Specialist OncoPlastic and Cosmetic Breast Surgeon Dr Michael Yunaev, Principal Doctor at the Breast and Body Clinic in Sydney has a particular interest in breast revisions, breast reduction, breast lifts and all surgeries relating to breast cancer; and has seen all sorts of complex problems whether it relates to implants needing a revision or re-do reductions, sent his way due to his specialised training. He chatted to us about breast surgery including revisions and why so many women need them, and different breast reduction approaches.
After completing his Fellowship in General Surgery with the Royal Australasian College of Surgeons (FRACS) while based in Westmead Hospital, Dr Michael Yunaev went on to do a further two years of a Fellowship through BreastSurgANZ with a focus on breast cancer surgery, breast reconstruction and oncoplastic breast techniques. He has worked with some of the pioneers in the field and also completed a Master of Surgery Degree and a dissertation on Oncoplastic Breast Surgery in Australia. He has spent a further 3 years subsequently honing his skills in cosmetic surgery to help his patients achieve the best aesthetic outcomes. Dr Yunaev has extensive training and experience in breast surgery and this is why he finds himself referred to for more difficult breast surgery cases.
Why do so many women need revisions?
Breast revisions may be necessary for a variety of reasons breast asymmetry; bottoming out, capsular contracture, double bubbles, implant rippling or wrinkling and rupturing to name a few – many of them avoidable by choosing a suitably qualified and experienced surgeon the first time. Dr Yunaev says that half his practice focuses on cancer and breast pathology but a lot of his time is also dedicated to breast augmentations and their revisions. “Patients find their way to me after they’ve had problems already and come to get them sorted.”
Dr Yunaev says revision breast surgery is not a simple surgery and requires specific expertise in dealing with the problems that arise over time. ”It is important to note that it is much more difficult to achieve results that were possible in the first operation at the second or third operation and therefore it is important to have realistic expectations before embarking on this. However, with right expertise, we aim to achieve good results even with some of the most difficult problems.”
Breast Reduction makes such a difference to a patient’s life
Another surgery that can make a massive difference to a patient’s life is a breast reduction. Dr Yunaev says this is one surgery that most women are extremely grateful for. “This surgery provides instant relief to a lifetime of back, neck and shoulder pain as well as unwanted attention to their chest. Interestingly it is never too late to have this procedure, as the benefits are self-evident.”
Dr Yunaev also does a large number of re-do reductions – patients who’ve already had a reduction but need another one. “Some reduction techniques have more “bottoming out” than others. When we do re-reduction it’s more challenging and riskier because we don’t always know what was done before – it’s all about the pedicle and the blood supply and where that comes from – we don’t want to disturb the pedicle from the last operation. It helps to know what kind of procedure was done in the first place. Having access to an operation report from original surgery is a massive help.”
Dr Yunaev also performs a large number of breast lifts and is known for his natural looking and aesthetically pleasing results. Dr Yunaev says of the breast lift, “This is a great operation for providing an “augmented” look to the breast without using the implants to achieve this goal. However, like any other operation, this procedure has its own limitations and depending on your expectations I may recommend that you have this procedure in conjunction with breast augmentation. This is called augmentation mastopexy, or breast lift and implants.”
A breast lift is often also combined with a breast reduction to provide a more aesthetically pleasing result.
Aftercare is the key to happy patients
Dr Yunaev has a huge focus on his aftercare. “I generally spend a lot of time with my patients. I don’t want them to feel rushed, I want to answer all their questions. Once they go through surgery I want to follow them up myself and deal with any problems that might arise myself. Taking responsibility and taking care of your patients in all cases, whether things have gone well or whether they haven’t gone well… it’s important for patients to know I’m there no matter what.”
Dr Yunaev operates out of Chris O’Brien Lifehouse at RPAH, St Luke’s Private and Norwest Private Hospitals. You can visit his website or phone his clinic on 02 98197449.