return to their pre-pregnancy state. Unfortunately, the breast fat component does not return as glands subside. Because the breast skin has expanded to accommodate the size increase of your breasts and your breasts’ loss of fat and volume, the skin expansion results in droop. Additionally, the hormonal changes have an impact on your skin overall.

Pregnancy, childbirth and breast feeding will result in your breasts becoming “empty” with significant droop. The pigmented skin around the nipple called the areola enlarges as well. These changes worsen the longer you breast feed, and the more children you have.

The next issue is the timeframe between delivering your baby and having surgery.  Ideally, you need to wait until your baby is 6 months old. This ensures that the hormone profile will have returned to the pre-pregnancy state.

If you would like to learn more about post-pregnancy breasts, read our article on breast augmentation, cosmetic surgery and pregnancy.

VAGINAL REJUVENATION

The next discussion point is much more personal and intimate. It is common during a vaginal delivery for a procedure called an episiotomy to be performed. This is a cut into the skin and tissues towards the back of the vaginal opening on the right side to prevent an uncontrolled vaginal tear from occurring.

Performing an episiotomy cut is precise and prevents unwanted tearing. In an uncontrolled situation, the tear can even extend backwards into the anal canal resulting in the so called 4th degree tear.

The episiotomy cut often involves the inner labia towards the back. Childbirth and multiple deliveries can lead to changes in the inner labia that result in an unfavorable situation.  These changes are more noticeable with the modern tendency for women to reduce pubic hair by shaving, waxing, hair reduction creams and IPL hair removal.

Vaginal rejuvenation and vaginoplasty are becoming increasingly sought after. The specific options will be discussed in relation to the operations that together comprise the mummy makeover.

All areas that women express interest in improving through the mummy makeover are affected by weight gain. Now, requests to reduce the body fat content are included because the changes are no longer simply just a matter of “repair” and tightening of loose skin, laxity and muscle separation.

Mummy makeovers typically include a combination of the following procedures:

  1. Tummy Tuck (abdominoplasty)
  2. Liposuction
  3. C/S scar revision
  4. Mons pubis lift
  5. Breast Augmentation
  6. Breast lift
  7. Breast reduction
  8. Labiaplasty
  9. Labial rejuvenation
  10. Vaginal Canal rejuvenation.

Most women will request a tummy tuck (or liposculpture) with one of the breast operations.

Cosmetic Procedures

surgery operating room

BREAST SURGERIES

1. Breast Lift vs Breast Augmentation

After childrearing, many women will come in for a consultation requesting a breast lift because they are unhappy with the droop and “emptiness” that has resulted.

However, women also state that they want “something done” but will not accept the scarring that results from a lift: scarring around the areolar skin (pigmented skin around the nipple) and the vertical scar from the areolar skin downwards into the crease underneath the breast.

At the consultation, I perform a series of measurements of the breasts, as well as the breast position on the chest wall. In addition, I assess the breast position in terms of certain landmarks that I assess and demonstrate at this consultation.

Here, it often becomes apparent that a breast lift surgery may in fact, NOT be necessary. In these cases, I offer and recommend a breast augmentation. The issue to be determined next is the size and shape of the implant that will give the best result possible for the individual woman in question.

If breast skin is loose and the breast base is wide, then, the implant will need to be “big” in order to fill the breast “skin envelope.” This can only be assessed at the consultation but may be assessed via a limited series of photographs.

The modern operation is to perform a breast lift together with implants. This results in a better shape especially at the so called “upper pole” of the breast: the part of the breast that is flat and has lost the most volume.

There are many options for this procedure. Unfortunately, this operation does not always result in a long term solution. Breast droop is a natural phenomenon with time/age/gravity as well as weight gain and loss. Further pregnancies will adversely affect the breasts also. Droop is not preventable.

Some women are fortunate in that the breast supporting structures and ligaments delay droop while with other less fortunate women, droop occurs early and easily. This applies to both the natural state as well as after a lift. It is estimated that droop after a lift procedure can occur as early as 3 years after the surgery with the lesser “donut” lift or 5 or 7 years after the “classic” breast lift.

2. Breast Lift vs Breast Reduction

The boundaries between a breast lift and breast reduction are becoming increasingly blurred. It is no longer true that a breast lift (mastopexy) is the operation of choice for an up-lifted, “perky” breast. Now days, a breast reduction will also result in small (or smaller) and perkier breasts.

A breast reduction is a much more durable operation, often lasting a far longer time before droop sets in again—often in excess of 10 years! It is possible to perform this operation with implants as well. In this case, implants are more for shape than size.

Ultimately, a breast reduction may be considered the “perfect lift”. This procedure can be performed with the removal of minimal breast gland tissue or a large amount of breast tissue, depending on the individual woman’s situation and what result she desires.

