Quick Guide to the Belt Lipectomy Procedure

Picture this: you have lost a significant amount of weight. You’re feeling proud of your accomplishment but, at the same time, you’re unhappy with the excess skin that’s sagging where the weight once was.

If this scenario sounds familiar, then you may be the perfect candidate for a belt lipectomy.

What is a belt lipectomy?

Unlike abdominoplasty or tummy tuck which eliminates fat from the stomach area, a belt lipectomy, also known as a lower body lift or circumferential body lift, will remove excess skin and fat from the entire lower torso/body.

It is perfect for those who have lost large amounts of weight and, as a result, have loose skin. However, that isn’t the only reason to get one. A belt lipectomy can also be done for cosmetic reasons, as it reshapes your body – making it a suitable solution after a pregnancy, for health reasons, and to remove fat that isn’t responding to diet or exercise.

Where is a procedure done?

For most candidates, it involves an overnight stay with the procedure done under local anaesthetic. Some people may require a longer stay under supervision if deemed necessary or if complications should arise.

With any surgical procedure, there is always an element of risk; any and all possible scenarios can be covered during your consultation.

What exactly does a belt lipectomy involve?

The surgery generally starts with a patient resting on their stomach while excess skin/fat is removed from their back, hips, and buttocks. Following this, the patient is moved to rest on their back and their abdominal area is addressed.

This includes muscle tightening if necessary (usually an on-the-table decision), creating a new belly button, and securing the skin after removal. From there, a drain tube is installed and the area is dressed and covered to protect it.

How quickly will I recover?

After the surgery, soreness and limited mobility is to be expected. For the first week, your bandages will restrict you from showering. Most people find it takes them a couple weeks to return to light activity, with most of the initial recovery time spent lying down – sitting up and walking may be done in small increments. Because of this, it is useful to have someone to help you out for an extended period of time after the surgery for day to day necessities.

For four to six weeks after the surgery, a binder, covering the stomach and back will need to be worn. For those who work, it’s advised that at least two weeks be taken off from work and then only going back to light work or a modified schedule. Plan for a follow up appointment 14 days after your surgery to remove the dressings, along with a six-week check, and three-monthly follow up to assess your progress and make sure there are no complications.

Can I get multiple procedures done in one go?

The tightening of your abdomen can be complemented by other reductions or lifts. Belt lipectomy is often combined with other procedures like a liposuction procedure or an arm, breast or face lift.

Patients often opt for this medical procedure to boost their weight loss goals, in efforts to target problem areas that store stubborn fats. Combined procedures – along with a healthy lifestyle – can accelerate visible weight loss results.

Is scarring likely to occur?

The surgery will most likely leave a scar on your stomach. Lifestyle and health habits will determine to what extent the scar heals, and the aftercare process can influence this significantly. Scarring, to some degree, may be unavoidable. If you have undergone gastric-bypass surgery, the same incision area may be used, limiting the scarring to what is already there.

Most surgeons will attempt to limit the scarring to areas that can be covered, to minimise their visibility in public. It is also worth noting that scarring can take up to two years to fade and heal, or it can happen after the initial three-month healing period.

Preparing for the procedure

To get ready for the surgery, a thorough consultation with your surgeon is the best starting point. Here you will be provided with all the information for the surgery along with any considerations you need to take note of for yourself.

Choosing a surgeon with experience in performing a belt lipectomy – and someone who you are comfortable with, are probably the most essential elements of the entire surgery experience.

Ready to schedule a consultation with Dr Goldman to see if a belt lipectomy is right for you? Get in touch now.

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.

Female holding many bras in hand, choosing witch bra to wear

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 NOT 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 surgeon with a focus in cosmetic surgery 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.

The Definitive Guide to Liposuction

What You Need To Know About Liposuction

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.


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 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.

What is Medical tourism?

In 2015, medical tourism has become synonymous with people from highly developed countries seeking ‘a cheap deal’ overseas. Traditionally, the term was applied to people from less developed countries seeking higher quality medical treatment.

People may also choose to participate in medical tourism if a certain procedure is illegal in their home country or if they have a specific condition that is better understood elsewhere.

Despite its growing popularity, medical tourism is nothing new. Ancient Greeks used to travel to the Saronic Gulf, which was believed to be the sanctuary of Asklepios, the God of healing.

