Ask the Specialist Plastic Surgeon - Dr Hunt Answers your Patient Questions

Q – I’m 56 years old and now classified as overweight. I became overweight with menopause and literally my breasts grew bigger and more painful over an 8 year period. I’m desperate to have a breast reduction. Not only can’t I run but I visit a chiropractor at least twice a month to help with my back pain, not to mention the weighty feeling on my chest when I lie down. It makes me feel as though my breathing is being hampered by the extra weight. My question is am I too old for the surgery? [Praying I’m not]

Dr Hunt responds – 

There is no strict cut off age for breast surgery or a breast reduction mammaplasty. Each individual may be a candidate at any age if your general health is good. A breast reduction mammaplasty can be a life altering procedure for the better, it can relieve back and neck pain, improve your ability to exercise, and add to your ability to participate in things you enjoy. There are Plastic surgeons throughout NSW, and the answer to finding one who services your area is to contact the Australian Society of Plastic Surgeons (ASPS), and they will direct you to a fully qualified Plastic surgeon who works in your geographical area.

Q – Hi I have been to my doctor and got a referral to see a plastic surgeon, as I have had ongoing problems with my neck and back over the last 5 years, I have been to chiro, physio osteo, acupuncture, massage.. you name it I’ve done it and nothing is helping there is structurally nothing wrong with my neck or back, so we have all come to the conclusion it is from my breasts which I thought was the case all along, I have to wear a bra all the time as they are so saggy especially my right breast,yes I have had a child and breastfed she is now 6, I am a size DD, I am only 27 and can’t imagine this constant pain that I have put up with for so long going on for the rest of my life let alone another year , and I have to sleep in a bra now, although I still constantly have a sore neck and suffer from regular headaches, and stiffness sometimes not even being able to turn my head. I have just about had enough, I am suffering from anxiety from this ongoing problem, I guess my question is am I able to get this procedure for a breast lift/reduction covered by medicare, as I can’t see myself being able to come up with that sort of money, and I really am at the last straw. would I need to get private health insurance and if so would I need to obtain this before I came for a initial consultation, could you also tell me the price of a consultation and if you think you would be able to help me.

Dr Hunt responds – 

Even for medical reasons there is difficulty performing the procedure in Public Hospitals as there is limited operating time and cancer and trauma cases come first. The other option is in a Private Hospital, and Private Insurance will cover the hospital costs, though it is still likely there will be an out of pocket or “gap” cost.

Q – Hi I am wanting to get my breast enlarged, but was wondering what the effect of being pregnant and breastfeeding would have on the end result. I am looking have children in the future but don’t want to get the enlargement only to find it’s better to wait until kids are not on the cards? Thank you

Dr Hunt responds –

With pregnancy and breastfeeding, there is always an increase in the size of the breast. This will occur in people who do have implants and do not. It is hoped that when the breastfeeding is stopped the breast will return to its normal volume. In some cases though the skin has been stretched and there is some drop of the breast after breastfeeding. This will occur in cases with and without implants. For people planning breast enlargement prior to children there may be these changes whether there is an implant or not.

Q. Hello, I am think of having a breast enlargement but wanted to find out if I would be able to have children in the few years after or would that cause problems?

Dr Hunt responds –

Having breast implants will have no effect on your ability to have children. The implant is often behind the breast tissue so does not interfere with milk production. There will be changes in the size of the breast tissue with pregnancy though and it is hoped the skin will return to its pre pregnancy size after stopping breastfeeding. If this does not happen it is possible a breast lift mastopexy may be needed and this can occur with or without breast implants.

Q. How long until breasts settle after breast augmentation?

Dr Hunt responds –

There are a few terms used in breast augmentation mammoplasty that may be unfamiliar to you before you undergo the surgery, such as ‘fluffing’ and ‘dropping’. Don’t worry, they’re just the terms given to how your new implants move and change during the months after surgery until they settle into their natural resting position.

Dropping or fluffing refers to when your breast implants fall into place. In the beginning, after surgery, they may seem unnaturally high on your chest or take on a ‘cone’ shape. This is because your muscle and skin take time to stretch and accommodate your new implants and some swelling will also occur. The time it can take for your implants to drop varies for patient to patient and is affected by a multitude of things from age to muscle strength, but don’t worry if you are unhappy with the shape of your breasts immediately after augmentation – it can take anything from a few weeks to a few months for your new breasts to completely settle.

Q – Is breast augmentation covered by Australian medicare?

