Australia’s specialist plastic surgeon with experience in:
- Breast Augmentation Mammoplasty & Recovery Technique
- Complicated Breast Revision Surgery & Internal Bra System
- Tuberous Breasts & Breast Asymmetry Corrections
- Comprehensive Understanding in Fat Grafting Technique
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with Dr Tavakoli
“As a plastic surgeon operating exclusively on the breast and body, including breast augmentation (mammoplasty) and breast lifting (mastopexy), I have been privileged to treat a large number of patients over multiple locations. Breast augmentation mammoplasty is a procedure that is often assumed to be ‘simple’ in nature but is actually quite complex. Precise pre-planning and meticulous surgery are essential in obtaining the patient’s desired results. Quality aftercare simply cannot be ignored; hence one of the main problems with travelling overseas for surgery with no follow up.”
Additional Breast Procedures offered by Dr Tavakoli Fracs
In certain women, simple breast augmentation (mammoplasty) may not produce the desired result. In these cases extra procedures can be undertaken by Dr Tavakoli in order to correct simple problems at the time of breast augmentation (mammoplasty). These conditions are detailed below:
Dr Tavakoli has developed a large practice specialising in Correction of Tuberous breasts deformities.
The Tuberous (snoopy or cone-shaped or constricted base) breast deformity is a rare entity affecting young women bilaterally or unilaterally. There are mild, moderate and severe grades of this condition. Women usually inherit this condition and when severe it can cause significant psychological issues.
The Tuberous deformity is characterised by a constricting ring of tissue at the base of the breast, which leads to deficient horizontal and vertical development of the breast with or without herniation of the breast tissue toward the nipple-areola complex and areola enlargement. Tuberous breasts are invariably asymmetrical in size in 90% of cases.
Interestingly enough pregnancy and rapid weight loss can convert Mildly tuberous breasts to Severely tuberous.
As you can imagine surgical correction is quite complex. The treatment in simple terms includes:
- Mild forms: Augmentation with Anatomical (teardrop) implants only
- Moderate & Severe forms: 3 procedures need to take place. Breast reduction and flap procedure to get an even breast thickness in ALL quadrants, Periareolar Breast Lift & Augmentation with anatomical (teardrop) implants. In some cases Fat Grafting may be needed at 6-12 months post-operatively to complete the transformation.
Medicare item numbers exist for this condition making correction of tuberous breast a reconstructive/corrective operation.
Click here to read the following CASE STUDY on this condition.
Click here to view Dr Tavakoli’s extensive Tuberous Correction Breast Gallery
The Von Heimburg classification describes 4 grades:
- Grade 1: hypoplasia lower medial quadrant
- Grade 2: hypoplasia of both lower quadrants with adequate areolar skin
- Grade 3: hypoplasia both lower quadrants with limited areolar skin
- Grade 4: hypoplasia of all quadrants
This is a very common problem (up to 80% of ALL women) as women seldom have identical breasts. Breast Asymmetry can be corrected in many ways. Implants can be used as well as Breast Lift procedures.
Dr Tavakoli uses different size implant for each breast in 25% of all his cases. Generally speaking Dr Tavakoli only corrects asymmetry of more than 1/4 cup size. Very slight breast asymmetry are recorded but best left untreated.
NB. Dr Tavakoli will advise if you need any extra procedures and explain the exact reason at the time of your initial consultation. The extra cost will also be discussed well in advance. Please note that only a properly specialised plastic surgeon can carry out these extra procedures combined with breast augmentation.
CT SCAN for asymmetry: Dr Tavakoli uses the latest technology when correcting high grade asymmetry. Prior to surgery you will have a CT scan of the breasts to measure the difference in volume or rib cage asymmetry. This allows Dr Tavakoli to select the correct implants and decide if Fat Grafting is required. All asymmetrical patients undergo intra-operative sizing by Dr Tavakoli.
Although mild cases of rib abnormalities are common in up to 25 % of my patients undergoing Breast Augmentation Surgery, more severe cases need special attention.
Pectus Excavatum is an abnormal development of the rib cage where the breastbone (sternum) caves in, resulting in a sunken chest wall deformity. Sometimes referred to as “funnel chest,” pectus excavatum is a deformity present at birth (congenital) that can be mild, moderate or severe. Pectus carinatum, also called “pigeon chest”, is a deformity of the chest characterized by a protrusion of the sternum and ribs.
There are many radical operative ways of treating this condition involving complicated and dangerous Thoracic Surgery to remodel the bone but I prefer to use breast implants in female patients to camouflage this condition as shown in the below case study of a 27 year old girl with severe pectus excavatum further complicated by breast ptosis (droopiness) after massive weight loss.
