Plastic surgery frequently asked questions

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Do I Need To Be Referred By My General Practitioner (GP)?

Under the new Regulations from AHPRA, all patients require a referral letter from their GP or another consultant to ensure that they are involved in all aspects of your care. You should therefore approach your GP for a referral letter before making an appointment with Mr Hanikeri.

In addition, your GP will be able to inform Mr Hanikeri of your past medical history so that this information can be taken into account when considering your procedure. Sometimes patients do not realize that a particular medical problem, which they might have suffered from in the past, could increase the risks involved in an operation.

How to choose the right plastic surgeon?

Do your research. Make sure they are listed on the AHPRA website as a Specialist Plastic Surgeon. Speak to your GP or friends if they have any knowledge of the surgeon. It can be risky looking at Social Media reviews as they are often fabricated. Independent sites such as Realself, Plastic Surgery Forum and Plastic Surgery Hub are more reliable.

How much do consultations cost?

As with all ASPS surgeons, Mr Hanikeri will charge a consultation fee, just like any other specialist. You will be asking him for a professional opinion about your condition and after consideration he will discuss the range of options available to you.

One option may well be that surgery is inappropriate. In some cases, Medicare rebates will apply to your consultation fee.

Patient Information

New AHPRA guidelines

From 1 July 2023, the Medical Board of Australia and the Australian Health Practitioner Regulation Agency (Ahpra) will implement updated guidelines for cosmetic surgery.

Cosmetic surgery is defined as procedures aimed at altering or modifying the appearance, colour, texture, structure, or position of natural bodily features, primarily with the objective of attaining a more desirable aesthetic outcome.

Cosmetic surgery procedures differ from medically-necessary or reconstructive plastic surgery procedures, in that they generally do not attract any Medicare or private health insurance rebates.

Examples of cosmetic procedures that Dr Hanikeri performs, can include the following when not deemed medically-necessary:

Abdominoplasty
Brachioplasty
Breast augmentation
Breast lift
Breast revision (removal and replacement of breast implants)
Brow lift
Fat grafting
Labiaplasty
Liposuction
Lower and/or upper eyelids (blepharoplasty)
Otoplasty (for patients over the age of 18)

These strict new guidelines encompass regulations concerning appointment scheduling, surgical bookings and marketing, and will apply to all doctors who perform cosmetic surgery.

We have outlined below details of the anticipated stages you can expect throughout your cosmetic surgery experience with Dr Hanikeri:

You will require a referral letter

To start your surgical journey, it will be necessary to obtain a referral letter from your usual general practitioner (GP), who can then refer you to Dr Mark Hanikeri. If you do not have a usual GP, you have the option of seeking a referral letter from another GP or Specialist.

It is mandatory for your referring doctor to inquire about your reasons for pursuing cosmetic surgery and whether you have been previously denied by another medical professional. Obtaining a referral letter from your referring GP aids in determining whether your surgical requirements will be fulfilled and provides crucial information regarding your medical history. While the initial consultation with the referring GP is eligible for a Medicare rebate, please note that your consultation with Dr Hanikeri may not necessarily qualify for a Medicare rebate.

You will be asked to complete a psychological questionnaire

An important aspect of your surgical journey is the care Dr Hanikeri has for your overall well-being and therefore, he needs to exclude important but uncommon causes for dissatisfaction with your appearance, such as Body Dysmorphic Disorder. This can be done with a simple psychology questionnaire prior to or at the time of your appointment. The questionnaire will be given to you electronically to be completed before your consultation. Dr Hanikeri may ask you to see another health practitioner (e.g. psychologist) if there are concerns raised in your questionnaire.

Dr Hanikeri will assess if you are a good candidate to undergo surgery

Cosmetic surgery is not suitable for every patient seeking such procedures. The main factor that can lead a surgeon to decline performing surgery is their assessment that it may not be in your best interest. This determination can be influenced by various factors, including the expectation of minimal enhancement in your appearance following the surgery or increased risks associated with the procedure due to underlying health conditions. In such instances, Dr Hanikeri will discuss alternative options, whether non-surgical or provided by another healthcare professional, that could be more appropriate for your specific situation.

