Where there's a will...
I first met Sarah in the spring of 2005. Sarah’s story is not that unusual. She was 62 years old and, like many of us, the years had ticked by all too fast. A career in local body politics had been shelved when her children arrived and the next 25 years were devoted to family matters. At one time she had been proud of her appearance, enjoying the social life her job had to offer, but somehow time for herself has waned and her weight had steadily increased. Eventually, the last of her children left home and a chance meeting with an old friend raised the possibility of returning to the workforce. Of course she would leap at the opportunity – she didn’t feel any older than 25 and was sure she had plenty of enthusiasm to offer a new job. However, she knew that on the outside she wasn’t the girl she used to be. This is where Sarah’s story differs from the norm.
Sarah came to see me to try and regain some of what she had lost. We discussed what could be achieved surgically. A raft of possibilities existed including tummy tuck, facelift, liposuction etc but it was clear that what she really needed to do first was lose some weight. We estimated that she was about 15kg above her ideal weight. Our first meeting ended on this advice.
To my surprise Sarah returned a year later. She had taken on what we had discussed, changed her lifestyle, changed her diet, began to exercise again and had lost weight.
She hadn’t quite managed the 15kg but a little over 10kg had been shed. She said she felt much better, she had more energy, had stopped needing medication for high blood pressure and her borderline diabetes was gone. Now she wanted to complete her makeover. A much-loved ball-gown from some years ago was produced. “I would really love to fit this once again”.
We decided on a plan. This summer it would be tummy tuck followed by a facelift and eyelid surgery. Next year would be an arm and breast lift.
So far the plan is working out well. She says that the old Sarah is emerging again. The improvement in her self confidence and happiness is remarkable. I have a feeling I won’t see her much more. She is back in the workforce and busy with her new life. I suspect there may not be time for stage two.
Sarah is not alone in her desires to regain her old self. In fact most of our patients have similar feelings. For some it is a dislike of what nature provided, for others it is a dislike of what the years have taken away. Many can be helped by plastic surgery. For some, like Sarah, it is a partnership of lifestyle change and surgery. For most, surgery alone is suitable. What is common to all is that they make the step to do something about it. Many have thought about it for years but have found the idea of a consultation too daunting.
When they finally take the step they realise it wasn’t as hard as they thought and they leave with a smile on their face.
So the message is clear. You are never too young or old to change. What you need is the will to do something about it. Whether it is a change of lifestyle or surgery, you won’t regret it.
At the New Zealand Institute of Plastic and Cosmetic Surgery we want you to feel comfortable about your choices. A consultation is the first step towards change and does not commit you to a decision. As a first step, our nurses have a wealth of knowledge and are available for informal consultations in person or by phone.
Written by Glenn Bartlett FRACS.
www.plasticsurgeons.co.nz/our-surgeons/glenn-bartlett.html
For a consultation phone 09 529 5783.
Skype your consultation
In an Institute first, Mr Glenn Bartlett was involved in a virtual Skype consultation. The patient’s partner was able to participate in the consultation using a computer and webcam over Skype. This allowed the patient to attend the consultation whilst her husband, who was several hundred kilometres away caring for their young children, was still able to be part of the consultative process.
No doubt with the advent of even newer methods of internet communications this type of process will become more common in the future and certainly we can see the advantages, particularly in allowing distant partners to be involved in consultations.
Plastic Surgery Nurses Symposium
This symposium is an annual event convened by Karen Baker, the Institute Coordinator at the New Zealand Institute of Plastic and Cosmetic Surgery and organised by the Institute and Obex Medical.
This year, the 6th, was held at the Novotel Hotel in Ellerslie and was attended by a record 200 plastic surgery nurse delegates from all around New Zealand. Speakers who included medical professionals, nurses and a motivational expert covered a variety of plastic, aesthetic and reconstructive topics.
Karen Coubray, a staff member of the New Zealand Institute of Plastic and Cosmetic Surgery presented a paper on micropigmentation (tattooing) of the nipple areola following breast reconstruction. This is the final stage of breast reconstruction and finishes the process of turning a reconstructed breast into a natural looking breast.
Two of our surgeons, Mr Glenn Bartlett and Mr Stephen Gilbert spoke. Glenn Bartlett, who is also a consultant at Middlemore Hospital gave two presentations, one on craniofacial surgery and the second on aesthetic eyelid surgery. Stephen Gilbert spoke on the changes in face lifting surgery over time.
Something new this year was the “Medical Trash to Something Flash” competition, nurses competed to turn the waste generated by their practices into something spectacular. “Fern”, the glamorous creation of the staff of the New Zealand Institute of Plastic and Cosmetic Surgery won first prize. All of the entries were stunning and symposium attendees look forward to another challenge next year.
Surgeons report Mr Glenn Bartlett
As summer nears, many of us will look to shed the accumulated weight of the winter comfort food.
There is no doubt that regular exercise and a healthy diet are the best prescription for weight loss and a trim figure, yet many of us find that there are areas of fat deposition that seem to defy our best efforts. In men this is often around the beltline and male breast, whereas for women the hips, thighs, saddlebags and buttocks are often the culprit. This is where body contouring surgery is of benefit.
