Q&A What motivates clients to seek cosmetic surgery – is it vanity or poor self-esteem? Almost everyone – man or woman – has stood in front of the mirror and fantasised about changing some aspect of their appearance from the size or shape of their nose to the colour or cut of their hair. This isn’t vanity or due to low esteem – it’s just being human! As a surgeon, you must examine many so called ‘flaws’ and, subsequently, promise to fix them – can you truthfully do so? In many cases, yes. For example, prominent ears can be set back and saggy, over-large breasts can be reduced or lifted. Where outcomes are likely to be more marginal I offer a guarded prognosis. Better to under promise, then over-deliver! Is cosmetic surgery safe? Relatively, yes. It is only carried out on healthy people and there is always a full discussion on risks preceding surgery. Cosmetic surgery is not trivial and I, my anaesthetist and nursing colleagues take patient safety very seriously. What are some of the most common types of surgery requested? Plastic surgery falls into two different categories – Reconstructive: • Masking good defects after cancer resecti0n (e.g. skin grafts) • Ameliorating the effects of traumas (e.g. scar revisions, broken noses etc). Aesthetic: • Body contouring (e.g.liposctions, tummy tucks, breast lifts etc) • Changing facial features (e.g. noses, ageing faces). What is the difference between cosmetic and reconstructive surgery? Reconstructive surgery aims to
8 | south | october 2020
Tristan de Chalain PL ASTIC SURGEON
make good or repair damaged, missing or deformed tissue. Cosmetic surgery aims to improve normal (albeit undesirable) tissues or features. In many cases both aspects may be required. What is the most requested cosmetic procedures? Among the most asked for are corrective or droopy upper eyelids, breast reduction and augmentation. Is a full facelift the only answer to softening/eliminating facial wrinkles and flaws? No, face-lifting involves a suite of possible procedures some surgical and some non-surgical – each face is different. The surgeon analyses the specific concerns and, in consultation with the patient, recommends a plan to address these concerns.
and recovery is usually two weeks of lying low and six weeks before resuming sport. Can enhancements be done in stages and, if so, what do most people opt for first if considering more than one procedure? Yes, they can. As to which is first depends on what one most wishes to change on the ageing face. Some opt for the eyes first, then face and/or mid-face. Of course, doing it all together means only one recovery process! Do clients ever become addicted to cosmetic surgery? Yes, the plastic ‘surgiholic’ is well recognised.
only 10-15% and most commonly requested treatments are for gynaecomastia (man boobs) and facial ageing. At what age do women generally start considering cosmetic surgery? It depends on the problem: Teens – prominent ears, breast augmentation or reduction, nose re-shaping, and liposuction; 20s – Botox, fillers, breast, lips and nose surgery; 30s – liposuction, breast lift, tummy tuck and nose re-shaping; 40s – as previous plus facial ageing changes; 50s to 70s – facial ageing procedures. Do many people opt for surgery in countries such as Thailand?
How relieved or thankful are clients after having reconstruction or cosmetic surgery and are there ever any regrets?
Yes, foolishly and often driven by cost. Cosmetic surgery in NZ is dear but an unsatisfactory procedure, or one which has complications done abroad, can end up costing far more.
What about appearance medicine such as Botox or collagen – where do they fit in with retaining youthfulness?
The great majority are pleased and satisfied. Some are not entirely pleased and this is usually due to unmet expectations.
What are the positives and negatives of this and have you ever been consulted about an unsuccessful overseas surgery?
They are most commonly used in isolation in younger patients who don’t have an excess of saggy skin. However, they can also form part of an overall treatment plan. The trick is in knowing when they have delivered all they can and it’s time to move on to surgery.
Can women breastfeed after a breast augmentation and also after a breast reduction?
I and most of my colleagues are frequently consulted about adverse outcomes from cosmetic surgery undertaken overseas. The positives are that work done abroad is often cheap; the negatives are that it is volume dealership/warehousestyle surgery rather than Smith & Caughey type surgery.
How many years can be taken ‘off the face’ when having a facelift or complementary procedure? Again, it depends on the individual, but five to 10 years is a general average. Is cosmetic surgery painful and how long is recovery? Cosmetic surgery is not trivial or necessarily ‘minor’ surgery. It is real surgery with the attendant risks of any surgery including bleeding, scarring, pain and discomfort. However, the pain and sensory changes do not last long
After breast augmentation, yes; the augmentation does nothing to the breast tissues. On the other hand, depending on the technique used, breast reduction cuts through the glands and milk ducts and will reduce the chances of successful breastfeeding. Have you every advised a patient against a particular request? Yes, some requests are simply not achievable, nonsensical or not in the patient’s best interests. Do many men request cosmetic surgery and if so what do they most commonly ask for? Men do request aesthetic surgery but at a lower rate than women. Of every 100 patients, men make up
Has cosmetic surgery become more affordable or are people ‘going for it’ because finance is readily available? Both, I think. It’s definitely become more socially acceptable and financially accessible. Can you provide a ballpark figure for some of the most popular procedures? Total costs work out at about $5000 per hour. A rhinoplasty takes 2.5 to 4 hours; a mid-face lift, 2 hours; droopy brows and upper eyelids, 2 hours and so on. www.southmagazine.co.nz