Dr Hunt responds –

There are some cases where you can apply for a rebate from medicare for breast augmentation mammoplasty when the procedure is performed by a specialist plastic surgeon. These are usually limited to augmentation mammoplasty procedures like tubular breast reconstruction surgery, breast implants for congenital deformity or asymmetry and post-cancer.

For example, if you were to have a mammoplasty augmentation procedure for significant breast asymmetry limited to one breast, you could get a 75% rebate on the cost of the surgery through medicare. However, if you want a breast augmentation mammoplasty procedure purely for cosmetic reasons, you won’t be able to apply for a rebate from medicare.

For more information, please visit the Australian Department of Health’s website: https://www.health.gov.au

Q – I had silicon breast implants done in the 70’s. They still look good but are quite firm which they always were to some extent. Are they safe to leave in?

Dr Hunt responds –

Silicon implants from the 70s are not the cohesive gel we now use. They used a more liquid form of silicon which was found to “bleed” or leak through the shell in small amounts. The result of this is that the body would form a layer of scar around the implant known as a capsule, and with time the capsule could contract resulting in a capsular contracture. This is what causes the firmness and can distort the implant making it round and hard, and in some cases painful. If this is happening the implants may need to be replaced, and the scar tissue excised to make the breast soft and shapely again. If this is not happening though the implants can be left indefinitely with safety.

Q – Should I get round breasts or teardrops?

Dr Hunt responds –

This is one of the most common questions for women considering breast augmentation mammoplasty. It’s important to talk to your surgeon about size and shape of your implants as they will be able to advise you. As a rule of thumb, round implants are better at giving you fullness at the top of the breast. They’re the most popular choice for women opting to enhance their natural breasts and suitable for most patients. They tend to work best for patients who have little to no breast droop.

Teardrop implants (also known as anatomical implants) are more suited to those who want to achieve a more natural looking bust. They have more volume at the base of the implant and are usually used for breast reconstruction surgery or for patients with very little breast tissue to augment.

Dr Hunt aims to achieve natural, proportionate results, whether through breast augmentation mammoplasty, breast lift mastopexy or breast reduction mammaplasty. So whatever you decide, Dr Hunt will discuss your options within your consultation, prior to committing to have breast augmentation mammoplasty surgery.

To book your consultation, contact Dr Hunt today.

Q – What can speed up the recovery after breast augmentation?

Dr Hunt responds –

The optimal way to recover after breast augmentation mammoplasty surgery is to follow Dr Hunt’s prescribed recovery plan, but there are also a few things you can add to your everyday lifestyle to ease your recovery time. There’s a golden rule to follow for recovery: if it hurts, avoid it. This applies to everything from exercise and cleaning to heavy lifting.

• Expect to take time off: you will need at least a week off of work after your surgery.
• Avoid driving: you should avoid driving for around 14 days after your operation.
• You should stay hydrated, avoid smoking, which increases the risk of infection, and keep out of the sun. Surgery scars can take up a year to fade completely so you should cover them up and use high factor sunblock until they have faded.
• While it’s recommended that you avoid strenuous activity, you should try to walk a little every day after your operation to improve blood circulation, gradually increasing your activity as you start to heal.

To book your consultation, contact Dr Hunt today

Q – Is it possible to have a breast lift without implants?

Dr Hunt responds –

It is possible to combine a breast lift mastopexy with breast augmentation mammoplasty surgery, but it isn’t essential. Breasts can droop for a variety of reasons, from childbirth to age and dramatic weight loss.

During breast lift mastopexy surgery, Dr Hunt will make an incision on each breast and lift the skin, stitching it in its new, elevated position, removing excess skin as he goes. Dr Hunt will cut around your nipples, removing and repositioning them to ensure that your new breasts look as natural as possible. A breast lift mastopexy without implants works on patients who already have some natural breast tissue to lift. If you are lacking breast tissue or want a more dramatically fuller final effect, you may opt to also have breast augmentation mammoplasty at the same time.

To book your consultation, contact Dr Hunt today

Q – Can breast lift creams really provide a lift?

Dr Hunt responds –

There are countless products on the market promising a quick fix for a smoother decolletage or firmer bust. The truth is, there’s very little that these creams can do to improve the lift and look of your breasts long term. At the most, these creams provide a temporary tightening of the skin, which will improve appearance of your breast for a limited time. This is because they are often packed full of moisturising ingredients like shea butter, hyaluronic acid and vitamin E, all of which improve skin’s tone and texture.

Industry experts have also questioned the effectiveness of breast lift creams time and time again. Dr Marianna Blyumin-Karasik of the Baumann Cosmetic and Research Institute, USA is sceptical of the claims, saying: “None of the bust firming creams on the market have scientific data to prove that they work. So they may advertise that they have ingredients that theoretically improve skin quality and then lead to firming, but they have no evidence to back it up.”

