Hydrafacial™

1. Those that are starting to form fine lines
2. Those looking to brighten a dull complexion
3. Those with uneven skin tone &/or patchy pigmentation
4. Those with oily & congested skin
5. Those with an uneven and/or rough texture to the skin
6. Those with enlarged pores
7. Those with poor hair and scalp health and growth
8. Those looking to boost self-confidence and esteem

1. Those with active herpes simplex (cold sore)
2. Those with active infection or open wounds on the face
3. Those with a Systemic allergy to Aspirin
4. Those allergic to shellfish (glucosamine)
5. Those that are pregnant and Breastfeeding
6. Those on active Cancer treatments
7. If you have had injectables or advanced skin treatments in the previous two weeks

• Hydrafacial Britenol
• Hydrafacial Dermabuilder
• ZO Rozatrol Booster Serum
• Murad Retinol Booster
• Hydrafacial Keravive Peptide Complex Booster (for the scalp and healthier hair)

The process starts with an assessment of your skin followed by a discussion about what, if any, elements of your skin are damaged and, where applicable, the options that exist to try to improve things (Boosters &/or Perks).

The Hydrafacial treatment will be carried out by one of the MD Aesthetics Team (Doctor or Aesthetician) and will take between thirty (30) and fifty (50) minutes to perform, dependent upon the level of Hydrafacial you have opted for (Platinum, Platinum Plus, additional Booster(s) and/or a Hydrafacial Perk).

We recommend that use of prescription grade crème(s) and topical product(s) used within you normal skin care regimen are suspended a few days before attending for your Hydrafacial Treatment so as to minimise the risk of unwanted interactions.

• Make-up will be removed prior to treatment
• • Avoid sun tanning your skin pre-treatment – if you are sufferening with sunburn at the time of treatment then your Hydrafacial cannot go ahead
  • Hydrafacial will be postponed if at the time of treatment, you have an active inflammatory skin condition

There are no officially reported side-effects of Hydrafacial, however there are reports of users having had breakouts post-treatment, possibly due to very sensitive skin or allergies to ingredients not previously known about.

Bleeding & Haematoma
Bleeding can occur at any time in the first 10 days or so after the surgery so you should therefore avoid any trauma to your breast area and avoid strenuous exercise or anything that is causing your breasts to be moving vigorously in any direction. Where possible, arm movements should be limited in the first week.

Your breast will usually become swollen and tender with a bleed and may develop bruising – if this occurs you should return for review as you may require a return to the operating theatre to explore and stop any bleeding vessel(s)and remove any blood.

Seroma
This is a collection of clear/pale yellow fluid that essentially leaks and collects from the tissues as part of the normal reaction to surgery/injury. This nearly always resorbs over a period of weeks, but is occasionally large enough to warrant it being aspirated with a needle and syringe in clinic.

Infection
Whilst not common, should it occur your breasts may be swollen, red, warm/hot and tender – not to be confused with the inflammation of healing. You may also feel unwell in yourself. This is treated with a 5-to-7 day course of oral antibiotics. Very occasionally an infection can result in part(s) of the wound coming apart – this is managed by a regular change of dressings and showering, and will be allowed to heal by itself over the subsequent four-to-six weeks.

Swelling &/or bruising
Swelling will almost certainly occur naturally and can take months to fully settle down. Bruising can be treated, unless contraindicated, with the use of Arnica or other such products should you wish.

DVT/P.E.
Very occasionally a blood clot may form in one of the deep blood vessels in the leg (Deep Vein Thrombosis). Blood clots have the potential to break bits off that can travel up to the lungs resulting in a pulmonary embolus. As a way of reducing the risk you will be required to wear compression(TED) stockings on your legs from admission on the day of surgery until 2 weeks after surgery. You will also be encouraged to keep as mobile as is possible and to stay well hydrated.

Scars
Scars are by definition permanent, so will always be there. Initially scars can be red and with time should fade through pink to ultimately be pale and flat. Occasionally scars can become hypertrophic or keloid whereby they are raised, red, lumpy, itchy and unsightly or can stretch to become wider.

Altered nipple sensation – numb or over-sensitive
The nerves supplying the nipple areolar complex can be damaged during the surgery resulting in your nipple(s) feeling numb after surgery. This usually recovers with time, however permanent loss of or reduced sensation can happen. Ever so occasionally the nipple can become oversensitive.

Inability to breast feed
It is not uncommon to be unable to breast feed after a breast uplift as the milk ducts and/or nerve supply to them is interfered with when relocating the breast tissue.

Altered breast sensation/numbness
As per the nipple, nerve damage can occur to the nerves supplying the skin over the breast. This is usually temporary but can occasionally be permanent, resulting in numb skin.

Nipple loss – full or partial
Just as the nerves to the nipple can be damaged, so can the blood vessels that supply and keep the nipple areolar complex alive. Damage to these can result in some (partial) or all (full) of the nipple and areolar being lost.

Asymmetry
No two breasts are ever completely symmetrical – they are “sisters not twins”. Despite best efforts to make the breasts as symmetrical as is possible, minor asymmetries will remain after surgery. Very occasionally a notable asymmetry can occur that requires further surgery to adjust volume, shape or nipple position.

Fat necrosis &/or lumpiness
When the breast tissue is mobilised its blood supply can become compromised, as per the nipple, resulting in some fat and breast tissue dying off (necrosing). This presents itself as a firm lump or lumpiness within the breast, and will usually settle by itself over the subsequent months. Very occasionally the old liquid fat can discharge itself through a hole in the scar/wound, requiring regular dressings until it settle sand heals itself. Very occasionally the fat will calcify requiring further surgery to excise it.

