Defects in the lower lip involving more than 50% of the lip need something more complex than a few sutures. In this case I have “borrowed” tissue (a flap) from the upper lip to repair the large lower lip defect following tumour excision. The bridge carrying the blood supply for the flap is left for 2 weeks. During this time the flap develops a new blood supply and the bridge can be safely divided.

Click on the link below to view the images from this procedure.

WARNING! This post contains images of a graphic nature.

Dr Stradwick would like to re-assure his patients that he only uses the highest quality implants for his patients.  He keeps meticulous records so any patient can contact the clinic and find out exactly what implant they have – even if they made the decision not to participate in the breast implant register.

In Dr Stradwick’s opinion the current controversy regarding PIP implants is a salient reminder of the inherent risks of breast augmentation.  All implants have a risk of rupture with an incidence of approximately 10% over a 10 year period.  This is not just a problem confined to PIP implants.  It does however highlight the vital importance of an ongoing relationship with your surgeon.  Dr Stradwick has written articles critical of “cosmetic tourism” and the the current PIP problem is yet another reason why the decision to have breast augmentation “on the cheap” is risky.  Who knows what kind of implants these overseas clinics are using?

The fallout of “Cosmetic Holidays”

As the head of the plastic surgery unit at the gold coast hospital Dr Stradwick is increasingly seeing the fallout from “cosmetic holidays”. He has a number of patients waiting on the public hospital waiting list for corrective procedures after “botched surgery”.

The overwhelming majority of problems following any cosmetic surgery but particularly breast augmentation occur in the weeks after surgery. The only real problem that happens in the first few days is bleeding – and this is relatively simple to correct. The other complications are usually much more difficult. Ensuring your surgeon is an Australian trained Plastic Surgeon is your first defence against problems. Australia has some of the toughest training and examination programs in the world. Anyone who makes it through a plastic surgery training program in Australia has to have achieved a certain standard. Other parts of the world are just not like that. Putting your trust in the hands of someone with an uncertain level of training is a risk

The other major issue is follow up. Who is going to look after you when you get home? The relationship between a surgeon and their patient continues indefinitely. Dr Stradwick’s own patients know that if any problems arise – even years down the track – he is there to help. Importantly such revisional work carries no or minimal additional costs for the patient.

However patients who have a procedure overseas have no choice but to find a local surgeon when problems occur. They are often alarmed at the costs of correcting “botched surgery” from a cosmetic holiday. Some end up on the public hospital waiting list because they only saved enough money for one operation.

These people are surprised when they discover that the cost of having the original procedure performed locally was about the same as overseas…

Plastic surgery takes origin from the Greek word plastikos – meaning to shape or mould. Plastic surgeons dedicate themselves to the restoration of shape and form. Such loss of form may be a result of birth defects, removal of cancers or accidents. They train for years to do this. By necessity plastic surgeons have a finely honed appreciation of shape and form, combining science with artistry on a daily basis. This places them in a unique position to perform cosmetic or aesthetic procedures that, in essence, are an enhancement of features that already exist.

A perfect example is breast reconstruction. The ability to create a beautiful breast from literally nothing allows a plastic surgeon to use those same skills to improve an existing breast. Similarly, being trained to rebuild a face transfers naturally to rhinoplasty. The same knowledge, skills and appreciation of form are required if you are building a feature or enhancing it. It is therefore of critical importance when considering any type of surgery to ensure your surgeon is appropriately qualified. An analogy I like to use is air travel. We all expect the person flying the plane is a trained pilot. After all, they are responsible for getting the passengers and the plane to the destination safely. How would it feel if we discovered the person at the pointy end was actually a bus driver having a bit of a go? The same applies for surgery. You need to make sure that your surgeon is qualified – not a ‘cowboy’.

Becoming a surgeon in Australia requires years of additional training and examinations – no shortcuts. The only way you can be sure your surgeon has completed this rigorous process is by looking for the letters FRACS. This denotes fellowship of the Royal Australasian College of Surgeons – the only recognised body for training surgeons. Not everyone can be accepted into surgical training and not everyone makes it through. It is a tough and competitive road. Australian surgeons are highly regarded around the world because the training is so intensive. If they make it through an Australian program you know they have met a high standard.

Unfortunately, some doctors need a shortcut. They may have not met the entry criteria to gain a place on an Australian surgical training program. Maybe they couldn’t make it through. Instead, they seek training outside the accepted pathways. Some spend time ‘observing’ overseas. Maybe they watch a few DVDs when they get back on the use of the term ‘surgeon’. The only protection from the rogue elements out there is to look for those letters FRACS.

Queensland is the first state to step up and attempt to regulate the cosmetic surgery industry by prohibiting the use of the term surgeon by those not properly trained. To wriggle around that problem ‘cowboys’ will usually use the term Dr, but then mention cosmetic surgery as their area of ‘specialty’. There will be reference to qualifications and membership of a college with lots of letters but if those letters don’t include FRACS then beware.

How would it feel if we discovered the person at the pointy end was actually a bus driver having a bit of a go? The same applies for surgery. You need to make sure that your surgeon is qualified – not a ‘cowboy’.

This is another good reason that the decision to have surgery overseas is a dangerous one. Apart from being a long way from home, other countries don’t have the same standards as Australia. There is no way you can be sure of the qualifications or level of experience of these people. Generally in life there are no free lunches. Overseas surgery is cheap for a reason – and it’s not  from their trip – what I like to call a DVD fellowship. Others receive training from ‘colleges’ that claim to train surgeons. Do not be fooled. If the doctor does not have the letters FRACS next to their name then they are not Australian-trained surgeons – it’s that simple.

Appallingly, in every other state apart from Queensland, a doctor can legally call themselves a surgeon despite having no formal surgical training or qualifications at all. How can this be, you ask?. If this was to occur in any other profession, let alone one where lives are at risk, there would be outrage. Imagine bus drivers being able to legally call themselves a pilot and trying to fly planes. Scary stuff. The government is promising to regulate this but so far only Queensland has any kind of restrictions the exchange rate. Too often Australian plastic surgeons end up correcting complications from poorly performed procedures. Unfortunately, victims find that the original ‘surgeon’ is missing in action when problems occur – especially because many complications of surgery can appear well after they have returned to Australia. Corrective surgery is usually difficult and often requires more than one operation and is inevitably much more expensive than if the surgery had been correctly performed in the first place.

Your best protection is to call the Australian Society of Plastic Surgeons and check that your doctor has the necessary qualifications. This society only accepts members who have completed the training and rigorous examinations to gain an FRACS in plastic surgery. For information call 1300 367 446.