If you want to prevent premature sagging of your breast tissue you should follow a few simple rules:

• exercise with a supportive sports bra
• avoid rapid weight gain or loss
• wearing a supportive bra during the day
• avoid push up bras as they can crease the skin and distort the natural shape of your breasts.

For further information, see our section on Breast Lifts.

Q – What is a breast lift lollipop scar?

Dr Hunt responds –

A lollipop scar is the result of a breast lift, or mastopexy, which lifts the breast to give a more rounded and youthful appearance. There are lots of different choices when it comes to your surgeon making incisions during the surgery and each offers different benefits in terms of recovery time and resultant scarring. A lollipop incision is also called a vertical lift. It occurs when an incision around the areola and extends downwards to the base of the breast, creating a lollipop shape.

Lollipop incisions are usually used in cases where the patient has some but not significant sagging of the breast tissue as it gives moderately dramatic results with a relatively short recovery time. If you have extensive sagging or require a significant lift, you may need to opt for the anchor incision instead, which allows for more excess skin and tissue to be removed.

Q – When can I wear a bra after having a breast lift?

Dr Hunt responds –

It can be frustrating to wait to try out your new lingerie after you’ve had a breast lift mastopexy, but to ensure that you heal properly post-operation, it’s recommended that you only wear a soft sports bra or non-wired bra for the first month after your procedure.

After breast lift mastopexy surgery, patients often suffer with swelling and bruising and it’s important to wear a bra that’s supportive as it will let your stitches heal correctly and, if you’ve had implants inserted during your breast lift mastopexy surgery, it will help them to settle into the correct position. Dr Jeremy may tell you to wear a compression bra for the first few days after your operation to aid recovery time.

The time period before you can switch to wearing your normal, underwired bras varies from patient to patient, however Dr Hunt will advise you personally, to ensure your feel fully comfortable before you transition to your regular underwear.

To book your consultation, contact Dr Hunt today.

Q – Could you please explain exactly what the Double Bubble is and why it can occur? Also, after surgery to correct it will it be unnoticeable, and will it reappear later?

Dr Hunt responds –

Double bubble is a term used when a breast enlargement is performed with an implant, but the skin and breast tissue do not draped evenly over the breast implant. The result is the appearance of a mound of breast tissue sitting on top of a breast implant, thus the “double bubble”. The problem can be avoided by using the correct style of implant to address the width of the breast mound, and the implant volume the patient needs to achieve the desired. This can mean that a larger implant than the patient desires may be needed to fill the loose skin, and if that is the case then a breast lift may be needed to evenly locate the breast tissue over the implant.

Q – What is the recovery time after having breast revision surgery?

Dr Hunt responds –

Breast revision surgery often involves the removal or replacement of existing breast implants. Surgery to perform revisions may be recommended if there were complications during your original augmentation procedure. Patients often opt for a breast revision when they want to change the size or type of implants, for example, if they want to switch from silicone to saline or to increase the size of their implants.

Recovery time for breast revision surgery is dependent on the level of work required during the procedure but, generally, should be less than the original augmentation as the patient will already have an existing ‘pocket’ internally in which to insert new implants or modify. Recovery time will also be longer if you chose to dramatically increase the size of your implants. Dr Hunt will be able to advise you on the scale of work required and how long they anticipate your recovery will take.

To book your consultation, contact Dr Hunt today.

Q – Does Breast Augmentation Hurt?

Dr Hunt responds –

As with all surgical procedures, there will be some pain and discomfort involved in breast augmentation mammoplasty. Unfortunately, there’s no quick and easy answer to predict how much (or how little pain) patients will feel as it varies from person to person. Some women describe postoperative pain as a feeling of ‘pressure’ while others feel it more acutely.

The amount of pain and recovery time also varies depending on the type of breast augmentation mammoplasty you choose. For example, if you opt to have implants placed underneath your chest muscle you may experience increased pain levels when compared to placing the implant above the muscle. It is key that you discuss any questions or concerns you might have with your surgeon before your operation to make sure that you feel as comfortable and happy about your augmentation as possible. You should also ensure that you follow your postoperative recovery plan and take any prescribed painkillers.

To book your consultation, contact Dr Hunt today.