The earliest recorded form of modern medical tourism was the spa towns and sanatoriums of 18th century England. People traveled to these places to treat conditions like gout, liver disorders, and bronchitis.

Why is medical tourism appealing?

 Cosmetic Surgery Tourism Statistics
source: My Med Holiday

According to the University of Leeds, people who opt for medical tourism are generally ‘ordinary people on modest incomes’. Their decision to have surgery is not a snap decision either. They have been thinking about it, on average, for 5-10 years.

While some people think it is merely an exercise in vanity, most people who have procedures performed just want to look or feel “normal.”

Therefore, it is not surprising that breast augmentation seems to be the most popular procedure abroad. When you factor in that this procedure can cost $8,000 in Australia and less than $4,000 in Thailand, it is no wonder that people are flocking overseas.

Medical Tourism- it’s no holiday

If you were hoping this article would support the idea of pursuing cosmetic surgery abroad – sorry to burst your bubble.  However, keep reading because there are a few things you should consider before making a decision.

1. Increased risks

Medical tourism breast augmentation mistake

source: Wikipedia

By having any medical procedure performed in a less developed nation, you are increasing the risks to your health. Tropical environments such as Thailand are prone to infection, particularly if rigorous hygiene is not maintained.

What’s more, many hospitals do not have an Emergency Room onsite, so if there is an emergency during the procedure, the hospital may not be adequately equipped to deal with it.

The risks are not only isolated to the hospital. There is an increased risk of post-operative deep vein thrombosis during the flight home, which can be life-threatening.

One Perth woman who had a breast augmentation in Thailand was infected with a Thailand-based superbug during surgery; causing her to spend 7 months in hospital to regain her health. She is still dealing with emotional distress and health complications 4 years later.

2. Unfamiliarity

It might seem obvious, but it’s important to keep in mind that other countries may have a different language, laws, and culture to your own.

With any medical procedure, communication is paramount in any doctor-patient relationship. When communicating in the surgeon’s second language, there is potential for misunderstanding in terms of desired treatment.

In Australia, many people take surgeons’ expertise for granted.   We have very strict laws on accreditation that are not practiced in other countries. Therefore, even though procedures abroad may be a fraction of the cost, they might not be performed with the same standardisation.

Thailand is renowned for having a lack of medical regulation. Perhaps if it had more medical regulation, a 24-year-old British woman would still be alive today.

If something goes wrong, it can be very difficult to know your rights and whether a surgeon will accept liability of mishaps when you are far from the familiarity of home.

3. Skipping steps to cut costs

One of the main differences in the procedure is the process, which is significantly shorter overseas.

Why is this a problem? A consultation 3 days prior to surgery in South-East Asia is typically not long enough to build a relationship of trust and understanding between the surgeon and patient.

Surgeon in operating room

In Australia, the majority of the process occurs post-operative, with follow-ups occurring for roughly 12 months after the procedure. This ensures that there is nothing amiss and that the patient’s health has not been compromised.

The biggest complications to any cosmetic enhancement occur after surgery and the fact that there are generally no follow-ups in other countries borders on negligence. In a study conducted by the University of Leeds, researchers found that “Most [patients] needed stitches replacing/ removing, infections treating with antibiotics, or seromas draining” after cosmetic surgery in Thailand.

4. Benefits now = costs later

Surgery is risky regardless of where it is performed. Even in Australia, where medical training is first class and regulations are stringent, things can go wrong. It is important that the surgeon and patient are located in the same place in case any pain, distress or complications arise. They are, after all, the best person to treat you.

As medical tourism increases, so too do the incidents of people returning home with problems associated with surgery. This is supported by a study by the University of Leeds, which found that “16.5% of our patients experienced complications from their surgeries. 8.7% received further treatment in the NHS or Medicare upon returning home.”

Having corrective surgery back home adds significantly to medical bills – so the original benefits (lower surgery costs) may be negated by paying more later.

5. Holiday activities are restricted during recovery

If the added bonus of a holiday after cosmetic enhancement is what you want, think again. Those who have had surgery before know that the recovery period is often quite painful. Many things that people enjoy on their getaways (drinking alcohol, swimming, sunbaking, etc.) are very much on the restricted list.


There is a discernible difference in the quality of cosmetic enhancement at home and abroad, leading one to believe that even though medical tourism is often cheaper, it is not as good and poses increased risks.

