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What's the difference between an AHPRA registered Specialist Plastic and Reconstructive Surgeon and an unregistered cosmetic surgeon?

  • Specialist Plastic and Reconstructive Surgeons have completed an additional 8-12 years of training beyond their medical degree  
  • Specialist Plastic and Reconstructive Surgeons can lawfully use the title Plastic Surgeon (approved by AHPRA - Australian Health Practitioner Regulatory Authority), because they have completed AMC (Australian Medical Council), accredited specialist training.
  • 100% of ASAPS (Australian Society of Aesthetic Plastic Surgery), and ASPS (Australian Society of Plastic Surgeons), members are recognised by AHPRA, the AMC, and Medicare as specialists in plastic surgery.

In contrast

  • Cosmetic surgery is not recognised by AHPRA as a separate specialty
  • Doctors with NO specialist surgical registration portray themselves as surgeons by using the fake title, 'Cosmetic Surgeon'

What kind of timeline should I expect from the first enquiry to the surgery date?

  • Time from enquiry to clinical nurse assessor appointment: 2 weeks
  • Time from nurse assessor to surgeon 1st appointment: 4 weeks
  • Time from surgeon 1st appointment to 2nd appointment: 6 weeks
  • Time from surgeon 2nd appointment to surgery: 2-3 months
  • Total time: 5-6 months

Will Medicare and private health insurance cover any of the costs of my procedure?

  • Medicare and you private health insurance will cover the hospital costs and contribute to your surgical costs if there is a medicare item number
  • There is a medicare item number, with specific criteria for:
    • fat grafting after breast cancer surgery
    • breast reduction
    • breast implant revision surgery
    • congenital breast conditions
    • mastopexy (breast lift)
    • male breast surgery (gynaecomastia)
    • abdominoplasty
    • body contouring surgery after massive weight loss
    • upper eyelid blepharoplasty
    • rhinoplasty with breathing obstruction
    • bat ear correction surgery
  • There may be additional costs for your surgeon, assistant, anaesthetist, pathology, and radiology

How do I know which procedure might be best for me?

  • Your surgeon will guide you as to what procedures will be likely to achieve your aims, depending on what part of your body you want improved
  • Your surgeon will explain what will improve after surgery and just as importantly what will NOT improve
  • Surgery is only appropriate to address a problem that the patient identifies.  A cosmetic problem is equally as valid as a non-cosmetic problem. 
  • Your surgeon will assess the metric of improvement you are aiming for (a small change vs a large change)
  • Your surgeon will educate you as to the severity of your problem compared to other patients.  Severe problems can have a large improvement.  Subtle problems can only have a small improvement.

Can I only access Hobart Breast Aesthetics if Dr Keating did my original surgery?

  • Hobart Breast Aesthetics is an annual surveillance clinic for ALL patients with breast implants, regardless of who did the original surgery
  • The Australian Society of Plastic Surgeons (ASPS), recommends that all women with breast implants have an annual review by a surgeon for the life of the implants.  This recommendation was made in 2019 and applies to all breast implants inserted before and after this date.
  • Women with breast implants require an ultrasound every 2-3 years to exclude a seroma around the implant

Why do I need to have my breast implants checked by a Specialist Plastic and Reconstructive Surgeon?

  • The Australian Society of Plastic Surgeons (ASPS), recommends that all women with breast implants have an annual review by a surgeon for the life of the implants.  This recommendation was made in 2019 and applies to all breast implants inserted before and after this date.
  • Some women with textured breast implants develop lymphoma in their breast.  In 2019 the therapeutic goods administration (TGA), removed the majority of textured breast implants from the market due to these safety concerns.  https://www.tga.gov.au/resources/resource/guidance/webinar-recording-bia-alcl-and-breast-augmentations

Should I have my breast implants removed?

  • Women without a breast implant seroma or red flag symptoms do not need to remove their breast implants
  • Red flag symptoms include a new breast swelling or a lump in the breast or armpit
  • Most breast implants require revision surgery 10-15 years after they were inserted.  This is due an increasing risk over time of capsular contracture or rupture.  The overlying breast ages and drops over time in everyone to a varying degree.  Commonly this results in a discrepancy between the position of the implant and the position of the breast.  This can be another reason for revision surgery.

How do I know what size breast implant is right for me?

  • Breast implant size is a personal choice
  • Your surgeon will measure your breast width and height which defines a limited range of implants that will suit your body
  • Most women aim for balance between their upper half (chest), and lower half (hips/curves), both from the front view and from the side
  • Breast implant choice can be guided by three methods: 1. Sizers; 2. Estimate breast volume; 3. 3D simulation
  • Sizers are placed in a bra overlying your natural breast and simulate adding volume.  They increase in increments of 50 cc (grams), because most women cannot tell a difference in breast volume less than 50 cc.
  • Breast volume can be estimated from 3D imaging.  One bra cup size is around 125-150 cc.  Therefore if a 12B cup breast is approximately 300 cc as a starting point, adding a 150 cc breast implant will give approximately a 12C cup and adding a 300 cc implant will give approximately a 12 D cup.
  • 3D imaging is a communication tool and helps visualise what a breast implant will look like on your body.  Similar to sizers, it is easier to see a change with increases or decrease in volume greater than 50 cc.

Do I need to have a consultation with Mr Keating before my procedure?

  • Surgery is an important decision and all operations have risks.  Our process at Hobart Plastic Surgery makes sure that you are both physically and emotionally at your best to successfully have an operation.
  • There are three key steps prior to booking a procedure with Hobart Plastic Surgery
  • Step 1 - You will have the opportunity to meet a nurse clinical assessor who will provide information about the procedures that you are considering and take baseline 2D and 3D photos
  • Step 2 - You will meet with Dr Keating who will discuss your concerns, examine you, assess your photos and imaging (if applicable), and provide you with a preliminary surgical plan.  You will be provided with a detailed quote after this consultation and a link on your mobile phone to complete a psychologist questionnaire. 
  • Step 3 - You will meet with Dr Keating a second time to discuss any further questions you may have.  Your psychologist assessment will be discussed and after this consultation Dr Keating will finalise your surgical plan and you can book a date for surgery.

Do I need a referral to meet with Dr Keating?

  • You do not need a referral to see the nurse clinical assessor but you will require a GP referral at your initial appointment with Dr Keating in order to be eligible for a medicare refund on the consultation fee

Is it possible to breastfeed after having a breast reduction, a breast lift (mastopexy), or breast implant surgery?

  • Most women can breast feed after these surgeries
  • Breastfeeding requires a breast gland to produce milk, ducts to connect the gland to the nipple, and a nipple to express milk.  All of these components are present after breast surgery.
  • However, successful breast feeding also depends the physical and mental health of the mother, the health of the child, and other environmental factors.  The rate of successful breastfeeding in women who have not have breast surgery is 60%.  Therefore, there will be at lease 40% of women or more who cannot breastfeed after breast surgery, but often this is not due to the physical effects of the operation.
Dr Cameron Keating (MED0001202462) Registered Medical Practitioner, Specialist Plastic Surgeon (Specialist Registration in Surgery – Plastic Surgery). Provider Number: 262586VB
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