Post-Weight Loss Body Contouring

What it accomplishes: 

With significant weight loss, volume may be lost from the upper arm area. This will often result in loose skin that can make it difficult to find clothes to fit and bothersome due to excess skin getting in the way when moving and exercising. The brachioplasty procedure is performed to essentially remove this loose skin creating a smoother, tapered contour to the upper arm area.

How is it performed: 

The surgery is performed in an accredited day surgery with an anaesthetist administering a general anaesthetic. Dr. Sjarif uses a combination of liposuction and excision of skin and fat to achieve a contour of the upper arm that narrows uniformly from the armpit to taper evenly down to the elbow. The skin removal is tailored to ensure that skin closure can be achieved without irregularities and without undue tension. The skin closure is performed using dissolving sutures, and then the incision dressed with waterproof tape.  The incisions  are placed on the inner aspect of the arms so that they are not visible from the front or the back when the arms are by the side.

Occasionally, there may be additional excess skin on the sides of the chest and if suitable the skin in this area may be removed along with the upper arm skin in a procedure that is referred to as an extended brachioplasty.

A drain may be placed at the time of surgery under the skin to ensure that no fluid collects under the wound – if required, the drain is generally left in place for only a day or so before being removed by Dr. Sjarif in the rooms.

If being performed as an isolated procedure, the surgery will be performed as day surgery meaning that you will be discharged home on the same day of your surgery.

What to expect after your procedure: 

You will be discharged from hospital with instructions on how to manage until you are reviewed in the rooms. You will be provided with antibiotics and pain medications along with instructions on how they should be taken. Your arms will be wrapped in crepe bandages which will remain in place until you are reviewed in the rooms. You may experience some discomfort in the arms where the incision is but this will be managed effectively with oral pain relief. You may find that your forearms and hands swell early in the post-operative course, but again this is temporary and will improve as you start moving around and using your arms. You may find that elevating your arms on a couple of pillows when sleeping or relaxing on the couch may ease both any discomfort as well as any swelling

If you go home with surgical drains in place, the nurses will show you how to empty and record the output of the drains when you are at home. When the output of the drains slows down sufficiently, you will come into the rooms to have them removed.

Dr. Sjarif will usually leave the waterproof dressings intact for three weeks before removing them and changing them. You will be able to shower normally with the dressings intact. It is at the three week mark that scar management will be discussed, and Dr. Sjarif will go through various options for ensuring that your scars have the best possible chance of healing favourably. LED light therapy sessions will commence at this time also.

You may be required to wear light compression sleeves on your arms for the first few weeks to support your scars and aid in swelling reduction.

Most patients can go back to normal activity including driving and light duties at work after one week. Heavy lifting and vigorous upper body exercises may need to be put on hold for three to four weeks.

Potential risks & complications: 

The brachioplasty procedure is generally safe with a very low risk of complications. Some of the potential complications include:

• Bruising and swelling is not uncommon following the surgery – may last for a few weeks
• Numbness – with all procedures involving cutting the skin, there can be reduced sensation in the area of the scar. This tends to improve over the first few months but in some cases may not return completely
• Bleeding – there may be some minor ooze from the incision line but significant bleeding is uncommon
• Asymmetry – best efforts are directed at ensuring that both arms are symmetrical at the end of surgery, but unfortunately perfect symmetry is not attainable – Dr. Sjarif’s meticulous planning and “tailor-tacking” technique ensure that symmetry is very close
• Wound healing issues – these procedures result in fairly long scars that are closed in layers using dissolving sutures. Because the sutures sit very close to the skin surface, they can sometimes make their way out through the skin resulting in small breaks in the skin that may require more frequent dressings while they are allowed to settle and heal. This may occur anytime in the first few months after surgery (until the sutures completely dissolve)
• Scars – Scars are a necessary trade-off for an improvement in contour following skin removal and repair. There are many variables that contribute to scar quality which includes genetics, general medical condition, smoking & vaping, surgical technique and body site. Scars can be widened, pigmented, pale or hypertrophic and raised. Unfortunately, the scars associated with brachioplasty procedures tend not to be as fine as those seen on other parts of the body such as the face, breasts or abdomen and can remain thick and reddened for an extended period of time – this will be discussed with you by Dr. Sjarif who will weigh up the pros and cons with you prior to any decision to proceed with surgery.