Q – I have read about a “boob jab” to enlarge breasts please tell me more

Dr Hunt responds –

To increase the size of the breast involves inserting volume. A breast implant is the standard treatment, though injections with a type of filler similar to that used in the lips is being trialled. The filler will increase the volume of the breast but only by small amounts. It may increase half to one cup size, though the filler is not permanent and needs to be repeated. The treatment is still in development and trial stage though offers an option to those looking for a small increase in cup size.

Q – I’m 15 years old and I have inverted nipples. I’m really self-conscious about them. I’m too embarrassed to tell my mum or any of my friends. Can you help? I don’t want to get them fixed with surgery. Is there another way?

Dr Hunt responds –

Inverted nipples are a very common problem. There are different degrees though and the worst is where you are unable to evert the nipple at all, and this can only be corrected surgically. If your case is one where you can evert the nipple but it springs back to being inverted, then there are ways to treat it non-surgically.

The most effective option is to treat it by piercing the nipple. This applies a gentle pull and over three to six months the short milk ducts lengthen and allow the nipple to stay everted. Get a surgeon’s opinion to determine what grade your inversion is and which treatment will be most beneficial.

Q – Has Dr Jeremy Hunt ever dealt with a patient with Poland Syndrome? I am an 18 yr old girl & ever since the age of 14 my left side of chest never grew… not an inch. This has caused me great amounts of depression, and my local GP has linked it with Poland Syndrome. Due to not being able to afford a breast re construction here in Australia, I got in contact with surgeons from Thailand. Yet no surgeon there could give me a straight answer on how they could make my chest symmetrical. Please help. 

Dr Hunt responds –

Poland’s syndrome is a condition where there can be undergrowth of the chest and the arm. It is condition you are born with and has varying degrees that may result in a lack of chest wall growth, or a short arm. The reconstruction often involves the chest and may need the replacemant of the head of the pectoralis muscle to give the fold at the front of the armpit, or may need reconstruction of the breast tissue using an implant. The results are to try and match the opposite side and this is always going to be difficult as there a shortage of tissue to work with.

Q – Dr Hunt, I am a 41 year old male and have nipples that protrude more than what i would like. I beleive that a simple procedure to correct the problem can be carried out in a surgeons office under local anasetic, if this is the case can you please devulge some more information on the procedure…..

Dr Hunt responds –

Prominent nipples can be corrected with surgical reduction of the nipple and this can be done in the office under local anaesthetic. If the problem though is excess breast gland tissue this require a surgical procedure under a general anaesthetic to incise the bottom half of the areolar, the pigmented skin around the nipple and access the breast gland tissue to reduce it.

Q – Dr Hunt, I am a 41 year old male and have nipples that protrude more than what i would like. I beleive that a simple procedure to correct the problem can be carried out in a surgeons office under local anasetic, if this is the case can you please devulge some more information on the procedure…..

Dr Hunt responds –

Prominent nipples can be corrected with surgical reduction of the nipple and this can be done in the office under local anaesthetic. If the problem though is excess breast gland tissue this require a surgical procedure under a general anaesthetic to incise the bottom half of the areolar, the pigmented skin around the nipple and access the breast gland tissue to reduce it.

Q – Can a macs lift and nose job be done at the same time?

Dr Hunt responds –

It is possible to have a rhinoplasty and facelift (rhytidectomy) at the same time. The advantage is that there is only one down time and recovery and this can be faster return to normal activities. Combined surgery on other areas of the body does exist such as breast surgery at the time of a tummy tuck (abdominoplasty), which again means one hospital stay and one recovery period.

Interested in a Face procedure. Have seen the facial thread shoe string and pulling instead of full face lift. Please comment.

Dr Hunt responds –

There are procedures that use threads as a non invasive facelift. The procedure is simpler than that of a surgical facelift (rhytdectomy) and I have used the techniques. The problem is that the procedure is not as powerful as a surgical facelift (rhytidectomy) so the results are not as long lasting. Patients have been disappointed in the degree of improvement and the duration the results last. For this reason I have stopped using these techniques as they were not delivering the results to the patients.

I had previously read about a “thread procedure” to lift jowls. Is this procedure something that Dr Hunt does and is it successful?

Dr Hunt responds –

Thread lifts have been suggested as a simple way to avoid a facelift (rhytidectomy) and achieve the same result. The difficulty with the results a thread lifts is that they do not seem to last. The result in some cases can disappear in as short as 6 weeks and others in months. In my opinion the lasting results of a short scar facelift make this the procedure of choice for correcting jowls.

Q – I would like to have some plastic surgery to make my eyes look healthier. My eyelids seem to be dropping downwards & I have big bags under my eyes. They make me look as if I haven’t had enough sleep or rest. I also want to make my eyelids have a double layer and still look natural. What is your advice please? Thank you.

