COSMETIC SURGERY WITH DESTINATION BEAUTY FACEBOOK GROUP FREQUENTLY ASKED QUESTIONS (FAQ)

I have complied these Q&As myself with some research. If your question is not on here let me know and I will find out and add it to the list!! Adele x
Q: What hospitals do Destination Beauty use? A: They use BNH & Tria in Bangkok and Bangkok Hospital in Phuket. Q: Do I have to get immunisations prior to surgery? A: It is always recommended if visiting another country, but I think you should check with your GP and have the discussion with them. A few girls havent and didnt have a problem . Q: What medication can and cant I take prior to surgery? A: Anti-coagulants (blood thinners) if you are taking Clopidogrel, Heparin, Warfarin, Aspirin, GingkoBiloba, Vitamin A & E, etc. The dosage will need to be adjusted or stopped 1-2 weeks before any surgical operations/procedures. You can take panadol prior to surgery for headaches if needed. If you exercise and use supplements please stop protein supplements 1-2 weeks prior to surgery and you can resume this 1-2 weeks after surgery. For pre-work out supplements these should be stopped 1 month prior and should not be resumed for 1 month after. Q: Can I smoke or drink alcohol before and after surgery A: No smoking 2 weeks before or after surgery. You run the risk of your surgery being cancelled or void if any complications arise from smoking. Most surgeons will not operate if you are not in good health. Alcohol is also a no 2 weeks before and 2 weeks after the course of antibiotics is finished so totally. Q: Does the surgery have to be paid in Thai Baht? A: Yes, you must pay the surgery in Thai Baht if paying cash. If paying with credit or debit card it will be charged in Thai Baht and converted in to AUD on your bank statement. Q: What brand are the implants? A: Mentor & Silimed are the implants used. You can find more information about these brands at: www.mentorwwllc.com & www.silimed.com.br All clients are given their serial numbers for each implant. This is also kept on record at the hospital. You can choose to register the implants in Australia on the Breast Implant Register (BIR). See the link for the form in the facebook group. Q: How do I decide on where the incision is to be place for breast augmentation? A: There are several options available. - an incision under the areola, - under the breast (just above the infra-mammary fold), - in the axilla (arm pit). The choice of incision is a decision made by the patient and the surgeon. In general, they try to use the incision which is best hidden and therefore less visible. Q: How do I decide to go over or under the muscle with the breast implant? A: The decision to do a under the muscle (under the muscle) or over the muscle (under the breast tissue) or sub-pectoral (dual plane/partial) breast augmentation is based on several factors. Some of these factors include the patients preference and the patients anatomy. Each type of augmentation has its pros and cons. It is best to discuss this with your surgeon.

Q: What is the difference between textured and smooth implants? A: Texturing refers to the surface of the breast implant. Textured implants have a rough surface in an attempt to prevent contracture formation (especially when the implants are placed above the muscle). This does not appear to be relevant in under the muscle implants. Textured implants may be associated with rippling more than smooth implants. Q: Does Destination Beauty offer different types of implant shapes such as round and tear drop? A: Yes, but discuss the price difference with your rep. Q: Why do I have to massage? A: Massaging helps create an open pocket for the implant and will help keep the implants feeling soft and natural. It also minimises the risk of capsular contracture. Your surgeon will explain what, how and how often with you. Q: Can I get a pre-paid sim (micro or standard) for my phone: A: Yes, you can get them from any 7 Eleven in Thailand and they sell these extremely cheap. Q: If something happens during surgery and a blood transfusion is required - Where does the blood come from? A: Destination Beauty only uses Hospitals that are JCI accredited. This means they operate at high international standards for all their services. Blood would be checked to the same standards that we would have in any hospital in Australia. The blood is supplied by Thai Red Cross. Q: Will I need time off work? A: It is recommended that you take 1-2 weeks off of work after breast augmentation surgery. Q: When can I remove the Steri-Strips? A: Let them fall off by themselves. If they are coming off and look dirty use an antibacterial wash to help remove them softly. DO NOT pull them off like a bandaid you risk opening the incision. Q: How can I find out the exchange rate? A: Visit www.xe.com and that can give you an approximate idea of the current exchange rate. Q: When can I lift heavy things or go to the gym/exercise (including yoga, Pilates, dance, pole dancing, gym classes (pump, combat etc) anything that is related to exercise whether low, medium or high intensity? A: It is not recommended to do heavy weight lifting or strenuous exercise until 6-8 weeks after the procedure. Any exercise (such as the ones listed above but not limited to) that uses your upper body needs to be avoided for 6-8 weeks. Your chest areas needs time to heal and if you do anything too soon you risk complications. It is also recommended not to drive 2 weeks after surgery. Patients may walk and do leg exercises soon after the procedure. You can work out prior to surgery but no chest region e.g. push-ups and weights that train that area - two weeks before surgery. Q: There is a squishy or farting like sound in my breasts is this normal. A: Yes this is normal it is just air pockets around the area and they remove themselves. concerns see your GP or contact your Surgeon. Any

Q: I am having sharp pains is this normal? A: Yes, this is normal they are more frequent after post-op and subside not long after. It is common to have random pain up-to 12 months post-op and then every now and then. If the pain last awhile and does disappear then see your GP and contact your surgeon.

