Introducing a New Treatment: PRP Injections

We are excited to announce that we are introducing a new treatment at Mode Medispa, PRP injections! 

Platelet-rich plasma (PRP) therapy is fantastic treatment which involves our practice nurse, Karyn, injecting a concentration of a patient’s own platelets in order to improve skin texture and tone and refine wrinkles.

What are plasma and platelets?

Plasma is the largest part of your blood, making up more than half of its overall content. It is composed largely of water and proteins, and is responsible for allowing your red blood cells, white blood cells and platelets to circulate through the body. Platelets are the blood cells that you have which cause blood clots when a blood vessel breaks and other necessary healing functions. Activating these Platelets is key in the body’s natural healing process.

How does this procedure work? 

PRP injections tap into a patient’s own biological healing system to improve their skin or hair health by releasing growth factors and regenerative molecules. 

The injections are prepared by taking a tube or two (between 11 and 22mls) of your own blood and running it through a machine called a centrifuge in order to concentrate the platelets. The PRP is a beautiful gold colour, and after anaesthetic cream is applied to the skin, very tiny needles inject the PRP back into the areas of concern such as: the under eye, mouth area, full face, neck, décolletage or hands. The downtime for PRP can include bruising and swelling, which is worst at 2-3 days, and could last up to 7-10 days. 

These activated platelets are then injected into the desired skin area, releasing growth factors that increase collagen and elastin formation as well as cellular growth and skin remodeling. The quality of the plasma affects the  results, which are normally visible at around 3 – 4 weeks. As such, results may  vary per patient. 

What is the difference between PRP and dermal fillers?

Dermal filler is a synthetic material used to fill a wrinkle or to add volume to an area, whereas PRP is an autologous natural substance used to address skin laxity, fine lines and improve skin complexion. Therefore patients who are unkeen on fillers, may find PRP more appealing. However PRP aims to improve skin quality and texture, whereas dermal fillers produce a volume effect that is long lasting (varying from 9-12 months). They can be used together or separately to achieve different results.

How many treatments of PRP are required?

This will vary between a patient’s skin situation and goals. PRP is often performed in a series of three to four sessions, 4 to 6 weeks apart. We also recommend maintenance treatments every 6-12 months for optimal long lasting results. In order to figure out your PRP treatment plan, talk to us about your goals and we will be able to assess your skin’s requirement and talk you through our recommendation to get you closer to the results you are looking for. It is important to note that results vary between patients. Patients with a good healthy regime, appropriate skin care, and those who do not smoke will generally achieve superior outcomes.

How much does PRP cost? 

The pricing for PRP treatments at Mode Medispa is as follows:

1 Vial for $495, or 2 Vials for $990

These costs also include your full consultation prior to the PRP treatment and follow up.  

When can I get my PRP procedure done? 

This new treatment is currently available at our Gordon clinic. Book your appointment slot now by contacting us on 1300 80 9000, or email us at info@modeplasticsurgery.com.au. If you have any further questions about PRP, please contact us.

We are also excited to announce that due to popular demand, we are adding appointment times outside of work hours. Once a month, we will aim to have availability on Thursday night (until 7pm) and by appointment on some Saturdays for all injectables and medispa needs.

Make sure you check our Instagram @modemedispa for the upcoming dates and times. 

 

Liposuction: Your 8 Most Common Questions Answered

Liposuction is a popular cosmetic surgery procedure at Mode Plastic Surgery – sometimes performed alone, or often in conjunction or as an adjunct to another procedure. It is a safe and reliable procedure that aims to remove fat deposits that are difficult to shift with diet and exercise. Like any surgery, it’s important to ask as many questions as possible so that you can, with as much certainty as possible, understand what you are walking into. 

Dr Aggarwal will always ensure that he answers your questions during consultations, as well as make sure that your expectations of the surgery and the process are realistic. In order to help you in your decision making process, we thought it best to go through some common questions on the topic.

Am I a good candidate for liposuction?

Liposuction is an excellent procedure to remove stubborn areas of fat that are difficult to shift through diet and exercise. The patient must also be of excellent health (who maintains a healthy diet and regime of exercise), has realistic expectations and does not have significant other medical conditions (such as heart disease, being on blood thinners, breathing issues, and so on).

Liposuction however is not appropriate in the following circumstances:

  • There is both excess skin and fat e.g. some patients requesting this for their abdomen actually need a tummy tuck that removes both skin and fat. If extra skin is present liposuction will remove the fat, and create even more loose skin, probably worsening the appearance.
  • Cellulite – liposuction can reduce circumference of the thighs, but as a standalone treatment for cellulite it is not great as it can worsen the appearance
  • Patient is significantly overweight, or someone who does not maintain a healthy diet/exercise – liposuction should not be seen as a quick fix. Firstly it can only target certain areas (whereas healthy eating and exercise achieves a more global reduction in weight), and the weight can simply rebound after liposuction.
  • Patient has unrealistic expectations
  • Patients who have lots of other medical problems such as heart, lung disease, diabetes, or other conditions that make them unsuitable for elective surgery.

What Should I Know Beforehand?

In order to prepare for liposuction it’s important to:

  • Cease fish oil, and other supplements such as Ginkgo, Ginseng etc. 
  • Discuss with Dr Aggarwal if you are on blood thinning medications as to when you should stop and recommence those.
  • If you are smoking you need to cease this well in advance of surgery

What does liposuction involve? 

Liposuction is typically performed under general anaesthesia, given by an accredited anaesthetist in a fully accredited and licensed facility (usually one of the North Shore’s premier private hospitals). It can take from one to three hours, and patients will be discharged either the same day or stay overnight.

Before liposuction is performed, the area is infiltrated with a solution containing local anaesthetic and adrenaline – this increases the safety of liposuction by significantly reducing bleeding.

Liposuction is then performed using a variety of liposuction cannulas and the end point is the desired contour. We record the amount of infiltration and the amount of deposit that have been removed. Patients who have more than 5L removed during liposuction will need to stay in hospital. This is because there is good evidence that fluids can shift around the body after large volume liposuction, and monitoring you in the hospitals is the safest option.

