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Providing cosmetic surgery in Subiaco and Perth. The Plastic Surgery Centre in Subiaco, Perth provides a wide range of cosmetic surgery treatments including breast implants, breast reduction, rhinoplasty (nose jobs), liposuction, skin peels and microdermabrasion Providing breast, facial, body and non-surgical beauty treatments in Perth. Cosmetic Surgeons Perth - Members of the Australian Social of Plastic Surgeons Download your Patient Medical History form that you can bring to your appointment Media Centre - Cosmetic surgery articles and special offers from the Western Australian Plastic Surgery Centre in Subiaco Cosmetic Surgery in Subiaco and Perth - Providing breast implants, breast reductions, rhinoplasty (nose surgery), tummy tucks and facelifts.
Providing cosmetic surgery in Subiaco and Perth. The Western Australia Plastic Surgery Centre in Subiaco, Perth provides a wide range of cosmetic surgery treatments including breast implants, breast reduction, rhinoplasty (nose jobs), tummy tucks and facelifts.

 Reconstructive surgery

Other Flaps

Sometimes your surgeon will suggest using a Latissimus Dorsi muscle and skin flap from the back to provide a greater quantity of skin. These flaps usually (but not always) need an implant to add sufficient bulk. They produce a scar on the back, which can be very visible, and a slight hollowing under the shoulder blade. However, this operation is often the best reconstruction for women who have had the older, more radical type of mastectomy where the surgeon has removed the pectoral muscle on the front of the chest, as the Latissimus muscle acts as a replacement.

In other cases where abdominal tissue is unsatisfactory, it may be possible to use similar tissue from either the buttock or upper hip areas, although this may cause some visual imbalance in the donor area. The first of these is called the Gluteal flap, taken from the upper, middle or lower parts of the buttock. Usually it is necessary to take some of the gluteus muscle with the skin and fat, which may have a weakening effect on the muscle (usually only of importance to women involved in athletic pursuits.) Most suitable for the Gluteal free flap are younger women who have had no chilMren, and thus have tighter and flatter tummies, and particularly those women who are having a subcutaneous mastectomy or partial mastectomy. Note though, that the Gluteal flap has a much higher failure rate, as high as 20%, and is not routinely recommended. As well, it is usually necessary to take a segment of vein from one leg as a vein graft, to allow the blood vessels to stretch to the armpit, as the vessels in the Gluteal flap are usually too short to reach. This will produce a scar or scars on the patients leg. All these matters should be fully discussed with your surgeon.

Another flap occasionally used is the roll of skin and fat on the upper hip area, commonly called the love handle area. This procedure is usually reserved for women in whom the abdomen or buttock is for some reason unsatisfactory, as hip tissue may be less than ideal in terms of breast shape, and it will also create a difference in the shape of one hip.

Tissue Expansion

In some patients it is possible to place an empty silicone bag under the skin of the mastectomy area, usually also under the muscle of the chest wall, which has a small valve attached and concealed under the skin. This first operation usually takes less than an hour. The bag or expander is usually partly filled at the time of surgery with sterile saline solution, then gradually further expanded over the course of several weeks or months with a once or twice-weekly injection through the skin into the valve, to pump up the expander. Often the expander is inflated deliberately to a size much larger than the normal breast, stretching the skin more into a better shape. After a defined period, from several weeks to months, another operation is performed to replace the expander with a permanent implant, either saline-filled or silicone gel-filled. The second operation is usually also short less than one hour.

A good tissue-expanded breast reconstruction may look very like the other breast in the vertical position, but will not fall naturally to the side when lying down, or fall forward when leaning forward. Further, the texture is never quite normal, usually feeling firmer than the other breast, occasionally with a a rippled effect under the fingers. Note that permanent implants can not be considered as lifetime devices and may require replacement in the future, but it is sometimes possible to replace an old implant with your own tissue.

Patients suitable for the tissue expansion and implant method might be those requesting immediate reconstruction at the time of mastectomy (especially young women with little loose abdominal tissue), patients having bilateral mastectomies, and those who cannot accept the restrictions on heavy lifting and other activity, associated with the abdominal procedure. The operation might also be more suitable for patients with a high risk of developing breast cancer, who elect to have subcutaneous mastectomy, preserving the nipple.

The Best Option

Choice of procedure will depend on many factors, including age, state of health, size and shape of opposite breast, sufficiency of loose abdominal skin etc. Your surgeon will discuss this with you and recommend the best option in your own case. Not all patients are suitable for microsurgery, and in some instances the use of tissue expanders and implants may be the best way to go. In other cases, the Latissimus Dorsi flap may have advantages. It is wise to be guided by your surgeon in these matters.

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Providing cosmetic surgery in Subiaco and Perth. We provide breast implants, breast reductions, facelifts, liposuction and tummy tucks.


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