Skin necrosis
Very rarely the blood supply to the skin of the breast can be compromised resulting in skin dying – this is most common at the T-junction where the vertical element of the scar meets the horizontal aspect of the scar in your breast crease. This is managed, should it occur, with dressings until healed. Very occasionally the scar requires revising.

Wound breakdown
Very occasionally some of the wound can come apart for a multitude of reasons. This is almost always small enough to manage conservatively with dressings, allowing nature time to heal the area. Should any scar that forms be unsightly or an issue then this can always be revised at a later date, often under a local anaesthetic such as those used by the Dentists if putting your teeth to sleep for a filling etc.

‘Dog ears’
These are little areas of skin and underlying fat/tissue that cause skin at the ends of your scars to sit a little proud. Often these settle with time and massage however occasionally they require removing under a local anaesthetic.

Implant displacement/rotation/extrusion
Despite making a pocket to fit the implant you have chosen, with time the implants can move position, more commonly when under the muscle &/or with smooth implants, thereby changing the distribution of volume and shape of your breast(s). Rotation of the implant is not an issue with round implants however with anatomical (tear drop) implants if the implant should rotate then the volume of the implant will be in the wrong position and result in distortion of the shape and/or volume distribution of your breast(s). Implant extrusion can happen if your wounds come open during the healing phase and a part of the implant becomes exposed. Very rarely this can happen years down the line where the tissues stretch and become weaker, eventually opening up at the scar line. Should this occur you will require a return to theatre to wash the breast pocket and implant out before repairing the open wound.

Implant rippling, folds and palpable edges
Implants are not completely filled with gel otherwise they would become too firm and unnatural. As a result of the slight under-filling the implant shell can form small folds or ripples that can be felt and sometimes seen through the skin and breast tissues. Placing the implants under the muscle can help to cover this, however with time as the breast soft-tissues stretch and become thinner and the muscle becomes thinner as the use of it is less once disturbed by an implant underneath it, this initial benefit becomes less and less. No matter whether you have an implant over or under the muscle, the implant edge +/- rippling is nearly always felt at the inferior margin where the breast crease is. Should palpable edges, rippling and folds in an implant be an issue then fat grafting over the top of the implant can often help cover this over.

Implant rupture
Although manufacturers guarantee their implants for life against rupture, one must accept that just like anything else machine and man-made, a small percentage are going to fail and rupture. Rupture can be as a result of multiple factors. It usually presents with your breast swelling and enlarging and/or the shape of your breast changing. Following clinical examination, you will usually be sent for a scan and if rupture confirmed it is recommended that you have the implant(s) removed or exchanged.

Capsular contracture
The body’s immune system recognises that the implant does not belong to it, however it is too large to be able to destroy it so it does the next best thing and builds a wall around it, encapsulates it, in order to ‘control & contain’ any potential problems the implant could cause the body. We call this wall a ‘Capsule’. For the most part you will not be aware that the capsule is there, however with time the capsule can become firm – this is not an indication to have anything done. The capsule can also start to contract, resulting in a change in shape of the implant and often the overlying breast. It can also cause pain. If you have a change in shape and/or pain these are the indications to have your implant(s) exchanged or removed completely.

BIA-ALCL
Breast Implant Associated – Anaplastic Large Cell Lymphoma is a rare blood type cancer that has become associated with having breast implants in. The theories of why it happens are to do with possible low grade infection and to do with the texturing of the implants – this will all be discussed with you in clinic, but data is always being updated as we learn more about this. Regular updates can be found on www.fda.gov and www.associationofbreastsurgery.org

BIA-ALCL most commonly presents between 8 & 10 years of having implants put in (reports are between 1 & 20 years) and is often represented by a spontaneous, painless swelling of the breast, although lumps, a rash and or pain can be presenting symptoms and signs. If the diagnosis is made, then the treatment is removal of the implant and surrounding capsule – this is often curative. Some patients have required chemotherapy and to date, 9 women have died from this condition.

The current lifetime risk ranges from 1:3000 to 1:30,000 depending upon the range of implants used.

Double-bubble deformity
If you have heavy breasts or the bulk of your breast tissue is located lower down your chest wall, then when an implant is placed the breast tissue will invariably fall off the top of the implant creating a so-called “double-bubble” effect – you have the mound of the breast implant with the breast tissue sagging off the bottom. This more commonly happens when the implants are placed under the muscle, but can occur when placed on-top of the muscle.

Future ptosis & ‘Bottoming out’
If you add weight to your breasts you are giving gravity more to work with so the resulting droop of your breasts will occur quicker than if you had no implants/extra volume and weight in place. The skin and soft tissues of your lower half of your breast can also stretch disproportionately resulting in implants dropping and too much volume being under your nipple-areolar complex – this is known as ‘bottoming out’. Similarly, just as the weight of your breasts combined with the help of gravity may have caused the skin and ligaments supporting your breasts to stretch and droop down or position themselves lower on your chest before a lift &/or reduction, these forces are still at work after your surgery with the remaining breast tissues.

The best way to combat this and prolong your results in all cases is to wear good, strong, well manufactured support bras as much as is possible. I advocate the use of LipoElastic® garments.

Visible veins/stretch marks
Any veins or stretchmarks on your breast can be magnified and thus become more obvious when the breast is stretched over the underlying implant.

Further surgery in the future
This is likely to incur more costs