Latest News

CoolSculpting has arrived @ SPS

Posted by Sandhurst Plastic Surgery on 26 April 2016

We are very excited to announce that CoolSculpting® is now available at Sandhurst Plastic Surgery. Over 3 million treatments have been performed world wide and it is exciting to have the opportunity to offer this to the people of Central Victoria. Over 20 years of scientific and clinical experience has lead to the development of this product which has its developmental origins at Harvard University.

CoolSculpting launching at Sandhurst Plastic Surgery (Bendigo, Central VIC)

CoolSculpting® uses controlled cooling to permanently reduce the number of fat cells in a targeted area, without surgery and with limited down time. CoolSculpting® is not a weight loss program. What CoolSculpting® does do, is remove stubborn deposits of fat from problem areas such as the belly, back, “Love handles," thighs, arms and chins. After the CoolSculpting® treatment the fat undergoes “cryolypolisis" which means the fat cell is permanently broken down by the body through the application of a controlled cooling process. Results may be seen in weeks but ongoing results continue for up to 3 months as the body continues to break down fat cells.

Our fat cell population is mostly set by the end of adolescence. When we gain and lose weight, all that happens is the population of fat cells store more or less fat respectively. The distribution of these fat deposits will not change. Most people notice that despite healthy diet and exercise, they are unable to move stubborn areas of fat. Often it is easy to identify a genetic predilection to this such as having “grandma’s legs” or “dad’s chins”. By permanently removing targeted areas of fat cells, CoolSculpting® is able to redefine our genetic shape. This is the reason that people are so satisfied with the results of this procedure. We will be launching CoolSculpting® in the rooms of Sandhurst Plastic Surgery on 18th May 2016. If you would like to attend our launch or would like further information, please contact the rooms on 03 5443 0294.

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Vectra 3D Photographic Simulation At Sandhurst Plastic Surgery

Posted by Sandhurst Plastic Surgery on 17 September 2015

3D photographic simulation brings a new dimension to plastic surgery at Sandhurst Plastic Surgery.

New technology allows patients to preview how they will look with a variety of aesthetic procedures.

If you are one of the tens of thousands of people each year considering an aesthetic procedure Sandhurst Plastic Surgery has some good news for you. Recent advances in three dimentional (3D) photography, combined with revolutionary new software, allows prospective patients to preview what they will look like as the result of many procedures performed by plastic surgeons such as breast augmentation, rhinoplasty and orthognathic surgery.

Vectra XT 3D Photographic Simulation Available at Sandhurst Plastic SurgeryBreastSculptor with VECTRA XT - 3D Imaging & Simulation for Plastic Surgery

Both the Vectra™3D camera and Sculptor software, which make this possible, were developed by Canfield Imaging Systems. The process starts with a Vectra 3D session, which produces a three-dimensional photograph of the patient. Then, using Sculptor software, the surgeon is able to simulate the expected results of a variety of aesthetic procedures.


“My patients absolutely love this,” said Mr. Snell. “For the first time, they’re able to see a 3D picture of themselves with their new look. Because it’s in 3D, I can rotate their picture to any viewpoint and they can really examine the desired result. We can make changes here and there and agree on a final look in advance, and this really helps them make a decision”.

Advanced 3D Imaging & Simulation Software (Vectra FaceSculptor)at Sandhurst Plastic Surgery Bendigo

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Perioperative Care & Procedure | The Bendigo Health Surgery Journey

Posted by Sandhurst Plastic Surgery on 23 July 2015

We would like to encourage everyone to spend a moment of their time watching a project that we have been involved in at Bendigo Health. It is the product of many hours of hard work by a team lead by Judy Ingwersen RN (Producer and Co-director), Matthew Theobold (original designer of the ‘patient flow chart’ titled ‘The Bendigo Health Surgery Journey) and Anthony Webster (Co-Director, Photographer – Imagine Studios).

Initiatives like this help immeasurably to demystify what goes on when a patient requires care at a hospital like Bendigo Health. Making sure patients are as informed as they can be prior to being admitted for a surgical procedure is a crucial part in ensuring good clinical outcomes. Congratulations to Judy and her team!!

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$7990 Breast Augmentation in Australia

Posted by Sandhurst Plastic Surgery on 12 June 2015

EXCITING & UNUSUAL DESTINATIONS, COCKTAILS & 5-START HOTELS - IS IT TIME TO EXPERIENCE THE EXTRAORDINARY? As the number of Australians jet setting to exotic locations for breast implant surgery increases each year, now is the perfect time to ponder good reasons for staying closer to home for cosmetic surgery & high quality post-operative care.

Breast Augmentation / Implants near Melbourne, Australia for $7990

Adventure... exposure to new and unique cultures... venturing into the unknown... There are many reasons to travel to new and exotic locations, but to have invasive plastic surgery should not be one of them. It is the comparatively cheap overall cost that is sighted as a primary reason for hundreds of Australians venturing overseas for breast implant surgery each year. However, with the risks involved, lack of regulation and standards, and the many related “unknowns”, there are good reasons for considering staying closer to home for cosmetic surgery. At Sandhurst Plastic Surgery Bendigo, just a stone’s throw from Melbourne, breast augmentation surgery can be performed from as little as $7990, all inclusive.

