Contents

Breast Enlargement
- A 30 Year Perspective

Dr Hodgkinson has performed thousands of these procedures over the last three decades

A Letter from Dr Hodgkinson

The Doctor is in!

“I work out at the gym, eat well, but my chest is still flabby. What can I do about it?”

Breast Lift & Reduction: Sought-after Procedures

Dr Hodgkinson gives you the background on these popular operations

Tummy Tucks (Abdominoplasties)

Dr Darryl Hodgkinson explains the procedure

Liposculpture focuses on body shape, not just removing fat

New Staff Member at CRSC

Tania Dalamangas, an enrolled nurse, has joined us

Operation Restore Hope has completed three surgical missions this year

Surgery for nearly 200 children so far

Breast Enlargement -
A 30 Year Perspective

I have been performing Breast Augmentation Surgery for the last 30 years, and of the thousands of patients for whom I have carried it out, I am still convinced that for the majority this operation gives as much satisfaction as any plastic surgical or cosmetic surgical procedure.

However, with caution, I realize that a small percentage of women will be dissatisfied with the procedure as they have unfortunate complications associated with having an implant in their bodies. Fortunately, over the years, the implants have definitely improved and newer ones seem to be being trialled all the time, to make them even better.

New products show promise

As yet we do not have a perfect product, but it may well be that the new titanium coated gel implant will actually reduce the complication of capsular contracture around the implants, which is currently the biggest “bugbear” of the operation.

The new gel implants are cohesive and this means if they break the gel, which is contained within the implant, cannot migrate too far into the breast tissues.

Saline implants popular

Saline implants are also very popular at my practice. I first began using saline implants prior to the breast implant moratorium that was placed on gel implants in 1992. However, silicone gel implants serve my patients very well because most them are primarily interested in going from an A to a C or C+ result. So generally the size chosen is in the 280 cc to 350 cc range.

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Before and after breast augmentation with saline implants by Dr Hodgkinson

Before and after breast augmentation with saline implants by Dr Hodgkinson

Many patients these days are highly health conscious and do not wish to have anything other than the “safest” implant in their bodies. Although saline and gel implants have the same rate of breakage, it is important to understand that it is more difficult to detect when a gel implant is broken. If a gel implant ruptures, it is much more difficult to remove the gel from the tissues.

In contradistinction to the gel implant, it is very easy to know when the saline implant is broken as the implant deflates and the body has intravenous fluid absorbed into it, without damage being caused to breast or surrounding tissues. The patient is immediately aware of this happening and can have the broken or ruptured implant replaced.

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A Letter from
Dr Hodgkinson

In contrast to these more drastic surgical procedures is Liposuction, which I have now been performing for nearly three decades.

Sincerely yours,

Dr Darryl J. Hodgkinson
M.B. MS. (Hons) F.R.C.S.(C) F.A.C.S.

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Our Body Contour Issue

Perhaps the greatest area of growth in aesthetic surgery today and something which will definitely continue into the future, is Body Contour Surgery.

In part, this is due to a patient population which suffers so much from being overweight. The increased popularity of stomach stapling and intestinal bypass, now performed endoscopically by our general surgical colleagues means that there is an ever-increasing number of patients who have lost considerable weight, namely 25 kg to 40 kg and need to have the excess skin removed.

Procedures such as Arm Plasty, Thigh Lift, and Body Lifts were relatively uncommon 15 years ago but now are often requested.

Patients undergoing these procedures need to be aware of the increased expenses down the track, when the loss of weight translates to sheets of sagging skin which need to be neatly and cosmetically removed. Of course, scarring results and this must be clearly understood by body contour patients.

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Dr Hodgkinson answers your questions

Q: “I work out at the gym, eat well, but my chest is still flabby. What can I do about it?”

Dr Hodgkinson answers:

Men of all ages can be embarrassed by excess fatty tissue in the chest area, and may be reluctant to wear tight-fitting shirts because this accentuates the problem. This condition (gynaecomastia) affects an estimated 40-60% of all men and cannot always be corrected by dieting or exercise alone.