Q: Can the silicone gel leak? Will the implant rupture? A: Microscopic amounts of silicone gel may cross through the implant envelope. All Silimed breast implants have a low bleed barrier layer that reduces permeability of the shell and the likelihood of gel leaking or bleed. The implant shell may rupture, however this is not a common issue. In the case of rupture the gel may migrate and lead to the appearance of local complications. Discuss this further with your surgeon. Note: SILIMED high performance BioDesign silicone gel in the P-URE implant minimises the occurrence of gel migration. Q: Is it necessary to wait until after having children before having breast augmentation surgery? A: No, this is personal choice to each women, it is recommended that if you havent had children and are considering it to have the implants placed behind the muscle so breast feeding isnt affected. The implants wont affect the ability to breast feed. Q: Are there problems with breast feeding and will I be able to after having breast augmentation? A: The presence of silicone in breast milk has been researched in several studies without significant levels of the substance being found in mothers who have silicone implants when compared with women without implants. There is, however a possibility of interference when breast-feeding in women who have had the incision for the implant around the nipple/ areolar area (ie: reduced production of milk). Q: How do I decide what size to go? A: This is best discussed with your plastic surgeon to see if your desired result can be achieved. The size of your chest wall and the amount of existing breast tissue can affect this. Q: Do breast implants interfere with mammography? A: Yes. Breast implants, regardless of under or over the muscle, it can interfere with mammography. Generally, the breast implants placed under the muscle position tend to interfere with mammography less than those placed below breast tissue. Mammography centres are well accustomed to performing mammography on patients who have had breast implants (using displacement techniques). Q: Can I get a tattoo in Bangkok before or after surgery A: Yes, as long as it isnt in the area of your surgery. Q: Can I have Botox or fillers done in Bangkok? A: Yes. Q: Can sensation of the nipple/areola be lost after breast augmentation surgery? A: Yes, a small percentage can lose sensation. Q: What is capsular contracture? A: This is scar tissue that forms around the breast implants causing the breasts to harden. This hardening may be associated with tenderness and pain. This is the most common complication with breast augmentation. Under the muscle breast augmentation helps to deter capsular contracture. Massage may be useful, especially for implants placed above the muscle. There are different degrees of contracture: - Grade 1: The breast is normally soft and looks natural - Grade 2: The breast is a little firm but looks normal - Grade 3: The breast is firm and looks abnormal - Grade 4: The breast is hard, painful and looks abnormal. If severe capsular contracture occurs, it may be necessary to remove the scar tissue and replace the implant (preferably under the muscle).

Capsular Contracture may be more common following infection, hematoma, and seroma. However, it is not known for sure why Capsular Contracture happens. Q: What do the implants feel like? A: In general, implants feel firmer than your own breast tissue. The appearance and feel of breasts implants depends on how much breast tissue the patient has before surgery. In general, the more tissue you have prior to surgery, the more natural the look and feel after surgery. Q: What is a haematoma/seroma? A: It is a collection of blood within the space around the implant. Your body will absorb small haematomas and seromas but this is why drains are put in to try and alleviate this issue. Q: What is the purpose of drains? Do I really need them? How long will I have them? A: Drains are normally recommended as they help to prevent the build-up of fluid in the breasts after surgery. They can also allow some of the toxins that were stirred up during removal to drain out. Some women decide they do not want drains and do just fine after explant while others might experience a seroma (see above question). There is also a possiblity of this happening even with drains although not as common. The amount of time you have the drains will be determined by how long you have fluid flowing into the drains. Normally once this slows, the drains will be removed. It is an easy procedure that will be done by your surgeon. It is usually not very painful, but it may feel quite strange. Q: Can implants rotate or move? A: Implants may rotate, move sideways or downwards in the breast pocket. Distortion of the breast shape and discomfort may result and require removal and replacement. With the most implants the surface of the implant adheres to the interface of the tissue capsule surrounding it in a velcro-type manner, holding the implant where it was placed by your surgeon. This is particularly important for patients receiving teardrop shaped implants. The likelihood of implant displacement is minimal and Silimed back up this claim with their Product Replacement Program which includes a 10 year warranty for downward displacement and rotation. Q: How do I reduce nausea after surgery? A: Nausea is a common problem after many surgical procedures. Many medications can be used during surgery in an attempt to reduce this problem. After surgery, nausea can be reduced by minimizing the use of narcotics and taking the medication with a small amount of food in the stomach. If nausea is not relieved by these measures, anti-nausea medication may be prescribed. Let your surgeon know if you have had any experiences with nausea after sugery. Q: How do I know if I need a breast lift? A: A breast lift (mastopexy) is an operation used to treat sagging breasts. A consultation with a plastic surgeon can help answer this question for you. In general, evaluating the position of the nipple/areola complex in relation to the fold under the breast (infra-mammary fold) will help determine the need for lifting. Different types of breast lifting operations are available depending on the severity of the sagging. Reviewing pictures of patients with similar situations may be helpful in deciding how to proceed. Q: What can I expect after surgery? A: Most patients experience a moderate to significant discomfort after surgery. This seems to be increased with implants placed under the muscle compared to over the muscle. Many people are unable to sleep because they are not used to sleeping on their backs. Soreness of the back and neck may be related to this difficulty finding a comfortable position. Some people choose to use 2 pillows and sleep in a reclined position. Q: When do the stitches come out? A: The stitches come out 7 days after surgery.