Choose safety and good care for breast implant surgery - save suntans and cocktails for your next holiday!

Women nowadays opt to have breast augmentation surgery for a variety of reasons. These include substantial weight loss or loss of volume after breastfeeding, but the goal is normally to enhance overall self image. Whatever the reason for considering having breast implant surgery, it is essential that your surgery is undertaken by a fully qualified plastic surgeon within a properly accredited medical facility. Sandhurst Plastic Surgery operates in world class, accredited medical facilities with highly skilled medical staff and the best anaesthetists. At our first class facility located in Bendigo, just over an hour from Melbourne, Victoria, you can expect to receive individual care tailored to your needs by fully qualified and caring medical staff.

Whilst it is purported that many of the surgeons offering cheap breast implant surgery in overseas facilities are internationally trained and accredited, really there is no way to ascertain the level of care you will be offered and whether the surgeon’s skills and ability are in line with international standards. It is definitely worth noting that a recent survey conducted by ASPS (Australian Society of Plastic Surgery) showed that breast implant surgery was the most common kind of surgery conducted overseas requiring corrective treatment and with some patients finding themselves caught off guard, with no back up plan in case things do go wrong.

In Australia, the current benchmark for standards of quality surgery and care, is set by the Royal Australasian College of Surgeons (RACS), of which Mr Broughton Snell is a fellow. This body ensures that all surgeons have undergone extensive education and training and are highly skilled to carry out breast implant surgery with the best possible outcomes for patients. Mr Snell is also a member of the Australian Society of Plastic Surgeons (ASPS) and is dedicated to maintaining the integrity of plastic surgery by ensuring the highest standards are adhered to.

Of course, high quality, post operative care is a primary concern for many women considering undergoing breast implant surgery, and this standard of care is profoundly lacking following many of the 'boob jobs' offered as part of attractive 'medical tourism' packages being offered. At Sandhurst Plastic Surgery, follow up appointments will be booked prior to your procedure with your surgeon, our practice nurse and therapist and your recovery will be closely monitored to ensure the best outcome following your breast surgery procedure. Your post operative care at Sandhurst Plastic Surgery is of paramount importance to us and our goal is to help you achieve your desired outcome following breast implant surgery.

Doesn't ‘one size fit all’?

So, madam, will it be silicone or saline? Contoured or round? Or perhaps, teardrop?

Once you’ve decided to have your breast implants surgery within Australia and have selected a qualified surgeon who you’re comfortable with, and a suitable facility, the choices don’t end there. And it’s most definitely not a case of ‘one size fits all’ when it comes to breast implants.

There are various decisions that need to be made prior to breast surgery, including options for breast implants regarding not only size, but also material, shape and surface, as well as the type of incision used. At times women can feel overwhelmed when confronting these decisions. At Sandhurst Plastic Surgery, we take the stress away by guiding you through the decision making process via frank and open discussions about your personal preferences. In consultation with the plastic surgeon, you will be carefully guided through this process of decision making so that you are clear about what you want to achieve from your surgery and what is realistically possible following a comprehensive clinical examination of your frame and measurements. Our desire is to assist you in making truly informed decisions regarding the optimal implants that perfectly complement your dimensions.

Breast implants and safety

Unlike overseas medical facilities offering cheap “boob jobs”, Australia regulatory bodies set rigorous quality control requirements for breast implants, which can help alay fears of breast implants “going wrong”. At Sandhurst Plastic Surgery we only use breast implants that have a known track record of safety and that have been subjected to rigorous scientific and technical testing and are manufactured to the high standard expected by surgeons and patients alike. Furthermore, all patients will have their implants registered on the ASPS Breast Device Registry, thus providing a method of tracking any safety issues that may arise in the future. This in itself is a good reason to stay closer to home for breast implant surgery, providing patients with peace of mind.

Your journey begins here

Currently prices for a ‘boob job’ in Melbourne are around $15,000 by Melbourne plastic surgeons. But just a short distance from Melbourne, at Sandhurst Plastic Surgery Bendigo we are offering an amazing package for breast implant surgery - only $7,990, including implants, facility fee, anaesthetist and surgeon’s fee, all at a world class medical facility, performed by Mr Broughton Snell, a highly qualified, experienced and caring plastic surgeon. If you are considering breast augmentation surgery, please contact us to arrange for a non obligatory consultation today. We will openly discuss your desires and expectations and give you ample information to make an educated decision. So play it safe and make Bendigo Victoria your choice for the highest quality consultation, surgery and post-operative care, all for the inclusive price of $7,990!

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Cooling Off Period for Cosmetic Surgery

Posted by Amy Corderoy, Health Editor, Sydney Morning Herald on 7 May 2015

Call for mandatory two week waiting period before cosmetic surgery and a reminder to check the qualifications of your surgeon before undertaking any procedures!!

Article published in the Sydney Morning Herald today.

The nation's plastic surgeons are calling for a mandatory two-week cooling-off period before a person can get cosmetic surgery, and have warned people they risk disastrous outcomes and even death if they don't ensure their doctor is qualified to treat them.