It is however common to have some fluid leak through the closed liposuction incision sites – this is usually remnants of the liposuction infiltration fluid injected at the start of the procedure. Other than being a nuisance it does not do any harm.

What do I need to do after my liposuction procedure?

Dr Aggarwal will place waterproof dressings over the incisions. You will also be placed in a liposuction garment at the end of the procedure before you wake up. This helps to reduce swelling, pain and discomfort in the early post-operative period as the area heals. This garment needs to be worn for approximately 6-8 weeks. 

You will be given a script for antibiotics by Dr Aggarwal which you must continue until the box runs out. You will also be given pain relief medications, although most patients only report minor amounts of postoperative pain that is responsive to simple oral analgesia. 

You should not drive for at least 24 hours after having an anaesthetic, so you will not be allowed to go back home on your own – you must have someone accompany you home, and it is best to have someone look after you for the first few days as you recover. You will be given instructions how to look after the wounds as they continue to heal, and you will be able to ask questions about what you can and cannot do.

How painful is liposuction?

While liposuction does not involve large incisions, it can be sore. This is because the cannula used to remove the fat is creating a zone of injury under the skin, that the body then needs to heal.

It is common to get extensive bruising and swelling (which is the zone that is sore after surgery) and it is for this reason that compressive liposuction garments are used for 6-8 weeks after surgery as they minimise bruising and swelling and therefore comfort after surgery.

Depending on the extent of surgery, and also where it is being performed, patients will need around 1 to 2 weeks off after surgery.

How long does it take to recover after a liposuction procedure? 

The bruising and swelling after liposuction is worst at day 2-3, and subsides rapidly over the first 2 to 3 weeks, but takes 6-8 weeks to completely disappear. Patients have to wear a compressive garments for 6-8 weeks. It is best to be off work for the first 1 to 2 weeks depending on the extent of surgery.

The small incisions heal over 2 weeks, and patients are not allowed to swim in these first 2 weeks. Gym exercise can be resumed at around 6 weeks.

Are the results of liposuction permanent?

Yes, provided the patient is selected carefully – meaning if it is performed for stubborn fat areas in a person who exercises regularly and maintains a healthy diet then it is permanent.

However if it is used as a quick fix, or someone does not maintain their healthy diet and exercise they can certainly put the weight and volume back on negating the effects of liposuction.

What does liposuction cost (Sydney)?

As a rule of thumb around $4000 per treatment area (at Jan 2021) which usually includes surgeon fee, anaesthetist and hospital, plus GST. However hospital and theater fees are subject to change.

Breast Cancer Awareness

The beginning of October marks the beginning of Breast Cancer Awareness Month! This is an important month on our calendar, as it’s a time that we dedicate to breaking down stigma and questions around breast health.

Breast cancer continues to be one of the most common cancers Australian women face, but survival rates continue to reach phenomenal highs! Mode Plastic Surgery is dedicated to the women that have battled breast cancer and face the new challenge of regaining the life they knew before diagnosis.

 

 

Monitoring your Breasts

Common breast cancer signs and symptoms include:

  • A lump or thickening in the breast, upper chest or armpit (you might feel the lump but not see it)
  • Swelling of all or parts of the breast  
  • ‘Dimpling’ or a change in your breast’s skin texture.
  • A change in the colour of the breast – ( it may look red or inflamed)
  • A change to the nipple, for example it has become inverted.
  • Rash, colouring or crusting around the nipple
  • Any unusual liquid (discharge) from your nipple(s)
  • Changes in size or shape of the breast

On its own, pain in your breasts is not usually a sign of breast cancer, however be one the look out for for constant pain. 

Noticing an unusual change doesn’t necessarily mean you have breast cancer, and most breast changes are not because of cancer, HOWEVER it’s important to get checked by your GP. 

 

Diagnosis and Resources 

Being diagnosed with breast cancer can be a shocking and confusing experience for many people and their loved ones. However, the support and information that has been provided by reputable Australian institutions can provide you comfort in knowing that there is assistance out there for coping with cancer and its following recovery. 

Cancer Council and Breast Cancer Network Australia have great resources to provide emotional and practical support for people affected by cancer, such as transport to treatment services, helplines and much more. 

Cancer Australia also has fantastic information on managing the physical and emotional changes following cancer, as well as information about finding support for people that have been impacted by cancer. 

 

Below are the links to some of these resources, so that you can copy and paste the link and find the services that speak to your needs. 

 

https://www.cancer.org.au/support-and-services

https://www.bcna.org.au/metastatic-breast-cancer/coping-with-metastatic-breast-cancer/where-to-find-support/

https://www.canceraustralia.gov.au/affected-cancer/living-cancer

https://www.canceraustralia.gov.au/affected-cancer/living-cancer/finding-support

 

Reconstruction.

Dr Aggarwal is fellowship trained in the world’s best plastic surgery centres in both autologous (own tissue) and implant based reconstruction. In fact Dr Aggarwal was selected as the first Australian plastic surgeon to complete the University of Pennsylvania Microsurgery Fellowship, the best microsurgery fellowship in USA and perhaps the world. During his time there he completed over 200 free flaps as primary operator, many of these in breast reconstruction. Dr Aggarwal brings his experience from low morbidity high volume world centres to Sydney, and since returning from overseas has reconstructed many women after breast cancer surgery. This is why a large number of our patients are cancer survivors, all pursuing a surgeon with extensive knowledge and experience in breast reconstruction.

Dr. Aggarwal specializes in what is called a DIEP flap reconstruction; where the fat, skin, and blood vessels are cut from the wall of the lower belly and moved up to your chest to rebuild your breast. Breast reconstruction using DIEP or msTRAM flap can be:

 

  • immediate (at the time of mastectomy); or
  • delayed (after mastectomy and other treatment such as chemo and radiotherapy)

This is considered the Rolls-Royce of Breast Reconstruction. Patients who have had it want to tell the world about it, because it offers advantages unmatched by other forms of reconstruction:

  • The reconstructed breast feels soft and natural like a normal breast because it is built from your own tissue
  • If you were to put on weight the reconstructed breast will add on weight and vice versa.
  • The reconstructed breast will sag with age mimicking a normal breast
  • It is possible to mimic the shape of a larger, ptotic (saggy) breast which is impossible with implant based reconstructions
  • There are no long term risks and complications of implants, and no future repeat operations to exchange implants.
  • No risk of BIA-ALCL
  • Immediate autologous reconstruction can be difficult to tell from a breast lift or reduction when completed.

