Eyelid Surgery (Blepharoplasty)

Muscle relaxing injections provide temporary facial muscle weakness or palsy to help smooth wrinkles and combat the aging process. They do not get rid of deep wrinkles which are present at rest or fine lines such as those around the mouth.

If you have wrinkles that worsen with animation, muscle relaxing injections may be appropriate. You can not have anti-wrinkle injections if: You are pregnant or breastfeeding You have certain neuromuscular disorders or myopathies You are taking certain medications (such as aminoglycosides) It is important to know that muscle relaxing injections can take up to a week to show maximal effect. They are temporary and usually need to be repeated every 3-4 months.

Muscle relaxing injections are usually performed without anaesthesia using a very fine needle. However, if you are particularly sensitive to needles we do provide a topical cream which can help numb the skin prior to injection.

No. Muscle relaxing injections are performed in the office.

All interventions carry risk, even if they are non-surgical. Some risks of muscle relaxing injections include: Bruising Swelling Asymmetry Infection Allergic reaction Headache Dry eyes or drooping upper eyelids Numbness or tingling Lack of response to the injection (sometime seen with repeated doses)

Cost is dependent on the areas treated and volume of product required. A quote will be provided to you after your consultation. If you have any further questions, please contact the Practice Manager.

A facelift involves tightening laxity in the supportive soft tissues of the face and redraping the skin, thereby improving the ‘smoothness’ of the face and giving it a more youthful shape. A facelift may also be combined with other surgical procedures such as a brow lift, eyelid surgery or fat grafting as part of facial rejuvenation surgery. The bone structure of the face will not be changed during facelift surgery. Non-surgical treatments such as anti-wrinkle injections or skin resurfacing may be undertaken also. The aim of these treatments is to treat sun-damaged skin, dynamic wrinkles, crow’s feet around the eyes and fine lines around the mouth which are not removed by facelift surgery.

At your initial consult Mr. Bunker discuss your motivations and concerns, clinically assess for stigmata of aging and generate a treatment plan if appropriate. Facial rejuvenation surgery is a highly individualised and may not be suitable for everyone. Facelift surgery may be a good option for you if: You have sagging in the midface You have deep creases below the lower eyelids You have deep creases along the nose extending to the corner of the mouth You have fat that has fallen or is displaced You have loss of muscle tone in the lower face which may create jowls You have loose skin and excess fatty deposits under the chin and jaw, creating the appearance of a double chin You are physically healthy and you do not have medical conditions that can impair healing or increase risk of surgery You have realistic expectations of what face lift surgery can accomplish You are a non-smoker or have stopped smoking at least 3 months prior Important considerations are: The results of a facelift usually last between five and twelve years. Facelifts can be repeated. While a facelift will make you look younger, it will not raise sagging eyebrows, remove deep frown lines in the forehead, change your upper or lower eyelids, or get eliminate wrinkles around the mouth. Other forms of treatment may be more appropriate to address these concerns. The natural aging process continues after a facelift. Smokers and patients with high blood pressure are at increased risk of complications. You need to stop smoking and have your blood pressure under control to be considering for facelift surgery. Facelift surgery is may not be a good option if you are prone to bleeding, have poor healing ability, a tendency to form thick scars or are at increased risk for surgical or anaesthetic complications.

Mr. Bunker performs facelift under general anaesthesia to maximise patient comfort. Modern anaesthetics are safe and effective but carry some risks, which you will discuss with your anaesthetist

Usually one night in hospital is required after a facelift. This allows your blood pressure to be monitored, ensure there are no early complications such as bleeding, make sure your pain is well-controlled prior to discharge and allows any drains inserted at surgery to be removed prior to going home as well as any necessary dressing changes performed.

All surgery has risks. There are general risks which apply to all operations as well as specific risks for individual procedures. General risks and complications of surgery may include: Bleeding Infection that may require treatment with antibiotics or further surgery in some cases Allergic reaction (to sutures, dressings or antiseptic solutions) The formation of a large blood clot (haematoma) beneath the skin that may require drainage Pain, bruising and swelling around the operated sites Keloids and hypertrophic scars that are raised, red and thickened scars over the healed incisions. These may be itchy, annoying and unsightly but are not a threat to health. Poor or slow healing Wound breakdown Short-term nausea following general anaesthesia and other risks related to anaesthesia Specific risks and complications associated with facelift surgery include: Hair loss around the scars, this is usually temporary but may be permanent. Loss of skin due to impaired blood supply. This may require a skin graft. Bruising and swelling Numbness around operated sites. In most cases this is temporary and will improve over many months Deformity of the earlobe Slight difference in appearance between the right and left side of the face Damage to the facial nerve, which occurs in about one in every one hundred patients. It can result in partial loss of movement and a “lopsided” appearance of the face. In rare cases, the damage may be permanent Revisional surgery may be necessary to correct complications

Your surgery will take place in an accredited hospital facility.

Avoid any strenuous activity or exercise in the week before your surgery Ensure you have arranged appropriate help at home including someone to stay with you for the first 24 hours. Consider pillows, cool compresses and a telephone within reach. Make sure you arrange for a relative or friend to drive you to and from the hospital or clinic. Consider work arrangements. Most patients will remain off work for 4 – 6 weeks after surgery. A medical certificate can be supplied to your preoperatively if required Take Vitamin C supplements 1 gram daily starting at least 2 weeks before your surgery, unless you are allergic or unable to tolerate Wash your hair the night before your surgery Do not wear any make-up on the day of surgery Be as fit as possible to help the recovery process You will be asked to complete a full medical history. You must list all medications you take including dietary supplements such as fish oil which increase your risk of bleeding. Check with your surgeon about your medications as some may need to be stopped. Any additional tests required preoperatively will be arranged by Mr. Bunker or your anaesthetists. If you decide to have facelift surgery, your surgeon will ask you to sign a consent form. Make sure you read the consent form carefully before signing. If you have any questions, ask your surgeon. You will receive detailed preoperative and postoperative instructions. Follow them carefully.

Arrange for a relative or friend to drive you home after the surgery. Someone should also stay with you for at least the first day after the operation and preferably for a few days. You can usually drink fluids and eat a light meal two or three hours after surgery. You may have some pain and discomfort, particularly around the incisions. You will be prescribed pain medication for home. In some cases a small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid that may collect. Some bruising and swelling is normal, and may take up to a few weeks to disappear. Sleeping with your head elevated will help to reduce the swelling. Depending on the extent of your procedure, you may need to take a few weeks off work to rest. Avoid heavy lifting, strenuous exercise, swimming and strenuous sports until advised by your surgeon. Your surgeon will give you specific postoperative care instructions which may include: How to care for your surgical sites Medications to apply or take orally to aid healing and reduce the risk of infection Specific concerns to look for at the surgical sites or in your general health When to follow-up with your surgeon If you experience any of the following symptoms, notify your surgeon immediately: Temperature higher than 38°C or chills Heavy bleeding from the incisions Worsening redness around the incision sites Increasing pain or tenderness, or other problems that appear to be worsening

Scars are an inevitable part of any surgery and are created when any incision through the skin heals. Mr. Bunker will endeavour to minimise scarring and to keep your scars as inconspicuous as possible by locating the incisions in hidden sites where practicable. Scars usually fade with time and become barely noticeable. If you are prone to scarring, advise your surgeon.

Revisional surgery may be necessary to correct minor irregularities. Often these can be performed under local anaesthetic in the rooms and do not required general anaesthetic or hospital admission.

Cost is always a consideration in elective surgery and may include: Surgical fee Hospital or surgical facility costs Anaesthesia fees Prescriptions for medication Postsurgery garments Medical tests A quote for the surgical fee is provided to you prior to surgery. This also contains instructions on how to obtain quotes for associated fees as listed above. If you have any questions, please contact the Practice Manager.

General anaesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness. When you are under general anaesthesia you are ‘asleep’. Intravenous sedation: Sedatives administered by injection into a vein to achieve relaxation. Also referred to as ‘twilight’ anaesthesia. Local anaesthesia: A drug injected directly to the site of an incision during an operation to relieve pain. Also referred to as ‘numbed with needles’. Jowls: A jaw line that sags into the neck, usually caused by loss tone tone in the lower face Meloplasty: Facelift Nasolabial fold: Crease between the corner of the nose and mouth Rhytidectomy: Facelift Tear trough: Deep creases below the lower eyelids

Abdominoplasty is used to improve the contour of the abdomen as well as correct abdominal anomalies caused by pregnancy or significant weight loss. There are a different types of abdominoplasties which vary in the length and type of scar, whether any rectus divarification is repaired and whether the umbilicus is repositioned. In some cases, patients develop a large distressing apron of fat and skin which interferes with mobility. Removal of this is a functional operation aimed at improving quality of life and movement to aid further weight loss. This is referred to as an ‘apronectomy’ and is not the same as an abdominoplasty. The goals of abdominoplasty are to: Create a more aesthetically pleasing abdomen. Address any divarification of the rectus muscles if present. Patient with separation of the rectus muscles often have functional impairment with reduced core strength and pelvic floor dysfunction Remove excess skin which can break down in the folds leading the rashes and infections.