The Australian Society of Plastic Surgeons will on Thursday launch a new campaign calling for people to "think it over" when they plan cosmetic procedures, and call for tougher regulation of the industry to ensure people are protected.

The Medical Board of Australia is currently consulting on a proposal to improve the regulation of cosmetic medicine in Australia, with little currently known about the number and type of procedures performed by a huge range of clinicians amid a booming market.

It says cosmetic surgery is unusual medical practice because unlike other areas the patient and doctor have a relationship that is much more commercial and is often driven by non-medical needs, and it attracts a disproportionate number of medical complaints.

The president of the Australian Society of Plastic Surgeons, Tony Kane, said the society was currently preparing a response to the Medical Board's proposal, and would be calling for a mandatory two-week cooling off period for anyone getting surgery.

The board is considering implementing a one-week cooling off period, but Dr Kane said that was not enough.

"All surgery carries risks, including cosmetic surgery, and people need adequate time to carefully consider their decision, and who is doing the surgery, and whether it is an accredited facility… as well as what protections they have in place if something goes wrong," he said. "Internationally in Britain they have already instituted a 14-day period, and I think we should be consistent internationally".

He said patients as well as doctors needed to take responsibility for the seriousness of the procedures they were undertaking. "We have seen increasing complications from people having surgery done overseas or in less desirable facilities, and we are concerned that people are doing themselves harm," he said.

However, he acknowledged it would be "unreasonable to expect an ordinary Australian to understand" the many different levels of training and accreditation needed for different procedures.

Plastic surgeons had ten years of specialist training, and people who were qualified this way were listed on the Society's website, and he said people should only choose practitioners who were equipped to deal with procedures done under general anaesthetic, rather than local. "If a facility is not able to perform general anaesthetic, I would be questioning why that facility is doing that procedure," he said.

Cosmetic surgery is a fast-growing area and can involve anything from minor to serious procedures, which makes it difficult to regulate, according to the Medical Board of Australia consultation paper, which is open for submissions until the end of May.

Clinicians who perform cosmetic procedures are members of four different professional bodies, of which the Australian Society of Plastic Surgeons has the most members, and range from fully qualified surgeons to beauticians.

The chairwoman of the medical board, Joanna Flynn, said there had been long-term concerns about cosmetic medicine, but increasing rather than decreasing regulation was difficult. She said the board was most concerned about vulnerable people undergoing cosmetic procedures with unrealistic expectations, or without completely understanding what they were going into.

"Normally for most surgical procedures the patients go through a GP and they have a discussion with the GP first about what the procedure is and what the likely risks and benefits will be," she said. But with cosmetic surgery patient initiate the consultation directly with a provider, who also has a financial incentive to encourage them to go ahead.

It is not known exactly how many doctors and nurses perform cosmetic procedures, but the board's consultation paper says the industry attracts "a proportionally higher number of patient complaints than providers of other medical procedures".

She said she welcomed all submissions, including those from the society of plastic surgeons, as the board wanted to know it was on the right track with its proposals, which include whether or not it should release detailed guidelines aimed at cosmetic doctors rather than the generic guidelines they currently fall under.

This story was found at: http://www.smh.com.au/nsw/call-for-mandatory-two-week-waiting-period-before-cosmetic-surgery-20150506-

 

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Smoking and wound healing.

Posted by Jane Sutton on 27 April 2015

“Does it really matter if I don’t stop smoking prior to my surgery?”

There are many reasons why it is recommended that patients stop smoking. People are aware of the general risks to their health such as heart disease and cancers, however smoking also has a direct affect on wound healing after surgery. Here are some of the many ways in which smoking is detrimental to wound healing.

• Collagen is a protein that is responsible for the strength and elasticity of the connective tissue of the skin. Collagen production is decreased in smokers. Overall the mean amount of collagen is less in the wound of a smoker, making the wound weaker, less resilient and more likely to break down. Potentially requiring further surgical or medical intervention.

• Nicotine increases platelet adhesion, therefore increasing the risk of clot formation in the small vessels of the injured area.

• Nicotine inhibits red blood cell production as well as macrophage and fibroblast proliferation. These are important cells responsible for delivering oxygen, cleaning up and preventing infection and providing the building cells that heal the wound.

• Smoking produces Carbon Monoxide. The carbon Monoxide enters the blood cells and reduces the amount of oxygen that can be carried to the wound. It takes 3 days for Carbon Monoxide to be cleared from the blood stream following a cigarette.

• Smoking causes significant vasoconstriction (shrinking) of the small vessels within the wound reducing blood flow. This will remain the case for up to 50 minutes after the cessation of each cigarette.

• Wound dressings can absorb cigarette smoke, just like furniture, curtains and cars can harbour cigarette fumes. This means that patients trying to heal should not be around smokers. Passive smoking is really problematic. It is no longer acceptable to smoke around babies or other vulnerable peoples. People with healing wounds should be given the same consideration.

