An interview with Dr Terrence Scamp
from Esteem Day Spa, Marina Mirage, Gold Coast QLD
TRISH: I’m here with Dr. Terrence Scamp who’s the resident Plastic Surgeon at the Esteem Day Spa located in the heart of the Gold Coast at the idyllic Marina Mirage in Queensland, Australia. Dr. Scamp has over twenty years experience as one of Australia’s leading cosmetic plastic surgeons. He’s a member of the Australasian Society of Aesthetic Plastic Surgery, the Australian Society of Plastic Surgeons, the American Society for Laser Medicine and Surgery, and an international corresponding member of the American Society of Plastic and Reconstructive Surgeons.
Welcome, Dr. Scamp and thank you for taking the time to give this interview. Can you tell us a little bit more about yourself and how you got into this field?
DR SCAMP: I’ve been in practice in the Gold Coast for twenty one years now, and I’ve trained in both Brisbane and overseas as well. When I came back, this looked like the best place to live, so here I am.
TRISH: I think you’re right. In your experience can you give us the main reasons why women have breast enhancement procedures?
DR SCAMP: We see two main groups. The first group are the younger girls who never developed too much at all and they want to get some shape there, and the second group, of course, is the women who have had a few kids and they had a nice bust line to start with and now it’s all begun to melt away, so they’re trying to restore what they had before.
TRISH: And what are the breast procedures that you do?
DR SCAMP: Here we do a lot of breast work. The Gold Coast is a very breast-conscious place because of the fact that eighty percent of the year it’s warm enough to get around with not too much on, so it helps to look your best and have a nice shape. We do breast augmentation, is the most common procedure. We do breast lift and breast reduction.
TRISH: And how would you suggest that someone chooses their plastic surgeon?
DR SCAMP: I think the first point is to make sure it is actually a plastic surgeon, because there’s a lot of people that come to see me, they’ve had work done elsewhere which they’re not happy with and I ask them who did the work and they tell me the name and I say that he’s not a plastic surgeon, and they seem quite surprised. So I think it’s very important to check the credentials of the person you see and that’s where the call line to the Australian Society of Plastic Surgeons can be quite helpful, or even the medical board can tell you exactly what someone’s qualifications are. So that’s the first step. After that, a lot of recommendations go on word of mouth. If someone’s been in practice for a long time, like I have, in one spot, then people do get to know you and they refer their friends to you so a lot comes through that way. But you always want to check that the person you’re seeing is what they are said to be, so it’s good to check their qualifications as well.
TRISH: Absolutely. And is there a type of boob job or procedure that’s more common than others?
DR SCAMP: Breast augmentation is the most common procedure that we do here. The most common person that we do it on is usually the mum who’s had a few kids and has melted away there and she just wants to get some size back to where she used to be or perhaps a bit more, and most commonly, they want to be in proportion. Sure we do, the Gold Coast has lots of clubs, and we do lots of dancers as well and they like to be at the upper end of size because they’re smart enough to know that their income and their bust line is proportional to each other, but they’re the exception, not the rule. It’s mostly people who want to be in proportion for their build.
TRISH: And is there a particular minimum or maximum age bracket that you would recommend not having implants?
DR SCAMP: Well, Queensland legislation means that no one can have a cosmetic procedure before eighteen years of age, and I think that’s a good time to be able to make up your own mind. The eighteen year olds we see, they often come in with their mum as a backup because mum’s often go for breast implants as well, so they get a second opinion there. In fact, I’ve been in practice long enough now that the mums are bringing their daughters in and I’ve done the mm’s breasts as well.
TRISH: And can you give us a brief outline of the different types of breast implants?
DR SCAMP: Yeah. Well firstly, the saline-filled implants, they’re pretty rare these days. We don’t use them too much at all, mostly because they don’t feel or look as life-like, so I mention them to sort of dismiss them. We can use them if people ask for them, but I think the last time someone asked me for saline-filled implants was probably ten years ago, because the results generally just aren’t as good. They can be fine in a small group of people, but across the board they’re not quite as good. These days the choices are much more complex because we have many more implants to use and to choose from. You can have round tear-drop shaped, they can have a smooth wall or a rough wall, they can have a coating on the outside of polyurethane, which is what they call the Brazilian implant. People think they’re brand new and they’re from Brazil. They were first used in the 80s, that’s when I first used them and they were taken off the market in 1991 because there were concerns that the coating on the outside could cause cancer. It doesn’t seem to do that in people, but it does in animals. So, they’re back in use now, but they haven’t been used worldwide for as long as the other types of implants. With the smooth implant, they’re round, we make a big space, we get people to massage to move them so they’ll bounce when the person bounces and feel nice and soft. With a textured implant, we’re after the implant to stay more or less still, not completely still, but for it to move less and the breast to slide on top. And with the textured implant, they can come in different shapes as well, and that’s really been the biggest advance in breast augmentation with the many different shapes that we have now to choose from. That gives us the capacity to better adjust for a degree of asymmetry on the two sides. All girls are different on their two sides and about sixty percent of the time I will use a different implant on each side to try to get things to match a bit better.
TRISH: So with the really hard ones, they generally the silicone?