A thorough history and physical examination is important to ensure that the correct surgical plan is implemented. Abdominoplasty is personalised procedure. During your consultation, Mr. Bunker will evaluate your condition, overall health, and provide recommendations for a tailored treatment plan that best suits your specific goals. Abdominoplasty is not a substitute for weight loss but may benefit patients who: Are physically healthy and at a stable weight Have realistic expectations about what surgery can achieve Do not smoke (or quit at least 3 months ago) Are bothered by the feeling of a large abdomen Suffer skin irritation in abdominal skin folds Have rectus divarification (this can sometimes be noted as a midline bulge when you attempt to do a sit-up) Abdominoplasty may not be suitable for people who: Have not achieved a stable weight Are planning future pregnancies Are still significantly overweight (though these patients may benefit from an apronectomy) Patients with significant medical comorbidities or who are prone to bleeding or poor wound healing

Abdominoplasty is performed under a general anaesthetic. Modern anaesthetics are safe and effective but carry some risks, which you will discuss with your anaesthetist.

Yes. The length of stay varies depending on exactly what surgical steps are necessary for your operation but is usually between 2 and 5 nights.

All surgery has risks. There are general risks which apply to all operations as well as specific risks for individual procedures. General risks and complications of surgery may include: Bleeding Infection that may require treatment with antibiotics or further surgery in some cases Allergic reaction (to sutures, dressings or antiseptic solutions) The formation of a large blood clot (haematoma) or fluid (seroma) beneath the skin that may require drainage Pain, bruising and swelling around the operated sites Keloids and hypertrophic scars that are raised, red and thickened scars over the healed incisions. These may be itchy, annoying and unsightly but are not a threat to health Poor or slow healing Wound breakdown Short-term nausea following general anaesthesia and other risks related to anaesthesia Specific risks and complications associated with abdominoplasty surgery include: Bruising and swelling which usually resolve in the first few weeks, often associated with any concurrent liposuction. Issues with blood supply to the abdominal skin leading to wound breakdown at the incision or loss of the umbilicus Asymmetry or contour irregularities Collections of fluid (seromas) under the skin of the abdomen which may require repeat drainage (usually done in the rooms). Numbness at the lower end of the abdomen which can be permanent. Tightness in the abdomen which can take some weeks to resolve. Injury to the internal organs.

Your surgery will take place in an accredited hospital facility.

Due to the recent cosmetic surgery reforms, all patients in Australia undergoing cosmetic surgery are required to undertake a Body Dysmorphic Disorder Questionnaire. You will be asked to complete a full medical history. You must list all medications you take including dietary supplements such as fish oil which increase your risk of bleeding. Check with your surgeon about your medications as some may need to be stopped. Any additional tests required preoperatively will be arranged by Mr. Bunker or your anaesthetist. If you decide to have abdominoplasty, you will need to sign a consent form. Make sure you read the consent form carefully before signing. If you have any questions, please ask them prior to surgery. Purchase some ‘high’ tights which go as far up your abdomen as possible to wear after the surgery. Avoid any strenuous activity or exercise in the week before your surgery Make sure you arrange for a relative or friend to drive you to and from the hospital or clinic and that you have arranged appropriate help at home including someone to stay with you for the first 24 hours. Think about the setup at home where you will recover – you may want extra pillows, fluids and a toilet nearby and it is useful to have a telephone within reach. Consider work arrangements. Most patients will remain off work 4 - 6 weeks after abdominoplasty. A medical certificate can be supplied to your pre-operatively if required. Take Vitamin C supplements 1 gram daily starting at least 2 weeks before your surgery, unless you are allergic or unable to tolerate. You will receive detailed preoperative and postoperative instructions. Follow them carefully.

You can usually drink fluids and eat a light meal two or three hours after surgery. Postoperatively you will have a catheter to assist with passing urine and drains to remove excess fluid. The catheter is removed whilst you are in hospital but the drains usually need to stay longer, sometimes for a number of weeks. Initially you may feel ‘tight’ in the abdomen and need to mobilise carefully in a slightly bent forward position. This usually resolves quickly. It is important you ask for help with getting out of bed and mobilising to the bathroom initially, as you do not want to strain any necessary muscle repairs. You can usually shower (with assistance) the day after your surgery. Arrange for a relative or friend to drive you home when you are cleared for discharge. Someone should also stay with you for at least the first day after the operation and preferably for a few days. You will receive medications for home (usually pain relief and antibiotics) as well as detailed postoperative instructions which include how to care for your surgical sites, signs which warrant concern, contact information and follow-up instructions. Some bruising and swelling is normal and may take up to a few weeks to disappear. You will usually have a garment to wear after abdominoplasty – this should stay on as much as possible. Avoid heavy lifting, strenuous exercise, swimming and sports for 6 weeks after surgery. If you experience any of the following symptoms, notify us immediately: Heavy bleeding from the incisions or into the drains Fever (>38°C) or chills Worsening redness around the incision sites or a foul odour from the wounds Issues with the dressings (becoming wet or dirty)

Some visible scars are inevitable, however Mr. Bunker will aim to make these are inconspicuous as possible. Usually an abdominoplasty requires a long scar low on the abdomen hidden under your underwear as well as another small scar around the umbilicus. For weight loss patients there may also be a vertical scar on the abdomen to deal with the additional excess skin.

Revisional surgery may be necessary to correct minor irregularities.

Cost is always a consideration in elective surgery and may include: Surgical fee Hospital or surgical facility costs Anaesthesia fees Prescriptions for medication Postsurgery garments Medical tests A quote for the surgical fee is provided to you prior to surgery. This also contains instructions on how to obtain quotes for associated fees as listed above. If you have any questions please contact the Practice Manager.

General anaesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness. When you are under general anaesthesia you are ‘asleep’. Necrosis: Death of tissue usually as a result of impaired blood supply. Rectus divarification: Separation of the rectus muscles in the midline. Liposuction: The surgical removal of fat using a suction cannula

An arm lift is designed to tighten the skin and improve the contour of the upper arms. The procedure tightens and smooths the underlying supportive tissue that defines the shape of the upper arm whilst reducing localised pockets of fat.

Arm lift surgery is an individualised procedure and may not be suitable for everyone. At your consult, Mr. Bunker will discuss your goals and expectations and perform a targeted examination prior to discussing a surgical plan if appropriate. Arm lift surgery may be a good option for you if: You have realistic expectations Your weight is relatively stable You have excess soft tissue along the upper arm You are physically healthy and do not have not have medical conditions that impair healing or increase the risk of surgery You are a non-smoker or have stopped smoking at least 3 months ago

Mr. Bunker performs arm lift under general anaesthesiae to maximise patient comfort. Modern anaesthetics are safe and effective but carry some risks, which you will discuss with your anaesthetist.

Usually you will stay in the hospital one night after an isolated arm lift. This is to ensure there are no unexpected early complications such as bleeding and that your pain is well controlled prior to discharge.

All surgery has risks. There are general risks which apply to all operations as well as specific risks for individual procedures. General risks and complications of surgery may include: Bleeding Infection that may require treatment with antibiotics or further surgery in some cases Allergic reaction (to sutures, dressings or antiseptic solutions) Pain, bruising and swelling around the operated sites Short-term nausea following general anaesthesia and other risks related to anaesthesia Specific risks and complications associated with arm lift surgery include: Prominent scars such as keloids and hypertrophic scars which may be red, raised and/or itchy. Numbness around operated sites. This is usually temporary but can be permanent. Wound breakdown or poor healing leading to delaying healing or requiring skin grafts for closure. Restrictive movement due over-tightened skin Accumulation of fluid (seroma) or blood (haematoma) under the skin which may require a procedure to remove. Fat that has a poor blood supply may cause discharge from the surgical wounds or palpable lumps.

Due to the recent cosmetic surgery reforms, all patients in Australia undergoing cosmetic surgery are required to undertake a Body Dysmorphic Disorder Questionnaire. You will be asked to complete a full medical history. You must list all medications you take including dietary supplements such as fish oil which increase your risk of bleeding. Check with your surgeon about your medications as some may need to be stopped. Any additional tests required preoperatively will be arranged by Mr. Bunker or your anaesthetist. If you decide to have arm lift surgery, you will need to sign a consent form. Make sure you read the consent form carefully before signing. If you have any questions, please ask them prior to surgery. Avoid any strenuous activity or exercise in the week before your surgery Make sure you arrange for a relative or friend to drive you to and from the hospital or clinic and that you have arranged appropriate help at home including someone to stay with you for the first 24 hours. Think about the setup at home where you will recover – you may want extra pillows, fluids and a toilet nearby and it is useful to have a telephone within reach. Consider work arrangements. Most patients will remain off work for approximately 4 weeks after surgery. A medical certificate can be supplied to your preoperatively if required Take Vitamin C supplements 1gram a daily starting at least 2 weeks before your surgery, unless you are allergic or unable to tolerate You will not be able to use you arms for heavy lifting for 6 weeks. You will receive detailed preoperative and postoperative instructions. Follow them carefully.