• The risks associated with smoking are significantly increased when the wound is in the extremities (hands, feet or head) or in tissues with poor blood supply (adipose/fatty tissue). In our field, Plastic and Reconstructive surgery, we live and breathe in the peripheral areas. Lack of blood flow and oxygen to these areas seriously affects our ability to ensure you successful healing and a great result.

• It is a known fact that the longer that a wound takes to heal, the greater the chance of hypertrophic (red, raised, lumpy) scarring.

• Other systemic issues such as diabetes, obesity, poor nutrition will compound the affect of smoking on wound healing.

Therefore by ceasing smoking as soon as possible you will:

a) Improve the success rate of the surgery.

b) Reduce the chance of further surgical/medical intervention.

c) Reduce the time it takes for the wound to heal and therefore have less visible scaring.

d) Avoid creating wrinkles prematurely!!!

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Shopping For A Breast Augmentation Surgeon

Posted by Ashley, blogger and friend of SPS on 12 November 2014

A shift in the wives’ club is in effect, and Janet is leading it.

Janet has always led it—the wives’ club—but I just need to be clear that she is responsible for the shift as well. She is a strong personality, maybe. Or maybe more confident than the rest of us. Maybe confidence, in women, is stored in the breasts. I am still working with that assumption. The point is, Janet goes after what she wants.

And today she wanted a friend to accompany her to her consultations.

Consultations, as in more than one. Plural.

Janet is shopping.

“Nothing is more important a factor than the right doctor.”

—Janet’s boob wisdom.

Also, “Clear your schedule.”

—Janet’s way of inviting me.

I am the accompanying friend. First thoughts, of course: why me? Have I appeared too curious recently? Did I sparkle and pop throughout the boob replacement conversation as opposed to my more normal nods and grunts as I try to look engaged above the drone of my own monologue? Is it that I don’t frown unwillingly anymore? Has she noticed this small improvement? Are we kindred spirits now, chasing our youth and sexualities backwards through time? Janet picked me. There must be a reason. Janet has never picked me for any of her special interest outings.

Seven. Seven doctors Janet scheduled for consultation meetings spaced each an hour apart. In one office alone she spoke to three of them. She is like a speed dater, asking each of them their hopes and dreams for her breasts and how they might accomplish such and then gliding into experience, philosophy, expectations. In her purse Janet carries pictures of the hopes and dreams that she intends one lucky doctor to fall in line with. The hope and dream is Pamela Anderson, circa 2000. With each new doctor, Janet pulls out pictures of Pamela Anderson. She says, “Not this Pamela, but this one,” as she shows the first picture, and then the second. Janet lists the subtleties between the two. In the first, Pamela looks like she’s still working towards something. In the second photo, Pamela is wearing white and heavy lip liner. Her breasts spill out generously, evenly, impervious to gravity, flaws, and, most importantly, nature. Pamela appears to have found what she was looking for, boob-wise.

We are each of us looking for something, boob-wise. Men are looking for it in women. Women are looking for it in themselves, in other women, in doctor’s offices. We are heavily concerned with boobs, and if we must buy them, then Janet is right—it is all in the doctor.

And so Janet pursues it with precision. She speaks with clipped, sure words; a cosmetic perfectionist.

Each doctor would study the Pamelas with reverence, and then to each, Janet would reiterate, “Not Baywatch Pamela,” and flash the first photo again to show what she meant. Then Baywatch Pamela would be sort of dismissed with a common sniff of doctor and patient in unison. Baywatch Pamela is the old guard. Hard, uneven, torpedo-shaped boobs are the old guard. They are early life-forms in the evolutionary history of cosmetically enhanced breasts, barely a step above tissue paper, if you ask Janet.

—the breasts of post-Barb-Wire Pamela, though, are an artistic feat. The stuff of dreams. Janet would make this clear as she flashed the second photo. Pamela in tan skin and white muslin and heavily-lip-lined. Perfect perky Pamela.

The doctors each had a purple marker and a camera. They would sketch out their artistic intentions for the recreation in Janet of Pamela circa 2000 as they named prices, dates, options. There are so many options. Entry points, for one. Size and material. Financing. Janet would rapid-fire her questions and then turn to me. She’d say “Write that down.”

The doctors would then stand Janet against a white wall and take pictures for the “before” album—nice little relics to reminisce on when Janet 3.0 looks back on this rudimentary phase of herself. Or, more likely, the photos were intended for some necessary use related to the doctors’ construction of Janet 3.0. The camera would click and pop at each angle as Janet turned 360 degrees front to back and front again, profile angles, quarter angles, shoulders back, lungs full of air with the breath she held waiting for him to direct the next pose.

Doctor number one promised anything—financing, triple-stacked-silicone implant options, a third breast if she was a sci-fi fanatic. A first ethical question began to sketch itself out in my head.

Doctor number two became jealous of the previous purple marker stitches left over from the consultation of doctor number one.

Doctor number three approved of the shopping. He made it a point to ask Janet why she was shopping for a second procedure when the first was already a relative success, didn’t cause problems, looked fine in clothing. It seemed like a nice doctorly question to ask.

Doctor number four listed statistics, studies, warned Janet that these things might need replacement at some point in time that was more than a decade from now but maybe not before her ultimate demise. They may not last a lifetime, is what he meant to say. Maybe just half of one.