What it accomplishes: 

Weight loss will often result in excess skin on the inner aspect of the thighs. This excess skin can be problematic for a number of reasons – the excess skin will rub together when walking leading to issues with chafing and rashes that can be resistant to treatment with conservative options such as barrier creams. The rashes can progress to chronic infection and ulceration in severe cases. Finding pants to fit can be very difficult when needing to cover the excess skin. A thigh lift procedure can target skin and fat in the inner aspects of the thighs – by removing this tissue, issues of skin rubbing and resultant chafing can be minimised.

How it is performed:  

The surgery is performed in an accredited hospital under general anaesthetic. Dr Sjarif uses a combination of liposuction and excision of skin and fat to achieve a contour of the upper thigh that tapers down from the groin to the knee. The incision generally starts in the groin crease and will extend down to as far as the knee on the inside of the thigh – leaving the scar on the inner aspect of the thigh ensures that it cannot be seen from the front or the back.

Skin closure is performed using dissolving sutures. Additional liposuction may be performed to the back of the thighs below the buttocks and the sides of the thighs to address the “saddle-bag” area.

A drain may be placed temporarily under the skin to ensure that no fluid collects under the wound. The drain will generally be left in for a day or two before being removed by Dr Sjarif in the rooms.

Patients will generally stay in for one night following a thigh lift procedure. 

What to expect after your procedure: 

You will be discharged from hospital with instructions on how to manage your wounds. You will be provided with antibiotics and pain medications along with instructions on how they should be taken. You will generally be discharged home wearing a garment like bike pants to help control swelling and bruising.

If you go home with surgical drains in place, the nurses will show you how to empty and record the output of the drains when you are at home. When the output of the drains slows down sufficiently, you will come into  the rooms to have them removed.

Dr Sjarif will usually leave the waterproof dressings intact for three weeks before removing them and changing them. You will be able to shower normally with the dressings intact. It is at the three week mark that scar management will be discussed, and Dr Sjarif will go through various options for ensuring that your scars have the best possible chance of healing  favourably. LED light therapy sessions will commence at this time also.

You may be required to wear the garment for the first few weeks to support your scars and aid in swelling reduction.

Most patients can go back to normal activity including driving and light duties at work after two weeks. Heavy lifting and vigorous lowerbody exercises may need to be put on hold for four to six weeks.

Potential risks & complications: 

The thigh lift procedure is generally safe with a very low risk of complications. Some of the potential complications include:

• Bruising and swelling is not uncommon following the surgery – may last for a few weeks
• Numbness – with all procedures involving cutting the skin, there can be reduced sensation in the area of the scar. This tends to improve over the first few months but in some cases may not return completely
• Bleeding – there may be some minor ooze from the incision line but significant bleeding is uncommon
• Asymmetry – best efforts are directed at ensuring that both thighs are symmetrical at the end of surgery, but unfortunately perfect symmetry is not attainable – Dr. Sjarif’s meticulous planning and “tailor-tacking” technique ensure that symmetry is very close
• Wound healing issues – these procedures result in fairly long scars that are closed in layers using dissolving sutures. Because the sutures sit very close to the skin surface, they can sometimes make their way out through the skin resulting in small breaks in the skin that may require more frequent dressings while they are allowed to settle and heal. This may occur anytime in the first few months after surgery (until the sutures completely dissolve)
• Scars – Scars are a necessary trade-off for an improvement in contour following skin removal and repair. There are many variables that contribute to scar quality which includes genetics, general medical condition, smoking & vaping, surgical technique and body site. Scars can be widened, pigmented, pale or hypertrophic and raised. Unfortunately, the scars associated with thigh lift procedures tend not to be as fine as those seen on other parts of the body such as the face, breasts or abdomen and can remain thick and reddened for an extended period of time – this will be discussed with you by Dr. Sjarif who will weigh up the pros and cons with you prior to any decision to proceed with surgery.