Dr Hunt Responds –

The appearance of the eye will often attract attention be it good or bad. In cases where there is excess skin in the upper or bags under the lower eyelid, people may comment that you look tired when you feeling fine. The solution is surgical. For the upper eyelid the excess skin can be removed and this will take the weight of the eyelid and allow you to see the natural crease of the eyelid. With the weight off the eyelid the eye will appear wider and more open. For the lower eyelid the problem is often excess fat behind the lower eyelid creating the bulge or bags. The solution is to remove or reposition the fat to give the eyelid a smoother appearance and remove the bag. The answer will be the opinion of a surgeon who performs these procedures, and they will be able to guide you in the right direction. See Eyelid Rejuvenation Options – Treatments & Surgical Procedures for Eyes.

Hi, I’ve had dark circle under my eyes since i was a kid. Nothing seems to work. I’ve tried many types of eye creams but its not getting better. The is no puffiness or bagginess. Just very very dark under the eyes towards the nose area. Please advise of the best way to fix the issue.

Dr Hunt responds –

There are options to treat dark circles and many involve eye creams. The difference is that the strength of a cream a doctor can supply is stronger than that a pharmacy or department store can provide, and so the medical grade creams are more effective. The cause of the problem is pigmentation in the skin so the treatment involves a slow and steady bleaching of the pigment resulting in a lightening of the dark circles.

Hi I would like to know what option there are for dark circles under eyes. They are quite bad/dark. Is surgery an option? Many thanks!

Dark circles under the eyes are due to excess pigment in the skin of the lower eyelid. This can occur for genetic or racial reasons and can be due to excess fat and puffiness of the lower eyelids. The pigment is best treated with medical grade skin care eye creams that will bleach the pigment from the skin.

I’m planning to get a nose job. My mum and my sister had one, theirs is a silicone implant. My friend recently had her nose done too but hers was injected collagen. Her nose looks and feels more natural than my sister’s and my mum’s. But some people say that silicone implants are safer than the collagen injections. Is this true?

Dr Hunt responds –

Different implants will behave differently over time and each surgeon will have different preferences for their use. Collagen is a nature substance and the body is less likely to reject it than a foreign material such as silicone, so that is an advantage.

Collagen though tends to be absorbed over time; the result will not last as long as silicone which is permanent. Ask your surgeon as to which technique will achieve your goals. This means that there are many different options with some surgeons using silicone, collagen, cartilage or bone to achieve the result. This can be confusing though a good surgeon will able to explain the pros and cons of each to you.
Find out more about Nose Surgery (Rhinoplasty) or contact Dr Jeremy Hunt to discuss your individual needs.

I have heard that your ears and your nose actually never stop growing as you get older. Does that mean that after rhinoplasty even if you are happy with the initial outcome, that eventually in a few years your nose will change shape and droop?

Dr Hunt responds –

It is true that your ears and nose do grow through your life, but the change will be minimal so the results of the rhinoplasty are long lasting.

Hi Dr Hunt, i am wondering about getting rhinoplasty, although i would like a very subtle change. i actually think my nose would be OK if it was on a face that was larger than mine – i have a very small face, narrow cheekbones and fine lines – which is fine, but my nose seems quite out of proportion. I am after a reduction in the bridge of my nose, but do not want it changed radically, or made into a small button nose or similar. is this a realistic request?

Dr Hunt responds –

For me the result of rhinoplasty is a nose that fits and balances a persons face. Given this each person is different so each rhinoplasty I perform needs to be tailored to the individual. This will involved measurement of the middle and lower thirds of the face and the length and projection of the nose (how far the nose sticks out). From these I can plan a procedure to alter what is out of balance and create a final result that is in harmony with the rest of the face.

My sides of my nose have shrunken in, just behind the ball/tip of my nose. It has become worse over the last few years, and is obvious when I have photos taken. Is surgey required to correct this, or can some sort of “filling material” simply be injected to fill out the deflated area?

Dr Hunt responds –

The deformity you are describing is known as a “pinched tip”. The problem is a lack of support for the nostril rim often due to weak cartilages. The weakness in the cartilage is most often due to previous surgery where some of the cartilage has been removed, but can occur by itself. The solution is to reinforce the strength of the cartilage and this is a surgical procedure often using cartilage from your nasal septum. Using a filler is unlikely to provide the support the skin needs and not achieve the result you are after.

To book your consultation, contact Dr Hunt today.