You will require two consultations before booking surgery

In order to ensure your comprehensive understanding of the surgery, including its associated risks and alternatives, your Dr Hanikeri will conduct two pre-operative consultations with you. At least one of the two consultations must be in person and the other consultation(s) can be in person or by telehealth.

Following the second consultation, you will be requested to sign a consent form, which serves as an agreement between you and Dr Hanikeri, confirming your willingness to proceed with the surgery.

Once the two consultations are completed, a cooling-off period of at least seven (7) days will required. After this period, you will then have the opportunity to schedule a date for your surgery and make a deposit payment.

Please note these two consultations and cooling-off period are mandatory and cannot be waived.

In order to safeguard the well-being of patients under the age of 18 who may be more susceptible to body image concerns, the cosmetic surgery guidelines mandate specific requirements. These include obtaining a referral from an independent psychologist, psychiatrist, or GP who is not directly involved in performing the procedure. Additionally, a minimum cooling-off period of three (3) months is necessary between the time of providing informed consent (i.e. the second consultation) and the actual surgical procedure. These measures aim to ensure adequate time for reflection and consideration before proceeding with the surgery.

You will be provided with all the information you need to know in order to make an informed decision

As part of your surgical journey, Dr Hanikeri and his team will provide you with:

Written information about the surgical procedure
A comprehensive explanation of the recovery process, including details on any necessary recovery services like massages or compression garments, and expected or potential lifestyle changes such as absence from employment or temporary restrictions on activity
Information regarding the possibility and associated costs of revisional surgery in both the short and long term
Informed Financial Consent details, including costs related to the surgeon, anaesthetist, medical devices, garments, and hospital expenses (if available, or where to obtain them if not available).

We wish you a safe and smooth journey with your surgery. Be sure you do your research and seek a second opinion from an appropriately qualified Specialist Plastic Surgeon before proceeding with surgery. Should you have any questions, we encourage you to discuss these with Dr Hanikeri or his team.

How many nights should I spend in hospital?

Your stay in hospital depends on how quickly you can recover which varies from patient to patient.

For breast augmentation patients, we may recommend an overnight stay in hospital if the implants are placed under the muscle
For breast reduction and and abdominoplasty (tummy tuck) patients we advise a 1-2 nights

At the time of your consultation Mr Hanikeri will discuss the length of your hospital stay and explain why a longer stay may be required for certain procedures or patients.

Will my breast surgery affect breastfeeding later in life?

The answer depends on exactly what type of breast surgery you are contemplating. As a Specialist Plastic Surgeon with 20 years’ experience in Surgery, Mr Hanikeri will take whatever measures are available to maximise your chances of maintaining normal breast function and nipple sensation – Unlike an underqualified ‘cosmetic surgeon’ or physician might do.

For breast augmentation surgery, we generally recommend “below the muscle” implants and making incisions under the breast for best results if you are going to breastfeed children later in life or want the lowest chance of loss of nipple sensation.

Will I meet Dr Hanikeri at my consultation?

Yes. Dr Hanikeri can give you an opinion about the suitability of an operation. You may also meet his nurse and administrative staff members who can assist you with health fund information and hospital bookings.

How much do operations cost?

The operation cost will be made up of Mr Hanikeri’s fee, the anaesthetist’s fee and hospital costs which will include the bed in the hospital, the facilities of the operating theatre and any other tests, which may be required.

When can I start exercising after my procedure?

We encourage leisurely walking and light duties following your procedure. At the time of your consultation, Mr Hanikeri will discuss the type of exercise that you would like to do and how soon you can return to the activity. For fitness enthusiasts, this may mean 10-12 weeks before heavy gym exercise like weights, bouncing or running.