And that, too, seems like a relevant conversation, yes? A second ethical question was raised.

But of course Janet already knew this. A veritable trove of breast implant information, that one.

Doctors number 5-7 shared an office. Theirs was the one Janet approached on referral. My next question became, referral by whom!? What woman does Janet know whose breasts are so wonderful that Janet would pay to have them recreated? Why haven’t I heard her name at the wives’ club? Her breasts may be legendary.

The large doctors office had pamphlets and samples and trade magazines and framed journalistic reports re: their very office that were spaced evenly across the waiting room walls. Three receptionists fielded phone calls and Janet and I waited in seats facing other patients who waited, too. The mood was pleasant with a slight current of excitement running through. As far as cosmetic surgery is concerned, we each seemed to be running away with thoughts of the possibilities.

We met with three doctors there and I learned three things:

  1. Women with breast implants report higher rates of sexual satisfaction, a new study shows. The factor has something to do with self-confidence.
  2. Janet can get some sort of package deal on a second procedure if they’re done (and paid for) at the same time. So can I, apparently. It was suggested that I remove the bags under my eyes while Janet was visiting the ladies’ room. It was also suggested that I consider breast implants myself, or a tummy-tuck, or a full mommy makeover. I was asked if I had any unsightly veins showing on my legs.
    1. Note: Doctor number 6 is a terrible person. I had plenty of bodily hang-ups without his help
      1. Further note: so many ethical questions raised.
  3. Doctor number seven is my guy. He may not end up being Janet’s guy, but if ever I take the plunge and decide to do a little self-improvement on any of my old (or brand-new) hang-ups, this is my guy. Because he didn’t try to sell me on anything, for one. Because he didn’t try to sell Janet on anything unrealistic. He didn’t promise that Janet would come out of surgery looking like Pamela Anderson. It is important to note here, I think, that doctor number one undeniably did promise that. Others hinted. Doctor number seven listed risks—real risks related to Janet’s specific condition of already having had one breast augmentation—because they are not exactly the same risks, and while each patient faces the same general list of risks with cosmetic procedures, they are also individuals, and face those risks at different rates of occurrence. Doctor number seven is my guy because he felt like a doctor rather than a magician or a salesman.

Janet had a few questions she asked each doctor. Aside from the Pamela Anderson phases and photographic evidence of improvements, she asked them point-blank how good they were, as doctors, and as artists. It is important to make this distinction, I think. I know Janet thinks that. Because a cosmetic procedure, at the end of the day, is an artistic one. It is accomplished through a medical means, but it is aesthetic. Being a good doctor is only one facet of being a good cosmetic doctor. It’s very good if they are skilled enough not to kill you on the operating table, or otherwise mess up the smooth functioning of one’s body, but it’s really quite pointless if the results are not an improvement upon the body in question—especially an improvement great enough to justify the high price tag.

Which I noticed, strangely, seemed to be about the same everywhere we went. There was not great difference in the cost of the procedure but there is likely a wild difference in potential outcomes.

Doctors 1-6 all claimed to be at the top of their fields, artistically and methodically. Which may be true. But if they are all at the very top, then it begs the question of who is below them? They all claimed to be known for their breast augmentations. And maybe they are. But if we had been shopping for a rhinoplasty, or a face lift, or a fifth limb, is it possible they would have made the claim that they were known for those procedures instead?

Doctor number 7 did not claim this. Instead, he said this: “My dear, this is why doctors practice medicine. We practice that which we aim to become better at. As doctors, we must all remind ourselves that we don’t know it all. As such, we must always force ourselves to learn and improve—it is our duty to our patients.” He pointed out that when Janet had her first breast augmentation, it appears that the surgery was done by someone who was, at the time, at the top of his field. Then he said that a surgery like that just wouldn’t do today. He said, “Am I good? I do believe so, absolutely. Am I at the top? I would hope so. Will I still be there tomorrow? It is my duty to you to keep clamoring for that.”

It is possible that he is nearly as set on perfection as Janet is.

When we were leaving the office Janet had one last test. She leaned in towards the receptionist’s desks and whispered, “If you were going to choose a doctor to do your breast augmentation, who would you choose?”

The receptionist blinked for a moment, and looked around.

She said, “I’m sorry, but it’s against office policy to make these recommendations.”

Then she slid doctor number seven’s card across the desk.

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It's time for some new ones

Posted by Ashley, blogger and friend of SPS on 27 May 2014

“It's time for some new ones.”

That is the what Janet announced today at the local wives' club. And this statement sounds simple and practical and well thought out but it is so undeniably multilayered with—nay, piled with—meaning that I am just about to burst at my ever-slacking seams.

Janet meant her boobs.

