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What is the New Zealand Association of Plastic Surgeons?

The New Zealand association of Plastic Surgeons is the peak body for specialist plastic and reconstructive surgeons in New Zealand. Our main role is to maintain excellent ethical and professional standards within the field of cosmetic and reconstructive plastic surgery. Membership criteria are stringent. Our members are registered to practice by the Medical Council of New Zealand (MCNZ). They hold a specialist qualification in plastic and reconstructive surgery from the Royal Australasian College of Surgeons or its academic equivalent and have undertaken at least five years of specialist postgraduate training.

What is plastic surgery?

Contrary to its name, plastic surgery does not involve the use of plastics during surgery. The word plastic is taken from a Greek word that simply means ‘moulding’ or ‘giving form’.

What is a Specialist Plastic and Reconstructive Surgeon?

The benchmark qualification, recognised by the Medical Council of New Zealand(MCNZ), for a trained plastic and cosmetic surgeon in New Zealand and Australia is FRACS (Fellowship of the Royal Australasian College of Surgeons). Trainees undergo a five year postgraduate programme in Plastic and Reconstructive Surgery Education and Training (SET). The programme is overseen by the Royal Australasian College of Surgeons (RACS) and administered by the New Zealand Association of Plastic Surgeons (NZAPS). Upon completion of their surgical education and training, qualified specialist plastic and reconstructive surgeons become “Fellows” of the Royal Australasian College of Surgeons (FRACS).

Sometimes doctors with a Fellowship of the College of Surgeons (of England, Ireland, Scotland or Canada), with evidence of additional training, may be accepted by the New Zealand Medical Council as specialists. The same applies to American doctors who are board-certified in plastic and reconstructive surgery.

All surgical procedures carry risk, but you can reduce the chance of risk and complication by consulting a specialist plastic and reconstructive surgeon who is trained, qualified and accredited to perform cosmetic and reconstructive surgery.

What is the difference between a cosmetic doctor and a specialist plastic and reconstructive surgeon?

Specialist plastic and reconstructive surgeons have at least 12 years of total medical and surgical education, have studied specialist surgery for a minimum of five years including extensive training to perform invasive surgical procedures, and are accredited as specialist plastic and reconstructive surgeons by the Medical Council of New Zealand(MCNZ). Cosmetic doctors are not MCNZ accredited surgeons and they are not trained in invasive surgical procedures.

What is the difference between cosmetic and reconstructive surgery?

Plastic and reconstructive surgery has two branches, cosmetic surgery and reconstructive plastic surgery. Cosmetic surgery is designed to improve a person’s aesthetic appearance by altering or reshaping facial or bodily features. Reconstructive surgery is concerned with improving function or to minimize disfigurement that has occurred as a result of an accident, disease or birth defect.

What are the most popular cosmetic surgery procedures undertaken in New Zealand?

No one knows exactly how much cosmetic surgery is being performed in New Zealand, as national statistics for the industry are not collected at this time. This is partly due to the fact that most cosmetic surgery is elective and so carried out in the private sector.

The other contributing factor is that so many different practitioners perform cosmetic surgery, ranging from specialist plastic and reconstructive surgeons to doctors, dermatologists and beauticians. For this reason statistics on individual procedures are also not available. It is generally accepted, however, that there has been a big rise in the past 10 years.

Can you breastfeed after breast augmentation?

Individual cases may vary but generally, mothers can breastfeed after having a breast augmentation. There is no evidence to suggest that the ability to breastfeed is adversely affected by the presence of breast implants, however, some women do experience reduced nipple sensation following breast augmentation surgery, and nipple sensation is an important part of the milk let down reflex.

Can you breastfeed after breast reduction surgery?

When conducting breast surgery reduction, the surgeon is always concerned with the preservations of breastfeeding potential in women. However, ability to breastfeed following breast reduction surgery may be affected. Women who intend to breastfeed in the future are advised to discuss the matter with their surgeon.

Is it safe to have injectable fillers during pregnancy or while breastfeeding?

There is a lack of controlled studies into the effects of injectable fillers, such as Botox®, on pregnant and breastfeeding women. Therefore, it is impossible to conclusively say whether it is safe or unsafe. For caution, it is recommended that women avoid using injectable fillers when pregnant or breastfeeding.

What do I need to know about advertising?

There is no specific regulation of cosmetic surgery advertising. However, the Medical Council of New Zealand’s statement on advertising and the New Zealand Advertising Standards Authority’s Therapeutic Services Code discourage misleading, deceptive or inappropriate advertising which may inflate patient expectations and trivialise the risks that are associated with any surgery.

What are the risks associated with cosmetic surgery?