There are essentially 4 methods of breast lifting that I perform at the time of implant augmentation:
- Breast Augmentation for Slight droopyness
- Benelli (around areolar only) or Mini-breast lift for Mild Droopyness (ptosis) for very deflated breasts. Always with an implant
- Le Jour (lolly pop scar) or Major- breast lift for Moderate Droopyness (ptosis). Can be performed with or without implant
- Inverted T or Anchor Scar or Mega-breast lift for Severe Droopyness (ptosis)
A successful lift is determined not only by surgical technique; diagnosis and correct planning are equally as important.
Long “floppy” nipple condition usually occurs as a result of prolonged breast feeding. More commonly is seen in Asian patients. If not corrected the nipples can be quite obvious after breast augmentation as nipples can be seen protruding in tight T-shirts etc… Dr Tavakoli prefers to perform nipple operations in women who have finished with breast feeding duties.
Dr Tavakoli has a large referral base of women with poor breast augmentation outcome from other centres in Australia and New Zealand. These terrible complications or undesired outcomes are very rare in experienced hands but no plastic surgeon in the world including Dr Tavakoli has a zero complication rate.
Unfortunately in great majority of revisional cases patients are psychologically affected and counselling is required to help patients through the corrective surgery. Dr Tavakoli ‘s team can organise counselling for patients undergoing corrective breast surgery.
Dr Tavakoli has a great deal of experience in correcting post breast augmentation complications. Most of these unsatisfactory outcomes occur as a result of poor patient selection and inadequate surgical skills to deal with a difficult breast condition but other problems can occur as a result of poor healing and scarring of the patient. Please note that the fees/cost for corrective surgery are higher than primary breast augmentation.
Please note that although complications are uncommon in Breast augmentation surgery they can happen around of 5-7% cases. Please read the list below before your consultation as good knowledge of the complications allows Dr Tavakoli to complete the consultation and the informed consent.
Please note that all complications are greater in smokers and those that return to full gym activity too soon after breast augmentation surgery.
- Prolonged stiffness
- Poor wound healing (usually smokers)
- Capsular hardening or Capsulization or Capsular Contracture or High riding implants
- Excessive wrinkling or rippling
- Excessive Cleavage Gap
- Symmastia or “Mono-Breast” or “Uni-Boob” or “Kissing Implants”
- “Double-Bubble” effect
- Implant rotation
- Bottoming Out
- Ruptured Implants
- Keloid scars
- Stretch marks
This is the most serious complication of breast augmentation. A capsule or capsule formation is a layer of scar tissue that normally forms around any artificial material placed in the body. It is important to realize that this is the natural response of the body to foreign material. Most times this capsule is so soft that it is virtually undetectable and therefore does not affect the breast implant in any way. Capsular contracture or hardening occurs when this layer of scar tissue shrinks around the breast implant, squeezing it so that it starts to feel firm, or in some cases, quite hard. Most capsular contractures experienced today stem from the smooth shell silicone breast implants placed some years ago. The capsule contracture rate in the past was 30-35% (in the 1980′s breast implants).
With the onset of textured shell breast implants, the problem of capsular contracture has been significantly reduced, now being between 5%.
The cause of capsular contracture is not totally clear, but seems to be multifactorial. It is important to realise that there are degrees of contracture and that the majority of women, who do develop this hardening, develop it only to a mild extent. In the minority however, it may be severe enough to be bothersome, even painful and may cause distortion of the breast. The condition may occur in one or both breasts and to a different degree either side.
It may develop any time, even years later although it is most likely to happen in the first 3 years after surgery. Unfortunately at this time there is no effective way to prevent capsular contracture if it is going to occur. However as mentioned previously, encapsulation is no longer the problem that it was. Having mentioned all the above, it is important to note that capsular contracture is not in itself a health risk other than its possible interference with mammography.
Are the prostheses safe? Can they cause cancer?
In Australia and Europe current sales figures show a distribution of 90% silicone, 10% saline. As modern silicone gel implants have been available since 1963, surgeons therefore have over 35 years of experience with these types of breast implants. This is more than any other type in use. Evolution has brought changes and improvements over the years with the introduction of textured surface envelopes made of newer formulations designed to minimise the “bleed” or diffusion of what is usually tiny amounts of the silicone oil fraction of the gel contents.
Fat Grafting to treat rippling and implant visibility is a common procedure. In women with small amount of breast tissue and body fat the implant can be felt more around the edges and in some cases the implant can become visual in the cleavage area and lower pole of the breasts.
To treat this Dr Tavakoli performs fat grafting. The fat is removed from the tummy or thigh region and gets prepared for injection into area of rippling; this gives coverage to the area and disguises rippling and implant visibility. This procedure can be done during or after breast augmentation.
43 yo female, nil pregnancies, deep hollow cleavage, minimal body fat, 380cc anatomical (teardrop) high profile textured silicone gel implants, dual plane pocket. Fat grafting to the sternum 15mls.