Here is a short list of the more pressing things that were acknowledged by Janet's statement:

First: Janet has boobs—and of course she does. Anatomically she has boobs expressed as a secondary female characteristic. We all do. Some more than others but we, as women, have them. But what I mean to say is Janet really has them. I mean this is a woman who turns profile and people take stock. Three kids, too. Three and they—the boobs—were still where one would want them to be placed, ideally, in relation to the other parts of her body. The things have perk. There had been whispers among the wives' club that perhaps Janet had been given a little “help” if you will. Maybe a push-up bra—that more refined version of toilet paper filling that was all the rage in middle school. But this theory was steadily disproven with each successive trip to the beach (the dressing rooms). The boobs fill the bra by themselves. Then, as you might expect, the question had become, but what fills the boobs? Because they are full. Quite so for a woman with the condition of three children, mid thirties, human. The thing is, we've all known Janet for so long and they've always been there. We saw her through her last pregnancy. Her boobs have always been strong. So there is no reason to believe that they may have had a little surgical enhancement aside from that sort of karmic acknowledgement that in the world we know these things don't happen. Because the world is not perfect, see. And Janet's boobs are. So the wives' club has been quietly left wondering through the years under the working assumption that it would likely be rude just to ask. Wouldn't it? I'm still not sure. The media asks celebrities every day. Not directly of course. It seems more like they throw out the accusation on a tabloid cover and then sit back in glee while the tendrils of blood curl and stink in the water. It is celebrity death, isn't it? Having work done. Meg Ryan. Bruce Jennings. Heidi Montag. Or is it? Because surely they're all doing something. A little something, somewhere. Maybe the death is in being caught? And that's why we were all so shocked when Janet announced it. Because she announced that it was “time for some new ones”, sure, but first she said, “The implants these days are more cutting edge than they were when I got them.”

Second: Not all breast implants are equal. Of course we know this, right? We all know this because we've all been at the beach or at one of those gyms that people actually work out or maybe we've been dragged (after five too many cocktails) to a strip club because we wanted to pretend like we were one of the boys. Or maybe that was just me. Maybe that's another thing the wives' club collectively agrees not to admit—assuming any other members have engaged in this sort of activity. But is it an anything goes policy now over there? Can I address this at the next meeting? Can I say, “Ladies, now that Janet has openly discussed her breast implants, I'd like to move that we also discuss a certain drunken foray I once made into a strip club.” But I'm getting off track. The point is that Janet has one type of breast implant, and she would like a different one. Simple logic would lead one to conclude that this is a quality control measure. When asked to elaborate she explained that at the time that she got them, silicone breast implants were off the market, and so she went with saline breast implants. Saline is just salt water. Safe when popped, is how I understand it. But now silicone is back on and they feel better, supposedly. But are not as safe when popped? Or weren't, but are now? Or presumably maybe just don't pop? I once heard of a woman who went rock climbing and fell a few stories and broke the ribs underneath her implants but the breast implants remained intact. I also once heard of a woman who was saved by her breast implants in a car accident when the airbag failed at its one big moment to shine. But is that urban legend? It feels like it might be. This is definitely urban legend—I once heard of a woman who survived a sinking ship on account of her breast implants. Why are these stories so entertaining to pass along? We are fascinated by them.

Third: Janet might have been a stripper. I am absolutely sure this is an off-limits question at the wives' club, but I've done the math and if the silicone ban was lifted in 2001, then wouldn't that make Janet around twenty when she got them? How do twenty-year-olds afford breast implants? Is this a pressing question anymore? Does this mean she was able to breast feed her children with breast implants? I saw her do it. Certainly that's what this means. Is it bad to have children and breast implants at overlapping times in one's personal history? I can't get a good grasp of what society truly cares about.

Fourth: Clearly what they don't care about is whether one has had breast implants at a point in her life when she is young and attractive. It seems to be the one thing women are given a pass on in the plastic surgery department. Especially at the point where a woman like Janet announces it as if she's thinking about buying a new pair of shoes. “It's time for some new ones.” This is a light statement meant for light things. Are breast implants light things now? I think Pamela Anderson made them light things. Maybe Baywatch made them light things. Not physically speaking, of course. Physically speaking they look rather heavy compared to the frames of those women. But I digress. My point is that they—breast implants—became open discussion back then, maybe. And then what was trending in Hollywood maybe just took its natural course through time before it became commonplace in the real world? Or are women just open about it because it cannot be hidden? A breast implant is noticeable, if one is intimate enough with the wearer, no? They can be grabbed and proven to be a little firmer than the expected globulous grouping of fat cells if one is lucky enough to have had her fat collect in just this one place. Especially the saline ones. At least that is the information that Janet imparted upon the wives' club. She said something about gummy bears. That there are breast implants that feel like gummy bears and are so real under the muscle that one hardly knows. Can this be true? And then she talked about under the muscle and over the muscle, because there is a choice for the wearer. Under the muscle is more, what? “invasive”, did she call it? But more natural looking. Over the muscle is easier but more prone to that strange rippling that one maybe associates with bad boob jobs if one (hypothetically) has had five too many cocktails and breached the threshold of the local strip club. Hypothetically speaking. And ripples are even less ideal than sag, in my opinion. But Janet had insight on that, too. Ripples come from saline and from the breast implant being too large for the wearer. Silicone doesn't do this. Or, should I say, not as much. Not if the surgeon knows when to stop in the size department. Not if the subject is realistic about exactly how much breast implant room she may be harboring. Not if things go right. And a good plastic surgeon should make things go right. Janet is a veritable trove of breast implant information.

