Gail is a 51-year-old operating theatre nurse with two small children. She decided some time ago that she was unhappy with the overall appearance of her face. After careful reflection and much research she went to see Sydney plastic surgeon Dr Kourosh Tavakoli.

‘I’d been thinking about getting something done for some time,’ says Gail. ‘I didn’t get married until I was 40 years old and so had my first child at 40 and my second at 43. Even though people used to tell me that I looked quite young for my age, I still felt that time had taken its toll. There were a few things about my face that I just didn’t like, especially around the mouth – the jowls were sagging a bit – and I’ve always hated my nose,’ she explains.

Many patients opt to undergo one procedure at a time but as a veteran theatre nurse Gail was experienced enough to know how to do her research and confident enough to undergo all the procedures she wanted at once.

‘I thought, if I’m having an operation on my face I might as well have everything I want done at the same time,’ she says.

Gail began her search for the right doctor by asking her colleagues for advice. ‘I knew a few doctors and I asked around for their recommendations,’ she says.

‘Then I looked up each doctor’s website and narrowed it down to just two, then saw both for a consultation. I chose Dr Tavakoli because he has a very good reputation.’

Nine months after her initial consultation, she returned to Dr Tavakoli and booked herself in for the surgery.
Dr Tavakoli perfomed a six-hour operation to rejuvenate her face and refine her nose, comprising a short scar facelift, upper and lower blepharoplasty, rhinoplasty, lip augmentation and finishing with Botox injections in her forehead.

Gail says she was very bruised immediately after the procedures but her profession had prepared her to expect this as a first result.

It’s now been five months since her surgery. She says an operation of this scope was bound to take some time to recover from and, though the recovery process has been a gradual one, it was well worth it.

‘When I look at myself now I’m really pleased with the result,’ she says.

However, it wasn’t until she saw Dr Tavakoli’s final set of ‘after’ photos that she realised the full extent of the dramatic changes to her appearance.

‘People I haven’t seen in a long time know there’s something different but can’t quite put their finger on what’s changed. That’s a good thing! I didn’t want to look like someone else – I still wanted to look like me but maybe better, or younger and healthier,’ Gail says.

‘Dr Tavakoli’s work on my nose was very subtle, but I really like the result. I have no regrets, I’d do it all over again!’

Sydney plastic surgeon Dr Kourosh Tavakoli outlines the options involved with mastopexy, or breast lifting, procedures. Francis Herron reports.

Breast ptosis, or droopiness, is a condition that can affect women of all ages, says Sydney plastic surgeon Dr Kourosh Tavakoli. ‘Although we tend to associate breast ptosis with older women, young women also often suffer varying degrees of droopiness after breastfeeding or significant weight loss. For these women, wearing a supportive bra can disguise but not correct the problem.’

With the increasing acceptance of cosmetic surgery procedures by the general population, more and more women are choosing to undergo corrective surgery on their breasts to achieve a more aesthetically pleasing appearance, Dr Tavakoli says.

Aesthetic plastic surgery of the breast involves a number of procedures that range from simple augmentation to more complex breast lifting, he explains. Mastopexy, or a lift, can be performed as a stand-alone procedure or combined with augmentation using implants. Breast reduction (mammoplasty) is in fact a form of breast lifting associated with removing breast tissue.

Due to the variation of breast shapes and conditions, a skilled plastic surgeon understands that simply using breast implants alone will not always produce aesthetically pleasing results. A decision about which procedure or combination of procedures best suits an individual must be made taking into account several factors. Assessing breast volume and shape, the condition and elasticity of the patient’s skin and the position of their nipples is crucial to the surgeon’s ability to obtain a good result.

Although augmenting breasts by inserting implants can correct some minor drooping, the issues relating to nipple position and an excessive skin envelope cannot be addressed by augmentation alone.

Mastopexy, on the other hand, does not change the amount of breast tissue a woman has, but it can change the shape dramatically, which in turn can affect the overall breast size and projection.

Breast-lift surgery restores breast shape to a more youthful appearance by reshaping the breast tissue, removing excess skin and relocating the position of the nipple-areola complex. Breast tissue must be surgically contoured from an elongated shape into a more youthful Sydney plastic surgeon Dr Kourosh Tavakoli outlines the options involved with mastopexy, or breast lifting, procedures. Francis Herron reports. conical structure. This manoeuvre is an integral part of the breast remodelling process.

Dr Tavakoli says three types of incisions can be used. These include making an oval-shaped incision around the nipple-areola complex (Benelli-Goes) in mild cases, a lollypop-shaped incision from the areola to the breast crease (Le Jour-Hammond) for most cases or the traditional anchor-shaped incision (Wise pattern) that also includes the breast crease for severe cases of droopiness.

‘Modern plastic surgery focuses on creating a minimal scar in return for achieving the most desirable aesthetic outcome,’ he says. ‘The prospective patient should be aware of this delicate balance before embarking on a mastopexy procedure.’ Some degree of scarring is inevitable in mastopexy surgery.

Accepting the scarring associated with mastopexy is a real concern for some patients, although fractionated laser scar therapy in the post-operative period has contributed immensely to superior scar formation.

In some cases, breast lifting needs to be combined with the insertion of implants to produce an optimal result. The combined breast lift and augmentation procedure is considered one of the more difficult operations in plastic surgery. It can be performed in a single procedure but is more usually undertaken in two stages.

Patients must stop smoking for at least four to six weeks before and after the operation, he advises.

‘Mastopexy is not usually a painful operation, but discomfort can persist for a week or so,’ he says. ‘Patients will need 10 to 14 days off work after this procedure for recovery and healing.’

‘Mastopexy can be a very rewarding procedure for women seeking to correct drooping breasts,’ says Dr Tavakoli. ‘Prospective patients should inform themselves about the procedure and discuss the operation and its projected outcomes thoroughly with their surgeon.’