 

Dr. Aggarwals knowledge in the field combined with the passionate care that our team provides ensures that the women that put their trust in us to reconstruct their breast move past this hiccup in their lives with a regained confidence. Dr Aggarwal offers breast reconstruction at the SAN, Chris O’Brien Lifehouse and also at RPAH and POWH/RHW. 

 

If you would like to read more about the reconstruction procedures we provide you can read more here: 

https://www.modeplasticsurgery.com.au/breast-reconstructive-procedures/

https://www.modeplasticsurgery.com.au/2020/03/11/breast-reconstruction-cost-2020/

https://www.modeplasticsurgery.com.au/2019/02/20/breast-reconstruction-north-shore-sydney/

 

Final Words

Breast cancer is a difficult experience to go through, but is no longer the death sentence it used to be. With the right support, information, and recovery plan, you will be able to get back to living the life that you love. The team at Mode have heard it countless times that reconstruction gives you back a piece of yourselves. Our work is one of recreating confidence and giving women back the lives they deserve

“Once I had the breast reconstruction it gave me my life back.. I can go and do my passions that I love. I love to dance, and I couldn’t do that before.” – Denise 

 

Abdominal Questions: Tummy tuck vs Liposuction

Tummy tuck vs Liposuction (vs mini tummy tuck): What operation do I need?

This is a common question asked by our patients at Mode Plastic Surgery. Some patients come requesting liposuction when what they need is a tummy tuck. Doing the wrong operation can yield worse results, and sometimes worse than where the patients originally started. Undergoing surgery, recovering and spending money to have the incorrect procedure is not an ideal situation. So we thought it best to go through some common questions on the topic.

What’s the difference between liposuction and a tummy tuck?

Liposuction involves removal of the fat under the skin. It uses a cannula that passes in and out, sucking the fat through a tiny hole. It does not remove the skin. Therefore this is an ideal procedure for those who are fit and healthy (not overweight) and do not have loose skin. It is suitable for people with areas of fat (such as love handles, upper or lower tummy, thighs, etc.) that they cannot shift through diet and exercise.

 A tummy tuck is a procedure involving the removal of excess skin and fat. Usually, the skin from the belly button down to the groin crease, and the hip bones at the sides, is removed. Some liposuction is always used as an adjunct to this procedure, especially out the sides (flanks, love handle area). The skin is then pulled down tight. Tummy Tucks are the ideal procedure for patients who have loose skin and excess fat. If these patients have liposuction alone, it can create more loose skin.

 

What is the difference between a tummy tuck and a mini tummy tuck?

A mini tummy tuck involves a short scar in the groin crease, mainly as a way for the surgeon to get access to the rectus (six-pack) muscles. Women (and men) who have muscle separation can have this corrected via this approach, and this is the main part of the procedure. It is not a replacement for a full tummy tuck as it does not remove much in the way of the skin of the tummy.

A mini tummy tuck seems appealing to many patients, as patients feel they would like to keep the scar of their tummy tuck as short as possible. In general, the longer the injury, the more skin the surgeon can remove. So if you have a tummy tuck to remove the skin, then you remove as much of it as you need to get a good result. The scar will be hidden in clothes and improves with time. However, if there is excess skin left behind, and the contours not corrected, this will be difficult to hide in clothing.

So what is the ideal procedure?

Each patient is assessed by Dr Aggarwal at Mode Plastic Surgery to determine if they are a candidate for liposuction, or a mini tummy tuck, or a full tummy tuck. In general, there is one procedure that each patient is the most suitable for, and we would counsel patients to do one that will achieve the outcome they want.

What happens during a tummy tuck surgery?

The skin of the tummy between the groin crease and up to just above the belly button (and out to the sides, roughly to the hip bones) is removed. The skin above this is lifted to the rib cage and is ‘window-shaded’ down to close the tummy. Before this is done, the underlying muscles (the rectus or six-pack muscles) are tightened to produce a flat contour. The belly button is usually kept by cutting around it, and when the skin is pulled down, it takes a new position on the surface of the belly, although its real position has not changed.

 

What are the signs of a good tummy tuck candidate?

In general, you need to be fit and healthy. Unfortunately, this is not a procedure for patients who are grossly overweight. They carry weight both inside the tummy near the organs (Visceral fat), as well as on the outside under the skin. There is no way to reduce the fat around the organs other than diet and exercise. Therefore being an ideal weight (or achieving your healthiest and stable weight) is essential so the flattest contour of the tummy can be achieved.

The procedure is also not offered to patients actively smoking, and those with multiple medical problems who are at risk under an anaesthetic.

Those who are; a healthy weight, maintain a balanced diet, do not have many medical problems, and overall have realistic expectations, are the ideal candidates for a tummy tuck.

 

Do I need to lose weight before my tummy tuck procedure?

Absolutely, this reduces the amount of fat around the organs, as well the fat under the skin. This allows the flattest contour to be achieved during surgery and the most amount of skin to be removed. Not to mention your recovery will be smoother; it is known to reduce both anaesthetic complications and also surgical complications like wound healing problems.

 

How long is the recovery time for a tummy tuck?

The first 8 weeks you are restricted from heavy lifting and heavy housework and are wearing a binder. Between 8 to 12 weeks you progress to regular activity and by 3 months you can go to the gym to do most if not all exercises.

 

How long will I need off work following a tummy tuck?

For most desk type jobs you’ll need around 4 weeks. If you are someone who does heavy lifting at work, that would not be allowed in the first 8 weeks.

 

Will the results last?

Absolutely – once the skin has been removed, it does not come back. However, one has to maintain a healthy lifestyle, including a balanced diet and exercise. Significant weight gain and loss will change the appearance as will a pregnancy for women.