Every procedure has risks, but these risks can be limited by having the surgery performed in a familiar environment by a trusted, board-certified doctor. If you are in the Perth or Cairns region and are considering a breast augmentation, please contact Dr Robert Goldman’s team.

Dr Goldman is an experienced and skilled cosmetic surgeon who will give the best possible results by providing the highest level of care and on-going support.

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.

The difference between plastic surgery & cosmetic surgery

This is important because some health insurers MAY provide full cover for all costs associated with your hospital admission for reconstructive plastic surgery but not for cosmetic surgery.

Plastic surgery and cosmetic surgery are closely aligned in required technique and skill. Plastic surgery is the reconstruction of facial and body defects due to birth disorders, trauma, burns, and disease and includes cosmetic surgery. Cosmetic Surgery is requested by the patient and is thus a matter of personal choice aimed at enhancing and improving the patient’s appearance.

Financing your cosmetic surgery

Supercare Fiannce for Cosmetic Surgery

Access Superannuation for Plastic Surgery

Introducing SuperCare

Can I access Superannuation funds early to pay for Plastic & Cosmetic Surgery? Yes, you can.

SuperCare assists with the application process to fund among other things, Cosmetic  Surgery via the Early Release of Superannuation. Based on the Australian Government Initiative, you can access your superannuation fund early to cover the costs of cosmetic and plastic surgery.

SuperCare can facilitate your application for funding with many surgery procedures including reconstructive surgery to correct or repair defects and deformities following trauma, skin cancer, accidents, excision, burns, and scars. Plastic surgery is directed and indicated by the surgeon.

Plastic surgery and cosmetic surgery are closely interwoven in technique and skill. Cosmetic Surgery is aimed at enhancing and improving the patient’s appearance. The best cosmetic surgery should be undetectable by others and should provide an increased sense of wellbeing and confidence in the patient.

Cosmetic surgery is unlike other surgery in that it is requested by the patient and as such is a matter of personal choice.

Surgeries may include:

Please contact SuperCare before taking your first steps at www.mysupercare.com.au/.

Cosmetic surgery health insurance

Private Health Insurance

Health funds are under more pressure to pay out fewer rebates on cosmetic and plastic surgeries and to charge higher fees; Medicare does not cover most cosmetic surgery procedures.

Those individuals who carry costly health insurance are shocked to find that they are only covered if the surgery is medically necessary to maintain your health. Medically necessary procedures such as these may be covered:

  • Breast prostheses implants after breast cancer
  • Breast cancer removal surgery
  • Skin grafts
  • Liposuction in the case of obesity or morbid obesity

Elective cosmetic surgeries such as these may not be covered or may not be fully covered:

There are different types of cover that offer different benefits. Check with your health fund to be sure of exactly what you are covered for.

Superannuation Early Access

In most cases, Australians cannot unlock their Super until they reach “preservation age” which is between 55 and 60, depending on birth date.

There is, however, a particular government process to follow to access their Superannuation Funds to pay for their life-changing surgery. The Department of Human Services (DHS) can allow early access on “compassionate grounds.”

The SIS Regulations 1994, Reg 6.19A allow advanced release of superannuation on compassionate grounds where:

  • Finance is required to pay for medical treatment for the individual
  • Based on the certification of two medical practitioners, the medical treatment is necessary to treat a life-threatening illness or injury; or to alleviate acute, or chronic, pain; or alleviate an acute, or chronic, mental disturbance
  • The treatment is not readily available to the individual through the public health system
  • The individual does not have the financial capacity to meet the expense of the treatment

This is often a drawn-out and arduous process for the regular individual with substantial amounts of paperwork and correspondence required.

Australian-based SuperCare provides specialist assistance to individuals and their families by facilitating their application to the DHS, who can provide an approval letter to release funds from your superannuation.

Why finance here in Australia and not overseas

Some Australians opt to go abroad where cosmetic procedures are cheaper, exposing themselves to some serious surgery risks. Procedures in other countries may not be as hygienic or safe, seek professional advice to understand the risks involved before you go overseas for major surgery.

*Disclaimer: Information about finance on our website is for general information purposes only. Before acting on finance for your surgery, consider its appropriateness to your individual situation. The information on this website is no substitute for financial advice.

