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The importance of financial consent in healthcare — a lesson I learnt the hard way!

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Financial consent in healthcare is a subject seldom spoken about. One of the issues is because takes a rocket scientist to understand the financial aspects of our health care system. Health fund rebates, Medicare rebates, schedule fees, no gaps, bulk bill, assistant fees, implant costs, incidental costs — what do all these words mean? And why are they important?

My not-so-great experience with unexpected medical bills

I was having a particularly busy day last May. So busy that I didn’t have time for lunch and was happy to find a hard piece of licorice “chew chew” in my work bag. So busy that I didn’t have time to suck my “chew chew” and ended up grinding down hard on a sharp wedge of licorice that split one of my canine teeth. I was devastated. I spent the rest of the day chatting to my patients while in significant pain and then cried after the dentist told me I would need to have the tooth pulled. Being a pirate is NOT a good look for a plastic surgeon.

But once the hurt of my ageing tooth passed, the agony of the cost of a dental implant started to take effect. The news of my dental extraction, dummy tooth insertion and three stage dental implant was drip fed to me. The financial hit came in increments that were almost as sharp as the initial piece of licorice that delivered me to the dentist’s chair.

I was truly financially cranky because financial consent was not a part of my dental implant process. Noone sat me down in a quiet room and gently talked me through the costs. I am now very grateful to have had an uncomplicated dental implant but I had taken my own thorough practices for financial consent In healthcare for granted.

Plastic surgeons are well and truly the most upfront, efficient and experienced doctors in delivering financial consent when it comes to their patient’s surgeries and care. Ironically, this is because our surgery is elective. Patients have a choice to go ahead with their procedure and significant choice in picking the surgeon, hospital and devices they would like to use. If the price is not right, they can elect to get a second opinion or not go ahead with the procedure.

What is financial consent in healthcare?

Financial consent in healthcare is a meticulous estimate of your fees which you agree upon prior to surgery. I say estimate because unfortunately, no surgeon has control of Medicare, hospital costs or mother nature.

In my practice atSouthern Aesthetic Plastic Surgery, a patient will receive the following information that will allow them to financially consent to any services we provide:

  1. On the day of consultation: Clients will receive a Surgeon and Surgical Assistant’s fee estimate and expected rebate. A rebate can only be expected if the procedure has a Medicare item number. For example, a breast lift only attracts a rebate from Medicare if two thirds of the patient’s breast gland sits below the inframammary fold and their nipples point downwards.In addition, patients are given a “Booking process” information sheet to explain the NSW Medical Board rules about cooling off periods, as well as expectations regarding surgical deposits, refunds, cancellation fees and the costs of revisional surgery.
  1. Within 7 days of consultation: Clients will receive the hospital estimate, anaesthetist’s estimate and cost of medical devices, eg. breast implants.
  2. Day 1 post operation: The client will receive a surgical receipt, which is issued to the patientand can then be taken to Medicare and the patient’s health fund to collect their rebates.

The role of Medicare

Traditionally, medical and surgical professionals have not felt the need to provide a detailed financial consent in healthcare practices as they deem their services essential.

It is important to realize that Australians are remarkably fortunate to always have the ability tochoose their doctor. You should always ask what the costs of surgery are before agreeing to a procedure. If it seems too much, then call other doctor’s rooms for an estimate or speak to your GP about an alternative person to see.

The final important point is that all essential surgery is covered by Medicare. Any Australian requiring surgery to treat cancer or a trauma (eg. hand fracture) can have this surgery performed, for free, in the public health care system.

Dr Amira Sanki is a highly-accredited plastic surgeon practicing in Sydney, Australia. She is an owner of Southern Aesthetic Plastic Surgery, which is based in Kogarah, Miranda and Newtown.

Five questions about breast augmentation recovery, answered

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From influencers on social media, to fellow mums at the local café, it seems like breast implants are more common than ever before. In fact, breast augmentation surgery is one of the common procedures that we perform at Southern Aesthetic. And while you’re probably aware of the many benefits of breast augmentation —such as having bigger or more even breasts —it’s important to consider what breast augmentation recovery looks like. As a female surgeon who understands a woman’s point of view —as well as the many jobs that women juggle in their day-to-day —here are five things I think you should know about how breast augmentation recovery might impact your everyday life.