 

Does insurance/medicare cover a tummy tuck?

A cosmetic procedure does not carry any insurance or Medicare rebates. The item number for abdominoplasty/tummy tuck was removed in November 2018 and restricted mostly to those with a significant weight loss (BMI drop of greater than 5 points). If someone has lost a lot of weight (5 BMI points) and can demonstrate interference with activities of daily living, and the excess skin causing issues/breakdown of skin that has not improved with conservative measures, then they qualify for a Medicare item number. Similarly, if the procedure is being done for a (significant) hernia repair, the procedure may also be covered by an item number.

Medicare Item number coverage, combined with appropriate health insurance, can mean the hospital and theatre costs are covered, a rebate possible for the surgical and anaesthetic fees, and that no GST is applicable (which is applied to cosmetic procedures). In general, this can halve the cost of surgery.

 

Will a tummy tuck help/remove my stretch marks?

While there is no excellent solution to removing stretch marks, a tummy tuck will often remove many of the tummy stretch marks. This is because the skin of the lower tummy is being removed during surgery. Given the lower belly is where most of the stretch marks occur, these are almost entirely removed in surgery. However, stretch marks in the upper tummy will usually remain after surgery.

 

 

For more information on the abdominal procedures we perform at Mode Plastic Surgery, click here.

Men’s Health at Mode

June is an important month on our health awareness calendars, as it’s time for Men’s Health Week, and the time to incite conversations around what it means for men to be healthy. 

Figures show that men are less engaged with their health and are less inclined to seek professional help for issues that they may face, which contributes to the fact that men die at disproportionately higher numbers throughout the stages of life. We as a community must reflect on how we can create positive and healthy environments for men and boys. We need to challenge perceptions – masculinity and self-maintenance are not antonyms. 

We at Mode Plastic Surgery primarily see male patients for skin health concerns (including skin cancer treatment) and cosmetic concerns. With this in mind, we believe it would be beneficial to share information on these health concerns that we treat every week. 

Skin Health- Cancers & Melanomas

Australia and New Zealand have the highest rates of melanoma in the world, and men are at higher risk of developing both non-melanoma and melanoma skin cancer than women. This could be because men are more reluctant to have their skin checked. Skin cancer risks include:

  • Excessive exposure to ultraviolet (UV) radiation from the sun (or from solariums)
  • Fair skin
  • Blonde hair
  • Multiple moles
  • Having a depressed immune system: People who are immunosuppressed, such as solid organ transplant recipients, have a higher risk of non-melanoma skin cancer and melanoma.
  • Family history: this is questionable but there is some higher risk amongst families of a person with melanoma – some of this could be genetic or growing up/living in a similar environment.
  • Previous personal diagnosis: People who have been diagnosed and treated for melanoma or non-melanoma skin cancer have a greater risk of additional diagnoses.

Our recommendation is a 6 monthly skin check with your GP or dermatologist. Even if you are not due for a skin check, you should be vigilant and watch for:

  • New moles and spots.
  • Existing moles which increase in size, change colour or become irregular. 
  • Any mole or spot that becomes raised, lumpy, scaly or ulcerated.
  • Red moles that are firm and enlarging.
  • Any mole or spot that itches, bleeds or weeps. 
  • Any spot that looks different from the others.

Both GPs and dermatologists will undertake non-surgical management of simple sunspots and some skin cancers such as superficial BCCs. However, SCCs and most BCCs will require surgical excision and it is best to pick these up as early as possible to limit the size of excision and surgery needed. 

Prevention is certainly better than cure and one of our best tips for prevention is year-round use of sunscreen, making sure that you reapply when spending prolonged time periods in the sun. When in direct sun you should use a sunscreen with the highest SPF (SPF 50+). If you are staying largely indoors a moisturiser with sunscreen is ideal. Other than preventing skin cancer, this is actually the best way to have your skin looking youthful for as long as possible as the number one cause of aging is photoaging related to sun exposure. 

Cosmetic Surgery for Men – Gynecomastia and Abdominoplasty

Gynaecomastia is one of the most frequently discussed procedures with our male patients. Gynecomastia is an enlargement of breast tissue in males,  most commonly caused by hormonal imbalances. It is very common – more than half of all boys develop the condition during puberty, and it normally disappears as they grow older. About 1 in 3 older men will develop it. 

The condition causes enlarged breasts that feel rubbery or firm. It can be mild where it is easily concealed in clothing to dramatic sizes where patients feel embarrassed in social settings as they find it difficult to conceal. We normally treat gynecomastia with liposuction and direct gland removal via an incision placed around the nipple. Patients in the past have stayed in the hospital for a night, and the surgery is performed under a general anaesthetic. 

The other most common discussed procedure is Abdominoplasty and Liposuction frequently around the tummy or torso region. These procedures are best in patients who maintain a healthy lifestyle with a balanced diet, and exercise. We can then target surgical solutions – liposuction being good for difficult to move fat deposits, and abdominoplasty or body lift being the solution when there is excess skin. Dr Aggarwal would guide you through this decision making if you have had massive weight loss or wish to discuss your concerns.

What we are doing at Mode for men 

Mode Plastic Surgery is committed to engaging with men’s health and their maintenance, and this month we will be offering a variety of specials and information. 

Injectable treatments 

Throughout June, Mode Plastic Surgery will be offering men anti-wrinkle treatments at $180 for one area, and $350 for two areas. Please note that standard quantities per site apply and that treatments all take place under the supervision of Dr Aggarwal, Specialist Plastic Surgeon.

Hydrafacial Special. 

Throughout June, we will be offering Hydrafacial Treatments for $150. HydraFacial is an amazing technology that delivers the results of an advanced facial in under 30 minutes. It uses a patented technology that can simultaneously cleanse, exfoliate, clear congested pores and deliver nourishing serums. Vouchers can also be purchased in June for the special price for use at any time over the next 12 months. 