How long should I wait after finishing breastfeeding before having breast surgery?

Dr Hanikeri recommends waiting several months after you’ve finished breastfeeding your last child before having breast surgery – typically a minimum of three months after breastfeeding finishes.

I hear the same procedure is cheaper overseas, isn't that a good way to save money?

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

Do your homework and make sure 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 that is to the standards set by the Australian Day Surgery Council.

Some of the questions you 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? For example, breast implants used in Australia must meet strict standards of safety and effectiveness, a process regulated by the Australian Therapeutic Goods Administration (TGA) and Medsafe (New Zealand). Other countries may not have similar regulations
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 my 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. Sitting by the pool, drinking cocktails and snorkelling does not qualify as post-operative care. A qualified and accredited surgeon should offer you a high level of post-operative care.

What do plastic surgeons do?

A specialist plastic surgeon is a doctor who specialises in cosmetic and reconstructive surgery. Not only do they treat patients after injuries, illnesses or burns they also see patients who want to change their appearance or aesthetic.

The most common procedures plastic surgeons conduce include all areas of breast reconstruction, burn repair, facelifts, abdominoplasty and more.

Who is the best plastic surgeon in Perth WA?

Finding the best possible surgeon is extremely important to have a comfortable experience throughout your surgery. When looking for a plastic surgeon, ensure they have relevant and respectable qualifications Australian Society of Plastic Surgeons’ (ASPS). Your surgeon should listen to you in regards to what you would like to achieve from surgery, and they also should provide you with realistic expectations during your consultation.

How do I choose the right plastic surgeon?

Choosing the right plastic surgeon for your operation can affect the experience of your procedure. You want to ensure you will be comfortable throughout your treatment, while also getting your dream results

The first step to find the right Plastic Surgeon is to check their credentials and experience. This includes all Australian Society of Plastic Surgeons’ (ASPS) Members, that are certified by The Royal Australasian College of Surgeons (RACS). These doctors have completed specialist surgeon training in plastic surgery (cosmetic and reconstructive) and operate only in accredited medical facilities. The ASPS also aims to maintain the highest standard of surgical practice and ethics in Plastic Surgery in Australia.

Is there any difference between a cosmetic and plastic surgeon?

Many plastic surgeons are cosmetic surgeons, however, not all cosmetic surgeons are plastic surgeons and in fact many “cosmetic surgeons” are not surgeons at all, as they do not hold a fellowship with the Royal Australasian College of Surgeons (RACS). Cosmetic surgery focuses on the enhancement of appearance by surgical and medical treatments or techniques. These are the techniques that Plastic Surgeons hone during their specialist training.

How to make a complaint ?

We are committed to providing our patients with the highest quality of care. If you have any concerns, questions, or complaints about your consultation, surgical procedure, or post-operative care, please do not hesitate to let us know.

Step 1: Talk to your surgeon

The first step is to talk to your surgeon directly. They may be able to address your concerns immediately. If you are unable to speak to your surgeon directly, you can speak to their office staff.

Step 2: Make a written complaint

If you are unable to resolve your complaint with your surgeon, you can make a written complaint to us. Please include the following information in your complaint:

Your name, contact information, and the date of your complaint

A description of your complaint

Any relevant supporting documentation

You can send your complaint to the following address:

The Complaints Officer
Suite 215, St John of God Medical Centre
25 McCourt Street
SUBIACO WA 6008

Step 3: Contact an external agency

If you are still not satisfied with the outcome of your complaint, you can contact an external agency for assistance. These agencies can investigate your complaint and make recommendations for how it can be resolved.

Health and Disability Services Complaints Office (HaDSCO)

Australian Health Practitioner Regulation Agency (AHPRA)

We value your feedback and appreciate your patience as we work to resolve your complaint.