The incision (and therefore scarring pattern) is the same with a classic mastopexy (lift) and a breast reduction: the so called “lollipop” scar. This is a scar around the areolar (pigmented) skin and a vertical scar down the front of the breast into the crease under the breast. The ‘old fashioned “anchor scar is rarely done today.

ABDOMINAL OPERATIONS

1. Tummy Tuck Vs Liposuction

This is a far less complex scenario. There are only 2 options: namely an abdominoplasty (tummy tuck) or one form of liposuction. The crucial factor in deciding which option is best relates to the quality of the abdominal skin and the amount of excess fat present.

As discussed above, the changes with pregnancy (more so if there is also significant weight gain) result in over-stretched skin and overall abdominal laxity. If the skin is in this condition, lipo is not an option; the only option is an abdominoplasty.

There are different “grades” of this operation, both being easy and relatively quick. The mini-tummy tuck involves the removal of a small amount of loose skin very low down that does not extend anywhere near the belly button. The scar from this procedure is almost the same as a Caesarean Section scar.

The middle grade tummy tuck involves the removal of excess skin from the level of the pelvic bone to above the belly button. This version will result in a scar from hip bone to hip bone on the other side, as well as a scar around the umbilicus (belly button).

The next two tummy tuck versions will also include liposuction as part of the procedure, as a tummy tuck operation deals exclusively with the tummy “overhang” at the lowest aspect of the abdomen.

This operation is not designed to deal well with the upper abdomen. Now, this is not a problem unless there has been significant weight gain with or subsequent to a pregnancy.

If the amount of excess upper abdominal fat is significant, liposuction will be necessary for the upper abdomen to achieve a more desirable result. Also, in the situation of upper tummy excess, it almost is universal that there will be excess fat deposited over the hips (the “love handles”). Here, liposuction will also be necessary to achieve a more desirable result.

This liposuction is an integral part of the tummy tuck operation without any additional charges. However, if other areas of lipo are to be undertaken, then additional charges will apply. This third version of the tummy tuck will also involve an incision from the hip bone of one side across to the hip bone on the other side and will include a small circular incision and scar around the belly button. This version also requires liposuction to the upper abdomen and hips.

The final grade of the tummy tuck operation is major surgery. This includes all the components of the previous version – long scar from hip bone to hip bone, scar around the belly button, liposuction of the upper abdomen and hips, with the possibility of muscle tightening with or without belly button hernia repair. This is necessary due to the separation of the muscle ligaments that occur with pregnancy with or without hernia formation.

This operation takes in excess of 4 hours, always requires an overnight hospital stay (maybe even a second nigh admitted) and will result in a very significant period of downtime and convalescence.

On the other hand, if the quality of the stomach’s skin is good with no or minimal stretch marks, then a liposuction operation is the procedure of first choice. This can even be done in the case of significant abdominal fat excess, and will be evaluated at the consultation.

Standard liposuction involves a process of “infiltrating” the fat layer with saline (salt water) solution under pressure to water-log fat. A suction then removes this water-logged fat. There are now modern liposuction systems that, include either ultrasound or laser energy to liquefy and emulsify fat prior to its removal.

These new systems allow a lower suction pressure to remove unwanted fat. The delivery of the ultrasound or laser accomplishes a significant part of the process. The result is that ultrasound or laser liposuction systems are far more accurate and will deliver overall better results than standard liposuction techniques.

Dr. Goldman is one of the very few specialists who have been trained in the art of High Definition Liposuction, also known as ultrasound or laser liposculpture. There is one final difference between liposculpture and traditional liposuction. There is conclusive evidence that ultrasound and laser energy both stimulate the skin’s under-surface to make new collagen and elastin fibres.

This caused the skin to retract/contract and “shrink-wrap” down onto the newly formed fat layer. No other liposuction system has been shown to result in this degree of skin retraction.

“THE GATEWAY”

The lower-most aspect of the abdomen is called the mons pubis. It is the junction or link between the stomach and the top of the vagina. The significance of this important zone has very suddenly become an area of concern for a large number of women due to the modern practices of pubic hair “management.”

As mentioned briefly above, it may be fair to say that most women below the age of 50 will undertake one form of hair management or another. This will range from trimming all the way through to the “complete Brazilian.” Brazilian is a term that has been coined to describe the complete absence of pubic hair via a waxing technique. Nowadays, the “best” form of The Brazilian is undertaken using IPL (Intense Pulsed Light) therapy or AFT (Advanced Fluorescent Therapy), a more powerful form of IPL.

The result of hair removal trends is that the skin of the mons pubis is now far more “noticeable.” Requests for liposuction in or even lifts of this region are becoming increasingly popular. Due to the overall effects of pregnancy, especially with significant weight gain, the mons pubis and the front aspect of the vagina (area just above the clitoral hood) descend to a lower level.

