Hi, I’m Dr. Tony Prochazka, a cosmetic surgeon working in Sydney and Melbourne. I’ve been doing this work for about 16 years, and I’ve qualified as a fellow of the Australasian College of Cosmetic Surgery, and I’m also a fellow of the Cosmetic Physicians College of Australasia. I’d like to talk to you a little bit about my approach to face lifting. Face lifting is a field that’s actually been around for over 100 years, believe it or not, but the early facelifts were very crude. Face lifting, I guess, in my opinion, really came into its own probably about 25, 30 years ago. During my training I was learning the very long involved and invasive facelift procedures that involve a very large incision that goes all the way behind the ear, down into the hairline here, a very large amount of dissection, and then actually also identifying the main supportive membrane of the face, cutting into it, undermining it, sometimes cutting a bit of it out, and then pulling it up, stitching it to itself. You can imagine this is really a very invasive procedure. In the year 2002, a Belgian plastic surgeon by the name of Dr. Patrick Tonnard published a seminal paper on a new less invasive type of facial lift, called the MACS lift, M-A-C-S, it stands for minimal access cranial suspension. Minimal access really just means short scar. Cranial suspension really just means vertical lifting, lifting upwards towards the cranium. The old style facelift with a lot of dissection behind the ear tended to pull all the tissues up pretty much behind the ear. This is a more oblique direction, can actually cause distortion of the corners of the mouth, so you get that kind of fish mouth look, and it can also give a windswept appearance. It’s a very effective lift, but I don’t think it’s 100% natural. The MACS lift, in my hands at least, gives a very natural result. It is still a true facelift because we are still identifying that deeper structural layer, and we are repositioning that. But instead of […]
Now you’ve probably heard, or read on the internet that you always get a more natural result if the implant goes behind the muscle. This is usually true, but not always true. There are some situations where we really can’t put the implants behind the muscle. A typical example would be a lady who’s had children and breastfed, and has got somewhat droopy breasts. There are some situations where we would actually need to do a lift, but if I decide that we can get away without doing a lift, I may nevertheless recommend that the implant go in front of the muscle, directly behind the breast tissue. As you can imagine, post breastfeeding breasts tend to be very mobile. They go a long way up and down, and they can move sideways. They’re kind of loose, and you can well imagine that if we sit an implant on the chest wall, that’s in a fixed position. The breast tissue is going to is still be mobile on that, if the implant is behind the muscle because the implant and the breast tissue are not in direct contact. So in that situation, when you do have a very mobile breast tissue, you might find that the breast tissue hangs off the implant when you’re leaning forward. When you lie back to go to sleep, the breast tissue sloshes to the size of the implant, and so on and so forth. Even when you’re just standing up normally, the breast tissue can hang off the end of the implant and we actually have a name for that. It’s a terrible name. We call it the Snoopy dog deformity. It’s not good. We find that if we get the implant size, diameter, and overall dimensions correct and put it in front of the muscle because the implant is now in direct contact with breast tissue, it’s going to control the breast tissue much better, and you won’t get those problems.
Let me talk to you a bit about implant selection in breast augmentation. We have a number of different types of implant available, and a number of different brands. As you probably all know, the main two varieties are ones with saline fill and those with silicone gel fill. I’m a big fan of the silicone implants. I don’t really like using saline. I don’t think it gives as natural a result. Silicone gel is a very safe, biologically inert product. The companies that make breast implants have been improving their procedures over a number of decades in order to achieve a product which is minimally invasive and minimally damaging to human tissue. I’m confident in the implants that we use now. I mainly use Mentor brand implants. I think it’s an excellent company, and they have a very good product. Once we’ve made that decision, we also have to think about the size. We have to think about whether we’re going to use round or teardrop implants. We have to think about whether we’re going to use smooth or textured implants. That refers to the surface treatment of the implant. There is actually a third variety of implant that uses a polyurethane microfoam coating on the outside. These are commonly known as the Furry Brazilian implants because the first company to offer this product were actually a Brazilian manufacturer. How do we go about selecting implants? It’s a very complex thing. I go very much by the measurements that I’ve taken at the time of the consultation and the examination. The measurements will give me a very good idea about the base diameter of the implant. Now, I’m going to show you what I mean by that. Let me just grab an implant. Okay. Here’s our basic implant. This is actually a teardrop, as you can see, it has that teardrop shape. It’s not round, but it does have a round base. This width from here to here is the base diameter. This is really the single-most important thing to get right in breast augmentation is the base diameter […]
I’d like to talk to you a little bit about my approach to breast augmentation. This is a procedure which might seem fairly straightforward. It’s a procedure that’s obviously done an enormous amount in the Western world and in Australia. In many respects, it is a straightforward procedure, but certainly, the planning of the procedure is extremely important, and it’s easy to get it wrong. I think that the initial consultation is a really important part of this. I always listen very carefully to what my patients are asking for, and I’m going to try and give that to them if I possibly can. If I can’t give them exactly what they want, then I’m going to explain why and I’m going to propose what I can do for them, and explain exactly why I think that’s the right way to go. Part of this is listening carefully as I said to what the patient’s desires are, but it’s also very important to do a full, careful physical examination, taking a lot of measurements, and we then need to refer back to our breast implant catalogues to make sure that we pick the exact right implant.
Hi. I’m Dr. Tony Prochazka. Let me tell you a bit about myself. I’ve been a cosmetic surgeon for about 16 years now in Australia, working primarily in Sydney and Melbourne doing a range of different procedures. Facial procedures such as facelift, neck lift, eyelid surgery, fat transfer to the face, and facial rejuvenation with lasers. I also do body procedures, mainly liposculpture and, again, fat transfer. And, of course, breast augmentation, which is a particular interest of mine.
Hi. Let me introduce myself. I’m Dr. Tony Prochazka, cosmetic surgeon in Sydney and Melbourne. I’ve been working in this field for about 16 years. I actually qualified as a medical practitioner from the University of Melbourne in 1984. After spending some time overseas, I came back to Australia and gained my fellowship of the Australasian College of Cosmetic Surgery in 2002, and I’ve been practicing as a cosmetic surgeon since then. I specialize in facial procedures such as facelift and neck lift and eyelid surgery, also, fat transfer, and I also am interested in body contouring via liposuction and breast augmentation.