Dr Amira Sanki, Specialist Plastic Surgeon based in Sydney NSW specialises in body contouring procedures after weight loss. Her clinic also offers a huge range of non-surgical procedures. We had a great chat about combining art with surgery and why Dr Sanki gets such awesome results and why her patients are some of the happiest.
Trish: Hey. So today I’m here with Dr. Amira Sanki and Dr. Sanki is a specialist plastic surgeon based in Kogarah. And we’re gonna have a bit of a chat about what’s on at the clinic, what they offer, the procedures and non surgical procedures as well. So, thank you so much for having me today.
Dr. Amira Sanki: Thank you Trish. Thank you for coming today.
Trish: Oh my pleasure. So tell us, I know that you’re an amazing body contouring plastic surgeon-
Dr. Amira Sanki: Thank you.
Trish: … because that’s how I kind of met you through all the social media channels of people that just love you. So tell us what else do you offer here in the clinic?
Dr. Amira Sanki: So I’m the body contouring specialist. My husband is the other side of the practise, he does mostly reconstructive plastic surgery. So plastic surgery for skin cancers and after trauma such as facial fractures. And then we’ve also got our nurse Shanne. So Shanne Taylor is a clinical nurse consultant who has specialised in injectables. And she just completes our picture.
Trish: That’s great. So you come for your surgical stuff but you can also look good with non surgical.
Dr. Amira Sanki: Absolutely. And what often happens is that we’ll have a patient who’s having surgery with me and Shanne will be doing their dressings and then they’ll just happen to launch into a discussion with her about how they could actually look better from the neck up. Yeah and she also does a few peels. she talks to them about our skincare range. Which is our own range, our Southern Aesthetic skincare range.
Trish: Okay, so I know it’s really important to look after your skin before and after you’re having surgery because it’s really important to have a good foundation before anything else starts. So it’s good that you offer that as well.
Dr. Amira Sanki: Absolutely and you know that I’ve always talked to you about how body contouring is really plastic surgery that people have for themselves to look and feel better but it’s your face that other people are actually seeing and making their first impressions on. So I think your face starts with the skin doesn’t it and also good lifestyle.
Trish: I try and do that, but not always great at it. So, look, I’m a real advocate for being really passionate about something then going with it and I know that you’ve done that in your career. I mean, there are all-rounder surgeons as well but I just love it when someone finds something and they become really passionate about it and then just go with it. Repetition is the mother of skill, so what you do you’re gonna do that particularly better. So I know your weight loss patients who love you. Can you tell me a little bit about the weight loss patient journey? So someones lost a heap of weight, wanna get different parts of their skin removed, so, what do they do? They go and see GP, get a referral.
Dr. Amira Sanki: Yeah, that’s perfectly right. So the steps are, it’s always best to start with your GP and have them on board so that they get yo medically fit enough for the surgery as well and I like to really communicate with patients GPs. So get a referral with them and that way patients can also have their rebate for the consultation. And then they book in for a consult. My waiting time for that consult is about six to eight weeks. But the good thing is is patients on their weight loss journey are usually thinking about things before their weights even stabilised, so it’s good to start thinking ahead the minute you know what you think you need to investigate further.
And then after that first consultation there’s a bit of settling time, we give patients information, they do a bit of discussion with my other patients maybe or you know on internet forums, your website and then we bring them back for at least two to three consultations further. To make sure that they’ve got all their questions answered, they know what they’re going to do and then we start the surgery.
Trish: And really to me that’s only like halfway there because then there’s the whole after surgery stuff. Where things might go wrong or they really want someone to hold their hand. And I know that one thing I’ve discovered about patients that come to you is, “She rang me.” and “She’s always following me up.” and you do provide the extra service. Number one, how do you manage to fit that all in to your time? And number two, tell us a little bit about that because to me that’s probably the most important thing. I’ve had this surgery where you have your surgery and then you’re done and that’s not really right.
Dr. Amira Sanki: That’s right. I think a lot of surgeons have the misconception that it’s just about doing the operation well. I think that’s just the first step and it is the most important step, but patients who are going through that operation for the first time, they don’t have the knowledge, the experience, the understanding that we do. So I think a lot of surgeons are a bit complacent about how their patients are feeling after the surgery. So aside from giving a lot of written information to help patients look up in my post-surgical guide what to expect. It’s really important that they’re able to contact me, that my nurse is also my assistant, so the person who they’re speaking to about their pokings is also the person they could speak to about any personal brief concerns.
