Q&Awith plastic surgeon

& Q A

Tristan de Chalain PLASTIC SURGEON

What motivates clients to seek cosmetic surgery – is it vanity or poor self-esteem?

Almost everyone –man or woman –has stood in front ofthe mirror and fantasised about changingsome aspect oftheir appearance from the size or shape oftheir nose to the colour or cut oftheir hair. This isn’t vanity or due to low esteem –it’s just beinghuman!

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 backand 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 precedingsurgery. 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:

• Maskinggood defects after cancer resecti0n (e.g. skin grafts) • Amelioratingthe effects of traumas (e.g. scar revisions, broken noses etc).

Aesthetic:

• Body contouring(e.g.liposctions, tummy tucks, breast lifts etc) • Changingfacial features (e.g. noses, ageingfaces).

What is the difference between cosmetic and reconstructive surgery?

make good or repair damaged, missingor 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?

Amongthe 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-liftinginvolves 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.

What about appearance medicine such as Botox or collagen – where do they fit in with retaining youthfulness?

They are most commonly used in isolation in younger patients who don’t have an excess ofsaggy skin. However, they can also form part ofan overall treatment plan. The trickis in knowingwhen they have delivered all they can and it’s time to move on to 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 ofany surgery including bleeding, scarring, pain and discomfort. However, the pain and sensory changes do not last long and recovery is usually two weeks oflyinglow and sixweeks before resumingsport.

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 ageingface. Some opt for the eyes first, then face and/or mid-face. Ofcourse, doing it all together means only one recovery process!

Do clients ever become addicted to cosmetic surgery?

Yes, the plastic ‘surgiholic’ is well recognised.

How relieved or thankful are clients after having reconstruction or cosmetic surgery and are there ever any regrets?

The great majority are pleased and satisfied. Some are not entirely pleased and this is usually due to unmet expectations.

Can women breastfeed after a breast augmentation and also after a breast reduction?

After breast augmentation, yes; the augmentation does nothingto the breast tissues. On the other hand, dependingon the technique used, breast reduction cuts through the glands and milkducts and will reduce the chances ofsuccessful 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 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 tuckand nose re-shaping; 40s –as previous plus facial ageingchanges; 50s to 70s –facial ageingprocedures.

Do many people opt for surgery in countries such as Thailand?

Yes, foolishlyand often driven by cost. Cosmetic surgeryin NZ is dear but an unsatisfactoryprocedure, or one which has complications done abroad, can end up costingfarmore.

What are the positives and negatives of this and have you ever been consulted about an unsuccessful overseas surgery?

I and most ofmy colleagues are frequently consulted about adverse outcomes from cosmetic surgery undertaken overseas. The positives are that workdone abroad is often cheap; the negatives are that it is volume dealership/warehousestyle surgery rather than Smith & Caughey type surgery.

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 workout at about $5000 per hour. Arhinoplasty takes 2.5 to 4 hours; a mid-face lift, 2 hours; droopy brows and upper eyelids, 2 hours and so on.

Cosmetic surgery has become increasingly common with many women (and men) opting for procedures which rectify ‘flaws’. Some seek to defy the ageing process and preserve facial youthfulness, others wish to enhance the figure or perhaps change a feature which has bothered them for many years. Here, respected Auckland plastic surgeon, Tristan de Chalain, who consults at his Pukekohe rooms twice a month, addresses some frequently asked questions regarding elective cosmetic surgery.

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.