How long does breast augmentation surgery take?

Breast augmentation surgery usually takes place as a day surgery in a hospital. The procedure usually takes about 1.5 hours and most patients are not required to stay overnight at hospital.

How long does breast augmentation recovery take?

As everybody is different, recovery time may differ depending on the individual. However, usually we recommend a rest time of one week. If you don’t have a physically intensive job, you should be able to return to work after one week. You should also be able to drive and do light exercise (light walking) after one week. However, we recommend patients wait at least six weeks before playing sport or getting back into the gym. In terms of physically-demanding or strenuous tasks —notably activitiesthat could raise your heart rate or blood pressure –we recommend waiting at least 2-3 weeks. Mums, this could include lifting young children throughout the day, so it might be wise to recruit some extra help around the house during your recovery period.

Are there any side effects that I may experience during breast augmentation recovery?

During the recovery period, it’s common for patients to experience swelling and soreness in the breasts and chest. Some patients may also experience bruising. If you are experiencing severe pain from these symptoms, contact your doctor and they may be able to prescribe medication to alleviate the pain. While you’re recovering, it might also help to wear a compression bandage or sports bra for extra support and positioning of the breast implants.

What are some warning signs that I should look out for post-surgery?

At Southern Aesthetic, our surgical team are highly-qualified and trained to deliver the best surgical outcomes possible. We alsouse the highest quality breast implants available for all our clients. However, there are still some risks associated with breast augmentation surgery,such as capsular contracture, infection, malposition and leaking. In some cases,breast implant associated-Anaplastic Large Cell Lymphoma(ALCL) may also occur. The severity of theseproblems can vary, and may result in minorissues or dissatisfaction,to needing further surgery or even the complete removal of your breastimplants.Should you experience any of these more severe consequences, please contact your doctor immediately.

Who is a good candidate for breast augmentation surgery?

While most of our clients are aged between 20-45 years, adult women of all ages opt for breast augmentation surgery for a variety of reasons —whether that be due to physical changes brought on by childbirth and breast feeding, to add implants following a mastectomy, or simply to gain more self-confidence.

At Southern Aesthetic, while there are many benefits of breast augmentation surgery, we believe it is important to recognise that this is a life-changing procedure that deserves thorough research and planning to ensure a safe and easy recovery.

At Southern Aesthetic, our all-female surgical team strive to make your surgery and recovery experience as safe and pleasant as possible. You can read more on breast augmentation surgery on our website, or check out our Instagram page to read about breast augmentation recovery, as well as see some of our latest work. To book a consultation with Dr Amira Sanki, call or email us today

Dr Amira Sanki opens up about her experience as a female plastic surgeon

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Dr Amira Sanki, qualified Plastic and Reconstructive Surgeon and owner of Southern Aesthetic Plastic Surgery, opens up about her experience as a female plastic surgeon and what she loves about her job. 

I spoke to the current year 10 cohort at my old high school recently as part of a careers afternoon. I think I found it even more inspiring than the students did! I reminded myself of all the important milestones I had to achieve to become a female plastic surgeon and the reasons why I chose this profession.

My young audience were a little shocked when I explained that it took me the duration of their lifetime to become a plastic surgeon. Six years of medical school, one year of internship, two years of surgical residency, two years as a general surgery registrar and four years as a plastic surgery registrar. Somehow I also managed to get married and have two children while doing ward rounds, operating, studying, sitting exams and attending hospital clinics. In my sixteenth post-high school year, I was also awarded a Doctorate of Philosophy.

The most important and soul searching question my young audience asked me was, “What kept you going in those fifteen years?” The answer is simple— I really wanted to be a plastic surgeon.

