cosmetic surgery procedures

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Dr. Jayne Bambit is a Fellow of the Australasian College of Cosmetic Surgery. Please visit the College's website at www.accs.org.au or call the College on 1800 804 781 if you wish to verify
Dr Bambit's credentials.

This website page contains information on Cosmetic Eyelid Surgery, along with what to expect should you wish to attend for a consultation.

Please call the clinic on (07) 5452 5222 if you would like to arrange an appointment for a consultation with Dr Bambit.

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Tummy Tucks

ABDOMINOPLASTY, or “tummy tuck,” is a surgical procedure to remove excess skin and fat from the upper, middle and lower abdomen and to tighten the muscles of the abdominal wall.

The best candidates for abdominoplasty are men or women who are in good health and relatively good shape, but are bothered by a large fat deposit and/or loose abdominal skin that won’t respond to diet or exercise. The surgery is particularly helpful to women who, through multiple pregnancies, have stretched their abdominal muscles and skin beyond the point where they can return to normal.

If your fat deposits are limited to the area below the navel, you may require a less complex procedure called a partial abdominoplasty, also know as a mini tummy tuck. You may, on the other hand, benefit more from a complete abdominoplasty. Liposuction alone may be satisfactory. After careful assessment and discussion, Dr Bambit will recommend the procedure or treatment that, in her opinion, is most appropriate for you and addresses your main concerns regarding your body contour.

It is most important to note that this procedure does produce a permanent scar. The length of the scar depends on the extent of the original problem and the surgery required to correct it, and can extend from hip to hip. If you’re realistic in your expectations and prepared for the consequences of a permanent scar and a lengthy recovery period, abdominoplasty may be the procedure which will address your concerns and restore your figure.

Patients who intend to lose a lot of weight should postpone the surgery. Also, women who plan future pregnancies should wait, as vertical muscles in the abdomen that are tightened during surgery can separate again during pregnancy. During your initial consultation, Dr Bambit will evaluate your health, determine the extent of fat deposits in your abdominal region, and carefully assess your skin tone. Be frank in discussing your expectations. Dr Bambit will be equally frank with you, and will discuss the procedure and any alternatives, along with the risks and limitations of each. If, for example, your fat deposits are limited to the area below the navel, you may require a less complex procedure called a partial abdominoplasty; also know as a mini- tummy tuck, which can often be performed as a day procedure. You may, on the other hand, benefit more from a complete abdominoplasty, which may be done in conjunction with liposuction to remove fat deposits from the hips, producing a better body contour. Liposuction alone may be satisfactorily. After careful assessment and discussion, Dr Bambit will recommend the procedure or treatment that, in her opinion, is most appropriate for you and addresses your main concerns regarding your body contour.

INITIAL CONSULTATION
You should come to the consultation prepared to discuss your medical and surgical history. It is advisable to go over any medical and surgical records to refresh your memory prior to your meeting with Dr Bambit. Be sure to disclose any allergies that you may have, medical conditions, past illnesses, previous surgery and if you are a smoker. Please bring a list of any medications you are taking. This includes, vitamins, herbal supplements, over the counter medications, etc. It is important for you to provide complete information.

During your first consultation, Dr Bambit will take a thorough medical and surgical history and carry out a general medical assessment.

She will then ask you what your main concerns are and what you wish to achieve. It is important to discuss your expectations frankly.

Dr Bambit will examine your abdomen. Treatment recommendations will be tailored to your individual needs and desires.

Dr Bambit will explain any proposed procedure/s in depth, including any alternatives.

Dr Bambit will discuss:
Pre-operative preparation: medications to avoid, blood tests, chest x-ray & ECG (where indicated)
The Hospital
How the procedure is carried out: anaesthesia, incisions, the operation
What to expect: immediately after surgery, and during the first few days, weeks and months after surgery
Post-operative period: dressings, drain tubes, garment, medications, recovery time, activity, time required off work
Risks and potential complications
Limitations of the procedure: Dr Bambit will discuss the variables that may affect the procedure, such as your age, the size and shape of your abdomen, muscle tone and the condition of your skin.
Safety of the procedure
Fee structure and methods of payment: If the operation is being performed to alleviate medical complaints then there is a small medicare rebate for the surgery and anaesthetic; private health insurance will usually cover some of your hospital costs.

PREPARING FOR SURGERY
You will be given specific detailed pre-operative and post-operative instructions. These outline how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins, and medications.

You will be required to have some blood tests before surgery. This is to ensure that your haemoglobin and iron levels are optimal. Depending on your age and past history, you may also be asked to have an ECG and/or Chest xray.

You should not take any aspirin or anti-inflammatory medications (eg nurofen, naprosyn, etc) or high dose vitamin E for at least 2 weeks prior to any surgery.

You are advised to take Arnica tablets for 2 weeks before and 1 – 2 weeks after the procedure. Arnica is a natural and safe remedy which reduces post-operative bruising & swelling, and promotes healing.

If you are a smoker, you must cease smoking several weeks before your procedure and refrain from smoking post-operatively. Smoking greatly increases lack of blood supply and oxygen to the tissues and increases the risk of skin and tissue necrosis (death of skin and tissue), infection, poor or delayed healing and excessive scarring.

THE OPERATION
Complete abdominoplasty usually takes 3 ½ to 5 hours, depending on the extent of surgery required. Partial abdominoplasty may take 2 to 3 hours. Abdominoplasty is carried out under general anaesthesia and requires a minimum of one night’s stay.