Arrange for a relative or friend to drive you home after the surgery. Someone should also stay with you for at least the first day after the operation and preferably for a few days. You can usually drink fluids and eat a light meal two or three hours after surgery. You may have some pain and discomfort, particularly around the incisions. You will receive medications for home (usually pain relief and antibiotics) as well as detailed postoperative instructions which include how to care for your surgical site, signs which warrant concern, contact information and follow-up instructions. In some cases a small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid that may collect. This is usually removed in the office at your post-operative appointment. Some bruising and swelling is normal and may take up to a few weeks to disappear. Dressings are to remain dry and intact until your postoperative review. Follow any instructions for postoperative garment wear if instructed. If you experience any of the following symptoms, notify us immediately: Temperature higher than 38°C or chills Heavy bleeding from the incisions Worsening redness around the incision sites Increasing pain or tenderness, or other problems that appear to be worsening Issues with the dressings (becoming dirty, wet or loose)

Some visible scars are inevitable. However, efforts will be made to limit the length of your scars and to place them in as inconspicuous a position as possible. Mr. Bunker will discuss the placement of scars with you prior to surgery. In cases where you have significant skin laxity, the scars may extend into the axilla (armpit) or below the elbow. Scars may be more noticeable than you anticipated. It is important that you have realistic expectations of the surgery and that you discuss potential outcomes with your surgeon. Keep in mind most scars fade with time.

Revisional surgery may be necessary to correct minor irregularities. Often these can be performed under local anaesthetic in the rooms and do not required general anaesthesia or hospital admission.

Cost is always a consideration in elective surgery and may include: Surgical fee Hospital or surgical facility costs Anaesthesia fees Prescriptions for medication Postsurgery garments Medical tests A quote for the surgical fee is provided to you prior to surgery. This also contains instructions on how to obtain quotes for associated fees as listed above. If you have any queries, please contact the Practice Manager.

General anaesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness. When you are under general anaesthesia you are ‘asleep’. Local anaesthesia: A drug injected directly to the site of an incision during an operation to relieve pain. Also referred to as ‘numbed with needles’. Arm lift: A surgical procedure (also known as brachioplasty) to correct sagging of the upper arms. Axilla: The armpit. Brachioplasty: A surgical procedure, also known as an arm lift, to correct sagging of the upper arms. Haematoma: A blood collection beneath the skin Liposuction: Also called lipoplasty or suction lipectomy, this procedure removes fat from beneath the skin surface to reduce fullness. Skin laxity: Degree of loose skin.

Breast implants can be used to: Enlarge small breasts Restore breast volume after weight reduction, pregnancy and breastfeeding Improve breast asymmetry Reconstruct a breast after cancer surgery Implants are placed behind the breast, not within the breast tissue. Specifically, they are placed either between the breast tissue and the pectoralis major muscle or behind the muscle. Mr. Bunker will discuss the pros and cons of each implant placement and recommend which position is likely to be the most suitable for you.

Breast augmentation may be a good option for you if: You are bothered by the feeling that your breasts are too small You are dissatisfied with your breasts losing shape and volume after pregnancy, weight loss or with aging Your breasts vary in size or shape One or both breasts have failed to develop normally You are physically healthy You have realistic expectations You do not smoke or quit smoking at least 3 months prior Before you decide on breast augmentation with implants some important issues to keep in mind are: Future surgery may be required to replace one or both implants If you are concerned about the way you look or are thinking about cosmetic treatments to boost your confidence, there are alternatives to cosmetic surgery. These may include wearing padded bras or prostheses. The scar is most commonly placed under the fold of the breast to remain as hidden as possible. However, if you require other procedures such as reshaping the skin or lifting the nipple, you may require longer scars. Mr. Bunker will discuss this with you at your consultation.

Mr. Bunker performs breast augmentation under general anaesthesia to maximise patient comfort. Modern anaesthetics are safe and effective but carry some risks, which you will discuss with your anaesthetist.

Usually you do not need to stay in hospital overnight after a breast augmentation. However, you will required a period of observation prior to discharge home to ensure there are no early complications such as bleeding and that your pain is well controlled.

All surgery has risks. There are general risks which apply to all operations as well as specific risks for individual procedures. General risks include: Bleeding Infection that may require treatment with antibiotics or further surgery in some cases Allergic reaction The formation of a large blood clot (haematoma) or fluid collection (seroma) beneath the skin Pain, bruising and swelling around the operated sites Keloids and hypertrophic scars that are raised, red and thickened scars over the healed incisions. These may be itchy, annoying and unsightly but are not a threat to health. Poor wound healing or wound breakdown Smokers are at increased risk of complications from any surgery. It is important to truthfully disclose your smoking status, including ‘social’ smoking. Short-term nausea following general anaesthesia and other risks related to anaesthesia Specific risks and complications associated with breast augmentation include: Numbness around operated sites or sensory changes to the nipple. This is usually temporary but can be permanent. Breast implants may affect your ability to breastfeed Breast implants are not guaranteed to last a lifetime and future surgery may be required to replace one or both implants Wound breakdown leading to infection or exposure of the breast implant Infection of the breast implant necessitating its removal A collection of air around the lung that may require insertion of a drain for removal. Formation of thick scar around the implant termed a capsule which can become tight and painful, displacing the implant. This is called ‘capsular contracture’ and may requires surgical correction. Visible wrinkling of the implant Implant animation (movement as the pectoralis muscles move) Some implants (especially heavily textured implants) have been associated with a rare type of cancer termed Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL). This is rare and usually presents with a unilateral swelling around an implant 6 – 10 years after surgery. It is usually completely treated with removal of the breast implant and capsule. Some women with breast implants develop a constellation of symptoms referred to as Breast Implant Illness (see below). Preoperative asymmetries of the chest wall are highlighted after breast implants are placed. Displacement or rotation of the implant Rupture of the gel in the implant, which may be contained to within the capsule around the implant or may leak into the tissues

Breast implant illness (BII) refers to a constellation of symptoms which some patients attribute to the placement of breast implants and include fatigue, joint pains or feeling ‘foggy’. Rarely, women with implants have reported general symptoms, including general aching, swollen lymph glands, greater frequency of colds and flu, hair loss, rash, headaches, poor memory, nausea, muscle weakness, irritable bowel syndrome and fever. There is no official medical diagnosis for BII. There have been allegations suggesting a potential link between breast implants and the development of connective tissue diseases. While some research has suggested small increased risks, many medical studies have failed to show a causal link between breast implants and these conditions. A small proportion of all women in the community will develop these diseases, irrespective of whether they have breast implants.

There is no conclusive evidence that breast implants adversely affect the stage at diagnosis or prognosis for breast cancer. It is important to disclose if you have breast implants when undergoing screening for breast cancer (mammography) and that you learn how to perform self-examinations of their breasts to detect any potential lumps or changes.

The ABDR is a registry for implantable breast devices. It is used to track the outcomes and quality of breast surgery and reports progressively on the long term performance and safety of implanted breast prostheses.

Your surgery will take place in an accredited hospital facility.

What do I need to do Before Surgery? Due to the recent cosmetic surgery reforms, all patients in Australia undergoing cosmetic surgery are required to undertake a Body Dysmorphic Disorder Questionnaire. You will be asked to complete a full medical history. You must list all medications you take including dietary supplements such as fish oil which increase your risk of bleeding. Check with your surgeon about your medications as some may need to be stopped. Any additional tests required preoperatively will be arranged by Mr. Bunker or your anaesthetist. If you decide to have breast augmentation, you will need to sign a consent form. Make sure you read the consent form carefully before signing. If you have any questions, please ask them prior to surgery. Avoid any strenuous activity or exercise in the week before your surgery. Take Vitamin C supplements 1 gram daily starting at least 2 weeks before your surgery, unless you are allergic or unable to tolerate. Make sure you arrange for a relative or friend to drive you to and from the hospital or clinic and that you have arranged appropriate help at home including someone to stay with you for the first 24 hours. Think about the setup at home where you will recover – you may want extra pillows, fluids and a toilet nearby and it is useful to have a telephone within reach. Consider work arrangements. Most patients will remain off work for 1-2 weeks after surgery. A medical certificate can be supplied to your preoperatively if required. You will receive detailed preoperative and postoperative instructions. Follow them carefully.

Arrange for a relative or friend to drive you home after the surgery. Someone should also stay with you for at least the first day after the operation. You can usually drink fluids and eat a light meal two or three hours after surgery. You may have some pain and discomfort, particularly around the incisions. You will receive medications for home (pain relief and antibiotics) as well as detailed postoperative instruction which include how to care for your surgical site, signs which warrant concern, contact information and follow- up instructions. No strenuous activity for 6 weeks after surgery. In particular, this involves no heavy use of the arms, no carrying heavy loads and no reaching high above the head. This can cause bleeding or the implant to move. Some bruising and swelling is normal and may take up to a few weeks to disappear. Dressings are to remain dry and intact until your postoperative review. Follow any instructions regarding postoperative garments as per Mr. Bunker’s instructions. If you experience any of the following symptoms, notify us immediately: Temperature higher than 38°C or chills Heavy bleeding from the incisions Sudden swelling or dark bruising around the breast A change in the colour of the nipple Worsening redness around the incision sites Increasing pain or tenderness Issues with the dressings (becoming dirty, wet or loose)

Some visible scars are inevitable and in most cases they are placed under the breast in the natural fold. Mr. Bunker will discuss the placement of scars with you prior to surgery.

Revisional surgery may be necessary to correct minor irregularities.

General anaesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness. When you are under general anaesthesia you are ‘asleep’. Ptosis: Drooping of the nipple-areola complex. Capsular contracture: Development of thick scarring around the breast implant which can cause it to become hard, painful and displaced. Animation: Unintentional movement of the implant associated with activated of the anterior chest muscles. ALCL: Breast Implant Associated Anaplastic Large Cell Lymphoma, a rare type of cancer which develops usually 6-10 years after breast augmentation and is usually completely treated with removal of the implant and surrounding capsule.

Breast lift surgery improves the breast contour by rearranging the breast tissue and redraping the skin. This gives the breasts a more youthful shape, repositions the nipple and usually firms the breast. A breast lift can also reduce the size of the areola, which often becomes enlarged over time.

A breast lift may be a good option for you if: Your breasts are sagging and have lost their shape and firmness Your breasts have flattened or are pendulous Your nipples fall below the breast crease or point downwards You have enlarged areolas Your breasts are asymmetrical, with one hanging lower than the other. Breast lift surgery is a highly individualised procedure and may not be suitable for everyone. Before you decide on breast lift surgery, there are some important issues to keep in mind: It is usually best to wait until breast development is complete and any breastfeeding has stopped before undertaking breast lift surgery If you are desiring a smaller breast or to fill the upper part of your breasts, a breast reduction or use of an implant may be required Large, heavy breasts tend to descend again after a breast lift more rapidly than smaller, lighter breasts. In these cases a breast reduction (LINK) may be more appropriate

Mr. Bunker performs breast lift under general anaesthesia to maximise patient comfort. Modern anaesthetics are safe and effective but carry some risks, which you will discuss with your anaesthetist.

Usually only a one night stay is required after breast lift surgery. This means we can monitor for any unexpected postoperative bleeding, ensure any pain is well controlled and remove any surgical drains prior to discharge if safe to do so.

All surgery has risks. There are general risks which apply to all operations as well as specific risks for individual procedures. General risks include: Bleeding Infection that may require treatment with antibiotics or further surgery in some cases Allergic reactions The formation of a large blood clot (haematoma) or fluid pocket (seroma) beneath the skin that may require drainage Pain, bruising and swelling around the operated sites Keloids and hypertrophic scars which are raised, red and thickened scars over the healed incisions. These may be itchy, annoying and unsightly but are not a threat to health. Poor healing or wound breakdown Smokers are at increased risk of complications from any surgery. It is important to truthfully disclose your smoking status, including ‘social’ smoking. Short-term nausea following general anaesthesia and other risks related to anaesthesia Specific risks and complications associated with breast lift surgery include: Numbness around operated sites or sensory changes to the nipple - this is usually temporary but can be permanent Issues with the blood supply to the nipple leading to delayed wound healing, subtotal or complete loss of the nipple (termed necrosis) Excessive ‘firmness’ of the breasts Reduction in the ability to breastfeed Asymmetry (in size of the breast or the shape and position of the nipple) Lumps in the breast due to issues with blood supply (termed fat necrosis) Wound breakdown and infection Requiring an implant with your lift to provide volume to the breast carries the risks associated with breast implants (LINK TO BREAST AUGMENTATION RISKS). Furthermore, the degree of asymmetry and need for revisional surgery is higher when a breast lift is combined with implants.

Your surgery will take place in an accredited hospital facility.

Due to the recent cosmetic surgery reforms, all patients in Australia undergoing cosmetic surgery are required to undertake a Body Dysmorphic Disorder Questionnaire. You will be asked to complete a full medical history. You must list all medications you take including dietary supplements such as fish oil which increase your risk of bleeding. Check with your surgeon about your medications as some may need to be stopped. Any additional tests required preoperatively will be arranged by Mr. Bunker or your anaesthetist. If you decide to have breast lift surgery, you will need to sign a consent form. Make sure you read the consent form carefully before signing. If you have any questions, please ask them prior to surgery. Avoid any strenuous activity or exercise in the week before your surgery. Take Vitamin C supplements 1gram a daily starting at least 2 weeks before your surgery, unless you are allergic or unable to tolerate. Make sure you arrange for a relative or friend to drive you to and from the hospital and that you have arranged appropriate help at home including someone to stay with you for the first 24 hours. Think about the setup at home where you will recover – you may want extra pillows, fluids or a toilet nearby and it is useful to have a telephone within reach. Purchase any postoperative garments if advised in your consultation with Mr. Bunker. Consider work arrangements. Most patients will remain off work for 2 weeks after breast lift surgery. A medical certificate can be supplied to your preoperatively if required. You will receive detailed preoperative and postoperative instructions. Follow them carefully.

Arrange for a relative or friend to drive you home after the surgery. Someone should also stay with you for at least the first day after the operation. You can usually drink fluids and eat a light meal two or three hours after surgery. You may have some pain and discomfort, particularly around the incisions. You will receive medications for home (pain relief and antibiotics) as well as detailed postoperative instruction which include how to care for your surgical site, signs which warrant concern, contact information and follow-up instructions. No strenuous activity for 6 weeks after surgery. In particular, this involves no heavy use of the arms, no carrying heavy loads, and no reaching high above the head. This can cause bleeding (and implants to move if used). Some bruising and swelling is normal and may take a few weeks to disappear. Dressings are to remain dry and intact until your postoperative review. If you experience any of the following symptoms, notify us immediately: Temperature higher than 38°C or chills Heavy bleeding from the incisions Suddenly swelling or dark bruising around the breast A change in the colour of the nipples Worsening redness around the incision sites Increasing pain or tenderness Issues with the dressings (becoming dirty, wet or loose) Follow any instructions regarding postoperative garments as per Mr. Bunker’s instructions.

Some visible scars are inevitable and in most cases go around the nipple, vertically down to the breast fold and in some cases along the fold itself. Mr. Bunker will discuss the placement of scars with you prior to surgery.

Revisional surgery may be necessary to correct minor irregularities.

Cost is always a consideration in elective surgery and may include: Surgical fee Hospital or surgical facility costs Anaesthesia fees Prescriptions for medication Postsurgery garments Medical tests A quote for the surgical fee is provided to you prior to surgery. This also contains instructions on how to obtain quotes for associated fees as listed above. If you have any questions, please contact the Practice Manager.

General anaesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness. When you are under general anaesthesia you are ‘asleep’. Ptosis: Drooping of the nipple-areola complex. Necrosis: Death of tissue due to a lack of blood supply. Heamatoma: A collection of blood under the skin or within the tissues which may necessitate open surgical drainage. Seroma: A collection of clear fluid under the skin.

Breast reduction surgery removes excess breast fat, glandular tissue and skin to achieve a breast size more in proportion with your body. During a breast reduction, excess breast tissue is removed, the nipple areolar complex is moved to a more youthful position and the skin around the breast is tightened.

Breast reduction may be a good option for you if: You are bothered by the feeling that your breasts are too large. You experience neck, back or shoulder pain and suffer from bra strap grooving. Your breasts are limiting your physical activity The skin folds under your breasts develop rashes or infections. Your breasts are droopy with low nipples or stretched areolas You are physically healthy You have realistic expectations Your breasts are fully developed Before you decide on breast reduction surgery, there are some important issues to keep in mind: It is usually best to wait until breast development, child birth and breastfeeding have stopped before having breast reduction surgery. Breast reduction may interfere with your ability to breastfeed Breast changes during pregnancy or rapid weight fluctuation will compromise the results of your procedure. Breast reduction surgery can interfere with some diagnostic procedures. A baseline mammogram should be undertaken 6 months after your surgery to provide a new baseline for your normal breast Patients who are significantly overweight and who smoke are at increased risk of complications. Lifestyle modification is necessary to address these issues before you undergo breast reduction surgery. Preoperative asymmetry may not be fully corrected and it is normal to have some asymmetry after breast reduction

Mr. Bunker performs breast reduction under general anaesthesia to maximise patient comfort. Modern anaesthetics are safe and effective but carry some risks, which you will discuss with your anaesthetist.

Usually only a one night stay is required after breast lift surgery. This means we can monitor for unexpected postoperative bleeding, ensure any pain is well controlled and remove surgical drains prior to discharge if safe to do so.

All surgery has risks. There are general risks which apply to all operations as well as specific risks for individual procedures. General risks include: Bleeding Infection that may require treatment with antibiotics or further surgery in some cases Allergic reaction The formation of a large blood clot (haematoma) or fluid collection (seroma) that may require drainage Pain, bruising and swelling around the operated sites Keloids and hypertrophic scars that are raised, red and thickened scars over the healed incisions. These may be itchy, annoying and unsightly but are not a threat to health. Poor healing or wound breakdown Smokers are at increased risk of complications from any surgery. It is important to truthfully disclose your smoking status, including ‘social’ smoking. Short-term nausea following general anaesthesia and other risks related to anaesthesia Specific risks and complications associated with breast lift include: Sensory changes to the nipple - this is usually temporary but can be permanent Heamatoma or seroma which may require drainage Issues with the blood supply to the nipple leading to delayed wound healing, subtotal or complete loss of the nipple (termed necrosis) Excessive ‘firmness’ of the breasts Reduction in the ability to breastfeed Asymmetry of the breasts or nipples Lumps in the breast due to issues with blood supply (fat necrosis)

Your surgery will take place in an accredited hospital facility.