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The good news is that the excess fatty tissue can now be removed surgically in conjunction with liposculpture. The procedure is carried out on an outpatient basis in our Double Bay Day Surgery and usually takes around an hour and a half to complete. Patients report a high level of satisfaction with the results.

Before and After Surgery for Gynaecomastia
by Dr Hodgkinson

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Breast Lift and Reduction: Sought-after Procedures

Dr Hodgkinson gives you the background on these popular operations

Breast lift and/or Breast Reduction is very popular in larger breasted women (over DD) or women with significant sagging of their breasts, where the nipple points to the ground.

Many of these patients suffer from back strain, neck pain, notching of the shoulders and a skin rash under their breasts, especially during the summer.

The procedures of Breast Lifting (Mastopexy) and Breast Reduction have been sought after by women ever since plastic surgery became a defined field in private practice after World War I. For nearly 80 years, we have been refining these operations. It is always necessary to have an incision around the nipple areola complex, in order to lift a “sad” nipple areola area.

Teenagers with parental support choose this procedure for the same reasons as older women but also to allow them to play sports and wear more fashionable clothing.

An Outpatient Procedure

All the breast procedures that I perform are carried out under a light general anaesthetic on an outpatient surgical basis. We find that patients usually need approximately 5 to 7 days off work for a breast enhancement and 10 to 14 days off work and activities for a breast reduction and lift.

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Drooping breasts improved by breast lifting performed by Dr Hodgkinson

Drooping breasts improved by breast reduction performed by Dr Hodgkinson

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Tummy Tucks (Abdominoplasties)

Dr Darryl Hodgkinson explains the procedure

For most women, after one or two pregnancies, the abdominal wall is stretched, and the abdominal muscles lose their tone and are pushed apart.

The abdominal skin often has stretch marks and hangs in sheets over the pants and then rolls when the patient bends over or sits down. The belly button may also distorted in shape and may have an associated hernia; patients often think of it as a “sad” belly button. Women can be distressed because clothes that they might have worn prior to pregnancy are no longer available to them and they wish to return to their shape prior to pregnancy.

Old scar can be used

Many patients have had a Caesarean Section and already have a horizontal line in their bikini area, where the old scar has healed. This can be used for access to the abdominal wall for tightening of the abdominal muscles, repair of hernias, removal of extra skin and also liposuction. The belly button is reconstructed at the same time.

I often combine a breast lift and augmentation with liposuction to complete the “Mummy Makeover”..

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Liposculpture focuses on body shape, not just removing fat

I have been performing Liposculpture since the early 1990s, focusing on the shape of the body rather than the volume of fat suctioned from the patient.

We now try to give a patient the best possible figure or in a male, the best possible muscular torso, using Liposculpture, specifically ultrasonic and reciprocating power instrumentation.

Much more thorough

These newer procedures are much more thorough than previously and by the assessment of a patient’s skeletal base, muscular development, skin tissue and fat content, we can design a procedure to give an optimal shape with Liposculpture.

Beware of “quick fix” no surgery injection techniques such as Lipolysis and Mesotherapy which offer little control and often leads to dissatisfaction in patients. We do not favour this mode of therapy for significant lipodystrophy.

Outpatient basis

All Liposculpture is performed on an outpatient surgical basis and up to 5 litres of pure fat can be safely removed from a healthy patient. Patients must wear a customized vest or garment for two to four weeks which is far more comfortable than bandages and allows patients to return to work in 3 to 5 days or to full activities in 3 to 4 weeks.

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Operation Restore Hope has completed three surgical missions this year

Operation Restore Hope Australia has already completed three surgical missions this year, providing surgery for nearly 200 children so far and dental work, health care and speech pathology for many more.

So much has been done but there is much more to do. Why not help a special child by becoming a member or making a donation payable to Operation Restore Hope Australia. You can download brochures, membership forms from our website www.operationrestorehope.org or phone us on 02 9362 7480 to leave your details and one of our volunteers will call you back.

Everyone is happy baby Benjie will have his cleft lip repaired (his lip was fixed in April 2007 and he’ll have his palate repaired in 2008). With Benjie are our volunteers Hector, an NZ nurse and Chris, an anaesthetist from AUS.