Dr Robert Goldman is a registered and participating doctor with SuperCare. Want to know more about your options for financing your cosmetic surgery? Book a consultation with Dr Goldman to discuss the financing options available to you.

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?

I am going to discuss the advantages and disadvantages of the cosmetic tourism industry in Thailand vs Australia. I hope that at the end of this, you will be more informed about the differences before you make your decision.

Firstly, I’d like to give you a warning: Do not be seduced by the cosmetic tourism industry and their claims; surgery is NOT a holiday! Surgery carries potential risks and complications, some of which relate to flying after surgery.

Advantages of cosmetic surgery in Thailand or overseas:

Advantages of Cosmetic Surgery In Thailand

  1. Price: cosmetic surgery procedures are very cheap in Thailand in comparison to Australia and other developed countries
  1. Exciting and glamorous: you can have an operation that will enhance your appearance and go overseas for a “holiday”
  1. Going away and arriving back home as the “new you”
  1. Thailand is world renowned for transgender, gender re-assignment and feminization surgery. No discussion or debate here!

Disadvantages of medical tourism in Thailand

Disadvantages of Cosmetic Surgery In Thailand

  1. Uncertainty: Thailand is a foreign country with many uncertainties in the medical world. Before deciding to undergo surgery in Thailand, you should have answers to the following questions:
  • Do you know what will actually happen?
  • Have you been correctly assessed and sized?
  • Have the surgery and all related options been discussed? Have you made decisions about your options?
  • Have you been listened to and given the opportunity to express your desires regarding the outcome of your surgery?
  • Have your expectations been met?
  • Are you aware of what’s involved with the consent process?
  • Have all the risks and complications been discussed?
  • Were you able to ask questions and voice your opinion?
  1. Process: You are going to undergo an anaesthetic (with its own set of risks and complications) and surgery. This process is very strenuous on the body– far from the glamorous holiday you may be imagining. Surgery and anaesthesia will leave you sore, causing tightness and pressure, and making you feel unwell from the anaesthetic and painkillers. You also may experience significant vomiting post-surgery.
  1. Air travel: flying comes with the innate risk of deep vein thrombosis (DVT). Surgery itself carries risk of DVT so, flying post-surgery “doubles” your risk. Deep vein thrombosis can result in what is called a pulmonary embolus.

This happens when some of the blood clot in a DVT breaks off from the veins in your legs, travels to and lodges in the veins in your lungs. This is a serious risk and can be fatal. It affects otherwise young, fit, and healthy people. It’s essential to examine DVT and other travel risks when considering to have your surgery overseas for cost saving reason.

  1. Regarding breast surgery and specifically breast augmentation, are you aware of the advantages and disadvantages of under the muscle vs over the muscle implants? Have you been properly evaluated and have the options and risks been discussed?

In general, surgeons in Thailand typically place implants behind the pecs (submuscular) and tend to use incorrect size implants in western women (often for cultural reasons).

  1. Despite what you might be told, there is no routine follow-up back in Australia for cosmetic surgery done abroad. When you arrive back, if something is wrong, you will struggle to find a cosmetic specialist in Australia that will see you and assess you for complications. If you have a complication that requires corrective surgery, Australian surgeons, in general, will not perform this surgery as a “no gap” operation.

Revision surgery for complications when the primary surgery is performed by a different surgeon is hard to come by. The outcomes are hard to predict and revision (corrective) surgery done by a different surgeon is more difficult and always more expensive.

  1. Finally, Australian hospitals and anaesthetic services/fees are much higher than non-western countries. There is often a superior standard of quality associated with the higher prices paid for these services.

Please take all of this into consideration when making your decision on overseas cosmetic surgery. Are the surgeons and anaesthetists abroad of the same standard as you would expect in Australia?

Please think about these issues carefully before you make a decision. The saying “You get what you pay for” is often true, especially when it comes to cosmetic surgery in Thailand vs Australia. If you cannot afford to have the surgery at home in Australia, can you afford to have the corrective surgery in Australia for complications with surgery abroad?

Want more information on cosmetic surgery and procedures? Check out Dr. Robert Goldman’s cosmetic surgery blog or if you wish to discuss any of these issues, contact Dr Robert Goldman, cosmetic breast and body surgeon today.

Mummy Makeover: Your Complete Guide to Post Pregnancy Surgery

The term “Mummy Makeover” has suddenly evolved but this is not an accurate or defined medical 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”, two 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 two 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 two 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.