  • Scarring
  • Bleeding (hematoma)
  • Infection
  • Fluid accumulation
  • Poor wound healing
  • Skin loss
  • Blood clots
  • Numbness or other changes in skin sensation
  • Anaesthesia risks
  • Skin discolouration and/or prolonged swelling
  • Fatty tissue found deep in the skin might die (fat necrosis)
  • Major wound separation
  • Asymmetry
  • Pain, which may persist
  • Deep vein thrombosis, cardiac and pulmonary complications
  • Possibility of revisional surgery
  • Suboptimal aesthetic result

Information is also available from the New Zealand Medical Council

What should I expect during the first visit?

The best and only way to find out if plastic surgery is right for you, is to consult your surgeon who will listen to your needs, and examine you and provide you with educated advice. Your surgeon can tell you what you need to know about the procedure you are interested in, or recommend another to meet your needs and goals.

During your initial visit, the doctor will explain the specific procedure you want, help you visualize the results and go over the risks. Although complications are rare, all surgeries, especially those that involve anaesthesia, carry some risks. Your surgeon will outline these for you based on the specific procedure.

What about insurance cover?

Cosmetic surgery is not covered by medical insurance. Many surgeons feel insurance companies should provide full cover for such a functional procedure as breast reduction.

Cosmetic surgery overseas: which countries and what procedures are most popular?
We don’t know which cosmetic procedures are most popular overseas, as statistics are not collected at this time. However, a recent survey of Specialist Plastic Surgeons in Australia suggested that a substantial number of breast surgeries are being performed overseas. Breast surgery has also been found to be the most common kind of surgery requiring corrective treatment. Some of the countries to which patients commonly travel for cosmetic surgery include Thailand, Malaysia and South America.

What advice do you have for patients thinking about travelling overseas for cosmetic surgery?

Patients often say that cost is the main reason for choosing to travel overseas for cosmetic surgery. However, if there are complications with the surgery and revisions are needed, that initial cost can increase significantly. It is therefore important that patients assess all the risks involved before making an informed decision.

Patients must do their homework and make sure that the person performing the procedure is properly qualified and accredited. It is also important to make sure that the surgery will take place in an accredited facility.

Some of the questions patients should ask before making a decision are:

  • Is my surgeon a member of the International Society of Aesthetic Plastic Surgery (ISAPS)? This means they have some form of internationally recognised qualification
  • Have I got the right information and had enough time to give informed consent?
  • Has there been at least a week between appointments so that I have had adequate time to consider surgery and make an informed decision?
  • Are the medical standards of care and quality control requirements at least as good as those in Australia and New Zealand?
  • Have I been assured that the devices and products used in overseas hospitals meet Australian and New Zealand standards?
  • Have I got a plan for what I will do in the case of post-operative problems?
  • Did I actually see the surgeon, or was the initial ‘free’ visit with a nurse or administration person?
  • Did I get full, written financial details, including all out of pocket expenses for not only the surgeon, but also the anaesthetist, assistant and hospital theatre or facility costs?
  • Were the risks and complications explained to me?
  • What will happen if things go wrong? Will by surgeon accept liability?
  • Where will I be financially if things go wrong, what other costs do I need to consider?
  • Have I been told about post-operative care and what to do if complications arise after the surgery?

Post-operative care is vital to your recovery from surgery and should not be combined with a holiday. A qualified and accredited surgeon should offer their patients a high level of post-operative care.

How many men are undertaking plastic surgery and what are the most common procedures?

National statistics are not collected partly due to the fact that most cosmetic surgery is elective and many different practitioners perform cosmetic procedures. It is however generally accepted that there has been a rise in men undertaking plastic surgery over the last ten years.

What is BMI?

BMI stands for body-mass index. The BMI indicates your body fat percentage by measuring your height/weight ratio. It takes your weight in kilograms and divides it by the square of your height in meters.

What’s the difference between being obese and being overweight?

Whether your overweight or obese depends on your BMI or body fat percentage. Generally, a person between 25 – 30% body fat is considered overweight. Someone with a BMI greater than 30% is considered obese.

Is cosmetic surgery for brides on the rise?

While figures for cosmetic surgery are not officially collected, anecdotal accounts from specialist plastic and reconstructive surgeons have noted an increase in all types of cosmetic surgery, including those sought out prior to weddings.

It is not advisable to undergo any major procedures prior to a big event, as every now and then complications arise from which there is insufficient time to recover. Surgical procedures should be completed many months before a wedding to ensure complete recovery. Some injectable treatments may be done closer to the wedding day, however, it is essential that patients consult their Specialist Plastic Surgeon well ahead of time.

Can cosmetic surgery be carried out on children?

There are many situations where surgery for children is beneficial and clinically indicated for physical and psychological health reasons. A blanket ban on all cosmetic surgery for all children would not be in the best interests of some children.

For any specialist plastic and reconstructive surgeon, the considerations include the best interests of the child, whether the parental consent is rational and informed, whether the child is sufficiently mature, the health of the child and the timing of the procedure – and whether it would be better to wait until adulthood.