What it accomplishes: 

A lower body lift is a surgical procedure that addresses excess tissue around the abdomen, waist, hips, thighs and buttocks. It is also known as a circumferential abdominoplasty or 360 degree abdominoplasty because of the way in which it treats the whole lower trunk. It has the benefit of lifting the buttocks and the sides of the thighs in addition to the improvement of contour in the abdominal area. 

How it is performed: 

The surgery is performed in an accredited hospital under general anaesthetic. 

Generally, the surgery is started with you positioned on the table lying on your stomach – this is so the tissue can be removed from your lower back. The incision on the lower back is then closed using dissolving sutures. After dressings are applied, you will then be turned and  placed onto your back so that the abdominal portion of the surgery can be performed. If required, loose abdominal muscles can be repaired and liposuction performed. At the end of the surgery, dressings will be applied to your incision that runs the whole way around your lower back, over the hips and then around the front above the pubic bone.

Drains may be placed temporarily under the skin to ensure that no fluid collects under the wounds. Up to four separate drains may be placed following body lift surgery. The drains will generally be left in for a few days before being removed by Dr Sjarif in the rooms.

Patients will generally stay in for three nights following a body lift procedure. 

What to expect after your procedure: 

You will be discharged from hospital with instructions on how to manage your wounds. You will be provided with antibiotics and pain medications along with instructions on how they should be taken. You will generally be discharged home wearing an abdominal binder to help control swelling and bruising.

If you go home with surgical drains in place, the nurses will show you how to empty and record the output of the drains when you are at home. When the output of the drains slows down sufficiently, you will come into  the rooms to have them removed.

Dr Sjarif will usually leave the waterproof dressings intact for three weeks before removing them and changing them. You will be able to shower normally with the dressings intact. It is at the three week mark that scar management will be discussed, and Dr Sjarif will go through various options for ensuring that your scars have the best possible chance of healing  favourably. LED light therapy sessions will commence at this time also.

You may be required to wear the garment for six weeks to support your scars and aid in swelling reduction. If you have had an abdominal muscle separation repair, you may be required to wear the binder for up to 12 weeks.

Most patients will require four weeks off work depending on the nature of your work. Driving can usually resume at the four week. Heavy lifting and vigorous lower body exercises may need to be put on hold for six weeks.

Potential risks & complications: 

The body lift procedure is generally safe with a very low risk of complications. Some of the potential complications include:

• Bruising and swelling is not uncommon following the surgery – may last for a few weeks
• Numbness – with all procedures involving cutting the skin, there can be reduced sensation in the area of the scar, the lower abdomen, flanks and back. This tends to improve over the first few months but in some cases may not return completely
• Bleeding – there may be some minor ooze from the incision line but significant bleeding is uncommon
• Seroma – a seroma is a collection of fluid that may build up under the skin after the drains are removed. Small seromas are generally undetectable and will usually self-resolve. Larger seromas if symptomatic can be drained fairly easily in the rooms.
• Asymmetry – best efforts are directed at ensuring that the scar is symmetrical, but with a long circumferential scar and variability in tissue elasticity, there may be some minor asymmetries. 
• Wound healing issues – this procedure results in a fairly long scar that is closed in layers using dissolving sutures. Because the sutures sit very close to the skin surface, they can sometimes make their way out through the skin resulting in small breaks in the skin that may require more frequent dressings while they are allowed to settle and heal. This may occur anytime in the first few months after surgery (until the sutures completely dissolve)
• Scars – Scars are a necessary trade-off for an improvement in contour following skin removal and repair. There are many variables that contribute to scar quality which includes genetics, general medical condition, smoking & vaping, surgical technique and body site. Scars can be widened, pigmented, pale or hypertrophic and raised. 

