Dr Anoop Rastogi is a Sydney based Cosmetic Surgeon and fellow of the Australasian College of Cosmetic Surgery (ACCS) specialising in Breast Augmentation, Facelifts, Liposculpture and non surgical Cosmetic Medicine. Dr Rastogi is best known for his outstanding surgical results creating natural looking breasts with artistic skill.
Sunday, 22 September 2013
Next Breast Thing
21st May 2009
You might have seen the stories hyping Macrolane — the “lunchtime boob jab” — a new injectable breast filler heralded as an alternative to implants. It’s been available in Europe and Asia for the past year and has just arrived in Australia, so we wanted to see whether it’s as straightforward as it sounds. BAZAAR UK’s beauty director, Newby Hands, underwent the procedure in London and kept a diary of her swell experience ...
FEBRUARY 14 It’s Valentine’s Day and I’m sitting in a bland conference room contemplating getting bigger breasts. Looking at the array of flat, boy-breasted “before” and pert, prettily rounded “after” photographs, it all seems too good to be true: take a flat chest and a big syringe of filler — the same filler that’s been used to fill out more than nine million lips, cheeks and lines, but thicker — and 15 minutes later, you’re spilling out of your B-cup. “This is not a ‘boob jab’,” the PR tells us. “We know that’s how the newspapers will portray it.” But despite the PR chat, it’s piqued my interest. There’s no general anaesthetic, only local. It’s not permanent: it’s made from naturally occuring hyaluronic acid (HA) and is safely absorbed by the body during the next 18 months. And it’s subtle: with only 100-150ml injected, compared with the smallest breast implant of 180ml, it takes you up a maximum of one cup size.
FEBRUARY 20 I’m surprised to find I’m thinking about the possibilities of Macrolane almost daily. I’ve never had a problem with my breasts — although when the fitter at a department store told me I was a small 32B, not a 36A as I’d thought, it cheered me up for months. And I do wear a push-up bra every day. What appeals is that little extra volume all the time. I’ve also never seriously considered having anything “big” done; just anti wrinkle injections and twice, a tiny bit of filler in the corners of my mouth. Breast implants have never been on the agenda — although I’ve certainly been offered them. It comes with the job, along with the offers of free lipo, face fillers and lasering in more places than I knew I had.
FEBRUARY 22 I wake pondering: should I or shouldn’t I? The pros: it’s safe — HA fillers have been used for more than a decade, and they are also used medically on osteoarthritic knees and hips and to treat bladder problems. The procedure only takes a local anaesthetic, looks extremely natural and will give me more volume, not huge knockers. And the effects last only a year and a half, so if I don’t like the difference, I’m not stuck with it. The cons: both anaesthetic and filler involve long needles. I’m putting something in my breasts that’s only been used as a filler in this part of the body for three and a half years. Could it trigger cancer in the future? Am I on a slippery slope? Will it be a designer vagina next?
MARCH 17 Having done my own research, I’ve decided to go for it. Ultimately, what swung it is that nothing permanent will be left in my body, and with the research I’ve been able to carry out as a beauty editor, I feel confident in the safety of these HA fillers. I book in with Chris Inglefield, the plastic surgeon I met at the launch, who is running the first UK study on Macrolane. Something akin to pre-exam nausea sets in; I still have concerns about injecting filler into my breasts, purely because it’s one place I could develop cancer. Research shows Macrolane does not interfere with mammograms, but I call up Mysore Chandrashekar, a consultant in breast oncoplastic surgery at Spire Liverpool Hospital. He reconstructs breasts for cancer patients, and recently trained in using Macrolane. “I’m not disputing its safety,” he says. “I will be using it for cosmetic breast enhancement as part of a clinical study that will take a minimum of five years, but as yet there is no long-term clinical safety data on [this] use.” In its various forms, this type of filler has an excellent safety record used elsewhere in the body; and HA surrounds every single cell. For the breasts, however, only time and clinical studies will tell. “Would you want your wife to have it?” I ask — the killer question for any doctor. “I’d make sure she had all the information on the safety issues,” he says. Chandrashekar and Inglefield are a world away from the flash, brash doctors I often meet. I find their serious, measured approach reassuring compared with medics who use PR and marketing teams to promote their procedures.
MARCH 27 I am sitting topless while Inglefield measures and examines my breasts. Every crucial question I wanted to ask has gone from my head as the reality hits me: he’s got a tape measure on my nipple and this is getting serious. He quietly talks me through the procedure: a long thin needle injects local anaesthetic; then a long, thick needle plumps in the jelly-like filler over the muscle and under the breast tissue. I must have a mammogram before the procedure, and wear a sports bra constantly for a week afterwards. I will be sore, swollen and bruised for up to 10 days.