Surgery risks

Surgery Risks and Complications

Before any surgical procedure, you will thoroughly discuss the risks and complications with Dr Mark Hanikeri, including how they can be minimised, prevented and managed.

All procedures can be associated with some form of risk. As a Specialist Plastic Surgeon, Dr Hanikeri will work to minimise risks throughout the procedure process, including informing patients on important preparation and recovery instructions.

Risks Associated with Plastic Surgery

The specific risks and complications of each surgical procedure can vary slightly. Some of these risks are more serious or severe than others. Temporary experiences immediately after surgery, such as swelling, can be expected to subside as the body heals. However, serious complications can require medical intervention, such as treatment or additional surgical procedures.

Dr Hanikeri will discuss all of the risks associated with your chosen procedure, including their severity and what would be required if they occur.

Generally, surgical procedures can be associated with the following risks:

Swelling: Swelling is a common post-operative symptom that might last a few weeks. It is generally a normal response to tissue trauma and manipulation during the procedure. It’s caused by increased fluid and white blood cells entering the surgical site, aiming to support healing. Swelling can persist as the body gradually resolves inflammation and restores tissue balance through natural healing.
Bruising: Bruising can occur around the surgical site. Bruising after surgery occurs due to blood vessel damage during the procedure. Leaked blood from damaged vessels triggers an inflammatory response, leading to discolouration. As the body gradually clears the blood and repairs vessels, the bruise fades over days to weeks.
Scarring: All surgeries result in some level of scarring, which can vary based on factors like genetics and wound healing. The level of scarring will depend on the particular incision type or pattern that your surgeon will use to perform your procedure, which will be discussed during your consultation so that you can know what to expect.
Numbness: Temporary or permanent numbness or tingling might occur due to temporary or, in some cases, permanent damage to nerves during the procedure. Nerves might be stretched, compressed, or cut during surgery, leading to altered sensations. As healing progresses, nerves may regenerate, and sensations can return, but it can take time for the nerves to recover fully, and in some cases, complete sensation might not be regained.
Pain: Pain and discomfort are expected after surgery but are usually manageable with pain medications. Your surgeon may prescribe you medication and instruct you on how often to take it.
Infection: Surgical sites can become infected, requiring medical treatment and antibiotics. Infections occur when bacteria enter the surgical site, which can result from compromised sterilisation, poor wound care, or weakened immune response. Symptoms of infection include redness, swelling, warmth, pain, and discharge. Infections can usually be treated with antibiotics, but severe cases might require additional interventions to prevent complications.
Delayed healing: Some individuals might experience slower wound healing, leading to prolonged recovery. Delayed healing after surgery can occur due to poor blood circulation, underlying medical conditions (like diabetes), or an individual’s overall health. It might result in slower tissue repair, prolonged inflammation, and an increased risk of complications. Patients with delayed healing might require extended recovery time, specialised wound care, and close monitoring to ensure proper healing eventually takes place.
Haematoma: A haematoma is a blood collection that accumulates in a tissue or organ after surgery due to damaged blood vessels. It appears as a localised swelling often accompanied by pain and discomfort. Haematomas can vary in size and severity. While small haematomas might resolve independently, larger cases might require drainage to prevent complications such as infection or pressure on surrounding tissues.
Seroma: A seroma is a buildup of clear or slightly bloody fluid that collects in a cavity or tissue after surgery. It forms when tissue layers separate or fluid accumulates due to disrupted lymphatic drainage. Seromas can lead to swelling, discomfort, and pressure in the affected area. Small seromas might resolve independently, but larger or persistent seromas might need to be drained using a needle and syringe to relieve symptoms and promote proper healing.
Skin irregularities: Skin texture changes, pigmentation changes, or unevenness might occur at or near the surgical site. These might result from factors like scarring, variations in healing, or the skin’s natural response to trauma. Depending on the extent, these irregularities can improve over time, but in some cases, additional treatments might be needed to address them.