Q: When can you shower after surgery? A: They recommend not to get the area wet up to 7 days after surgery. Discuss this further with your surgeon. Q: If I have to have the surgery redone later in life, will the incision be made in the same place as the original? A: Usually, yes, the incision would be made in the same area. Q: If I develop a capsule and the implants has to be removed, will I be able to have them put back again? A: Most of the time, patients wish to have implants replaced after removal of capsules (capsulotomy). Q: What is the best way for me to determine the size implant I will need to go from where I am to where I want to be? A: By looking at pictures and doing some research you should be able to have an idea of the size and shape of breast desired. You can try the Rice Test for an approx. size & CC. See the info on the facebook group page for instructions. Q: When can I sleep on my stomach? A: You need to sleep upright for at least the first 2 weeks then ease into other options. Each person is different so depending on how you feel it could be longer before you can sleep on your side or stomach. Some people can never sleep on their tummy again as it is too uncomfortable for them. Q: How long should I have to wear a post-op bra? A: It is recommended to wear a surgical garment for at least 4-6 weeks. But each person is different so the recovery will be different. You may choose to wear it for longer. Q: How long do I have to wear the bandeau (strap)? A: The amount of time that the bandeau needs to be worn depends on your specific situation. On average, the bandeau will be worn for 2-4 weeks after the procedure. Q: How long is the recovery? A: Most people are able to resume the majority of their normal activities 4-6 weeks after the procedure. Overall healing time takes 4-12 month and this varies person-to-person. Q: How long will my breast implants last? A: Breast implants do not have a determined useful life limit acknowledged by the scientific community. For this reason an annual clinical follow-up is recommended. SILIMED defines an average period of ten years as the expected lifetime of the product, but this parameter may be modified in the event of a justifiable reason. Some ladies have reported having their implants for over 20 years and never any problems! Q: I am having my surgery in sunny Thailand can I sunbake? A: It is recommended that you dont sunbake before or after your surgery. Yes you can get some sun, but no baking! Q: When can I go swimming? A: You can swim 4-6 weeks after surgery. If you are worried about your incisions maybe cover them with waterproof plastics before going in the water (after waiting 4-6 weeks!). Q: What can I use on my scars? A: There are HEAPS products on the market. Bio Oil is very popular and silicone sheets are also very popular to help minimise scars. Talk to your doctor or GP and they will give you some options.

Q: My implants are sitting high, is this normal? A: Yes, implants will sit high until they drop. They will settle and eventually find their way down. Wearing a strap and massaging will help with this. This can sometimes take up to 6 or more month. Q: What is bottoming out? A: Also known as breast implant displacement. The pocket created for the implant can sometimes fail. When this happens the loss of tissue support at the bottom half of the breast can allow the implant to move downward on the chest, gradually lowering the natural bottom, or crease fold of the breast. Although in most cases, an adequately created pocket can prevent this from happening in the first place, some doctors avoid this condition with full under the muscle coverage. Under muscular coverage involves placing the implant not only below the pectoralis muscle but also under the abdominus rectus fascia and serratus muscles. Q: Are you able to contact your plastic surgeon afterwards with questions about your healing progress A: Yes you can. Ask your surgeon for their contact details after surgery. Q: Can the plastic surgeons speak good English? A: Yes, they speak good English. Q: What should I do to reduce the risk of capsular contracture? A: Massage, Massage, Massage this is very important! Sometimes you cant prevent it though. Q: What options are there for medical travel insurance? A: There are two companies I found that I believe offer medical travel insurance. It is different to normal travel insurance and will cover you for surgery in other countries and also in the event if any complications arise. - Seven Corners https://www.sevencorners.com - Global Protective Solutions https://www.globalprotectivesolutions.com/ I would make sure that you read the fine print and get a quote to decide which policy is suitable for you. Q: What should I pack? A: Please refer to my What do pack document in the files section .