DR SCAMP: The hardening is a reflection not of the implant, it’s a reflection of the reaction of the body to the implant. In other words, the body’s formed a scar wall around the implant. It does that with anything you put into it, be it a joint prostheses or a piece of glass. It will wall that off. In some people, however, when the scar tissue forms around the breast implant, it will thicken, and shrink and push on it, and make it feel firm. When you take the implant out, it feels soft, but it’s the scar tissue holding it in a bunch that makes it feel hard. When this procedure was first done in the 60s, that occurred about sixty percent of the time. Now, our risk of going hard like that is about five percent or a bit less, and that’s because the techniques have evolved so much to try and prevent that to try to get that down to naught.
TRISH: Okay, and with implants, what type do you most commonly use and why? Do you have a preference?
DR SCAMP: I really try to match the implant to the person, so I examine them, I talk to them about what shape they like, what size they want to be, and then based on what their breasts look like now, I can choose an implant and show them with the Vectra system we can take a photograph and then with the computer we can adjust it to show them what they would look like with that style of implant, so it helps us to communicate back and forth. Now, the biggest thing that determines your shape after the operation is actually your shape before the operation. The implant can’t change the breast shape completely, but it can lead you a bit more one way or the other depending upon where you want to go. So I try really not to have a set type of implant that I use. I try to match it to the person and what they’re trying to achieve.
TRISH: So it’s very individual?
DR SCAMP: Extremely.
TRISH: Okay. And what advice would you give to someone who’s not at their ideal weight but wants to have a boob job?
DR SCAMP: Breast augmentation is a pretty safe procedure regardless of your weight, so long as you’re fit enough for anesthetic. Breast reduction, however, breast lift, if you’re significantly overweight, they can be much more dangerous. The complication rate goes up a lot higher, but it’s often a good time for me to talk to people about their weight and how it’s not good for their health and if they’re trying to improve their appearance, it makes sense to get the rest of them to look as good as they can too.
TRISH: Sure. Maybe it could be a little bit of incentive for them to lose a bit of weight.
DR SCAMP: Yeah. If they’re suddenly in the mood where they’re trying to make themselves look as good as they can, then it makes sense to get the rest of you in shape as well.
TRISH: Absolutely. Many women out there feel that the new breasts might look fake, but how can they make sure that they end up with natural-looking boobs? For example, is there different implants to suit different body shapes?
DR SCAMP: People think that breast jobs can look fake because the ones they see that are looking fake are the ones that they know have had a breast job. What they don’t see is the hundreds of girls that walk past them each day who’ve had their breasts done in such a way as for them to look real.
TRISH: Very true.
DR SCAMP: So again that comes back to matching the implant shape and size to the person’s breast and to their desires where they’re trying to get to. And saying if someone’s tiny, that a very large implant can look a bit fake and that’s okay if they’re a dancer and that’s the look they’re trying to get, but other people need to be aware that they can push it too far if they go too far.
TRISH: Okay. And what are the main factors women should consider when deciding on a final size?
DR SCAMP: I think the main thing is to have their breasts measured so we can see what fits within the breast shape and what would be well-hidden by the breast. You don’t want to have a breast that’s too small to hide the implant, or you’ll be able to feel the implant around the edges. Then once we’ve worked out the framework in which we can work, then once you know the width of the implant from that, you can work out how much projection, and how we do that is with the Vectra, by giving them an idea of what it would look like and also we have a sizer kit that they can try on, so they can see themselves in a tight t-shirt knowing what they would look like with that implant and see a picture on the computer screen. We’ve only had this device for almost a year now, but I think it’s made a nice improvement to people’s degree of comfort when they come to the operation. They’ve got a pretty firm idea of what they’re going to get and they’re quite comfortable with it.
TRISH: Great, so I can come and see you wanting a breast implant, come and have a photo, see what it will look like, try on a bra and see what I would look like after the surgery. That’s fantastic. Is there anything else that you’d like to add?
DR SCAMP: I think that people need to know that a breast prostheses isn’t necessarily something that will last them a lifetime. They’re quite strong now, the gels we use are dense. You can actually cut these implants in half and they’ll stay in two chunks. They don’t leak as such. They can still break, but they’re designed to last a long time. But, your breasts will change as the years go by and you may wish to come back to change the implant as well. We don’t have a set timeline. People seem to think they’ve got to change them each ten years once they get them in. It isn’t like that. Most commonly we see someone doing this at twenty one and they come back at forty-something or other. They’ve had kids, their breasts have changed and they want to change things again. But it is an operation where you’re embarking on a course that you will have to keep in mind for the rest of your life.
TRISH: And just to close off, what range of services do you provide if anyone’s looking for a consult, how do they contact you?
DR SCAMP: The easiest way to get a consult is just to ring the office which on the Gold Coast is 07 5539 1000. Some people if they’re interstate or at a distance, overseas, they like to email us and we can often answer and give them a good idea of what would be required, what would be entailed, and send them information that works well because they fly in, they’re completely informed, I’ve already spoken to them on the phone and we’re halfway towards making a firm decision and then I see them and we plan the operation for a day or so’s time because of the fact that we’ve done all the work beforehand.
TRISH: Great, so you don’t necessarily have to be on the Gold Coast
DR SCAMP: No, lots of people have a vacation house here, but they live elsewhere or they come here once a year and they like to take advantage of that fact.
TRISH: Thank you so much, Dr. Scamp. If you’re interested in seeing or using Dr. Scamp’s service, you can get them on the website at www.esteemdayspa.com.au. Thank you.
DR SCAMP: Thank you.