At the New Zealand Institute of Plastic and Cosmetic Surgery our surgeons have extensive experience in all methods of body contouring including liposuction, tummy tucks, arm reduction, thigh lifts and body lifting procedures.
Liposuction has received much media exposure – often portrayed as a simple procedure lacking in sophistication. The reality is somewhat different. Performed properly it is a highly effective and refined technique requiring the skilled eye and attention to detail of a Plastic Surgeon to achieve optimum contour without dimpling or irregularities.
In addition to traditional liposuction we have utilised ultrasonic assisted liposuction since its introduction in the mid-nineties, finding it particularly useful for more fibrous areas or for revisional treatment. Recently modified and renamed as the VASER machine, this technology offers the same advantages of less bruising and is a useful adjunct to liposuction.
In many instances a fatty deposit is associated with laxity of skin that requires removal of both skin and fat. The commonest example is a tummy tuck where skin laxity following childbirth has never resolved. There have been significant advances in such “lifting” procedures over the past 5 years, often combined with liposuction to offer improved contour with faster recovery. After a significant weight loss, or after weight loss surgery, the shape of the body can change dramatically due to the extra skin. Body lifting procedures can be quite transforming for such people, and many of these techniques are directly applicable to those with more modest weight loss associated with adoption of a healthier lifestyle.
Our specialist Plastic Surgery nurses offer free no obligation consultations and can explain procedures, costs and recovery before you decide to see a surgeon.
GLENN BARTLETT
Overseas Nip Tucks Attacked
A young woman has told of her heartache at spending thousands of dollars on a nose job in Thailand – only to be told by a Kiwi plastic surgeon that in his opinion the operation was a “sham”.
The 24 year old, who declined to be named, said she wanted her nose made smaller and a bump removed but in her opinion there was no difference after her operation.
“I went over there, I paid the money, I made it very clear what I wanted and the surgeon didn’t speak English very well”
“He performed very unsatisfactory surgery. My nose looked pretty much the same … there’s very little done.”
She said she “immediately knew something was wrong” after the procedure, when she woke up vomiting and in pain.
“I kept asking the nurses for medicine but none of them knew what I was saying.”
“I asked repeatedly, I made it very clear that I was sick, I threw up about seven times. They kept saying 'no understand, no understand.’
The woman claims the agency that arranged the operation – Beautiful Escapes – has ignored her complaints and she is taking it to the Disputes Tribunal. But agency director Jane Horgan said the woman got the operation she asked for.
“She hasn’t had a botch-up. With plastic surgery, especially nose surgery, obviously expectations can be different, but in this particular case what she asked for is just what she got.”
No other clients had reported problems and she was “looking forward” to the tribunal because there was a “night and day” difference in her client’s nose.
The woman said she spent $4000 for the surgery and another $3500 on extras such as accommodation. She said the procedure would have cost $10,000 in New Zealand.
Auckland plastic surgeon Mr Glenn Bartlett, who examined her nose on her return, said he believed the Thai surgeon was “out of his depth” and, in his opinion, “she’s just had a sham operation, basically.”
Bartlett performs private operations but also works in the public sector at Middlemore Hospital.
He said four patients had arrived at the hospital in the past three months after botched operations overseas and warned Kiwis to be very wary of “cosmetic tourism”.
Three were admitted with infections that could place them at risk of a flesh-eating bug or septicaemia and the fourth needed reassurance about their surgery.
He said that based on some of the cases he had seen, it seemed that some overseas surgeons had inadequate training and performed operations that were unsuitable for the patient.
(The New Zealand Herald, 17 August 2008)
14th Annual Aesthetic Surgery Workshop
The surgeons from New Zealand Institute of Plastic and Cosmetic Surgery - Glenn Bartlett, Stephen Gilbert and Janek Januszkiewicz attended the 14th Annual Aesthetic Surgery Workshop organised by the Melbourne Institute of Plastic Surgery over the weekend of 12, 13, 14 February.
Invited speakers at this Conference included Mr Richard Warren from Vancouver Canada and Mr Alain Fogli from Marseille, France, both internationally recognised leaders in the field of aesthetic facial and breast surgery.
Points of interest from the conference included -
A general acceptance of the principles of volumetric face lifting aiming to restore volume to the eyelids and cheeks and in particular to restore a youthful appearance.
Techniques of lipostructure (fat grafting by injection).
Concentric malar lifting and lifting of the malar fat pad showing significant improvements over the techniques of the past.
General refinements to the techniques of neck and face lifting continue to be made with modifications to existing techniques, the use of newer techniques of suspension of the brow and approaches to the neck utilising less incisions.
In the field of breast surgery recognition of the benefits of multiplanar approaches to breast augmentation allow for more individualised results appropriate to each patientÂ’s breast shape, body shape and chest wall shape. We now have the options of implants beneath the breast, beneath the chest wall fascia, beneath the chest wall muscle and combinations of these three.
It was encouraging for our surgeons to note that many of the techniques that they are using have been following these international trends and that approaches to facial and breast rejuvenation in our Institute mimic many of the approaches of the surgeons in France and Canada.
Once again this was felt to be a very useful workshop and certainly several new techniques will be introduced into our own practices over the next few months.