Dr Robert Goldman has extensive experience in producing results suitable for different patients. Call us today to get an obligation free consultation.

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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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.

Update: Safe Medical Cosmetic Surgery

Dr Goldman’s professional opinion on this very serious and dangerous situation

The recent case of a young woman who had a cardiac arrest in a Sydney clinic while undergoing a cosmetic procedure (breast augmentation) once again highlights the fact that safety is paramount. All else is secondary.

The operation was performed under local anaesthetic with intravenous sedation. According to the published article, a specialist anaesthetist was not present. The assumption is that the doctor performing the surgery also administered the sedation and local anaesthetic. Doctors regularly give local anaesthetic but can also give the intravenous sedation as well as performing the surgery. This should not be performed if a significant surgical procedure is being done. The correct medication at the correct dose is essential for a safe level of sedation and anaesthetic to enable an operation of this nature can be performed. It also requires appropriate monitoring of the patient’s breathing, heart and circulation. This is impossible to do safely if the doctor is also performing the surgery with the required level of concentration.

Local anaesthetics are schedule 4 drugs with significant potential risks and side effects. In addition, they often also contain a drug called adrenaline, which has a potent effect on the heart and circulation. Adrenaline is also a natural hormone. All these local anaesthetics have a maximum safe dose that cannot be exceeded. The effects of excessive doses of local anaesthetic administered to a person will often cause generalised seizures of the type that occurs in a patient with epilepsy. However, more dangerously, excessive doses of local anaesthetic can initially cause irregularities of heart beat but also a cardiac arrest.

Although it is possible that a particular person has an unknown sensitivity to a particular local anaesthetic drug or even adrenaline, or has an unknown medical condition that can contribute to such a sensitivity, it is far more likely that the maximum safe dose was exceeded in the case in question, without the appropriate monitoring. The reason for this opinion is that the first side augmentation had already been completed and the cardiac arrest occurred during the surgery on the other side. If appropriate monitoring was in place, alarms would have alerted the doctor (better still, the anaesthetist if present) to the fact that the heart rhythm had become irregular. Further, in these situations, there can often be a fall in the blood pressure which would have triggered alarms on the monitoring equipment if present.

None of this occurred according to the published report.

Credentials and accreditation requirements for clinics in Australia

There are a number of cosmetic operations that are often performed in “clinics” that are not subject to the same level of credentialing and accreditation that mainstream hospital are.

The Australian Council of Healthcare Standards (ACHS) is the national organisation that maintains standards in Australian hospitals. Hospitals with IVF and laboratory facilities have to comply with other credentialing organisations in addition.

The philosophy of ACHS is as follows:

“We’re an independent, not-for-profit organisation dedicated to improving quality in health care.  Our Council represents governments, consumers and peak health bodies from throughout Australia.

We are Australia’s leading health care assessment and accreditation provider.

Our mission is to improve the quality and safety of health care.

We develop performance measures with industry and deliver quality improvement programs.”

– Last Review Date 27 May 2014

Hospitals are compulsorily part of this system. It is imperative to apply this same credentialing authority to ALL facilities that perform significant and invasive medical and especially surgical procedures in Australia in order to ensure the safety and quality of healthcare (and procedures) across all segments of the healthcare industry in Australia.

It is inconceivable and illogical to apply these standards to one segment of the healthcare system but allow a large, unregulated alternative set of facilities to provide invasive medical/surgical procedures completely without standards/levels of compliance/quality and safety of healthcare to be assessed and measured.

It is well known that there are a litany of procedures that occur in unregulated facilities in terms of the administration of various forms of anaesthesia from local anaesthetic to local and intravenous anaesthetic all the way through to general anaesthetics.

The performance of a variety of surgical procedures ranging from mainstream surgery (vasectomy, termination of pregnancy, excision of various benign and malignant skin lesions), various cosmetic surgical procedures (for example breast augmentation, liposuction plus others) and various dental procedures.

There are ample reports in the press and other media (coronial inquests) regarding very serious life threatening complications such as seizures, cardiac irregularities even cardiac arrest, catastrophic bleeding, severe and life threatening infections, and DEATH.