I completely believe I belong to oneof the best professions in the world. The immeasurable gratitude and respect my patients afford me when they have finished their surgical journey gives me the greatest high any professional can experience. I also have the privilege of becoming my patients’ confidante, advisor and friend. Today in the office, I reviewed a young artist whose tendon I repaired last week after a glass injury and then I saw one of my post-operative tummy tuck patients. They were both equally grateful. The enormous spectrum of plastic surgery has one common link —we restore form by restoring function. And vice versa

What insight does being a female plastic surgeon give me? I understand first-hand the changes a woman’s body and face goes through with time. I understand how critical a mother is to the smooth functioning of her family’s network. So many women put off essential plastic surgery to restore and help themselves because they are concerned that their family will not be able to cope without them during the recovery period. In fact, one of my breast reduction patients wanted to cancel her surgery this week because her young child has a cold! A woman should not be considered selfish if she is not selfless.

Being a female plastic surgeon entails so much more than just being a surgeon. I am an advocate for my patients, my profession and my gender. It is very important to me to stick up for the health “rights” of my patients. I am very proud to be a board member of ASAPS, which excels in providing the highest level of aesthetic education to our members and is an authoritative voice to help improve the public’s understanding of our profession.

Finally, when I started my plastic surgery training, there were only four female plastic surgeons in New South Wales. Now we have eleven female plastic surgery registrars in training. It gives me great pleasure to mentor these women to become great surgeons.

Plastic surgery empowers women. While we are unfortunately faced with ridiculous photo-shopped images of perfect faces and bodies in magazines and billboards, it is not a plastic surgeon’s goal to sculpt women into manufactured perfection. It is our goal to help women regain their confidence by looking as good as they feel. You can tell who the post-operative patients are in my waiting room-they are the women with a strong smile, tall posture and a little skip in their stride. They are happy, healthy and beautiful.

Four reasons why women get breast augmentation surgery

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Breast augmentation surgery involves the enhancement of the natural breast my placing an implant behind the breast tissue. What was once a somewhat taboo procedure is now becoming more and more common in today’s society. There are many different reasons for why women get breast augmentation surgery, each as valid as the next.

Here are four common reasons why women choose to get breast implants.

  1. To reclaim their pre-pregnancy breasts

It’s no secret that pregnancy changes your body. Once you fall pregnant, it’s normal for your breasts to change shape, size and feel. After years of pregnancy and breastfeeding children, many women are left with stretch marks, sagging skin, a loss in breast density and an increase in lumps and bumps. While it’s normal to experience these changes, it’s also normal to feel self-conscious about them. That’s where breast augmentation surgery can help. Breast implants will help give shape and density back to your breasts, as well as lifting them higher on your chest – back where they belong.

  1. To restore their breasts following breast cancer

One way many women treat or prevent breast cancer is through undergoing a mastectomy. This is the procedure whereby one or both of the breasts are removed – either partially or completely – to prevent the spread or development of cancer cells. As great as it is to beat cancer, it’s common to feel a sense of sadness and loss following a mastectomy. Restoring your breasts to their pre-cancer state is another reason why women get breast augmentation surgery. This is one solution to overcoming this emotional time in their lives and close the chapter on their battle with cancer.

  1. To repair their breasts after weight loss

While weight loss has many health benefits, one of its few detriments is that it often leaves women with excess skin and saggy breasts. The chest is one area where fat deposits are stored, so when you lose weight – especially when you lose a lot of weight – it’s normal for your breasts to lose shape and density. Luckily, breast implants and a breast lift will fix that right up!

  1. To feel confident

Not all of us were born happy with our breasts. Many people feel having breasts is an intrinsic part of being a woman, and having small, uneven or misshaped breasts can take a huge toll on your self-esteem. From not being able to fill out clothes properly to feeling too self-conscious to date, being unhappy with your natural breasts can affect your day-to-day life in a variety of ways. Overcoming these challenges is another reason why women get breast augmentation surgery. Enhancing and lifting your natural breasts can be liberating in many ways, with many clients reporting feeling more confident and feminine post-surgery.

For more information about breast augmentation surgery, get in touch with Dr. Amira Sanki at Southern Aesthetic. Call or email us to book in your consultation today.