Due to the recent cosmetic surgery reforms, all patients in Australia undergoing cosmetic surgery are required to undertake a Body Dysmorphic Disorder Questionnaire. You will be asked to complete a full medical history. You must list all medications you take including dietary supplements such as fish oil which increase your risk of bleeding. Check with your surgeon about your medications as some may need to be stopped. Any additional tests required preoperatively will be arranged by Mr. Bunker or your anaesthetist. If you decide to have breast reduction surgery, you will need to sign a consent form. Make sure you read the consent form carefully before signing. If you have any questions, please ask them prior to surgery. Avoid any strenuous activity or exercise in the week before your surgery. Take Vitamin C supplements 1 gram daily starting at least 2 weeks before your surgery, unless you are allergic or unable to tolerate. Make sure you arrange for a relative or friend to drive you to and from the hospital or clinic and that you have arranged appropriate help at home including someone to stay with you for the first 24 hours. Think about the setup at home where you will recover – you may want extra pillows, fluids and a toilet nearby and it is useful to have a telephone within reach. Consider work arrangements. Most patients will remain off work for 2 weeks after surgery. A medical certificate can be supplied to your preoperatively if required. Purchase postoperative garments if instructed to do so. You will receive detailed preoperative and postoperative instructions. Follow them carefully.

Arrange for a relative or friend to drive you home after the surgery. Someone should also stay with you for at least the first day after the operation. You can usually drink fluids and eat a light meal two or three hours after surgery. You may have some pain and discomfort, particularly around the incisions. You will receive medications for home (pain relief and antibiotics) as well as detailed postoperative instruction which include how to care for your surgical site, signs which warrant concern, contact information and follow-up instructions. No strenuous activity for 6 weeks after surgery. In particular, this involves no heavy use of the arms, no carrying heavy loads and no reaching high above the head. This can cause bleeding. Some bruising and swelling is normal and may take up to a few weeks to disappear. Dressings are to remain dry and intact until your post-operative review. Comply with any instructions regarding postoperative garment wear. If you experience any of the following symptoms, notify us immediately: Temperature higher than 38°C or chills Heavy bleeding from the incisions Sudden swelling or dark bruising around the breast Changes in the colour of the nipple Worsening redness around the incision sites Increasing pain or tenderness Issues with the dressings (becoming dirty, wet or loose)

Some are an inevitable part of breast reduction surgery and are usually an ‘inverted T’ or ‘lollipop' pattern. Mr. Bunker will discuss the placement of scars with you prior to surgery.

Revisional surgery may be necessary to correct minor irregularities.

Cost is always a consideration in elective surgery and may include: Surgical fee Hospital or surgical facility costs Anaesthesia fees Prescriptions for medication Postsurgical garments Medical tests A quote for the surgical fee is provided to you prior to surgery. This also contains instructions on how to obtain quotes for associated fees as listed above. If you have any further questions, please contact the Practice Manager. Terms you Should Know General anaesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness. When you are under general anaesthesia you are ‘asleep’. Ptosis: Drooping of the nipple-areola complex. Necrosis: Death of tissue due to a lack of blood supply. Heamatoma: A collection of blood under the skin or within the tissues which may necessitate open surgical drainage. Seroma: A collection of clear fluid. Intertrigo: Skin inflammation and breakdown caused by skin on skin friction, intensified by heat and moisture. Inverted T scar: A scar which runs around the areolar, vertically down to the breast and along the breast fold. Lollipop scar: A scar which runs around the areolar and vertically down to the breast fold.

The aim of eyelid reduction surgery is to improve facial appearance and reduce the signs of ageing. Whilst it is an individualised procedure, specific issues which may be addressed include: Excess skin and wrinkles of the eyelid Excess fatty deposits that appear as puffiness in the eyelids Bags under the eyes Droopiness of the lower eyelids, showing white below the iris (coloured portion of the eye)

At your consult, Mr. Bunker will discuss your goals and expectations and perform a targeted examination prior to discussing a surgical plan if appropriate. Blepharoplasty can be performed alone or along with other facial rejuvenation procedures such as facelift or browlift. Eyelid reduction surgery may be appropriate for you if: You have significant skin redundancy in the eyelids You have realistic expectations of what surgery can achieve You understand that eyelid reduction surgery cannot remove dark circles under the eyes, lift sagging eyebrows or eliminate crow’s feet. These require different interventions. You do not have any significant ocular conditions You do not smoke or have a history of poor wound healing, bleeding, or medical conditions which significantly increase your risk of surgery or anaesthesia.

Some eyelid surgery can be done in the rooms under local anaesthetic whilst other cases are best done with sedation or under a general anaesthetic in a hospital setting. Modern anaesthetics are safe and effective but carry some risks, which you will discuss with your anaesthetist.

Blepharoplasty as a standalone procedure is usually performed as day surgery. Prior to discharge home you will have a period of observation to ensure there are no early complications such as bleeding and that your pain is well-controlled.

All surgery has risks. There are general risks which apply to all operations as well as specific risks for individual procedures. General risks and complications of surgery may include: Bleeding Infection that may require treatment with antibiotics or further surgery in some cases Allergic reaction (to sutures, dressings or antiseptic solutions) The formation of a large blood clot (haematoma) or fluid (seroma) beneath the skin that may require drainage Pain, bruising and swelling around the operated sites Keloids and hypertrophic scars that are raised, red and thickened scars over the healed incisions. These may be itchy, annoying and unsightly but are not a threat to health Poor or slow healing Wound breakdown Short-term nausea following general anaesthesia and other risks related to anaesthesia Specific risks and complications associated with eyelid surgery include: Asymmetry of the eyelids Noticeable scarring Itchiness, watering or dryness of the eyes Swelling of the tissue over the white part of the eye (scelera). This is referred to as chemosis and may require medications to settle Removal of too much skin which can interfere with the ability of the eyelid to close, exposing the cornea to injury Drooping of the lower eyelid (ectropion) which will usually recover with massage and taping but occasionally requires further surgery Temporary changes in vision. In rare cases, changes in vision may be long lasting or permanent In extremely rare cases, eyelid reduction surgery can lead to blindness.

Your surgery will take place in an accredited hospital facility.

Due to the recent cosmetic surgery reforms, all patients in Australia undergoing cosmetic surgery are required to undertaken a Body Dysmorphic Disorder Questionnaire. You will be asked to complete a full medical history. You must list all medications you take including dietary supplements such as fish oil which increase your risk of bleeding. It is also important to disclose any ocular conditions or the use of prescription glasses or eyedrops. Check with your surgeon about your medications as some may need to be stopped. Any additional tests required pre-operatively will be arranged by Mr. Bunker or your anaesthetist. If you decide to have eyelid surgery, you will need to sign a consent form. Make sure you read the consent form carefully before signing. If you have any questions, please ask them prior to surgery. Avoid any strenuous activity or exercise in the week before your surgery Make sure you arrange for a relative or friend to drive you to and from the hospital or clinic and that you have arranged appropriate help at home including someone to stay with you for the first 24 hours. Think about the setup at home where you will recover – you may want extra pillows, fluids and a toilet nearby and it is useful to have a telephone within reach. Ensuring you have sunglasses available is also useful as you may be sensitive to light for a few days postoperatively. If you wear contact lenses, you will need to consider obtaining eyeglasses as you will be unable to place contacts for 2 weeks postoperatively. Consider work arrangements. Most patients will remain off work for 1 -2 weeks after surgery. A medical certificate can be supplied to your preoperatively if required Take Vitamin C supplements 1 gram daily starting at least 2 weeks before your surgery, unless you are allergic or unable to tolerate You will receive detailed preoperative and postoperative instructions. Follow them carefully.

Arrange for a relative or friend to drive you home after the surgery. Someone should also stay with you for at least the first day after the operation and preferably for a few days. You will receive medications for home (usually pain relief and antibiotics) as well as detailed postoperative instructions which include how to care for your surgical site, signs which warrant concern, contact information and follow-up instructions. You can usually drink fluids and eat a light meal two or three hours after surgery. Some bruising and swelling is normal and may take up to a few weeks to disappear. Dressings are to remain intact until your postoperative review unless otherwise advised. You may be required to clean your eyes as the incisions sometimes become crusty. You may also need to use lubricating drops. Your eyes may be sensitive to light for a few days requiring you to wear sunglasses. Do not wear contact lenses for at least 2 weeks. Avoid heavy lifting, strenuous exercise, swimming and strenuous sports for 4 weeks. If you experience any of the following symptoms, notify us immediately: Heavy bleeding from the incisions Significant swelling around the eye or pain Changes in vision Fever (>38°C) or chills Worsening redness around the incision sites

Some visible scars are inevitable, however Mr. Bunker will aim to place these in natural creases where possible and they usually become inconspicuous with time.

Revisional surgery may be necessary to correct minor irregularities.

Cost is always a consideration in elective surgery and may include: Surgical fee Hospital or surgical facility costs Anaesthesia fees Prescriptions for medication Medical tests A quote for the surgical fee is provided to you prior to surgery. This also contains instructions on how to obtain quotes for associated fees as listed above. If you have further question please contact the Practice Manager. Terms You Should Know: General anaesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness. When you are under general anaesthesia you are ‘asleep’. Intravenous sedation: Sedatives administered by injection into a vein to achieve relaxation. Also referred to as ‘twighlight’ anaesthesia. Local anaesthesia: A drug injected directly to the site of an incision during an operation to relieve pain. Also referred to as ‘numbed with needles’. Blepharoplasty: A surgical procedure to address excess skin (+/- fat) of the eyelids. Ectropion: A pulling down of the lower eyelid as a result of tension, scarring, or weak eyelid support mechanisms. Chemosis: inflammation of the covering (conjunctiva) over the sclera. Sclera: The white part of the eye.

