Dr Michael Yunaev, Principal Breast Surgeon at Breast & Body Clinic, was recently interviewed by Dr Suzie Bekir, Sydney based GP and clinical director at collective.care and Taylor Clinic. Dr Suzie asked Dr Yunaev directly the questions patients are asking her so they can get it Straight From The Surgeon.
Here is what they shared:
“Dr Suzie: As a GP I like to get the most up to date information for my patients.
Many women these days are coming to see me seeking advice about who best to see regarding breast augmentation or revision. Some perhaps disappointed with an outcome or complication (sadly, some of which could have been avoided if a more qualified doctor like an accredited surgeon had been chosen in the first place😣).”
Here are the 5 top things Dr Suzie wished many of her patients had known BEFORE they had breast augmentation.
1 – Revision is inevitable. They don’t last forever!
Dr Suzie: How long do breast implants last these days?
Dr Yunaev: I think that if you are a young woman and you are trying to decide whether to have breast surgery, you need to realise that you are planning not for just one operation, this is likely to be a life-long journey, requiring revision surgery/ies in the future. These are man-made devices, which have an expiry upon them, so you need to factor in that you will need revision surgery – even if nothing goes wrong.
Implants these days last 10-15 years. Although I have seen cases of them lasting up to 30 years – although they mostly do start to have problems at that stage.
Therefore, breast augmentation surgery patient needs to factor in a couple of revisions in her lifetime as part of her ongoing management of these implants and the optimal shape of the breast for the patient involved.
2 – Don’t be fooled! Cosmetic doctors do not have the extensive surgical training that surgeons do. Go for experience not cost!
Dr Suzie: What’s the difference between seeing a plastic/oncoplastic surgeon vs cosmetic surgeon or cosmetic doctor for breast augmentation?
Dr Yunaev: There is a big difference and it’s important people do their research. Certainly, people have been quoted to say “you can train a monkey to do a breast augmentation” – however, this is going back to the days when there was limited scope for what breast augmentation stood for, which was an operation that has little in common with modern techniques.
To summarise, the difference between someone who is trained extensively in this field is that you are not getting a ‘one size fits all operation’ – which is what you might be getting in a cut-price-cosmetic-clinics. No matter who you are, there you are getting the same operation, same implant, same technique and not taking into account any of the individual variations. And in fact, there are a lot of variations to take into account for a great and importantly long lasting, natural result.
It’s very common for patients after 1-2 years to seek out another surgeon not satisfied with their results and looking for improvements. They may have had complications or it wasn’t done professionally in the first place.
3 – NEW REPORTS of the risk of lymphoma with implants.
Dr Suzie: What are the risks with implants and lymphomas? Is this a real risk?
Dr Yunaev: Recently, over the last 3-5 years we have started to notice a particular condition called ALCL – this is a type of lymphoma that seems to be associated with breast implants. There is no causative relationship that has been identified as yet, however. About 300 cases have been identified throughout the world so far out of many millions of women with breast implants in Sydney.
It’s important we put this into perspective, with 300 cases worldwide this puts a patient at an approximate 1 in 60 000 risk to develop this condition. If you think about NHL (a more common type of lymphoma) the risk is 1 in 50 and breast cancer risk in women is 1 in 8, so it’s a very very low risk overall for ALCL.
What we know is that it may be completely curable by removing the implants and the capsule if detected early on. We also now know that some implants are more likely to lead to it; with textured implants particularly heavily textured implants largely implicated. There have been no cases to date with smooth implants.
4 – SIZE REGRET. You might regret the size and wished you had gone bigger!
Dr Suzie: Is it true that many women regret going conservative and wish they had gone bigger?
Dr Yunaev: Yes, this is common for patients to come back and let us know maybe I should have gone a bit bigger and think of upsizing on revision.
5 – Add another expense, albeit an enjoyable one!! 😜You might need an entire update for your wardrobe! (I never thought of that)
Dr Suzie: How do you choose the size of implants in breast augmentation?
Dr Yunaev: When I meet patients, I make it clear if you have come here for gigantic breasts that look extremely fake, I don’t do that and I don’t offer that type of surgery. I am there to help people to regain their confidence. I think in general population is moving away from extremely fake breasts and wants a more natural look of the breasts.
My practice is focused on providing a natural look. I look at a number of indicators to achieve that goal including their overall appearances, their frame, what sort of clothes they wear.
If you think about the fact that when you change your breast size, you may need to change your wardrobe and lot of clothes. Do you want to change your wardrobe entirely?
We want to ensure that women look proportional. We don’t want to compromise their waist for sake of larger breasts and make them look frumpy and odd. A lot of attention is given to curvature of the breast, the upper breast and the so-called “side boob” – this is the lateral contour that gives the breast a certain aesthetic appeal. To achieve a certain pleasing aesthetic look that’s right for the individual patient in front of you requires knowledge, experience, technical science but also an eye for the aesthetic and for art.
About Dr Michael Yunaev
Dr Michael Yunaev is an Oncoplastic Breast, General and Cosmetic Surgeon and is the Principal Doctor at Breast & Body Clinic. Dr Yunaev is a highly trained Surgeon with extensive experience and passion for the treatment of all aspects of Breast Cancer Surgery, Benign and Congenital Breast Disease and Aesthetic Breast and Body Surgery, as well as General Surgery.
About Dr Suzie Bekir
Dr Suzie Bekir, MBBS FRACGP, is a General Practitioner and co-founder of Australian Allergy Centre and collective.care clinics at Bella Vista, Edgecliff and Wollongong.