Five brilliant benefits of breast reduction surgery

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Breast reduction surgery is one of the most common procedures that I perform and the procedure that my training plastic surgery registrars ask about most. Why? Because there are so many benefits of breast reduction surgery. At Southern Aesthetic, my team and I get our patients great results by lifting the breast, removing its unnecessary weight and reshaping it to get a prettier, more youthful look.

Why do patients and plastic surgeons LOVE breast reductions? Here are five great reasons.

  1. A breast reduction reduces the weight of your breast.

I know this sounds obvious, but one of the biggest benefits of breast reduction surgery is the removal of weight from the breasts. In my experience, most women have 300-1000g removed from EACH breast during surgery. Have you ever thought that you might be carrying an unnecessary kilo on your chest for the past few decades? Once removed, you will immediately feel lighter. In fact, even my anaesthetist notices a change in our patient’s ventilation pressures during their surgery after the weight has been removed.

  1. A breast reduction lifts the breasts.

Few women are fortunate enough to have large AND perky breasts. Most of the time, the weight of the breast tissue drags the breast skin and nipple down with gravity. Another of the many benefits of breast reduction surgery is that it lifts the breasts higher on the chest. A breast reduction is designed to raise the nipple into a higher position, as well as removing all the low-hanging breast tissue.

  1. A breast reduction produces long lasting results.

While breast production surgery won’t stop your breasts from sagging and aging naturally, since they are no longer as heavy as they once were, they are unlikely to ever go back to their old shape. Women who plan not to change weight or have more children will find that their result has good longevity.

  1. No one will be aware that you’ve had a breast reduction (unless you tell them!)

One of the social benefits of breast reduction surgery is that you don’t have to tell anyone – or explain to anyone – why you’ve opted to have the surgery. Unlike other types of cosmetic procedures, it’s hard to tell that you’ve actually had a breast reduction – although many people will tell you that you look great.

Most of my patients report that people keep asking them if they have lost weight, started going to the gym or have just had a holiday. After a breast reduction, your friends and family will be more aware of the balance in your shoulder-waist-hip ratio.

  1. Breast reduction surgery reduces the relative risk ratio of breast cancer by 2.2!

One of the little-known benefits of breast reduction surgery is that it’ll reduce your risk of getting breast cancer. While this doesn’t mean that you’ll avoid getting breast cancer, there will be less breast tissue that can potentially transform into a breast cancer. Please note that women who have had breast reduction surgery still need to get mammograms every two years.

 For more information about the benefits of breast reduction surgery, get in touch with Dr. Amira Sanki at Southern Aesthetic. Call or email us today to book in your consultation!

Completing your weight loss journey with body contouring sugery

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Wow. You did it. You got motivated and had a gastric sleeve, band or bypass. You saw dieticians and psychologists and personal trainers. You blogged about your journey. The receptionist at the doctor’s rooms knows your entire family history because you see her more than you see your friends.  You dragged your family through the surgery, the fasting, the exercising. And you’re finally done.

You constantly flick through your phone. Staring. Amazed. Was that really me? Your photos and old clothes are the only evidence you have of being large. Huge. Morbidly obese. You’re not morbid anymore. You’re full of life and energy. It makes you smile when people don’t recognize you.
 
But then they say something that takes all the joy away. You look gaunt. You look too thin. You pack your folds of skin into your spanks and underpants. You strap your skin up so it doesn’t bounce when you exercise. Your arms are a size 16, but your waist is a size 10. You go online to hear reassurance from your Facebook friends that it was still worth it. You are healthy but unhappy.
 
This is an incredibly common experience that people have once they’ve undergone extreme weight loss. It’s often an emotional and confusing time, as you may have many unexpected consequences that you find yourself facing.
 
One solution that many of my patients opt for is body contouring surgery.
 
Body contouring surgery is the final step in the massive weight loss journey. I really enjoy these consultations as my patients are filled with dread and concern about their body, and I provide them with information and reassurance about the predictable results we can achieve.
 

What is body contouring surgery?

Body contouring surgery encompasses plastic surgery procedures on the arms, chest, breasts, tummy and thighs to remove excess skin and artfully mould the remaining skin and fat into a feminine shape. The goal of the surgery is to achieve a fit and healthy appearance.