A brow lift improves facial appearance by targeting stigmata of aging including: Elevating the brow into a more youthful position Reducing forehead wrinkles Reducing frown lines that develop between the eyes near the top of the nose A brow lift does not address dynamic wrinkles or inherent skin aging. For these issues, non-surgical treatments may be appropriate such as anti-wrinkle injections or skin resurfacing techniques.

At your consult, Mr. Bunker will discuss your goals and expectations and perform a targeted examination prior to discussing a surgical plan if appropriate. Brow lift can be performed alone or in combination with other facial rejuvenation procedures such as facelift or eyelid surgery. Brow lift surgery may be a good option for you if: You have sagging of your eyebrows You have deep creases in your forehead You have deep frown lines at the top of your nose You have realistic expectations of what brow lift surgery can accomplish You are physically healthy and you do not have medical conditions that can impair healing or increase risk of surgery You are not prone to bleeding You are a non-smoker or have stopped smoking at least 3 months prior

Brow lift surgery is usually performed under general anaesthetic. Modern anaesthetics are safe and effective but carry some risks, which you will discuss with your anaesthetist.

Brow lift as a standalone procedure can be performed as day surgery. Prior to discharge home you will have a period of observation to ensure there are no early complications such as unexpected bleeding and that your pain is well-controlled.

All surgery has risks. There are general risks which apply to all operations as well as specific risks for individual procedures. General risks and complications of surgery may include: Bleeding Infection that may require treatment with antibiotics or further surgery in some cases Allergic reaction (to sutures, dressings or antiseptic solutions) The formation of a large blood clot (haematoma) or fluid (seroma) beneath the skin that may require drainage Pain, bruising and swelling around the operated sites Keloids and hypertrophic scars that are raised, red and thickened scars over the healed incisions. These may be itchy, annoying and unsightly but are not a threat to health Poor or slow healing Wound breakdown Short-term nausea following general anaesthesia and other risks related to anaesthesia Specific risks and complications associated with brow lift surgery include: Bruising and swelling which usually resolve in the first few weeks The hairline may raise slightly Temporary hair loss may occur near the treated area Hair thinning or loss may appear at the line of incision Temporary or permanent numbness at operated sites Numbness may be replaced by itchiness, which typically resolves within several months as nerves heal Numbness at the top of head which can be permanent No movement or poor movement of the forehead muscles in the first days after surgery In rare cases, permanent injury to the nerves that control eyebrow movement can result in asymmetry of the eyebrows. Revisional surgery may be necessary to improve appearance

Your surgery will take place in an accredited hospital facility.

Due to the recent cosmetic surgery reforms, all patients in Australia undergoing cosmetic surgery are required to undertake a Body Dysmorphic Disorder Questionnaire. You will be asked to complete a full medical history. You must list all medications you take including dietary supplements such as fish oil which increase your risk of bleeding. Check with your surgeon about your medications as some may need to be stopped. Any additional tests required preoperatively will be arranged by Mr. Bunker or your anaesthetist. If you decide to have brow lift surgery, you will need to sign a consent form. Make sure you read the consent form carefully before signing. If you have any questions, please ask them prior to surgery. Avoid any strenuous activity or exercise in the week before your surgery Make sure you arrange for a relative or friend to drive you to and from the hospital or clinic and that you have arranged appropriate help at home including someone to stay with you for the first 24 hours. Think about the setup at home where you will recover – you may want extra pillows, fluids and a toilet nearby and it is useful to have a telephone within reach. Consider work arrangements. Most patients will remain off work for 1 -2 weeks after surgery. A medical certificate can be supplied to your preoperatively if required Take Vitamin C supplements 1 gram daily starting at least 2 weeks before your surgery, unless you are allergic or unable to tolerate Wash your hair the day before surgery and on the day of surgery to not use any hair products. You will receive detailed preoperative and postoperative instructions. Follow them carefully.

You can usually drink fluids and eat a light meal two or three hours after surgery. Arrange for a relative or friend to drive you home after the surgery. Someone should also stay with you for at least the first day after the operation and preferably for a few days. You will receive medications for home (usually pain relief and antibiotics) as well as detailed postoperative instruction which include how to care for your surgical site, signs which warrant concern, contact information and follow-up instructions. Some bruising and swelling is normal, and may take up to a few weeks to disappear. Dressings are to remain intact until your postoperative review. You can usually shower 48 hours after an isolated brow lift. Avoid heavy lifting, strenuous exercise, swimming and strenuous sports for 4 weeks. If you experience any of the following symptoms, notify us immediately: Heavy bleeding from the incisions Significant swelling around the eye or pain Changes in vision Fever (>38°C) or chills Worsening redness around the incision sites

Some visible scars are inevitable, however Mr. Bunker will aim to make these as inconspicuous as possible.

Revisional surgery may be necessary to correct minor irregularities.

Cost is always a consideration in elective surgery and may include: Surgical fee Hospital or surgical facility costs Anaesthesia fees Prescriptions for medication Medical tests A quote for the surgical fee is provided to you prior to surgery. This also contains instructions on how to obtain quotes for associated fees. If you have any questions please contact the Practice Manager. Terms you Should Know General anaesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness. When you are under general anaesthesia you are ‘asleep’. Intravenous sedation: Sedatives administered by injection into a vein to achieve relaxation. Also referred to as ‘twilight’ anaesthesia. Local anaesthesia: A drug injected directly to the site of an incision during an operation to relieve pain. Also referred to as ‘numbed with needles’. Brow lift: A surgical procedure to elevate the eyebrows to a more youthful position and create a forehead which appears more youthful. Alopecia: Hair loss.

Fat grafting may be appropriate to add volume to the breasts or buttocks or to address stigmata of facial aging. It requires the removal of fat from a donor area via liposuction (chosen depending on the volume required and your body habitus) and the careful grafting of this fat into the desired location. Facial rejuvenation with fat grafting can be used to treat areas of volume loss and restore a more youthful contour to the face. Facial fat grafting can be used to address temporal hollowing, soften the nasolabial folds or ‘bags’ under the eyes, improve chin and jawline definition or add volume to the lips.

Fat grafting is a highly individualised procedure. Fat grafting may be appropriate for you if: You have been assessed as suitable for fat grafting by a qualified specialist You have realistic expectations Your weight is stable You do not smoke or quit at least 3 months prior You are otherwise healthy and safe to receive an anaesthetic Fat grafting is often performed in associated with other procedures such as a facelift or eyelid surgery. Before you decide on fat grafting, it is important to know that: Significant changes in your weight also affect the size of the grafted fat – it is living tissue There is some degree of resorption of fat after grafting, meaning areas may initially be ‘over filled’ to compensate for this expected loss Some areas may require multiple rounds of fat grafting to achieve the desired goal

Usually only a one night stay is required after breast lift surgery. This means we can monitor for any postoperative bleeding, ensure any pain is well-controlled and remove any surgical drains prior to discharge if safe to do so.

All surgery has risks. There are general risks which apply to all operations as well as specific risks for individual procedures. General risks include: Bleeding Infection that may require treatment with antibiotics or further surgery in some cases Allergic reaction The formation of a large blood clot (haematoma) or fluid (seroma) beneath the skin that may require drainage Pain, bruising and swelling around the operated sites Keloids and hypertrophic scars that are raised, red and thickened scars over the healed incisions. These may be itchy, annoying and unsightly but are not a threat to health. Poor healing or wound breakdown Smokers are at increased risk of complications from any surgery. It is important to truthfully disclose your smoking status, including ‘social’ smoking. Short-term nausea following general anaesthesia and other risks related to anaesthesia Specific risks and complications associated with fat grafting include: Bruising and swelling Overcorrection due to the transfer of excess fat Under correction due to transfer of an insufficient volume of fat or excessive resorption of grafted fat Lumps or cysts secondary to prolonged inflammation or necrosis (death) of transferred fat Visible or palpable deformities Blindness or stroke due to occlusion of important arteries with fat Fat embolism resulting in areas of skin loss or issues with breathing Deformity at the donor site due to excessive or unequal fat harvesting

Your surgery will take place in an accredited hospital facility.

Due to the recent cosmetic surgery reforms, all patients in Australia undergoing cosmetic surgery are required to undertaken a Body Dysmorphic Disorder Questionnaire. You will be asked to complete a full medical history. You must list all medications you take including dietary supplements such as fish oil which increase your risk of bleeding. Check with your surgeon about your medications as some may need to be stopped. Any additional tests required preoperatively will be arranged by Mr. Bunker or your anaesthetist. If you decide to have fat grafting, you will need to sign a consent form. Make sure you read the consent form carefully before signing. If you have any questions, please ask them prior to surgery. Avoid any strenuous activity or exercise in the week before your surgery. Take Vitamin C supplements 1 gram daily starting at least 2 weeks before your surgery, unless you are allergic or unable to tolerate. Make sure you arrange for a relative or friend to drive you to and from the hospital or clinic and that you have arranged appropriate help at home including someone to stay with you for the first 24 hours. Think about the setup at home where you will recover – you may want extra pillows, fluids and a toilet nearby and it is useful to have a telephone within reach. Consider work arrangements. Most patients will remain off work for 2 weeks after surgery. A medical certificate can be supplied to your preoperatively if required. You will receive detailed preoperative and postoperative instructions. Follow them carefully.