Men’s Health Skin Care Bundle 

In this new Men’s Basic Bundle deal, we will be providing the essentials for improving skin’s overall health, giving any man a refreshed look. The pack includes three products:

  • Foam Cleanser
  • Moisturiser with sunscreen OR AHA/BHA Exfoliator 
  • Hydrating moisturiser.

These products would normally be valued at a combined value of $310, but this new Bundle is being sold at an astounding price of $199. 

Mode Skin Protection Pack 

For all our patients who have had excisions of any moles or skin cancers, or alternatively any surgery, we suggest this pack as a way to maintain the best scar, and for general sun protection. 

The pack includes three products:

  • SPF 50+ sunscreen
  • Moisturiser with sunscreen 
  • Silicone Gel 5g.

These products would normally be valued at a combined value of $145.95, but this new Bundle is being sold at an astounding price of $100. June only; for our regular pricing, please refer to our online store.

 

Contact Us

Throughout Men’s Health Month, we will be highlighting that Mode Plastic Surgery is practice for all, and that we are committed to the health and positive results of all clients, no matter their gender. We want to commit to showing men that it’s okay to seek help. If you would like to find out any more information on our offers, services or health concerns that we specialise in treating, contact us on 1300 80 9000, or email at info@modeplasticsurgery.com.au.

Cosmetic and Elective Surgery Resumption

The federal government has announced an easing of elective surgery restrictions – this will allow a
graduated return of elective surgery from 50%, then 75% and finally to 100% of normal operating in
a staged plan outlined by the Prime Minister (for those interested – the announcement is reported
here.)
It is then up to the individual states how quickly to progress through these stages.
Given that NSW had the most number of coronavirus cases, it is wise for the NSW government to be
more cautious in the relaxing of elective surgery as this means some capacity in all hospitals is
reserved in case a ‘second wave’ of Covid-19 occurs. This is also important to carefully protect the
precious supply of personal protective equipment (PPE), and other resources such as ICU beds
needed to manage any outbreak.
The NSW Health department has advised elective surgery will resume up to 75% capacity by the end
of June 2020. While the types of surgeries were restricted previously, all restrictions have now been
relaxed. This means that cosmetic surgery can safely resume. However it is now up to the individual
hospitals to manage their resources, including beds and PPE, and therefore it is at their discretion
what they will and will not allow up to 75% of their total capacity.
Dr Aggarwal works at a number of private hospitals. Hunters Hill Private Hospital has advised they
will resume cosmetic surgery, while the Sydney Adventist Hospital (being a larger hospital with ICU
beds) is likely to be more cautious.

What surgery can we now offer?
We are pleased to announce that we can now resume our full range of surgeries normally offered at
Mode Plastic Surgery. We were already offering our full range of skin cancer and reconstructive
cancer services over the past few weeks, and we can now resume offering cosmetic surgery, and
other more elective (non-urgent) plastic surgery.
However for any cosmetic surgery, or more elective plastic surgery it is up to the discretion of the
hospitals where Dr Aggarwal works if they will allow the operation to go ahead. We therefore
request patients to take this into account when booking and flexibility may be needed as to your
preferred date.
Please also note that in the event of a ‘second wave’ of Covid-19 restrictions may resume, and
therefore elective surgery (including cosmetic surgery) may be postponed at short notice. In these
unprecedented times, if this was to occur (as we did in March and April) any deposits for surgeries
cancelled due to government restrictions will be refunded or if preferred held for a future date of
surgery.

My surgery was cancelled when the government restrictions were announced – what happens
now?
We will be in contact with patients soon who had their surgeries cancelled in late March, April and
early May. We will prioritise these patients for new dates – depending on the type of procedure and
the hospital at which it was going to take place.

What about public hospitals?
If you are a patient waiting for surgery at one of the public hospitals at which Dr Aggarwal works
(RPA, POWH, or RHW) it will depend on what the surgery is for.
More urgent plastic surgery needs such as skin cancer treatment has been allowed throughout the
Covid-19 period. However, since Dr Aggarwal’s regular operating lists have been cancelled surgeries
such as this have been booked using ad-hoc operating time depending on the urgency of the surgery
needed. Most patients for this type of surgery are on a 90 day wait list at the hospital and will be
accommodated on the basis of urgency.
Patients needing urgent breast cancer surgery, and immediate reconstruction are also priortised and
booked on an ad-hoc basis.
For other less urgent requests, the public hospitals are yet to open the usual elective plastic surgery
operating lists. Till that time, we are not able to resume these other types of surgeries.

What about cosmetic injectable treatment?
We are now able to safely resume these – please see our other blog on this topic for more
information by clicking here.

Surgical Consultations – Resumption of face to face consulting.
While we have been offering telehealth services throughout this Covid -19 period, we always prefer
to see patients face to face as this allows a physical examination, more accurate assessment and
therefore more individualised, considered plans for surgery to made.
There is a new normal in our clinic since the reintroduction of face to face consulting. We are
continuing to follow strict protocols to provide social distancing within our office, encouraging use of
hand sanitiser on entry, questionnaire and temperature screening of all patients, regular disinfection
of all surfaces, and spacing our appointments.
As for face to face consulting, all patients are requested to come alone for appointments. We also
recommend that you do not attend if:

  • You have been overseas in the last 14 days
  • You have had contact with someone who is unwell, has confirmed coronavirus or is confined
    due to possible coronavirus
  • You are unwell in any way, including with a sore throat, fever, shortness of breath, loss of
    smell or cough.
  • We recommend patients drive to our Gordon office, with undercover parking dedicated to our clinic
    available for patients. In this environment, we recommend against using public transport wherever
    possible although we are only a short walk from Gordon and Pymble stations if you did need to catch
    the train.

Are there any services not offered at the moment?

At this stage we are unable to offer medispa services such as Hydrafacial and peels. But we continue
to offer skin care advice and our skin care products are available for purchase in the clinic or via
phone (and they can be shipped to you, or be ready for collection from our office).

Contact us
We are back to normal clinic hours of 9am-5pm Monday to Friday. You may wish to call us on 1300
80 9000 or email us at info@modeplasticsurgery.com.au to enquire further.