All of the above concepts were gathered from such a simple statement: Janet would like to get new breast implants. It was a fascinating study of human behavior, I think, the way the wives' club started with halting, polite questions at first and then became more brazen as information was offered up freely. And we had questions. So many questions. Do they hurt, for one. Somehow no, she says. She used such words as “nerve blocks” and “general anesthesia.” I suppose this makes sense, if you think about it. How much pain could really get past a nerve block? Morphine isn't even that effective, and isn't there a quote that goes something like, “Morphine is a hell of a drug”? Or am I now confusing my pop-culture references? Is the quote“Cocaine is a hell of a drug?”

I am maybe too sheltered to keep my jokes straight.

I have two children. My cool-factor has grown to reflect that.

Regardless. It's no reason not to have great boobs. We asked Janet, “But what about after the surgery?” The post-surgery. The weeks when one is supposed to have a free pass to sit around on the couch and be waited on and not questioned or expected to perform her normal duties? What about that? And Janet said it's not any more pain than the soreness of a heavy workout. I hate workouts, but I do them. And it's not the post-workout soreness that gets me, it's the during-workout that feels like death on wheels. I wonder if they have over-the-counter nerve blocks for gym-goers? This I could do with.

Scarring—we asked about scarring. Where the scars are. What the options are. Numbness? Strange feelings? Nipple sensitivity? These are pressing questions, are they not? She said she had a slight curve of a scar along the areola. There had been numbness for a couple of years on one side. I ask myself whether it's worth it. I've had twins. Two small humans have sucked the life out of my breasts in a simultaneous fashion. For eighteen months they were nonstop and like magic I could not only regain what I had but come out with a better version—Ashley's Breasts 2.0—all for the low cost of some gym-type soreness and some possible numbness. Six weeks, technically. And six weeks of off-time, physically speaking. No gyms or skydiving. That sounds nice. I live for reasons to avoid gyms. And skydiving. But then I wonder if six weeks of a perfectly sedentary life would maybe add a sort of unappealing padding in unappealing places? These are the fears that drive me to gyms. Could I afford six weeks off for the superficially noble cause of boobs?

Why am I even thinking about this for myself?

It is Janet who should be the one thinking about this. Janet who will have the newer, better boobs than the already amazing ones she has today. Janet who must choose whether the surgeon cuts in through the nipple or the armpit or below the breast. Science! What a strange world we live in where one can acquire perfectly lovely boobs through an armpit! But still I find myself asking the questions. Where would I want the plastic surgeon to go through, if given the choice? Certainly not underneath the breast, no? I think there are urban legends about the hack jobs involved with that raised ugly smile of a scar that surgeons have left under the breast. Or maybe I'm having strip club flashbacks. Even hypothetically I would not allow a surgeon to cut straight under the breast. Or are things just better these days? Is it just a matter of finding the right plastic surgeon? Because Janet is talking about going under the breast this time around—through the "inframammary fold", she called it—and when she said it I cringed and she smiled. Because technology and skill is so much more advanced than it was fifteen years ago. Ten years ago. Last year. Because modern science says this is the way now.

And why am I even thinking about this hypothetically?

Maybe because Janet seems so sure of herself. Maybe because she has always been the most confident among us and maybe because I'm looking back through the years and wondering if it is all due to her breasts. “What a step back for feminism,” the politically correct part of me wants to say. But I don't have to be politically correct in the privacy of my own thoughts. I am female and females think about this. Females think about every last thing they would change about their bodies, and breasts are very often at the top of that list. Some don't see a problem with simply fixing what bothers them. Whether that is concealer on blemishes or something as determined as elective surgery—we're all fixing ourselves. We all feel more confident when we are showing the face to the world that we want it to see. That's what Janet does every day—she puts her best self forward. And of course she has plenty of reasons to be confident—better and deeper reasons—that don't involve the size of her breasts. But in clothes she is confident. I remember the freedom of that feeling. It was five years ago, right before I got pregnant. Then again it's an expensive lifestyle—shopping because one likes the look of clothes on her body and not from the mere necessity that society imposes by requiring we engage in it clothed. Not that I'm not grateful. It would be a terrible world that expected me to casually venture out without clothes.

I wonder if Janet feels this way?

Too, I wonder what she feels when she lies on her stomach? Can I ask her this? I should have thought to ask her this. We go tanning at the beach. It's not a thing I would say with any authority that she necessarily avoids. But does it feel different?

But here is the big question—the one that Janet can't answer: What would my husband think? This is the question that matters. And so I raised it casually over dinner. A hypothetical. A sort of, haha what if? And of course he said no—that I don't need them. He's very supportive and loving and all of those desirable things, my husband. So of course he said no. But he used that particular brand of tone he uses when he's dieting and I offer him dessert.

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A Brief Word On Workplace Injuries

Posted by Mr Broughton Snell on 27 May 2014

Over the last decade, approximately 20,000 Victorians injured themselves at work each year. The most common parts of the body injured include the back, the shoulder, the knee and the hand. In addition to this, a significant number of people have psychological issues directly related to their workplace. It is no secret that there are certain industries in which workers injure themselves more often than others. These include the manufacturing, construction and healthcare industries.