Arrange for a relative or friend to drive you home after the surgery. Someone should also stay with you for at least the first day after the operation. Some bruising and swelling is normal and may take up to a few weeks to disappear. You can usually drink fluids and eat a light meal two or three hours after surgery. You may have some pain and discomfort, particularly around the incisions. You will receive medications for home (pain relief and antibiotics) as well as detailed post-operative instruction which include how to care for your surgical site, signs which warrant concern, contact information and follow-up instructions. Follow any instructions regarding postoperative garments as per Mr. Bunker’s instructions. No strenuous activity for 4 weeks after surgery. Do not massage the area firmly as you may change the position of the fat grafts. Dressings are to remain dry and intact until your postoperative review. If you experience any of the following symptoms, notify us immediately: Temperature higher than 38°C or chills Suddenly swelling or dark bruising Headaches or changes in vision Increasing pain or tenderness Difficulty breathing

Very small scars are required to both harvest and transfer the fat. These usually become inconspicuous with time.

Revisional surgery may be necessary to correct minor irregularities.

Cost is always a consideration in elective surgery and may include: Surgical fee Hospital or surgical facility costs Anaesthesia fees Prescriptions for medication Postsurgery garments Medical tests A quote for the surgical fee is provided to you prior to surgery. This also contains instructions on how to obtain quotes for associated fees as listed above. If you have any questions, please contact the Practice Manager. Terms You Should Know: General anaesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness. When you are under general anaesthesia you are ‘asleep’. Intravenous anaesthesia: Drugs delivered to provide sedation, also known as ‘twilight' anaesthesia. Necrosis: Death of tissue due to a lack of blood supply. Autologous: Tissues obtained from the same individual.

Liposuction aims to remove areas of excess fat and create a more pleasing figure.

At your consult, Mr. Bunker will discuss your goals and expectations and perform a targeted examination prior to discussing a surgical plan if appropriate. Liposuction results depend not only on the skilful removal of excess fat, but it is essential that you have adequate skin quality to enable the skin the retract. If you have poor tissues and too much liposuction is performed, this can result in excess or ‘baggy’ skin over areas where the liposuction was performed. Liposuction can be appropriate if: You have excess resistant fat with good quality skin You have realistic expectations Your weight is relatively stable You are a non-smoker or have stopped smoking at least 3 months prior You are physically healthy and do not have not have medical conditions that may impair healing or increase the risk of surgery

Mr. Bunker performs liposuction under general anaesthesia to maximise patient comfort. Modern anaesthetics are safe and effective but carry some risks, which you will discuss with your anaesthetist.

The need to stay in hospital depends on the extent of liposuction performed. Smaller procedures can be performed as day surgery, whereas cases with a longer operating time and larger quantities of fat removed often require a short hospital stay.

Your surgery will take place in an accredited hospital facility.

Due to the recent cosmetic surgery reforms, all patients in Australia undergoing cosmetic surgery are required to undertaken a Body Dysmorphic Disorder Questionnaire. You will be asked to complete a full medical history. You must list all medications you take including dietary supplements such as fish oil which increase your risk of bleeding. Check with your surgeon about your medications as some may need to be stopped. Any additional tests required pre-operatively will be arranged by Mr. Bunker or your anaesthetist. If you decide to have liposuction, you will need to sign a consent form. Make sure you read the consent form carefully before signing. If you have any questions, please ask them prior to surgery. Post-operative garments may need to be purchased and will be discussed at your consultation if appropriate. Avoid any strenuous activity or exercise in the week before your surgery Make sure you arrange for a relative or friend to drive you to and from the hospital and that you have arranged appropriate help at home including someone to stay with you for the first 24 hours. Think about your recovery area at home – you may want extra pillows, fluids and a toilet nearby and it is useful to have a telephone within reach. Consider work arrangements. Most patients will remain off work for 2 weeks after surgery. A medical certificate can be supplied to your pre-operatively if required. Take Vitamin C 1 gram daily starting at least 2 weeks before your surgery, unless you are allergic or unable to tolerate. You will receive detailed preoperative and postoperative instructions. Follow them carefully.

Arrange for a relative or friend to drive you home and stay with you for the first night after surgery. You will receive medications for home (usually pain relief and antibiotics) as well as detailed postoperative instruction which include how to care for your surgical site, signs which warrant concern, contact information and follow-up instructions. You can usually drink fluids and eat a light meal two or three hours after surgery. You may have some fluid leak from the small incision sites in the first few days. If dressings become wet, please contact the rooms as per the postoperative instructions to arrange a dressing change with the nurse. Some bruising and swelling is normal and may take up to a few weeks to disappear. Dressings are to remain intact until your post-operative review. Any postoperative garments can be removed for showering but otherwise should stay in on. If you experience any of the following symptoms, notify us immediately: Fever (>38°C) or chills Heavy bleeding from the incisions Worsening redness around the incision sites Increasing pain or tenderness, or other problems that appear to be worsening Issues with the dressings (becoming dirty, wet or loose) In some cases, a small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid that may collect. This is usually removed in the office at your postoperative appointment or before you are discharged from the hospital.

Any time the skin is cut it heals to form a scar. Hence visible scars are inevitable, however they are very small and usually become inconspicuous with time.

Cost is always a consideration in elective surgery and may include: Surgical fee Hospital or surgical facility costs Anaesthesia fees Prescriptions for medication Postsurgery garments Medical tests A quote for the surgical fee is provided to you prior to surgery. This also contains instructions on how to obtain quotes for associated fees as listed above. If you have any questions, please contact the Practice Manager. Terms You Should Know: General anaesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness. When you are under general anaesthesia you are ‘asleep’. Intravenous sedation: Sedatives administered by injection into a vein to achieve relaxation. Also referred to as ‘twilight’ anaesthesia. Local anaesthesia: A drug injected directly to the site of an incision during an operation to relieve pain. Also referred to as ‘numbed with needles’. Liposuction: Also called lipoplasty or lipectomy, this is the removal of fat from beneath the skin using a suction cannula. Tumescent: A mixture of saline (salt solution), local anaesthetic and adrenaline which is infiltrated into the soft tissues prior to liposuction.

The goal of a thigh lift is to provide a more aesthetic contour to the thighs as well as excise redundant skin, thereby creating a more youthful shape to the legs. Liposuction is used to remove fat and help shape the thighs before excess skin is excised, leaving a scar which usually runs from the groin down the inside of your thigh to end just above your knee.

Thigh lift surgery is not suitable for everyone. At your consult, Mr. Bunker will discuss your goals and expectations and perform a targeted examination prior to discussing a surgical plan if appropriate. Thigh lift surgery may be a good option for you if: You are physically healthy and you do not have not have medical conditions that can impair healing or increase the risk of surgery You have realistic expectations Your weight is relatively stable You have excess soft tissue along the medial (inside) of your thighs You are a non-smoker or have stopped smoking at least 3 months prior

Mr. Bunker performs thigh lift under general anaesthesia to maximise patient comfort. Modern anaesthetics are safe and effective but carry some risks, which you will discuss with your anaesthetist.

Usually you will stay in the hospital 1 - 2 nights after an isolated thigh lift. This is to ensure there are no early complications such as unexpected bleeding and that your pain is well controlled prior to discharge. Usually, surgical drains are placed at the time of surgery and these may need to remain in for a number of weeks to prevent fluid collections developing under the skin.

All surgery has risks. There are general risks which apply to all operations as well as specific risks for individual procedures. General risks and complications of surgery may include: Bleeding Infection that may require treatment with antibiotics or further surgery in some cases Allergic reaction (to sutures, dressings or antiseptic solutions) The formation of a large blood clot (haematoma) or fluid collection (seroma) in the soft tissues deep to the skin Pain, bruising and swelling around the operated sites Poor or slow healing Wound breakdown Short-term nausea following general anaesthesia and other risks related to anaesthesia Specific risks and complications associated with thigh lift surgery include: Prominent scars such as keloids and hypertrophic scars. They may be red, raised and/or itchy. Numbness around operated sites. This is usually temporary but can be permanent. Wound breakdown or poor healing leading to delaying healing or requiring skin grafts for closure. As the wounds around the groin are stressed during everyday movements, the risk of delayed wound healing after a thigh lift is high. Restrictive movement due tightened skin Accumulation of fluid (seroma) or blood (haematoma) under the skin which may required a procedure to remove. Swelling in the legs due to damage of lymphatics, which may be permanent. Labial spreading (separation of the vulva due to scar contracture)

Your surgery will take place in an accredited hospital facility.