Cosmetic Injecting Reintroduction

The Australian Society of Plastic Surgeons (ASPS), the Australasian Society of Aesthetic Plastic Surgeons (ASAPS) along with NSW Health have advised that cosmetic injecting can now recommence provided these are delivered in clinics operated by medical practitioners. ASAPS in conjunction with the Australian Society of Cosmetic Dermatologists have introduced safety guidelines for the safe introduction of cosmetic treatments in the time of Covid-19.

We are able to now offer both returning and new patients cosmetic injectables with our Nurse, Karyn, under the supervision of Dr Aggarwal.

 

Antiwrinkle treatments

We are pleased to announce that we have resumed taking bookings for antiwrinkle treatments. At Mode we offer these treatments most commonly for frown lines, forehead lines, crows feet, and other indications such as for teeth grinding/masseter slimming, and hyperhidrosis.

All of these locations are away from the mouth and nose, which means they are considered the safest sites with respect to Covid-19 exposure for our staff and patients. These are also not considered Aerosol Generating procedures and take less than 15 minutes of close contact therefore also reducing exposure.

Our standard fees apply, which you can find in the non-surgical section of our website, or alternatively call or email us to find out more.

Dermal Fillers

Hyaluronic acid based dermal fillers are used for many indications – at Mode Plastic Surgery we use these predominantly for cheeks, and lips. Filler can also be used for the chin, and jaw line definition. We do not offer fillers for nose (liquid rhinoplasty), forehead, temples or tear-troughs.

Cheek fillers

These are considered safe injecting sites, as they are also far away from the nose, mouth and lips. These will be offered at our regular price and standard quantities apply – you can ring or email us to enquire further.

Lip fillers

Any filler around the mouth, or nose is considered an aerosol generating procedure, and can put at risk (mainly) the injector if the patient was positive for Covid-19. Our governing societies have now allowed these treatments to commence in medical clinics provided appropriate safety precautions are taken. Given that these are higher risk for exposure (especially to staff) we will screen you with questions and temperature check (just like all our patients), and in addition we may ask you to use a mouthwash prior to the procedure. Furthermore you will see our staff wearing special masks for protection of everyone. Lip fillers will also be offered at our standard pricing – you can call or email us to find out more.

Fillers for other sites

We can also offer chin, and jaw line treatments. Pricing will depend on individual treatments and requirements, and can be discussed with our practice nurse Karyn.

 

Your Safety For Cosmetic Injectables

There is a new normal in our clinic since the reintroduction of face to face consulting. We are continuing to follow strict protocols to provide social distancing within our office, encouraging use of hand sanitiser on entry, questionnaire and temperature screening of all patients, regular disinfection of all surfaces, and spacing our appointments. You will also see us wearing masks during your cosmetic treatment.

As for face to face consulting, all patients are requested to come alone for appointments. We also recommend that you do not attend if:

  • You have been overseas in the last 14 days
  • You have had contact with someone who is unwell, has confirmed coronavirus or is confined due to possible coronavirus
  • You are unwell in any way, including with a sore throat, fever, shortness of breath, loss of smell or cough.

We recommend patients drive to our Gordon office, with undercover parking dedicated to our clinic available for patients. In this environment, we recommend against using public transport wherever possible although we are only a short walk from Gordon and Pymble stations.

All cosmetic treatments take place with the supervision of Dr Aggarwal, as has always been the policy at Mode Plastic Surgery. 

 

What about other non-surgical services?

At this stage we are unable to offer services such as Hydrafacial and peels. But we continue to offer skin care advice and our skin care products are available for purchase in the clinic or via phone (and they can be shipped to you, or be ready for collection from our office).

Contact us 

We are back to normal clinic hours of 9am-5pm Monday to Friday. You may wish to call us regarding specific products and pricing that we are not able to advertise, and you may ring us on 1300 80 9000 or email us at info@modeplasticsurgery.com.au to enquire further.

COVID-19: Update to Restrictions

The Government Eases Ban on (Some) Elective Surgeries during COVID-19
The Prime Minister today outlined a plan to wean back the restrictions on elective surgery.
Combined with the surgeries that were allowed during the shut-down period we are now in a
position to be able to offer the following operations:

  • All skin cancer surgeries
  •  Breast Reconstruction Surgery – both DIEP flaps and also implant based breast
    reconstructions
  • Medically necessary breast implant removal e.g. For rupture, pain or concern regarding
    cancer or ALCL
  • Medically necessary procedures on those under 18 (such a breast reductions).
  • Trauma surgery such as hand injuries, facial trauma (fractures, lacerations) and other
    wounds such as skin loss/tears or burns
  •  Any other trauma or cancer reconstructions
    The situation will be assessed by the government again on 11 May, and hopefully this will further relax the remaining restrictions on elective surgery.

Face to Face Consultations at Mode Plastic Surgery
For all the services listed above we are now offering face to face consultations but social distancing
rules strictly apply in our practice and patients will be screened via a questionnaire and temperature
check on arrival. We also ask kindly that you arrive alone for any appointments, please see our
previous blog for further information on what we are doing in our office during times of Covid-19.
Our standard consultation fees and Medicare rebates apply to all appointments. Our current office
hours remain Tuesday to Friday 9am to 5pm – outside these hours feel free to leave us a voicemail
or an email.
We also continue to consult primarily at our flagship office at Gordon. However, as restrictions ease,
we may very soon be in a position to resume consulting at our other locations. At this stage we
tentatively aim to begin consulting at our other locations from May 11.

Are there any operations or services you are unable to offer?
Unfortunately at this stage cosmetic plastic surgery and medispa services such as fillers and
anti-wrinkle treatments are still unable to be offered. However we are able to consult with patients
via phone or video, and will be in touch as soon as the restrictions on these services are lifted.

Changes to tele-health consultations
Telehealth consultations are offered via phone or video for all plastic surgery concerns including
cosmetic surgery. The government has now allowed Medicare rebates to be offered for private
tele-health consultation fees and therefore we have moved to charging the same fees for tele-health
consultations as we do for our face to face consultations. The same amount of time will be dedicated
to your virtual visit, as it would be for a face to face visit. The Medicare rebate you receive is also the
same as what applies to a face to face visit.