I have really chunky, muscly calves like a man’s. They’re like upside-down milk bottles and they make me feel incredibly unfeminine. I cannot remember the last time I wore a skirt. I’ve never heard of anybody having surgery to make their calves thinner and more feminine, so I was wondering if any such kind of procedure existed.

Dr Hunt responds –

Procedures for altering the contour of the calves do exist and the most commonly used is liposuction. The contour of the calf is made by the muscle and the fat below the skin, and altering the fat layer is far easier than altering the muscle. Liposuction of the lower calf can thin it and add more curve to the lower leg. The results though are not as effective as liposuction on other areas as there is simply less fat to work with.

Since I gave birth to twins nine years ago I have been left with a pad of fat just above my navel. I am a healthy weight, I eat well and exercise every day, but I cannot get rid of this lump of fat. Are there any surgical procedures that would help me with this?

Dr Hunt responds –

Changes in abdominal contour are common post childbirth and this is a common complaint. There is not a ‘new’ deposit of fat above the navel but the tension and tightness of the skin has altered with the pregnancy and stretch on the tummy. The result means less support from the skin and this laxity means the fat tends to hang over the navel that is pinned to the abdominal wall. The solution may be liposuction if the skin tone is still good enough, or a mini tummy tuck (abdominoplasty) to re-tighten the skin.

Find out more about Tummy Tuck (Abdominoplasty) or contact Dr Jeremy Hunt to discuss your individual needs.

Hi Dr Hunt, I am 42 and am interested in a tummy tuck. I have never been overweight (55kgs/164cm) but two pregnancies have left a pot belly, despite 4 years at the gym and good eating. I have seen a surgeon who will do lipo but advises I will be left with saggy skin and recommends a tummy tuck. The scar that goes with this REALLY turns me off and I was interested in your endoscopic tummy tuck. I realise this doesn’t remove skin but would rather live with some loose skin than a scar that size. What rules someone out as a candidate for endoscopic tummy tucks? Will endoscopic tummy tuck achieve a greater result than lipo alone? Thanks.

Dr Hunt responds –

There are a number of different tummy tucks and using the right one for each patient is the answer. It is true that liposuction of the abdomen will leave excess loose skin and that a skin tightening abdominoplasty may be needed to achieve a flat stomach. A mini tummy tuck (abdominoplasty) will remove some skin from below the tummy bottom only and has a shorter scar which is located down low just above the pubis. An endoscopic tummy tuck (abdominoplasty) will leave the same scar as skin often needs to be removed, but adds tightening of the loose abdominal muscles. This is opposed to a full or radical abdominoplasty that will remove all the loose skin between pubis and tummy button and so has a longer scar.

I am considering undergoing an arm tuck due to “wobbly bits” on the underside of my arms. I can’t seem to find enough information about the procedure or surgeons here in Australia that perform it. Is there any advice you can offer? Will weights at the gym fix my problem or is surgery the best option?

Dr Hunt responds –

The arm tuck operation (brachioplasty) is performed for excess deposits of fat, and skin laxity in the upper arm. Going to the gym will improve muscle tone but will not effect the distribution of fat and lax skin. The operation involves removing fat with liposuction and then excess skin is removed by surgical excision. The contour of the upper arm can be greatly improved but the surgical scars are significant.

Find out more about Upper Arm Lift (Brachioplasty) or contact Dr Jeremy Hunt to discuss your individual needs.

I’d like to know where, how and if I can get a clitoral reconstruction surgery? I am originally from western Africa and have been living in Australia for a few years now. I was circumcised as a little girl and I’m in my mid 20’s now. I do enjoy sex and can orgasm with much pressure on the spot where the clitoris was removed, however I haven’t been able to orgasm during sex or through oral sex. I desire this and I would like to know if there are surgeons you can recommend to me in or outside Australia who are professionals at this. Thank you.

Dr Hunt responds –

Clitoral tissue is a very specific and sensitive tissue and that is the problem when it comes to clitoral reconstruction. The tissue that has been lost in the circumcision is impossible to replace as there is no similar tissue to use when performing the reconstruction. Sadly this means that in most cost cases reconstruction is impossible. For an opinion a gynaecologist or Plastic Surgeon with an interest in genital reconstruction will offer an opinion in each case.

My 3 year old daughter had a bad accident 3 months ago and has a 5cm scar from the middle of her forehead, through her left eyebrow and inside her eye socket from the internal and external sutures by the plastic surgeons in the emergency department of our childrens’ hospital. It is slightly indented and looks shiny and is still red- I know it’s early days but are there any lasers treatments that have proved effective in minimising scarring and when is the best time to start treatment?