Due to the recent cosmetic surgery reforms, all patients in Australia undergoing cosmetic surgery are required to undertake a Body Dysmorphic Disorder Questionnaire. You will be asked to complete a full medical history. You must list all medications you take including dietary supplements such as fish oil which increase your risk of bleeding. Check with your surgeon about your medications as some may need to be stopped. Any additional tests required preoperatively will be arranged by Mr. Bunker or your anaesthetist. If you decide to have thigh lift surgery you will need to sign a consent form. Make sure you read the consent form carefully before signing. If you have any questions, please ask these prior to surgery. Avoid any strenuous activity or exercise in the week before your surgery. Take Vitamin C supplements 1 gram daily starting at least 2 weeks before your surgery, unless you are allergic or unable to tolerate. Make sure you arrange for a relative or friend to drive you to and from the hospital or clinic and that you have arranged appropriate help at home including someone to stay with you for the first 24 hours. Think about the setup at home where you will recover – you may want extra pillows, fluids and a toilet nearby and it is useful to have a telephone within reach. Consider work arrangements. Most patients will remain off work for 2 - 4 weeks after surgery. A medical certificate can be supplied to your preoperatively if required. You will receive detailed preoperative and postoperative instructions. Follow them carefully.

Arrange for a relative or friend to drive you home after the surgery. Someone should also stay with you for at least the first day after the operation and preferably for a few days. You can usually drink fluids and eat a light meal two or three hours after surgery. You may have some pain and discomfort, particularly around the incisions. You will receive medications for home (usually pain relief and antibiotics) as well as detailed post-operative instruction which include how to care for your surgical site, signs which warrant concern, contact information and follow-up instructions. Follow any instructions regarding post-operative garments as per Mr. Bunker’s instructions. Some bruising and swelling is normal and may take up to a few weeks to disappear. In some cases a small, thin tube (surgical drain) may be temporarily placed under the skin to drain any excess blood or fluid that may collect. This may need to stay in place for a number of weeks. Dressings are to remain dry and intact until your postoperative review. No strenuous activity for 6 weeks after surgery. If you experience any of the following symptoms, notify us immediately: Temperature higher than 38°C or chills Heavy bleeding from the incisions Worsening redness around the incision sites Increasing pain or tenderness, or other problems that appear to be worsening Issues with the dressings (becoming dirty, wet or loose)

Some visible scars are inevitable. However, efforts will be made to limit the length of your scars and to place them in as inconspicuous a position as possible. Mr. Bunker will discuss the placement of scars with you prior to surgery. Scars may be more noticeable than you anticipated, but most scars fade with time.

Revisional surgery may be necessary to correct minor irregularities.

Cost is always a consideration in elective surgery and may include: Surgical fee Hospital or surgical facility costs Anaesthesia fees Prescriptions for medication Postsurgery garments Medical tests A quote for the surgical fee is provided to you prior to surgery. This also contains instructions on how to obtain quotes for associated fees as listed above. If you have any further questions, please contact the Practice Manager. Terms You Should Know: General anaesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness. When you are under general anaesthesia you are ‘asleep’. Intravenous sedation: Sedatives administered by injection into a vein to achieve relaxation. Also referred to as ‘twilight anaesthesia’. Local anaesthesia: A drug injected directly to the site of an incision during an operation to relieve pain. Also referred to as ‘numbed with needles’. Thigh lift: A surgical procedure to target redundant soft tissue in the thigh and provide a more pleasing aesthetic contour. Lymphatics: A system in the body which drains fluid within the tissues back into the bloodstream. Skin laxity: Degree of loose skin.

A neck lift involves addressing fat (by liposuction and/or excision), tightening laxity of superficial neck musculature and redraping the skin, thereby improving the contour of the neck.

At your initial consult, Mr. Bunker discuss your motivations and concerns, clinically assess for stigmata of aging and generate a treatment plan. Any facial rejuvenation surgery is a highly individualised procedure and may not be suitable for everyone. Neck lift surgery may be a good option for you if: You have loose skin and excess fatty deposits under the chin and jaw, creating the appearance of a double chin You have ‘banding’ at the front of the neck You are physically healthy and do not have medical conditions that significantly increase the risks of surgery or anaesthesia You have realistic expectations of what face lift surgery can accomplish You are a non-smoker or have stopped smoking at least 3 months ago Important considerations are: Sometimes fullness in the neck is due to deeper structures such as the parotid gland or descent of the submandibular glands, which may not be addressed with a neck lift. The natural aging process continues after a neck lift. Smokers and patients with high blood pressure are at increased risk of complications. You need to stop smoking and have your blood pressure under control to be considering for neck lift surgery.

Mr. Bunker performs neck lift under general anaesthetic to maximise patient comfort. Modern anaesthetics are safe and effective but carry some risks, which you will discuss with your anaesthetist.

Usually one night in hospital is required after a neck lift. This allows your blood pressure to be monitored, ensure there are no early complications such as bleeding, and make sure your pain is well-controlled prior to discharge and also means drains inserted at surgery can be removed prior to going home and any necessary dressing changes performed.

All surgery has risks. There are general risks which apply to all operations as well as specific risks for individual procedures. General risks and complications of surgery may include: Bleeding Infection that may require treatment with antibiotics or further surgery in some cases Allergic reaction (to sutures, dressings or antiseptic solutions) The formation of a large blood clot (haematoma) or fluid (seroma) beneath the skin that may require drainage Pain, bruising and swelling around the operated sites Keloids and hypertrophic scars that are raised, red and thickened scars over the healed incisions. These may be itchy, annoying and unsightly but are not a threat to health Poor or slow healing Wound breakdown Short-term nausea following general anaesthesia and other risks related to anaesthesia Specific risks and complications associated with neck lift surgery include: Hair loss around the scars, this is usually temporary but sometimes may be permanent Loss of skin due to impaired blood supply. This may require a skin graft. Bruising and swelling Numbness around operated sites. In most cases this is temporary and will improve over many months Deformity of the earlobe Slight difference in appearance between the right and left sides of the neck Damage to the facial nerve, which occurs in about one in every one hundred patients. It can result in partial loss of movement and a “lopsided” appearance of the face. In rare cases, the damage may be permanent Revisional surgery may be necessary to correct complications

Your surgery will take place in an accredited hospital facility.

Due to the recent cosmetic surgery reforms, all patients in Australia undergoing cosmetic surgery are required to undertake a Body Dysmorphic Disorder Questionnaire. Avoid any strenuous activity or exercise in the week before your surgery Ensure you have arranged appropriate help at home including someone to stay with you for the first 24 hours. Consider pillows, cool compresses and a telephone within reach. Make sure you arrange for a relative or friend to drive you to and from the hospital or clinic. Consider work arrangements. Most patients will remain off work for 4 – 6 weeks after surgery. A medical certificate can be supplied to your pre-operatively if required Take Vitamin C supplements 1gram a daily starting at least 2 weeks before your surgery, unless you are allergic or unable to tolerate Wash your hair the night before your surgery Do not wear any make-up on the day of surgery Be as fit as possible to help the recovery process You will be asked to complete a full medical history. You must list all medications you take including dietary supplements such as fish oil which increase your risk of bleeding. Check with your surgeon about your medications as some may need to be stopped. Any additional tests required preoperatively will be arranged by Mr. Bunker or your anaesthetists. If you decide to have facelift surgery, your surgeon will ask you to sign a consent form. Make sure you read the consent form carefully before signing. If you have any questions, ask your surgeon. You will receive detailed preoperative and postoperative instructions. Follow them carefully.

Arrange for a relative or friend to drive you home after the surgery. Someone should also stay with you for at least the first day after the operation and preferably for a few days. Follow your postoperative instructions including taking any prescribed medications. Some bruising and swelling is normal and may take up to a few weeks to disappear. Sleeping with your head elevated will help to reduce the swelling. Avoid heavy lifting, strenuous exercise, swimming and strenuous sports for 6 weeks after surgery. You will receive specific instructions on post-operative care. These instructions may include: How to care for your surgical sites following surgery Medications to apply or take orally to aid healing and reduce the risk of infection Specific concerns to look for at the surgical sites or in your general health Follow-up arrangements If you experience any of the following symptoms, notify your surgeon immediately: Temperature higher than 38°C or chills Heavy bleeding from the incisions Worsening redness around the incision sites Increasing pain or tenderness Any other concerns

Scars are an inevitable part of any surgery and are created when any incision through the skin heals. Mr. Bunker will endeavour to minimise scarring and to keep your scars as inconspicuous as possible by locating the incisions in hidden sites where practicable. Scars usually fade with time and become barely noticeable. If you are prone to scarring, advise your surgeon.

Revisional surgery may be necessary to correct irregularities or issues with wound healing.

Cost is always a consideration in elective surgery and may include: Surgical fee Hospital or surgical facility costs Anaesthesia fees Prescriptions for medication Medical tests A quote for the surgical fee is provided to you prior to surgery. This also contains instructions on how to obtain quotes for associated fees as listed above. If you have further questions, please contact the Practice Manager. Terms You Should Know: General anaesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness. When you are under general anaesthesia you are ‘asleep’. Intravenous sedation: Sedatives administered by injection into a vein to achieve relaxation. Also referred to as ‘twilight’ anaesthesia. Local anaesthesia: A drug injected directly to the site of an incision during an operation to relieve pain. Also referred to as ‘numbed with needles’. Platysmal bands: Folds of skin hanging down from under the skin to near the Adam’s apple, due to separation and loosing of a superficial neck muscle called the platysma. Cervicomental angle: The angle formed between your neck and a line drawn under your chin (on a side view). With age, this angle becomes more obtuse and contributes to the appearance of aging.