When will there be more information?
After the next national cabinet meeting on May 11 regarding elective surgery. If the remaining
restrictions are relaxed, we may seen a near return to normal practice, with more hospitals also able
to open their normal operating list allowing us to offer tailor made solutions for our patients like we
have always done.

Finally we wish to say that now more than ever, we are proud of our community and people for
doing the right thing, flattening the curve, and leading the world in controlling Covid-19 cases. Four
weeks ago we thought the situation would escalate quickly with our hospitals full of sick patients
requiring ICU and ventilator treatment. Fortunately this has not happened, and the return to (some)
elective surgery marks the beginning of returning to some sense of normality.
Well done Australia! We will get through this!

Coronavirus Update: Your plastic surgery at Mode

Coronavirus Update: Your plastic surgery at MODE

 

At the end of March, the coronavirus situation was rapidly escalating in Sydney. Our practice has
regularly and timely taken decisions to help the community flatten the curve, and get the situation
under control. When it was necessary we ceased all our elective operating and consulting (to help
divert precious medical resources to help fight Covid-19), and now we are in a position to help in the
way we know best. We continue to provide the highest standard of care for our plastic surgery
patients, and as the situation develops in Australia we will continue to prioritse the safety of our
patients.

New patients with urgent plastic surgery needs:

We are now taking bookings for face to face
consultations for patients who need help with urgent plastic surgery care. We are taking bookings in
line with recommendations of the Australian Society of Plastic Surgeons. For example these include
skin cancer treatment such as that for melanoma, squamous cell and basal cell cancer, and
emergency surgery such as that for hand trauma, facial trauma, and lacerations. Any women with
breast cancer, or ruptured implants with significant pain or concern regarding ALCL also fall in this
category. Patients can have phone or video consultations if they prefer.

Any decision for surgery will be offered on a case by case basis and Dr Aggarwal is continuing to
operate at the Sydney Adventist Hospital, and Hunters Hill Private to help those requiring urgent
plastic surgery care. Any patients that are suitable for local anaesthetic will be offered a procedure
in our Gordon rooms, whilst on the other hand anyone who is elderly, with significant medical
problems (ie those at highest risk of getting sick with coronavirus), and if their medical condition
allows will be deferred until the coronavirus situation has settled.

New patients with non-urgent plastic surgery needs.

Patients hoping to discuss their options about
cosmetic concerns such as breast surgery (reduction or lift, augmentation, revision of implants),
body surgery (tummy tuck, liposuction, thigh or arm lift, body lift), face and neck lift surgery can call
us to make a tele-health consultation appointment. Face to face consultations are not available at
this time for these requests, but we will continue to reassess the situation, and offer our patients
this option as soon as it is safe to do so. Prior to the tele-health consultation, we will ask you to email
us photographs of your concern that reflect the area of concern in clear detail.
We will ask you to attend a second consultation in person when the coronavirus situation has
settled. We will also place you on a waiting list for surgery, and provide you with quotes and
information via email. As soon as the coronavirus pandemic is over, we will work hard to provide you
with the most suitable date for surgery.

Patients who have had surgery:

Patients will be invited for a face to face appointment if needed for
removal of sutures or removal of drains. Wherever possible we will aim to do follow-up using phone
or video, and this is generally possible after the first post-operative visit. You are always welcome to
come in for a face to face appointment especially if you have any concerns during the post operative
period, but in the times of COVID-19 we are doing whatever we can to keep people safe and reduce
their exposure.

Safety in our offices:

When you arrive in our offices you will notice certain differences:

  • Our main door will be open when you arrive
  • You will be asked to maintain social distance from the front desk
  • We will ask you to sanitise your hands on arrival
  • We will obtain your information over the phone wherever possible; if needed we will give
    you a clean pen and a registration form to complete.
  • We will ask you to take part in some screening both via a questionnaire with our nurse, and
    a temperature check.
  • We ask you maintain social distance in our waiting room, and we will try to have as few
    patients in the office at any one time as possible
  • We kindly request that you attend our rooms alone. If you require a support person, they
    can participate in the consultation via speaker phone. If you had a friends or family drive
    with you we ask that they stay in the car during your consultation.

Mode Medispa:

Karyn our practice nurse is conducting video consultations for skin care free of
charge during the coronavirus pandemic which means you can have these from the comfort of your
home during self-isolation. For those interested can purchase skin care over the phone. During the
pandemic we are offering 10% off, and free express shipping for orders over $50 (a nominal $10 fee
applies for shipping for orders under $50). We can also have your order ready for pick-up if you
prefer this option. We also have silicone gel available for purchase.

*This special is no longer currently running*

At this present time however, injectables, and other cosmetic facial treatments such as peels, facials
(including Hydrafacial) are on hold until NSW and Federal government advise us that it is safe to
proceed. For those interested in these treatments, you can contact our office and we will put you on
a waiting list for an appointment for when our MediSpa services recommence.

Please stay safe, and together we will beat this.

 

COVID-19 and Plastic Surgery

COVID-19 and Plastic Surgery in Sydney

How is COVID-19 (Coronavirus) affecting plastic surgery in Sydney?

Coronavirus is changing the economic and social climate across Australia and the world. These are unprecedented times and the situation is evolving day by day, and week by week. As of 23rd March 2020, in Sydney, we are preparing to see a surge in Covid-19 pandemic cases across the city. Therefore our city, its care facilities, and its hospitals slowly go into lockdown.

At the time of writing this article, plastic surgery offices of most plastic surgeons are still open but that is about to change. Last week we were still performing surgery in the public and private health system sector although with some restrictions. However, both are likely to change by the end of this and next week.

This stage at Mode Plastic Surgery, we are only seeing URGENT consultations this week and early next week. We have made the difficult decision to almost completely stop our practice as of 1/4/20.