Dr Hunt responds –

All wounds when they are healing will be firm and have high blood flow and appear red. There are scar management treatments that can be used soon after the injury and for the next 12 months while the scar matures. They include massage of the scar and silicone sheeting, also protection from the sun with sunscreen. Until the scar has fully matured treatment these treatments are the optimal option. After the scar has fully matured treatments such as laser or scar revision can be considered. The answer is to have good advice and this can be found form a consultation with a Plastic Surgeon or through the outpatient clinic at major hospitals with a Plastic Surgery department.

Hi There, I have a facial scar from a surfing injury I would like to have corrected. The scar is approximately 7cms in length on my left cheek. I would like to know what options there are in correcting such a scar. I’m 35, non smoker and quite fit. Thanks

Dr Hunt responds –

Scars can be treated in various ways and the biggest factor is ” How old is the scar?”

New scars should be treated with Silicone, massage and kept out of the sun for 3-6 months to get the optimal result. Once the scar has matured and is still not acceptable a scar revision may help. This will involve excising the scar surgically and repairing the wound precisely to get the optimal outcome. The difference being that a traumatic injury will cause more tissue than a controlled surgical revision and the result of the surgical revision should then be a less obvious scar. Remember though there is no way to totally remove a scar.

Hi doctor. About 2 weeks ago i had an accident whilst dancing at a friends wedding and fell to the dancefloor and hit my head on the ground and cut my forehead.I had to get stitches(internal ones as the cut was 2 cm in length) and im a bit worried about the scars on my head.I have been given dermatix and i would like to know if there is any other treatment which will help reduce the scar as i have my own wedding in 4weeks and would like the scar to be as minimal as possible.I have done some research and came across something mentioning steroid injections.Is there anything you can recommend from your professional experience which might help me?

Dr Hunt responds –

There are ways to minimise scars after surgery or an accident. New scars should be kept out of the sun for at least 3 months to avoid pigmentation. The use of massage and Silicone creams or sheets for the first 3 months will also allow the scar to mature more quickly. All scars will improve over the first 12 months and there are some options including corticosteriod injections during that period that may help improve the appearance of a scar. Ultimately after 12 months if a scar is not acceptable surgical revision can be considered.

I’m 21 years old and have awful scars from having moles removed. I had four moles removed in 1999 and was never informed that the scars could be about seven times the size of the actual mole, and that they could turn into keloid. I now have large scars which really make me self-conscious! I went to a mole scan and got two of them recut to get a better scar, but it hasn’t worked. I have been told in the past that I have keloid scars, but I went to see a specialist for it and was told that it’s not keloid, that it’s hypotrophic, and that I need to see a good plastic surgeon. I don’t know how much it would cost or what can be done, but I get really depressed about it and am so upset that I wasn’t even warned that I could get such scarring. Being only 14 at the time, I had no idea! Is there any help? Can you give me some advice?

Dr Hunt responds –

Unfortunately all surgical procedures result in scars, but in your case the scars are more significant. Keloid scarring is similar to hypertrophic scarring and the treatment is also the same.

The first option is non-surgical treatment with corticosteroid injection into the scars to decrease their size combined with silicone sheeting on the scars. Surgery may be an option but may not be the best choice. A plastic surgeon would be able to advise you on the optimal options.

I have several scars on my forearm and wrist from self harm, I have 5 major ones that are on average 2.5 cm in length and .5cm in width they are all on a diagonal to my arm. I have been able to find healthier ways of dealing with these feelings and have managed to go without self harming for 2 years now, despite having tough times still, I have been applying vitamin e oils and creams to the area on a regular basis and they have gone down a bit, however I am not comfortable showing them because of the way people react, they are also a painful reminder of the past. Are there any surgical solutions to this? I have done a bit of research but have heard many stories of people written off as soon as the surgeon has found out that they are self inflicted. It is becoming increasingly difficult to keep hiding, particularly in summer time and in the workplace. Thank you for your help.

Dr Hunt responds –

Scars can potentially be surgically revised to excise an unsightly or wide scar. Non surgical treatment such as massage with Vitamin E oil of pressure dressing such as silicone can help. The difficulty is that the surgical revision will leave a scar and hopefully this is less unsightly than the original scar. If multiple scars need to be revised over a small area it can make the situation difficult in terms of creating an improvement. The other option is camouflage makeup similar to that used in burns cases to cover burns scars. It is a difficult problem and offer the surgical opinion you receive will be disappointing not because of the cause of the scars, but that the surgeon does not feel a major improvement can be made.