A tummy tuck alone will result in a minor lift of the mons pubis but it is possible to perform specific operations to either flatten this area or to perform a lift of the mons pubis “complex.” Dr. Goldman evaluates this as part of the mummy makeover, if specifically requested.

VAGINAL REJUVENATION

Vaginal rejuvenation consists of labiaplasty, outer labia (labia majora) rejuvenation and vaginal canal lining rejuvenation. Vaginal rejuvenation is an elective part of the mummy makeover but yields substantial results.

1.      Labiaplasty

Labiaplasty is a surgery with growing popularity: it is now almost as common as breast augmentation surgery. There are a number of reasons why women request this operation. The reasons are not always cosmetic (physical appearance) and include, for example, discomfort with activities and the wearing of certain items of clothing.

A labiaplasty is designed to result in the shortening of the overall length of the inner labia so that the “outers” will mainly cover the “inners.” It is not possible to perform this operation so that the outers completely cover the inners. This is not a natural nor desirable outcome.

There are two common operations that are considered labiaplasties: the “trimming” operation (or amputation operation) and the “wedge” operation. Dr. Goldman only performs the wedge operation and explains the differences between these operations at the consultation.

The surgery is performed using traditional surgical techniques but will soon be performed via laser. Laser labiaplasty results in better and potentially faster healing and overall yields better results. The current “gold standard” operation results in scars that are almost imperceptible. The importance of performing laser labiaplasty relates directly to the next topic.

2.      Laser Vaginal Canal Rejuvenation

There is now scientific evidence that CO2 ( carbon dioxide ) laser, through a very specific system, results in the improvement of the vaginal canal lining, including significant tightening. This is so effective in achieving this that it is now being offered as a non-surgical options for women with mild prolapse and certain forms of urinary incontinence.However, the main rejuvenating aspect of this relates to the re-establishment of the glandular structures within the vaginal canal lining.

This is also now being performed after a recent vaginal delivery to prevent undesirable changes in the vaginal canal later in life.

Peri- and post-menopausal women will achieve remarkable results in terms of the vaginal canal lining: these women develop a “wasting” of this lining with falling oestrogen levels. This manifests with a condition (in its worst form) called vaginitis.

What happens is the lining layer becomes thin and weak with a resulting loss of vaginal glands. This increases the “local” trauma but much more importantly, reduces the vaginal lubricating capability, resulting in difficult and painful sex.

Femilift from Alma Lasers or The Mona Lisa Touch from Deka Lasers are the only two systems that are able to offer this level of success. This is a non-surgical treatment that is often performed in the consulting rooms it is such a minor procedure that normally, no form of anaesthetic is necessary. A course of 3-4 treatments are usually all that is required.

Dr. Goldman will soon be offering this together with labiaplasty and outer labial rejuvenation in an operating theatre under general anaesthetic:

Labiaplasty + Outer labial filler injections + Femilift = Vaginal rejuvenation.

The concept of the mummy makeover has become mainstream but is yet to be accurately defined. Dr. Goldman will spend an hour or more with you at the consultation going through your issues and areas of concern. You may only need one or two of the operations but the surgical recommendations will be tailored to your specific needs and requirements.

Please contact Dr Goldman on 1300 453 307 , 08 9446 4444,  dr@robertgoldman.com.au, or reception@robertgoldman.com.au  for more information.

Breast Augmentation Surgery Decisions [Infographic]

If you are considering undergoing a breast augmentation, you are certainly not alone.

Breast augmentation surgery has grown in popularity over the past decades, and, in 2014, breast enhancement surgeries were the most popular form of cosmetic surgery in the US. In Australia, there has also been an increased demand for breast augmentation.

Women undergo breast augmentations for a number of reasons: to correct breast asymmetry; to enhance breast aesthetics post pregnancy, weight loss, or breastfeeding; and simply to improve confidence and self-image.

Whatever the reasoning behind your intentions may be, it is important to consider all factors of breast augmentation.

To help you make safe, smart decisions on your surgery, we have made an infographic outlining all aspects of breast augmentation: from finding a reputable surgeon, choosing implant size, and what you can expect before, during and after the surgery procedure.

Breast Augmentation Surgery Infographic

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Conclusion

We hope you have found our breast augmentation infographic useful and have learned many helpful breast augmentation facts. Should you decide to undergo a breast augmentation, we are confident that you will join the 98% of women whose expectations became reality through the transformative surgical procedure.

If you would like to know more information about breast augmentation surgery or would like to schedule a consultation with a specialised cosmetic surgeon with over 35 years’ experience, contact Dr. Robert Goldman.