Asymmetry: Surgery can sometimes result in minor differences between the sides of the body. Some degree of asymmetry is normal and might not be noticeable, while significant discrepancies might result from surgical techniques or individual healing. Surgeons aim for balance, but complete symmetry is not always achievable.
Allergic reactions: Some individuals might experience allergic reactions to anaesthesia, sutures, or other materials used during surgery. These reactions range from mild to severe, with symptoms like rash, itching, swelling, hives, or even anaphylaxis—a life-threatening allergic response characterised by difficulty breathing, low blood pressure, and loss of consciousness. Surgeons take precautions to minimise the risk of allergic reactions by reviewing patients’ medical histories and using hypoallergenic materials when possible.
Anaesthesia complications: Anaesthesia can lead to allergic reactions, respiratory issues, or adverse drug interactions. Anaesthesia is carefully administered and monitored by an Anaesthetist to minimise these risks. he Anaesthetist will review and discuss with the patient their medical history to identify potential risks and tailor the anaesthesia approach accordingly.
Deep Vein Thrombosis (DVT): DVT is a serious complication that can occur after surgery, including plastic surgery. It involves the formation of blood clots in deep veins, commonly in the legs. If a clot forms and breaks loose, it can travel through the bloodstream and potentially block blood vessels in the lungs, causing a life-threatening condition called pulmonary embolism. Preventive measures, such as compression stockings and blood-thinning medications, are often used to minimise this risk after surgery.
Excessive bleeding: Excessive bleeding can occur when blood vessels cut or manipulated during the procedure, fail to clot properly, leading to prolonged or heavy bleeding. This can result from surgical technique, clotting disorders, or improper wound care. In severe cases, excessive bleeding might require surgical intervention to control, such as cauterisation, sutures, or even blood transfusions. Surgeons take precautions to minimise bleeding during surgery and closely monitor patients post-operatively to promptly address any signs of excessive bleeding.
Nerve damage: Permanent nerve damage can occur during surgery, leading to sensory or motor deficits. It can occur when nerves are stretched, compressed, or accidentally cut during the procedure. This can cause altered sensations, such as numbness, tingling, or pain in the affected area. While some nerve damage might be temporary and improve as the nerves heal, more severe cases can result in permanent sensory or motor deficits. Your surgeon will take precautions to minimise the risk of nerve damage, but it’s an inherent risk of any surgical procedure involving delicate structures like nerves.
Organ damage: Some procedures can inadvertently damage internal organs, leading to complications that require further treatment. It can occur if surgical instruments or procedures inadvertently cause harm to internal organs near the surgical site. Depending on the procedure and its proximity to vital structures, organs like the liver, intestines, or bladder might be at risk. Organ damage can lead to pain, bleeding, infection, or dysfunction of the affected organ. Surgeons are highly trained to avoid such complications.
Complications from implants: Implants used in procedures like breast augmentation can rupture, leak, cause infection, or be affected by capsular contracture, malposition, displacement, extrusion, allergies, or implant failure. Surgeons take measures to minimise these risks, but patients should understand potential issues and long-term considerations associated with implants.
Poor wound healing: Poor wound healing after surgery, including plastic surgery, can result from infections, diabetes, smoking, malnutrition, age, medications, poor circulation, health conditions, tension, or foreign bodies. Preventing it involves proper care, managing health issues, following instructions, and minimising risk factors. Surgeons will work to reduce these risks and promote sufficient healing.
Unsatisfactory results: The final outcome might not meet the patient’s expectations due to various factors. Unsatisfactory results in plastic surgery may arise due to mismatched expectations, individual anatomy, healing variations, procedure limitations, complications, or unpredictable responses. Minimising this risk involves clear communication, realistic expectations, experienced surgeons, and considering individual factors.