And then I’m in touch with them. So I do call them regularly after the surgery, even in between their followup appointments here in the office.
Trish: That’s great because they do need to feel safe and looked after.
Dr. Amira Sanki: Absolutely. Absolutely. And Dr. Google doesn’t have the answer to everything.
Trish: No. Dr. Googles caused me lots of grief. Alright, so they’ve been through the process, they’ve had the surgery, they’ve had the aftercare, so what sort of skin removal procedures do you actually offer? Because I know there’s so many, so maybe if we start from the bottom because then we can cover the face as well.
Dr. Amira Sanki: Absolutely. So starting from the bottom there’s thigh lifts, vertical thigh lifts and horizontal thigh lifts. And then we move to the body-
Trish: So can I just ask, so vertical is what?
Dr. Amira Sanki: Yeah. So the vertical thigh lift is where the scar runs from the groyne to the knee in a respect with the thighs. And that’s basically to address that loose skin that people get that rubs as they’re walking on the inner aspect of their thighs. And that’s quite a big operation, I would say that’s probably the toughest one to recover from. As we’ve discussed before it’s like having two tummy tucks because the wounds are so long, the entire length of the thigh. A horizontal thigh lift is just where we take a crescent within the groyne skin crease line and it’s an operation I infrequently do because I think there’s only a very few people that it targets. So it’s really just for people that have a small amount of skin excess right in the very, very top of their thighs.
Trish: So like around about that area there, just that little wedge.
Dr. Amira Sanki: Just that little wedge there.
Trish: And is that one of those that has a T incision.
Dr. Amira Sanki: That one doesn’t need a T, it’s just a crease line or a scar within the groyne crease. Which is nice because it’s nicely hidden.
Trish: Much better.
Dr. Amira Sanki: Yeah. And it has to be for people who only have like the skinny thigh girl who then loses a little bit more weight and just has a little bit of loose skin. Because if it’s heavy then that skin will drag down that groyne crease line and it has a scar and make the scar very broad.
Trish: Okay. So that’s the horizontal and the vertical thigh lift. Where do we go from there?
Dr. Amira Sanki: And then where do we go. The mons pubis. That little mountain of pain.
Trish: Yeah. Well people don’t think of it until usually after they’ve had a tummy tuck, they’re like, “What’s happened, I’ve got this big bulge here.”
Dr. Amira Sanki: That big bulge. Which is an area that everyone is really nervous to bring up to me. It’s that quiet little, there’s just something else I wanted to ask you about. I always know where that’s leading to. And I think that little mound accumulates a lot of fat when we’re larger and so the corollary’s that when we deflate it really turns into a little shrivelled mass of excess skin and people are very self conscious of it.
Trish: And also I think if sometimes the tummy tuck is done without a reduction of mons pubis where it might be needed, so people think, “Oh my God what’s happened I’ve had a tummy tuck and all of the sudden I’ve got a bulge there.”
Dr. Amira Sanki: Yeah, sticking out through their jeans.
Dr. Amira Sanki: Yeah.
Trish: So you do lipo?
Dr. Amira Sanki: So some people do still carry a lot of fat there and need liposuction and what I often do is we’ll just tie them with a tummy tuck and reset a lot of the excess skin in the mons pubis. And then during the tummy tuck if I see there’s still a lot of redundant fat I will lipo it as well. Or we’ll just reset the fat.
Trish: Okay. Alright.
Dr. Amira Sanki: And then moving further up is the actual tummy tuck, is the body contouring section. And within the tummy tuck realm we’ve got just the classic abdominal plastic.
Trish: Which is hip to hip?
Dr. Amira Sanki: Which is hip to hip. And then that goes round to an extended tummy tuck, where the scar ends sort of just around the corner from your hip area to tighten up the loose skin at the hip area and tie up the outer thighs. And then the biggest operation is the belt lipectomy or the total body lift, where the scar goes all the way around.
Trish: And with the scar going all the way around, what I’ve seen on some is the scar goes all the way around and it ends right at the bum crack at the back. But some people have a problem with the, like a little T intersection that they’re working in.