These extreme events have occurred in ALL the procedures mentioned above. The most recent event was reported as recently as Friday January 27th 2015 in the Sydney Morning Herald. There have been liposuction deaths in “unregulated” clinics in Australia in the recent past few years. Other complications were a death in a dental clinic related to unexpected and uncontrolled bleeding in a woman after a simple dental extraction. This woman had a particular bleeding disorder and was on blood thinning medication.

There have also been three reported liposuction-related deaths over a three year period in the recent past in Australia. Two of the three were from unrecognised bleeding after the surgery while the patient was in the recovery area. The third was from unrecognised perforation of the abdominal muscle wall following liposuction within the abdominal cavity, resulting in multiple intestinal perforations.

Preventable complications with greater regulation

These are dramatic and catastrophic complications that were ALL preventable if better, closer monitoring and more regulated healthcare facilities and services were in place across all levels of facility.

Unfortunately, this is not the case in the Australian healthcare system overall. Certain aspects of the Australian healthcare system are very well and adequately regulated (examples are the mainstream hospitals, all aged-care facilities, which also have federal healthcare regulations, general practitioners, all specialists, dentists and dental specialist nurses, allied healthcare professions). This is NOT an exhaustive list.

The crux of the problem at hand is the following:

Various levels of surgery are performed out of the mainstream regulated healthcare facilities. On occasion, these clinics and facilities will have other quality designations that DO NOT comply with the currently accepted healthcare regulatory requirements. These are used to allay the fears of the uninformed public.

Every surgical procedure and every form of anaesthetic carries risk, these risks can be life threatening and must never be underplayed. The common complications relating to anaesthesia all relate to overdose of these drugs with toxic effects on the brain (seizures), the heart (irregularities of heart rhythm and cardiac arrest in advanced and unmonitored/inadequately monitored cases), a fall in blood pressure/low blood pressure which contribute to the heart effect as well. In addition, the same drugs can inhibit the breathing mechanisms. There are extremely rare cases of allergic reactions to anaesthetic drugs that can be completely unpredictable. These are far less common than the administration of far too much local anaesthetic.

Further, a number of these clinics will also use intravenous sedation drugs in addition to the local anaesthetic. These drugs all also cause depression of the respiratory (breathing) mechanisms and can cause breathing to stop (respiratory arrest).

Some of these clinics and facilities will employ the services of a registered anaesthetic specialist. This will often negate the above mentioned anaesthetic complications. Unfortunately, the majority of such facilities do not employ specialist anaesthetic services for a number of reasons including attempts to reduce the cost of these procedures.

Lastly, the surgical procedures like breast augmentation, liposuction (in almost all forms), vasectomy, skin lesion removal to name a few are often performed by medical practitioners (doctors) with qualifications, training and experience that is inadequately regulated and poorly controlled. A significant number of these doctors are not registered specialists. Some are GP’s with a “cosmetic training”. Some are registered as GP’s in Australia but may be specialists from their country of origin but not registered specialists in Australia. Some of these “non-specialist” doctors are working under the training and supervision of Australian trained, registered and practicing specialists who only loosely supervise these doctors under their control.

The basic medical degree and qualification is called a Batchelor of Medicine and a Batchelor of Surgery (MB.BS) depending on the country of origin. We have inherited a version of the British medical system. This has led to the current situation and difficulty because it means an individual who is a licensed medical practitioner (a doctor) has a degree that “qualifies” the individual to practice medicine and surgery without meaningful registration.

It is now time for  all the Australian Healthcare jurisdictions to come together with important stakeholders ( limited, important and workable) to regulate the entire healthcare industry including cosmetic, dental, allied, alternative, ancillary and mainstream (medical and nursing). If this does not occur, more young, fit and healthy, unexpected and preventable deaths WILL occur.

It has to be about public safety first and above all else. Better compliance must become mandatory to protect the health and wellbeing of Australians undergoing medical and surgical procedures in all segments of society.

Dr Goldman’s Cosmetic Clinics: Safety Practices & Accreditation

Dr Goldman will only perform surgery in fully accredited hospitals with a specialist anaesthetist providing the anaesthetic (general anaesthetic or local anaesthetic with intravenous sedation). All of Dr Goldman’s cosmetic procedures are done in a certified hospital operating room with ALL the appropriate safety and monitoring in place. In addition, this safety and monitoring continues after the anaesthetic, in the post-surgery recovery area and out into the ward until it is safe for discharge home. Learn more about Dr Goldman’s professional accreditation.