At Sandhurst Plastic Surgery Bendigo we regularly see patients with injuries sustained as a direct result of their employment. A majority of these patients have injured their hands in some way, but we also see patients with facial injuries, lacerations to just about anywhere on the body and also burns. Unfortunately, whilst patients immediately realize when the accident occurs that they have a significant injury, they often do not appreciate what happens thereafter. We thought we would put something together that can help people understand the process of treatment following a workplace injury.

Firstly, a lot of our patients are concerned about the financial aspects of a workplace injury, so we thought we would give some clarification. Your employer will have an insurance policy that covers their employees for injuries sustained at work. When you injure yourself your employer will contact their insurer and obtain a provisional claim number which will help cover the cost of your hospital stay and also the treatment given by the surgeon, the anaesthetist and the therapist involved in your rehabilitation. It is important that you take control of your case and keep a copy of every document that you receive, that way the cost to you will be minimized.

Once you have been assessed by the surgeon, and the therapist, a management plan that is appropriate for your injury will be devised. From the outset, the goal of treatment for a workplace injury is to restore as much function as possible. In most cases where surgery is required, the therapist may visit you in hospital, or ask to see you in their rooms and a custom-made splint will be fabricated. This is so that it can be fitted at the completion of the procedure. This splint may need readjusting as you progress through your recovery.

The time off work can vary depending on the nature and extent of the injury. For a simple skin laceration the time off normal duties may be only a week. For a complex injury involving tendons or nerves, provided there are no complications, the time off work may be up to three months. The key to success, particularly when it comes to hand injuries, is listening to your hand therapist and doing everything they say. Fortunately, most complications such as finger, or hand stiffness are avoidable if you are diligent with your exercises and splinting. It may seem like an inconvenience at the time, but you need to stay focused and remember that following the instructions of the therapist will put you in a position to make the best recovery possible.

Of course, the best intervention is prevention. Over the years, the members of our clinical team have noticed certain trends in workplace injuries. In most cases they represent common sense, but to summarize here are a few tips from the team at Sandhurst Plastic Surgery Bendigo:

1. Safety Features: Use Them

The safety features of any machine are there for a reason – use them!

2. Safety Gear: No Exceptions

Wear appropriate safety equipment. It doesn't matter how experienced you are, or think you are, or if you think you look stupid.

3. Ask For Help

If you are new to a job and are not sure about something, ask.

4. Return to Work

If you are injured go back to work as soon as possible. Your surgeon and hand therapist can discuss suitable modified duties for you to do.

5. Be a Teacher

If you have junior staff or apprentices, make it your responsibility to make sure they are safe.

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Bendigo Health, the new hospital and where to from here?

Posted by Mr Broughton Snell on 10 April 2014

Having recently returned from working in the US, and having worked in hospitals in Victoria, New South Wales and South Australia I am probably in a better position than most to comment on how the delivery of healthcare in Bendigo stacks up on both a domestic and international scale. It would probably be worth prefacing what I am about to write by saying that my observations are purely based on my experience in plastic and reconstructive surgery.

The three hospitals in Bendigo (Bendigo Health, St John of God and Bendigo Day Surgery), particularly with the new Bendigo Hospital being built, are on par with any of the hospitals in Australia and the US that I have worked in. The other specialists, the nurses, the allied health staff and the support staff that I have encountered so far in Bendigo would hold their own, in some cases shine, at any of these other hospitals. It must be pointed out also, because credit where credit is due, I would say that the focus of the treatment at any of the hospitals in Bendigo would be closer to being patient centered than perhaps it is at some of the ‘centers of excellence’. Whether a patient is seeing their surgeon for a hand injury or for an aesthetic procedure, the focus should always be on them and not on the hospital or the institution. While protocols and procedures help deliver healthcare efficiently, which is vital in order to provide the greatest good to the greatest number, the patient should never be made to feel like they are just a number being pushed through a system. In my recent experience, I would say that both the craniofacial teams in Seattle and Adelaide provide excellent examples of how to be ‘patient centered’ whilst practicing according to protocols. What I hope to achieve in my practicing lifetime, is to take the principles from both these units and implement them not only for patients with craniofacial disorders or injuries, but any patient presenting for hand surgery, head and neck surgery, breast surgery and any other condition that can be treated by a specialist plastic surgeon.

So, can we achieve multidisciplinary patient centered delivery of plastic and reconstructive surgery in Bendigo? The answer is ‘absolutely’. There are currently highly trained and experienced surgeons from general surgery, oral and maxillofacial surgery and otolaryngology providing care for patients with head and neck cancer, and surgeons from general surgery providing care for ladies with breast cancer. Now there are two plastic surgeons in town we can work with these two teams to add a comprehensive reconstructive service for their patients. While there is a vast amount of behind the scenes work to be done by doctors, nurses, allied health and support staff in order to provide such a service, if we make sure that the protocols are clearly documented and the systems are patient centered (not hospital or doctor centered) and the success of our outcomes gauged by health and quality of life measures, then the service will succeed.

Please watch this space.

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