What it accomplishes: 

An abdominoplasty is performed to help improve the contour of the upper and lower abdomen in patients who have excess skin and/or fat resulting from weight loss, post-pregnancy or when lifestyle modifications have not had the desired effect. Muscle separation can also be addressed at the same time to restore muscle tone in patients who have issues with lack of core-strength as often occurs after pregnancy.

How it is performed: 

The surgery is performed in an accredited hospital under general anaesthetic. 

An incision is made low down on the front of the abdomen usually from hip to hip. This incision may be longer or shorter depending on how much extra tissue needs to be removed. The incision is placed low so that it can be hidden under briefs. The skin is then undermined up to the breast bone centrally, isolating the belly button which is carefully preserved on its attachment to the underlying muscle layer. 

Muscle separation can then be repaired at this point if required and is usually performed using two layers of strong suture material. The bed is then flexed and the excess skin and fat is removed from the lower abdomen, closing the wound in layers using dissolving sutures.

The final part of the surgery is to then re-inset the belly button. Waterproof dressings are then applied to the incisions.

Drains may be placed temporarily under the skin to ensure that no fluid collects under the wounds. The drains will generally be left in for a few days before being removed by Dr Sjarif in the rooms.

Patients will generally stay in for three nights following an abdominoplasty procedure. 

What to expect after your procedure: 

You will be discharged from hospital with instructions on how to manage your wounds. You will be provided with antibiotics and pain medications along with instructions on how they should be taken. You will generally be discharged home wearing an abdominal binder to help control swelling and bruising.

If you go home with surgical drains in place, the nurses will show you how to empty and record the output of the drains when you are at home. When the output of the drains slows down sufficiently, you will come into  the rooms to have them removed.

Dr Sjarif will usually leave the waterproof dressings intact for three weeks before removing them and changing them. You will be able to shower normally with the dressings intact. It is at the three week mark that scar management will be discussed, and Dr Sjarif will go through various options for ensuring that your scars have the best possible chance of healing  favourably. LED light therapy sessions will commence at this time also.

You may be required to wear the garment for six weeks to support your scars and aid in swelling reduction. If you have had an abdominal muscle separation repair, you may be required to wear the binder for up to 12 weeks.

Most patients will require four weeks off work depending on the nature of your work. Driving can usually resume at the four week mark. Heavy lifting and vigorous lower body exercises may need to be put on hold for six weeks.

Potential risks & complications: 

The abdominoplasty procedure is generally safe with a very low risk of complications. Some of the potential complications include:

• Bruising and swelling is not uncommon following the surgery – may last for a few weeks
• Numbness – with all procedures involving cutting the skin, there can be reduced sensation in the area of the scar, the lower abdomen, flanks and back. This tends to improve over the first few months but in some cases may not return completely
• Bleeding – there may be some minor ooze from the incision line but significant bleeding is uncommon
• Seroma – a seroma is a collection of fluid that may build up under the skin after the drains are removed. Small seromas are generally undetectable and will usually self-resolve. Larger seromas if symptomatic can be drained fairly easily in the rooms.
• Asymmetry – best efforts are directed at ensuring that the scar is symmetrical, but with a long scar and variability in tissue elasticity, there may be some minor asymmetries. 
• Wound healing issues – this procedure results in a fairly long scar that is closed in layers using dissolving sutures. Because the sutures sit very close to the skin surface, they can sometimes make their way out through the skin resulting in small breaks in the skin that may require more frequent dressings while they are allowed to settle and heal. This may occur anytime in the first few months after surgery (until the sutures completely dissolve)
• Scars – Scars are a necessary trade-off for an improvement in contour following skin removal and repair. There are many variables that contribute to scar quality which includes genetics, general medical condition, smoking & vaping, surgical technique and body site. Scars can be widened, pigmented, pale or hypertrophic and raised. 

What it accomplishes: 

A breast lift procedure (mastopexy) is an effective surgical procedure that aims to elevate breast tissue that sits too low on the chest wall. The aim is to redistribute descended breast volume further up the chest and elevate the nipple and areola complex so that it sits at the front of the breast mound at the most projecting portion.