APRIL 7 The mammogram is clear, so I’m booked in for three days later. I call Inglefield’s office to get some frank answers. “How did previous patients find the whole procedure?” I ask. “Well, one went shopping straight after, another nearly fainted.” I know I’ll be a fainter.
APRIL 8 I tell my boyfriend of my plans. He laughs nervously. “But I like small breasts,” he says. “Think of it as a built-in push-up bra with an extra bit of spillage,” I reassure him. As a man who regularly works with models, he warns me that “getting bigger breasts can make even someone very slim look chunky — I’ve seen it happen”. I feel even sicker.
APRIL 10, 9AM I’m terrified because (a.) a big needle is going to be thrust under my breasts, and (b.) I’ve never had anything invasive done to me before for purely cosmetic reasons. But if I hate it, it can either be removed or injected with an enzyme to destroy it. Nurse Shona gives me some painkillers, and when Inglefield appears, I begin to feel better. His quiet manner and way he approaches the procedure means I trust him implicitly. As I lie naked to the waist, he injects anaesthetic under each breast. Not bad at all, I think, not realising this is the preliminary to the next big, long needle, that’s injecting more, right in the middle of my breasts. It’s unpleasant, but not as bad as I expected. I stare fixedly up and behind me so as not to glimpse the thick canula that will deliver the filler. The worst part is the aggressive thrusting it takes to get the blunt end through the tough fibrous tissue under the breast. The “filling” takes minutes, although initially I feel full to bursting. I can’t look, but it feels as though my right breast is channelling Dolly Parton. With both breasts done, Inglefield and Shona squat down like golfers eyeing up a putt, eyes level with my nipples to check size, shape and balance. They sit me up, and Inglefield tells me to take a look. They look amazing; incredibly natural, but bigger. Only the blood drying on my stomach detracts from the thrill.Minutes later, delayed shock sets in: my teeth chatter so much I can hardly talk; I feel sore, weak and frail. The pain is less than I thought, but the whole procedure is more invasive and aggressive than expected. Don’t believe what you’ve read — this is not a lunchtime boob jab. “It’s a proper surgical procedure done under a local,” says Inglefield. “And I hope you tell people that.”
APRIL 10, 3PM I nearly pass out waiting for my antibiotic prescription in the pharmacy, but it’s definitely more from trauma than pain. The painkillers and antibiotics make me feel light-headed, but overall I feel worn out, battered and sore. It’s bearable but exhausting, and I daren’t touch or even look at my breasts.
APRIL 11 Getting out of bed makes me breathless with pain, as the tissue drops down as I stand up. But I feel better with every hour. Overall, I’d say it is 36 hours of pain and discomfort, then just a bit of soreness. I still haven’t looked at or felt my breasts.
APRIL 14 Daily doses of arnica seem to help: there’s no bruising, no bleeding; just a little soreness. The only downside is not being able to wash properly, as I have to keep the surgical plasters dry. I stand in front of the mirror to have my first good look. I am amazed: my breasts look incredibly natural, even with a bit of swelling. The shape is perfect, standing up and lying down. And my almost C-cup definitely balances out nicely with the rest of my body.It’s astounding the level of interest the procedure generates. Other women are fascinated: they seem to love the idea of filler rather than implants. Colleague Katy tells me my bigger breasts make my frame look smaller. In gratitude, I ask if she’d like to feel them. “Er … no … thank you,” she demurs.
APRIL 17 I’m getting to grips with clothes hanging differently; tops are tighter, and what fits here is too big in the waist. It’s no wonder curvy women go for clingy clothes. All this from going from a small B-cup to almost a C.
APRIL 18 At last I’m back to my own bras, which still fit but with a new fullness. I spend ages looking at my breasts from every angle. They are perfect, and I couldn’t be happier. Macrolane is a godsend for those who don’t want big breasts, just fuller ones, those who don’t like the idea of implants and surgery. My one worry is that, like anti wrinkle injections and other fillers, this will get into the wrong hands. Legally, any doctor or nurse can do it, however I can’t state strongly enough that anyone thinking of having this done should only go to a plastic or cosmetic surgeon who regularly does breast operations. Along with other problems, “it’s easy to puncture the lung with the needle,” says Chandrashekar. In the right hands, Macrolane is a brilliant, safe and impressive procedure — but only in the right hands.
* Macrolene is yet to be TGA-approved. However, it is available under a special access scheme. It costs from approximately $5500 for the first procedure. For more information contact Q-Med (Sweden) Australia on 1800 144 944 or a reputable surgeon such as Dr Anoop Rastogi, (02) 9362 1426.