Dr. Amira Sanki: Yeah. Do you mean where the bum crack sometimes looks elongated by that scar.
Trish: Or the fact that it doesn’t heal properly.
Dr. Amira Sanki: Yeah. And I think it is again on those skin problem, that loose skin is never just in one plane, it’s never just vertical or horizontal. So in the front we target those two planes by doing maybe a fluid release or a corset tummy tuck. But in the back area we do rarely put a vertical scar because I think that’d be quite painful. Look, my way of avoiding that is to sort of cantilever will take out the skin out naturally. So you’ve just gotta think ahead and if you can see that a patient does have a lot of skin excess around that buttock crack area you’ve gotta view about how your gonna gather it outwards rather than inwards.
Trish: It’s like a dress making skill isn’t it.
Dr. Amira Sanki: It is completely dress making. Absolutely. And sometimes I look at my patients and go, “Gosh, we just need to take a pleat here or nip tuck that.” And I think that’s the beauty of contouring in a massive way and also that you do need to be a little bit creative and tailor those operations to the patient to make sure that it does look beautiful and that you’ve given that patient the best possible results.
That’s the thing I love about the patient group as well, is that they’re up for it. You know, they listen and they trust and again thanks to forums like yours they can discuss it with other people and get some ideas.
Trish: And it’s true sometimes just by being in they might decide, “Oh, no I don’t wanna have that. I think I’ll have this instead.” You know.
Dr. Amira Sanki: Exactly.
Trish: Because it’s what they’re comfortable with as well.
Dr. Amira Sanki: Yeah. It’s a joint decision and the classic example is whether or not to have a fleur-de-lis and there are some people who look at that vertical scarring and just go, “You know what I’m just happy to accept a little bit of loose skin because I really don’t want the vertical scar.” And then there are other people who just want to be as tucked and as flat as possible and don’t care about the scars at all. So important to listen to your patients and hearing what they actually want.
Trish: That’s so true. And so just really quickly because I already talked about corset before, but the corset tummy tuck which I just love for the right person. It’s basically where you cut, is it all the way around the bottom?
Dr. Amira Sanki: Yeah. So it’s like a classic tummy tuck in the bottom incision, it’s like a fleur-de-lis in that it’s vertical as well and then there’s like a reverse tummy tuck in that there’s a cut under the bra line.
Trish: So great for anyone who’s got like the skin up there, actually it’s just cool because you get rid of all the skin up here, the skin down here and you’re tightening the middle as well.
Dr. Amira Sanki: That’s right. It’s the triple roll tummy tuck operation. So if you’ve got a roll at the top, a roll in the middle and then a lower tummy roll, that’s the operation that you should be having.
Trish: Well I’ve seen some results of people that have had that. It’s just like whoa, is that the same person? It’s just crazy. What’s the most you’ve ever worked with like skin and fat you’ve ever removed from someone weight wise.
Dr. Amira Sanki: Look, in total I think we worked out that there was one patient that we took of 15 kilos.
Trish: Yeah, that was the one. That was one of them on the group I was like whoa. That’s insane.
Dr. Amira Sanki: Yeah, it’s amazing.
Trish: I mean imagine walking around with all that excess skin.
Dr. Amira Sanki: Exactly. And I remember the assistant, my surgical assistant and I worked out the amount and then she sent me a little picture of her doing her workout with the 15 kilo weight on her back and I thought that’s essentially what that woman’s been doing for the past few years. Walking around with this unnecessary 15 kilos. The extra labour on her heart was just completely unnecessary.
Trish: Love the weight loss surgery. Alright so we’ve done the tummy and then?
Dr. Amira Sanki: And then boobs. Yes. What defines us as being woman and feminine and beautiful. So of course the main concern after weight loss is that you get breast deflation and that usually compounds on whatever breast sag and breast deflation that we’ve got from having children. So it’s a double whammy effect. And most people actually wanna go back to being as full as they were when they were a little bit larger and I think that’s because it was the only part of their body that they used to enjoy and like. So a lot of people do tend to up size with the breast implant and then we usually do a lift as well. So that’s an augmentation mastopexy or a breast lift and implants.
Trish: Do you do them at once?