How it is performed:

Breast lift Surgery is performed under general anaesthesia in an accredited day surgery facility in Wollongong or Bowral. Most breast lift procedures can be performed as day surgery only with no need for staying in hospital.

It can be performed on its own or as part of a combined surgery when it can be performed with an abdominoplasty or body lift in patients who have lost weight or in post-pregnancy surgery.

In situations where a woman has very little of her own breast tissue, the breast lift procedure can be combined with a breast augmentation using silicone breast implants to provide more volume. In some cases, breast implants may not be wanted by a patient and in these cases, the extra volume may be provided by using a patients own fat which can be transferred to the breasts in a procedure known as fat grafting.

Dr. Sjarif will begin the surgery by making incisions in pre-determined locations on the breasts. There are three common incision patterns:

• around the areola (sometimes called the “doughnut” pattern)
• around the areola and vertically down to the breast crease (the “lollipop” pattern)
• around the edge of the areola, vertically down to the breast crease and horizontally along the crease in the inframammary fold (the “anchor” pattern) 

Through the incisions, Dr. Sjarif will lift and reshape the breast tissue higher on the chest wall and reposition the nipple-areolar complex higher on the breast mound. He can reduce the size of the areolas, if needed. Dr. Sjarif will remove excess skin and wrap the remaining skin tighter around the breast mound. Finally, he will close the incisions with sutures. Waterproof dressings will then be applied to the incisions before you are placed into a surgical bra.

Drains may be placed temporarily into each breast to ensure that no fluid collects under the wounds. The drains will generally be left in for a few days before being removed by Dr Sjarif in the rooms.

What to expect after your procedure: 

You will be discharged from hospital with instructions on how to manage your wounds. You will be provided with antibiotics and pain medications along with instructions on how they should be taken. You will be discharged home wearing a bra to help manage swelling and supports the breasts and incisions in the healing phase.

If you go home with surgical drains in place, the nurses will show you how to empty and record the output of the drains when you are at home. When the output of the drains slows down sufficiently, you will come into  the rooms to have them removed.

Dr Sjarif will usually leave the waterproof dressings intact for three weeks before removing them and changing them. You will be able to shower normally with the dressings intact. It is at the three week mark that scar management will be discussed, and Dr Sjarif will go through various options for ensuring that your scars have the best possible chance of healing  favourably. LED light therapy sessions will commence at this time also.

You may be required to wear the bra for six weeks to support your scars and aid in swelling reduction. 

Most patients will require 1 -2 weeks off work depending on the nature of your work. Driving can usually resume at the two week mark. Heavy lifting and vigorous exercise may need to be put on hold for six weeks.

Potential risks & complications: 

The breast lift procedure is generally safe with a very low risk of complications. Some of the potential complications include:

• Bruising and swelling is not uncommon following the surgery – may last for up to three months
• Numbness – with all procedures involving cutting the skin, there can be reduced sensation in the area of the scar, the breast skin and nipple. This tends to improve over the first few months but in some cases may not return completely
• Bleeding – there may be some minor ooze from the incision line but significant bleeding is uncommon
• Seroma – a seroma is a collection of fluid that may build up under the skin after the drains are removed. Small seromas are generally undetectable and will usually self-resolve. Larger seromas if symptomatic can be drained fairly easily in the rooms.
• Asymmetry – best efforts are directed at ensuring that the breasts are symmetrical, but with variability in tissue elasticity, there may be some asymmetries. 
• Wound healing issues – this procedure results in incisions that are closed in layers using dissolving sutures. Because the sutures sit very close to the skin surface, they can sometimes make their way out through the skin resulting in small breaks in the skin that may require more frequent dressings while they are allowed to settle and heal. This may occur anytime in the first few months after surgery (until the sutures completely dissolve)
• Scars – Scars are a necessary trade-off for an improvement in shape following a breast lift. There are many variables that contribute to scar quality which includes genetics, general medical condition, smoking & vaping, surgical technique and body site. Scars can be widened, pigmented, pale or hypertrophic and raised. 