How do patients feel after their body contouring surgery?

Our patients describe that after their body contouring surgery, they feel confident for the first time in their lives. They are able to buy clothing that fits comfortably and beautifully. I receive photos every week from my patients in slinky dresses and revealing bikinis showing how transformed they are by their surgery.

There are many physical benefits to body contouring as well. Heavy residual skin folds gather a lot of bacteria and can lead to “panniculitis” or skin and fat infections. Over time, the skin fold can also chronically gather fluid and become very heavy.

What kind of body contouring procedures do I need?

Most patients that lose around 30kgs often only require an abdominoplasty or tummy tuck. Patients that lose over 45kgs, usually require multiple operations. These are staged into 4 to 6 hour segments to minimize the patient’s complications from the anaesthetic and from lying still for too long.

The usual sequence of procedures are a tummy tuck and augmentation, mastopexy (breast implant and breast lift), followed by arm lift and thigh lift. Many patients forget that their face has also aged a lot after their weight loss. A face and neck lift is the best method to deal with facial hollowing and neck skin excess.

What if I’m not sure about body contouring?

Making an appointment to talk about surgical and non-surgical alternatives to help improve your body does not necessarily commit you to going ahead with these procedures. An appointment is a great first step to get a proper body assessment to help determine if plastic surgery is a good option, and also to find out more about the expectations, risks and alternatives of body contouring procedures.

For more information about body contouring surgery, get in touch with Dr. Amira Sanki at Southern Aesthetic. Call or email us today to book in your commitment-free consultation.

5 benefits of a tummy tuck

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A tummy tuck, also known as an abdominoplasty, might sound like a drastic way to reclaim your old body – or even get the body you have never had. Going ahead with surgery is a simple calculation of making sure the benefits of the procedure outweigh its potential disadvantages. Here are five benefits of a tummy tuck, as described by my patients after their tummy tuck procedures.

A tummy tuck flattens your tummy.

Do people ask you how many months pregnant you are? Does your tummy bulge through your clothing? This may be due to separation of your rectus abdominus muscles. The muscles split to allow your baby and uterus to grow during pregnancy. But after multiple babies – or even one or two big babies – the muscles are irreversibly damaged and stay wide open. One of the benefits of a tummy tuck is that it zips the muscles back to their normal position and pushes your abdominal contents back into your abdomen, where they belong! Which brings me to…

A tummy tuck improves your core strength.

This makes perfect sense. If the muscles are restored back to their normal position, they can finally function again. Other lesser-known benefits of a tummy tuck is that it also shows improvement to other bodily functions. Our muscles have been designed to work together. An Australian clinical trial has also shown that women notice an improvement in their back pain and continence after a tummy tuck.

Your undies won’t slide under your tummy roll.

You know the look: you see a woman discreetly sneak her hand to the elastic band of her underpants and slip her tummy back into her nanna pants.
We all like to be held in. We wear Spanx, Nancy Ganz and compression pantyhose to hold our skin down so we can’t feel it flopping about. Other benefits of a tummy tuck are that the procedure gets rid of excess skin from pregnancy and weight loss, so that you won’t need to squeeze yourself back into compression gear.

The scar is neatly hidden beneath your panty line.

Worried about judgment? No-one even needs to know that you’ve had a tummy tuck as the scar will be completely hidden – under even skimpy clothing! How you scar will depend on your genetic history. If your other scars are nice, fine lines then your tummy tuck scar will also hopefully heal well, too.

Your work and family will cope while you are healing.

Many women feel selfish having elective plastic surgery. Finding the right time in your life to have surgery and arranging for others to help manage your family are the two most difficult aspects of planning a tummy tuck operation. Amazingly, partners and children do cope while Mum is out of action. In fact, most women are happily surprised how much support their family and friends give them. It is not selfish to have surgery to improve your wellbeing. You are the important core of your family. If you are happy and healthy, then your family is happy as well.

For more information about the benefits of a tummy tuck, get in touch with at Southern Aesthetic. Call or email us today to book in your consultation.