Dr. Amira Sanki: Yeah I do do it at once. Yeah. There are few people who have a such extraordinary amount of breast sag that you should split it up into two different operations because of the risk that their nipple might die if you try and do it in one. But that’s rare, I think I’ve only had to do that once or twice.
Trish: So, we’ve done the boobs and then the crème de la crème I guess for people who don’t want anything else is the arms.
Dr. Amira Sanki: Arms yeah.
Trish: I’ve seen amazing results with arms.
Dr. Amira Sanki: Yeah. It’s the bit that people see, especially in Australia were wearing sleeveless.
Trish: Exactly. Unless you’ve been that person who’s paranoid about the arms, you don’t realise how much that on its own can be life changing. I know a lot of people that actually start from the top and that way they can wear their dress in summer.
Dr. Amira Sanki: That’s right. That’s right and still, yeah, exactly. The main problem with arms is the scars of course like thighs they’re long scars so they can be visible. But again, I have never had a patient where I talked to, look this is the best you’re gonna have scars, you know, that’s the cost of having nicer arms. Everyone’s like yeah, “I don’t care. I just want my arms to fit into shirts again.”
Trish: That’s true. I’ve been lucky with the arms I bet. But it’s true, the difference in there, like, you go from looking like a B person to looking tiny once you’ve had your arms done.
Dr. Amira Sanki: I think so. It makes you look young again too because the big nana arm is a major like thing.
Trish: Yeah, that’s so true. And do you do any of the face stuff.
Dr. Amira Sanki: I do, I do. So again, most massive weight loss patients do need a face and neck lift if they want something done to their face. So it’s rare that you just do a neck lift, rare that you just do a face lift. You usually need to tie them both together. And funnily enough after losing all that weight we actually fat graft, we replace some of the fat that people lose from their face from the weight loss.
Trish: Perfect. I mean if I could just do that I’d just have this massive beautiful big fat face, but then I’m skinny it sounds perfect.
Dr. Amira Sanki: I know what’s that expression everyone’s saying, it’s either your face or your ass.
Trish: Yeah, face or the body.
Dr. Amira Sanki: I mean you can have both.
Trish: Yeah exactly. So you don’t do just a neck lift, you usually do face and neck.
Dr. Amira Sanki: Yeah. To get rid of the turkey gobbler, a loose skin that you get once your double chin goes away. And then also just to bring up the cheek volume using a facelift and also get rid of the jowls. Yeah, really beautiful operation.
Trish: Yeah, I saw one of those on a group yesterday. She had a big, I mean, you have different sort of jaws, but she got it done and she used to have this beautiful refined jaw and like a neck line. But before that, it actually went from here to here.
Dr. Amira Sanki: Yeah. It was just kind of like a bleak straight line from chin down to collar bone.
Trish: Yeah and honestly she looks 20 years younger. She’s gone from looking like a 60 year old to looking like a 34 year old.
Dr. Amira Sanki: One of the nicest things I’ve ever heard one of my patients say is after her face and neck and she was a young woman, she came back to me and said, “Look, it’s so good. People have stopped asking me if my daughter is my granddaughter.”
Dr. Amira Sanki: Yeah. It must be so deflating to have people think you’re decades older than you actually are.
Trish: Yeah. And I’ve heard the expression as well, “Oh, I’m too old for that.” Or too young for that, but it’s not true these days, if it’s out there and you want to why not?
Dr. Amira Sanki: I think the youngest facelift I’ve done has been someone actually in her late thirties and that sounds extraordinary. You know, I would never have thought that that would be the right thing to do. But different people age different and you just really be open to it.
Trish: I’ve heard like people in their mid 30s looking at having a facelift because they might have a not as great chin or they might have just aged really badly.
Dr. Amira Sanki: Or kind of a weirdness in their structural features of their face that predisposes them to ageing. Yeah.
Trish: That’s great. And I know that you’ve got an aftercare booked. Do you mind if I have a little look at that later on.
Dr. Amira Sanki: Yeah, that would be fantastic. I’d love for you to have a look at it.
Trish: Well thank you so much for today.
Dr. Amira Sanki: Thanks Trish that’s my phone ringing, so unfortunately I really have to go.
Trish: So, if you’re after Dr. Sanki at Kogarah, easy parking, too good. Thanks so much.
Dr. Amira Sanki: Thank you! Thanks for coming.
Trish: Thanks a lot.