What it accomplishes: 

Male Breast Reduction is performed to treat the condition known as gynaecomastia. Gynaecomastia refers to abnormal breast development in men. It is colloquially known as “man boobs”

The surgical procedure aims to remove the abnormal breast tissue resulting in a flatter and firmer chest.

How is it performed: 

The surgery is performed under general anaesthesia in an accredited day surgery in Wollongong or Bowral. Most gynaecomastia surgery can be performed as day surgery only with no need for hospital stay.

The majority of milder cases of gynaecomastia can be performed using a single small incision on each side of the chest. Liposuction of excess fatty tissue in the chest is first performed through these small 1cm incisions. Once the fatty tissue has been removed, any residual glandular breast tissue is broken down and then removed effectively using these same small incisions.

In more severe cases, excess skin may also need to be removed as part of the surgery which will result in more visible scarring. The areolae may also need to be relocated so that they are positioned at a more appropriate position on the chest wall. Any incisions are generally closed with dissolving sutures. Waterproof dressings are then applied to the incisions. A surgical garment or vest is then applied to help manage any swelling and bruising that may develop.

Drains are generally not required unless significant skin removal is needed.

What to expect after your procedure:

You will be discharged from hospital with instructions on how to manage your wounds. You will be provided with antibiotics and pain medications along with instructions on how they should be taken. You will be discharged home wearing a surgical vest to help manage swelling and support the incisions in the healing phase.

If you go home with surgical drains in place, the nurses will show you how to empty and record the output of the drains when you are at home. When the output of the drains slows down sufficiently, you will come into  the rooms to have them removed.

Dr Sjarif will usually leave the waterproof dressings intact for three weeks before removing them and changing them. You will be able to shower normally with the dressings intact. It is at the three week mark that scar management will be discussed, and Dr Sjarif will go through various options for ensuring that your scars have the best possible chance of healing  favourably. LED light therapy sessions will commence at this time also.

You may be required to wear the vest for six weeks to support your scars and aid in swelling reduction. 

Most patients will require 1 -2 weeks off work depending on the nature of your work. Driving can usually resume at the two week mark. Heavy lifting and vigorous exercise may need to be put on hold for six weeks.

Potential risks & complications:

The male breast reduction procedure is generally safe with a very low risk of complications. Some of the potential complications include:

• Bruising and swelling is not uncommon following the surgery – may last for up to three months
• Numbness – with all procedures involving cutting the skin, there can be reduced sensation in the area of the scar, the chest skin and nipple. This tends to improve over the first few months but in some cases may not return completely
• Bleeding – there may be some minor ooze from the incision line but significant bleeding is uncommon
• Seroma – a seroma is a collection of fluid that may build up under the skin after the drains are removed. Small seromas are generally undetectable and will usually self-resolve. Larger seromas if symptomatic can be drained fairly easily in the rooms.
• Asymmetry – best efforts are directed at ensuring that the two sides of the chest are symmetrical, but with variability in tissue elasticity, there may be some asymmetries. 
• Wound healing issues – this procedure results in incisions that are closed in layers using dissolving sutures. Because the sutures sit very close to the skin surface, they can sometimes make their way out through the skin resulting in small breaks in the skin that may require more frequent dressings while they are allowed to settle and heal. This may occur anytime in the first few months after surgery (until the sutures completely dissolve)
• Scars – Scars are a necessary trade-off for an improvement in shape following a breast lift. There are many variables that contribute to scar quality which includes genetics, general medical condition, smoking & vaping, surgical technique and body site. Scars can be widened, pigmented, pale or hypertrophic and raised. 
• Nipple necrosis – with severe gynaecomastia surgery, the nipple areola complex may sometimes be required to be removed and grafted onto the correct location – usually the graft heals well, but there can occasionally be issues with graft take leading to nipple necrosis
• Recurrence – although uncommon, the gynaecomastia tissue may return particularly if any underlying cause for the condition are not addressed prior to the surgery