I caught up with the super lovely Dr Mark Hanikeri at the recent 40th ASAPS conference in Melbourne and asked him about one of his more common procedures, the Mummy Makeover. Watch the video below.
What are the more common procedures you perform as part of the Mummy Makeover? Eg. tummy tuck, breast lift, etc.?
Dr Mark Hanikeri: The most common procedures as part of a mummy makeover are breast surgery and tummy tuck. With the breast surgery, most women after breastfeeding and having children lose a bit of volume, particularly in the upper pole, and so most of them want their breasts lifted and filled up again. That usually involves elevating the nipple back to the position that it was before they had kids and filling the lost volume that they’ve experienced after breast feeding with an implant. I usually do that.
Often that’s combined with a tummy tuck. Many women after having babies lose a lot of tone in their abdominal wall and so that’s often a problem for them, they get bloating, they feel a lack of confidence because even though they may not be significantly overweight, they feel overweight because they have low abdominal tone, and sometimes they’ve got a little bit of stretched skin. Combining the tummy tuck with tightening of the muscle fascia, lifting and elevating the breasts and filling up the lost volume gives a lot of these women a lot more confidence.
What are your views on performing more than one procedure at a time? What are the pros and cons?
One of the other advantages of combining procedures other than the fact that there’s only one recovery, is that sometimes it can save the patients a bit of money. Sometimes there are procedures that have with them a Medicare item number and so part of their theatre fee can be covered by that Medicare item number if they have private health insurance. Combining the procedures can sometimes save the patient’s money. Also, some surgeons, including myself, will apply a discount and right to a second procedure because of the fact that time is saved for the surgeon, anaesthetic time and wake up recovery time is saved if there’s two procedures that are combined. Often the surgical fee is less for two procedures than it is for one, so some patients see that as an advantage.
Some of the disadvantages of combining procedures are that it is an increased metabolic demand for the patients, so patients who may not be particularly robust or strong, if they have a lengthy operative procedure that might take six or seven hours in some cases, that can be quite a challenge to them metabolically and it can cause problems like an increased risk of infection, increased problems with recovery or bleeding.
Although that’s not very common, it is a greater risk particularly for patients, such as body contouring patients where you might be combining large procedures into one. Another potential disadvantage of combining procedures is that it is, even though they may save money, it is a bigger total cost than doing those procedures separately, and so patients need to be able to fund a bigger procedure with more financial outlay in one occasion.
What do you find the biggest challenges are for tummy tuck/abdominoplasty patients?
There’s a number of challenges. From the surgical point of view, some of the challenges include managing the patient’s expectations. Sometimes patients feel that you can make them look very young again or that you can make them look like something that’s not within their anatomy, so managing patient expectations can be a challenge, particularly for the larger patients that think that you can make them very slim simply by lipo sucking all their fat away and trimming and tightening. That’s not always achievable.
If patients were slim, then often you can make them the way they used to be. If patients have never been slim, it’s very difficult to make them the way that they might expect to be that isn’t in line with their anatomy. Managing patient expectations is one difficulty. Another difficulty is sometimes challenging the patients for the recovery and the financial outlay that they may need for the procedure.
Some patients aren’t aware that many of these procedures are not covered by Medicare and private health insurance, and sometimes when you let them know that they need to come up with the money for the operation, not only for my fee and for the anaesthetist’s fee, but for the hospital and on some occasions, for unforeseen circumstances where they might be revision or additional procedures. That can be challenging.
What other advice do you have for women looking to undergo mummy makeover procedures?
Look, I think it’s really important for people who are considering any surgical procedures to do their research, but that’s particularly the case for mummy makeover surgery. One of the challenges for augmentation mastopexy, which is one of the procedures that is part of a mummy makeover is whether or not you do it one stage or in two stages. There are some surgeons who always do it in one stage, and some surgeons who always do it two stages. There are pluses and minuses of each approach.
I think it’s important for the patient to understand why a surgeon might want to do that type of operation in two stages and what the challenges are, not only from a cosmetic point of view but from a risk point of view because in some circumstances combining procedures into one stage like an augmentation and a mastopexy introduces a lot of risk. That risk might not only be the way that the breast looks but also things like the blood supply to the nipple and the nerve supply to the nipple, which can be more affected by combining those procedures into one stage.
Doing your research as to whether or not you’re an appropriate candidate and whether the surgeon that you are going to see for that procedure has experience in both one stage and two stage procedures and has the ability to let you know which is more appropriate is important. There are also some surgeons that are not trained plastic surgeons who will often try and fill up the lost volume and tell people that they don’t need a lift when in fact they do need a lift, and they’re never going to get an appropriate aesthetic result without a lift.
You need to just check the qualifications of your surgeon and make sure that you’re seeing a specialist plastic surgeon who’s aware of the techniques of nipple elevating and augmentation at the same time with an acceptable amount of risk.
To find out more about Dr Mark Hanikeri check out his listing where you’ll find contact details, blogs and more.