Surgery Preparation Instructions for Minimising Risks

You will receive personalised preparation instructions from your surgeon, but some general surgery preparation instructions that can help minimise risks and promote sufficient healing after surgery can include:

Complete medical evaluation: Undergo all required medical tests and evaluations to ensure you are a suitable candidate for the procedure.
Disclose medical history: Provide your complete medical history, including allergies, chronic conditions, medications, and previous surgeries, to your medical team.
Stop smoking and alcohol consumption: Avoid smoking and alcohol in the weeks leading up to surgery, as they can hinder healing and increase risks.
Follow a healthy diet: Eat a balanced diet rich in vitamins and minerals to support your immune system and healing process.
Stay hydrated: Proper hydration aids in optimal recovery. Avoid excessive caffeine and alcohol intake.
Discontinue medications: Follow your surgeon’s advice on discontinuing certain medications, such as blood thinners, before surgery.
Follow pre-op skin care: If advised, follow proper skin care routines to minimise infection risks.
Follow fasting guidelines: Adhere to fasting guidelines provided by your surgical team to prevent anaesthesia-related complications.
Adhere to hygiene recommendations: Follow guidelines for showering and personal hygiene provided by your surgeon.
Ask questions: Don’t hesitate to ask questions or express concerns about the surgery or the recovery process.

Recovery Instructions for Minimising Risks

Your surgeon will provide you with personalised recovery instructions, but here are some general guidelines for a successful recovery after surgery that can help minimise risks and promote healing:

Pain management: Take prescribed pain medications as directed to stay ahead of discomfort and prevent pain from worsening.
Inspect incisions: Regularly check incisions for signs of infection such as redness, swelling, warmth, or discharge. If you notice anything unusual, contact your surgeon immediately.
Prioritise rest: Get plenty of rest and aim for quality sleep to aid your body’s healing process.
Stay hydrated: Drink enough water throughout the day to help your body heal and stay hydrated.
Eat a nutrient-rich diet: Consume a balanced diet with plenty of vitamins, minerals, and protein to support healing.
Avoid alcohol and smoking: Refrain from alcohol and smoking during recovery, as they can hinder healing.
Ease back into activities as advised: Gradually reintroduce light activities based on your surgeon’s recommendations. Avoid strenuous exercise until advised.
Wear compression garments if advised: Wear compression garments to minimise swelling and encourage proper healing if your surgeon recommends it.
Shield surgical areas from the sun: Keep surgical areas protected from direct sun exposure to prevent scarring and pigmentation issues.
Resist picking or scratching: Avoid picking scabs or scratching incisions to prevent infection and promote proper healing.
Opt for comfortable clothing: Choose loose-fitting clothing that will not rub or irritate surgical sites.
Adhere to lifting limits: Stick to your surgeon’s lifting restrictions to avoid straining surgical areas.
Attend follow-up appointments: Attend all scheduled post-operative appointments for proper monitoring and assessment.
Engage in physical therapy if recommended: If your surgeon suggests it, participate in recommended physical therapy exercises to regain strength and mobility.
Care for scars: Follow your surgeon’s scar care instructions to minimise scarring and encourage healing.
Hygiene matters: Maintain proper hygiene around surgical areas. Follow guidelines for bathing and wound care from your surgeon.
Manage stress: Employ relaxation techniques to manage stress levels, which can positively impact your recovery.
Recognise warning signs: Be alert to any signs of complications like persistent pain, fever, increasing redness or swelling, and immediately inform your surgeon.

Further Information on Risks and Complications of Each Procedure

For more details about the risks and complications of the specific procedure you are undergoing, please get in touch with our team or book your consultation with Dr Mark Hanikeri.

Contact Dr Hanikeri

CONSULTING ROOMS:

SUBIACO: Suite 215 25 McCourt Street Subiaco Western Australia 6008

MURDOCH: Suite 51, Wexford Medical Centre 3 Barry Marshall Parade Murdoch Western Australia 6150

ALBANY: Great Southern Specialist Centre 55 Cockburn Road Mira Mar Western Australia 6330

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