Just wondering if something can be done to get rid of scar from classic ceasarian

Dr Hunt responds –

A scar from any surgical procedure or accident can often be improved upon be scar revision. The scar though will always be there and the answer is to make it as subtle and hidden as possible.

I have a surgical scar which is growing bigger because of my weight and it’s painful sometimes. Can I remove it with plastic surgery?

Dr Hunt responds –

It is impossible to remove any scar though it may be improved. Improving scars by scar revision may involve non-surgical treatment such a silicone therapy or injections with corticosteroid surgery may totally remove the scar. Unfortunately, a scar will result from the surgical revision though it is hoped this will be a better result than the original.

Q – I’m currently 19 years old and I need your advice on whats the best solution for chicken pox scars?? I had chicken pox for about 3 years now and I’ve developed deep scars around my forehead, between my eyebrows and one under my right eye. This has been a big factor socially. I want people to stop taking notice when they talk to me. I’m really self conscious about these scars. I just want to get rid of it completely or even minimise the scars as much as possible. If you had some case like mine could you please send me any pictures of results?? Looking forward to hearing your advice. 

Dr Hunt responds –

The answer to the scars is to improve the contour of the skin and this can be done non-surgically or surgically. If the scars are narrow and deep the optimal solution is surgical excision. For shallower broad scars the optimal solution will be a form of resurfacing and this can be laser, dermabrasion, or chemical peels. Chemical peels can be done out of hospital and repeated to achieve the final result, and also have a lesser down time and faster recovery. This is my preferred choice.

Q –  I have been informed that i have cholosma melasma pigmentation on my face due to an unfortunate reaction to a high dosage estrogen pill-mixed with some sun damage. The area is most prominent under my eyes and for head cheeks and around my lips. It causes great embarassment to me and i look like a bandicoot at best or my face just needs a good wash. I am 7 months pregnant at the moment and have tried fading creams and ipl to no avail-they have if not added to the problem. im interested in laser skin therapy, as a means of new, fresh unblemished skin..I would appreciate your feed back.

Dr Hunt responds –

Pigmentation may often be related to hormone change, with the commonest being pregnancy but often due to the oral contraceptive pill. The melanocytes are the cells in the skin that make pigment, and the hormones can make them overproduce melanin. The answer is to correct the abnormal cells and this is best done with a medical grade skin care program. This may involve peels or laser and needs to be tailored to each individual. The aim is to slowly bleach and blend the excess pigment and achieve a more even complexion.

Q – I am interested in anti wrinkle injections, but understand that about 1% of people get eyelid or eyebrow droop which takes 3-5 weeks to go away untreated. Is there anything that can be done to speed this up if you have this adverse effect? Is it usually noticable to other ppl or just the person who has had the procedure?

Dr Hunt responds –

It is possible to treat the problem depending on the cause, it may need medication as eye drops or anti-wrinkle injections elsewhere to correct the imbalance.

Q – I had anti wrinkle injections around my eyes about two years ago which did not produce any change. I then received a more concentrated dose, which still produced no result. Last week I had restylane in a line on my top lip and the deep folds alongside of my mouth. After initial swelling, this too appears to have had little effect. Are there any reasons why these procedures seem to have no effect on my skin and are there any viable alternatives available at a similar cost?

Non-surgical treatments are not as powerful as surgical options. In cases where non-surgical options have failed and then repeated at higher doses, such as around your eyes, it is possible the result you are looking for is not achievable with non-surgical treatment options. Being more powerful, surgery may be the answer.

Q – Can you get a tummy tuck and breast lift at the same time?

Dr Hunt responds –

It is possible to have abdominoplasty and breast surgery be it a lift mastopexy, implant or breast reduction mammaplasty at the same time. Many people choose this as it sames recovery time with one surgical procedure and recovery as opposed to two.

Q – Do you operate in public hospitals?

Dr Hunt responds –

Dr Hunt operates at Sydney Children’s Hospital and Prince of Wales Hospital at Randwick. These are both public hospitals where Dr Hunt works as a VMO surgeon looking after public patients, providing Plastic Surgery for trauma and cancer cases for those in need.

Dr Hunt is also the supervisor of training at Sydney Children’s Hospital ensuring the next generation of Plastic Surgeons are trained to the highest standard.

For breast, body and face cosmetic surgery Dr Hunt is in private practice and operates in private hospitals.

Q: My age is 58 years, am I too old to undergo tummy lift and breast reduction all at once at this age?

Dr Hunt responds –

Depending on general health and other medical conditions each patient is considered individually. There is no age limit to procedures and breast reduction mammaplasty and abdominoplasty have been performed on healthy 70 year olds.