This will mean that until that time we are undertaking the following measures:

–       Strict handwashing or use of hand microbial gel for each patient, and staff member before and after any patient review

–       Strict wipe down of all surfaces between patients

–       Booking only URGENT consultations for new patients

–       Cancelling all non-essential follow up for patients (ie other than for drain or suture removal)

–       Cancelling our consulting at Chris O’Brien Lifehouse – this is our only consulting location within a hospital setting, and where patients share a common waiting room with other patients. Lifehouse is also across the road from RPA which is one of the major Coronavirus testing centres. To reduce exposure to the virus for our staff and patients, we have relocated this consulting to our other more private locations to increase social distance.

As of 1/4/20 :

·      We will not be conducting any private or public hospital lists as our hospitals will be faced with overwhelming demand

·      We will continue to see URGENT follow-ups in rooms ie those patients who are post-op and need drain or suture removal. We may see URGENT new referrals but these will be very restricted given that no hospital operating lists are going to be available for surgery.

·      We will have our office/ phones attended for 2 days a week only, at other times messages can be left on our voicemail and email. In case of emergency, private patients can contact Dr. Aggarwal on his mobile, and public patients may need to contact their GP. Or the plastics registrar on call at the hospital where they had their surgery.

·      At this stage, we do not know when our normal consulting and theatre lists will resume. The patients who had their consultations postponed this week, and those that may have contacted us will be contacted to schedule their appointment when it is safe to do so. This may occur in June or July (or later if things have not settled).

wash hands

 

 

How is COVID-19 (coronavirus) affecting plastic surgery in public hospitals?

Dr Aggarwal works at two major public and teaching hospitals in Sydney – Royal Prince Alfred and Prince of Wales/Royal Hospital for Women. RPAH has been designated as one of the key Coronavirus testing sites, although all public hospitals are running a Covid-19 check clinic.

Ultimately all public hospitals will be key in responding to the onslaught of coronavirus cases that NSW Health is predicting. These will require resources from all specialties and departments to be pooled to look after potentially sick patients on the ward, in ICU and possibly convert operating theatres to makeshift ICU beds.

In preparation for the possible catastrophic number of ill patients, our public hospitals have gone into lockdown. Cancelling all elective surgery (other than urgent cancer or trauma cases) to free up resources such as hospital beds, ICU beds, and operating theatres. RPAH took the decision 3 weeks ago to cancel all elective surgery, and Prince of Wales/Royal Hospital for Women has had to make the same decision last week.

The situation at both hospitals is unlikely to change until we are well past the coronavirus pandemic. Meaning many elective operations will be indefinitely postponed, and even more urgent things like skin cancer surgery may carry significant delays.

 

How is COVID-19 (coronavirus) affecting plastic surgery in private hospitals?

Last week and this week, the private sector is proceeding with activity as normal with very strict criteria on patients that have to be excluded from surgery (e.g. returning from overseas, ill-health or close contact of a COVID-19 patient).

However, this situation is likely to change by next week (commencing 30th March).  Dr. Aggarwal does a big part of his private operating lists at the Sydney Adventist Hospital, the largest private hospital in Sydney and New South Wales in general.

Given that the SAN has a significant infrastructure including ICU to manage sick patients it will be called upon by NSW Health, and the government to look after sick coronavirus patients needing ICU. Or alternatively performing urgent surgery lists from the public hospitals who may not have the capacity to do so. This is going to restrict private operating theatre time available to all the surgeons at the Sydney Adventist Hospital. We expect this to happen as early as 1st April 2020.

Currently, we are bringing forward patients due for urgent skin cancer surgery to this week and early next week, and anticipating that all lists as of 1st April will likely be cancelled. Any conditions or requests that are not pressingly urgent will be advised to wait for 3 to 6 months for their surgery.

 

Can I still have my skin cancer surgery during the COVID-19 (coronavirus) pandemic?

Unlikely. We are still consulting URGENT patients this week. However, due to the public and private hospital response in the health care system to the coronavirus, and general safety of the public we will not be doing any regular lists as of 1/4/20.

 

Can I still have my breast reconstruction surgery during the COVID-19 (coronavirus) pandemic?

Unlikely. We are still consulting URGENT patients at our clinic locations.

However due to the public hospital restrictions on what is allowed during the pandemic we are likely to only see breast cancer patients proceed to surgery. With all patients requesting prophylactic mastectomy and reconstructions placed on hold indefinitely. Even patients with breast cancer may face some delay in getting to surgery due to lack of theatre time in the public hospital and the need to coordinate breast and plastic, surgery teams.

In the private sector, theatre time is likely to be restricted as well due to overflow from the public sector, and also the ICU needing to look after coronavirus patients. The planning may be slightly easier in the private sector at the time of writing this article – 23rd March 2020.

 

Can I still have my cosmetic plastic surgery during the COVID-19 (coronavirus) pandemic?

No. We have had to make the decision for the safety of our patients and staff to postpone seeing new cosmetic patients until the pandemic has settled.

If you are a patient of ours, that had booked elective cosmetic surgery with us in the near future it is our opinion that anything that can wait until the situation settles, should. Our staff will be in contact this week to discuss postponing your elective surgery to 3 to 6 months later when hopefully the coronavirus situation is under control.

 

Which plastic surgeons’ offices are still open during the COVID-19 (coronavirus) pandemic?

Until last week Mode Plastic Surgery was hoping to stay open. But as of March 23rd, we have taken the difficult decision to wind down our practice until the coronavirus pandemic is over. After 1/4/20 we will move to very restrictive contact hours with patients, and run a virtual office for 2 days a week without patient contact.

 

What do I do in the case of an emergency and my plastic surgeon’s office is closed due to the COVID-19 (coronavirus) pandemic?

Mode Plastic Surgery will move to restricted opening hours as of 1/4/20 during the coronavirus pandemic. If it is not immediately urgent, you will be able to contact us via phone or email if you have any concerns but you may need to leave a message. If you are a private patient of Dr. Aggarwal’s you will also have his mobile number in case of any emergencies.

If we are closed, you will need to contact your GP. You could visit your local hospital emergency department – however, you should only do so in the case of an absolute emergency as they are likely to be attending to unwell coronavirus patients, and their resources will already be stretched.

 

Stay safe everyone.

wash hands