Partial or “mini” abdominoplasty may be performed under intravenous sedation and local anaesthetic
Most commonly, a long incision will be made from hipbone to hipbone, just above the pubic area. A second incision is made around the belly button to free it from the surrounding skin and subcutaneous tissue. (The belly button is not removed, but is moved. It remains attached to its deep tissue connections.) Next, the layer of skin and fat is separated from the abdominal wall up to the lower border of the rib cage (ie the costal margin).This large skin flap is lifted to reveal the vertical muscles of the abdomen. These muscles are tightened by pulling them close together and stitching them into their new position. This provides a firmer abdominal wall and narrows the waistline.
The skin tissue flap is then stretched down and the excess skin is removed. A new hole is fashioned for your belly button, which is then stitched in place. Finally, the wound will be closed with 3 layers of stitches, dressings will be applied, and temporary drain tubes will be inserted to drain excess fluid from the surgical site.
With partial abdominoplasty, the incision is much shorter and the belly button may not be moved, although it may be pulled into an unnatural shape as the skin is tightened and stitched. In partial abdominoplasty, the skin is separated only between the incision line and the belly button. This skin flap is stretched down, the excess is removed, and the flap is stitched back into place. Most of the sutures used are dissolvable.

AFTER SURGERY

• As previously stated, you will be given detailed post-operative instructions along with Dr Bambit’s contact numbers.
• Depending on the extent of the surgery, you may be discharged the same day or you may have to remain hospitalized for one to three days. Moderate discomfort expected over the first 24 – 48 hours, subsiding over the week - relieved by oral painkillers.
• Moderate swelling & mild bruising.
• You will be given instructions for showering and changing your dressings. And though you may not be able to stand straight at first, you should start walking as soon as possible. Important to walk for at least 5 – 10 minutes per hour as soon as possible after your surgery.
• Rest - with regular light activity - is recommended for the first few days after surgery.
• Instructions for showering/bathing will be given.
• Resumption of normal daily activities over 1 – 2 weeks
• Exercise as tolerated is encouraged after 2 weeks
• Any non dissolvable sutures will be removed in 10 - 14 days.
• Pressure garment must be worn for several weeks.
• Return to work depends on the type of work you do, and varies from 1 to 6 weeks
• Post-operative follow-up routinely consists of 3 - 4 further appointments over a 12 month period.

ARE THERE ANY RISKS?
All surgery carries some uncertainty and risk

When performed by a doctor with experience in this procedure, complications are infrequent and are usually minor. However, individuals vary greatly in their anatomy, their physical reactions, and their healing abilities, and the outcome is never completely predictable or controllable.

Complications are unexpected problems that can arise during or after the procedure. Most people are not affected. However, in rare cases they can be severe and even fatal. All attempts are made to prevent complications and reduce risks by meticulous attention to surgical detail and technique along with adequate post-operative care and follow up.

Nevertheless, you must be informed about and understand both the general risks of any surgical procedure, the specific risks of the particular procedure/s, and any potential risks which may apply to you as an individual. It is also important to be aware of the “side effects” of a procedure that is what to expect in the way of bruising, discomfort etc. These expected sequelae are not classified as risks or complications.

This is a brief outline of some potential complications. I do not wish to alarm you but inform you. A detailed discussion of potential risks & complications will take place during a consultation, and you will be given further written information to read after a consultation.

MAJOR COMPLICATIONS OF ANY OPERATION

• Unexpected reaction to the anaesthetic
• Excessive bleeding during or after surgery
• Wound infection
• Developing a blood clot, usually in a vein in the leg (deep vein thrombosis) which may break off and travel to the lung (pulmonary embolus) which may be fatal This serious complication is less likely if you are up and walking as early as possible after your operation and if you wear special support stockings during the operation and in the early post-op phase. This risk is increased in smokers and those taking oral contraceptives.
• Increased risk in smokers and obese people of wound infection, chest infection, heart and lung complications, and thrombosis.

SPECIFIC COMPLICATIONS OF ABDOMINOPLASTY

• Scars: Abdominoplasty surgery always leaves permanent scars, but the severity of the scars varies from person to person and by the type of incision. Although red and swollen at first, scars typically fade over time. However, scars may remain very noticeable in some patients long after surgery. Sometimes the scars can be red, thick and itchy. Fortunately, the incisions usually can be limited to areas of the abdomen that can be covered by underpants or swimmers.
• After the operation, the abdominal skin will feel numb. This is usually temporary, lasting 6-12 months, but in some patients it lasts much longer or may be permanent.
  • Very rarely, there can also be numbness on the outer side of your thighs and sometimes this is permanent.
• Seroma and haematoma. Uncommonly, despite the use of drains, a collection of body fluid (seroma) or blood (haematoma) may build up under the skin. If this occurs it usually has to be removed with a needle and syringe.
• Wound breakdown Sometimes the wound will become infected or breakdown. This can result in skin loss which can require skin grafts. This is much more likely in smokers, which is why you should stop smoothing at least before and after the operation.
• Necrotising Fasciitis: Fortunately this very serious complication is very rare. It is an insidiously advancing soft tissue infection characterised by widespread tissue death, ie necrosis. It can occur after several different surgical procedures and can be fatal.

Before you decide to have surgery, think carefully about your expectations and discuss them with Dr Bambit. Please be sure to ask if there is anything about the procedure you don't understand.

“If you are considering Abdominoplasty I can certainly guide and advise you. I want your new shape to be as attractive and appropriate for you as possible. All surgical procedures have limitations. Therefore, if for any reason I feel that I am unable to fulfill your expectations I will tell you immediately. I look forward to meeting with you to discuss this procedure. Following consultation I encourage you to take as much time as you need to reach your decision, and either contact me or come and see me for further discussions if desired.” Dr Jayne Bambit