Plastic Surgery – Your Common Questions Answered By Dr Rory Dower

I grew up on a small farm in the Eastern Cape and plastic surgery was certainly not on my horizon at that stage. I started off doing medicine but soon became intrigued by plastic surgery and, more specifically, cosmetic surgery. When I tell people that I’m a plastic surgeon, they inevitably think of the types of operations performed on reality TV shows like Dr 90210, which unfortunately give plastic surgery a bad name. Here’s why I find it rewarding.

Recently, a young lady had a rhinoplasty with me, and she told me a few months later how this surgery had changed her life. Her fiancé no longer complained about her snoring, and even her sense of taste had improved! She had always been called ‘hook nose’ at school but after the surgery, for the first time she caught herself laughing freely with her friends in a public place – something she would have felt too self-conscious to do before. These are the types of cases that keep me motivated, because if I can help people feel better about themselves and more confident, then I’ve done what I set out to do.

Not all my patients feel this way after a procedure though, which leads me to the most common questions I get asked about plastic surgery:

  1. Why do women choose to see a plastic surgeon?

Most women who have surgery are not doing it for anyone but themselves. According to the American Society of Aesthetic Plastic Surgeons, the number of patients having cosmetic surgery increased by 11% in 2017 due to:

  • The “selfie effect” and social media where people are seeing more photographs of themselves and noticing previously unseen imperfections
  • Improved techniques and safety, which have led to better and more natural results
  • Social stigma is less of an issue than it was in the past

  1. Would you choose NOT to operate on someone?

The patients who are happiest are those who have surgery to address something specific that bothers them, for example, signs of facial ageing, very small breasts or very large, prominent ears. I enjoy these surgeries because I see the change they bring to a person’s life. I wouldn’t operate on patients who:

  • Have unrealistic expectations
  • Are not good candidates for the surgery they desire
  • Suffer from Body Dysmorphic Disorder
  1. After liposuction, will the fat come back if I gain weight?

Liposuction is a contouring procedure. Fat cells are reduced in certain areas, and this is permanent. If you do gain a significant amount of weight after the procedure however, the cells that remain can enlarge, which diminishes the benefits. Overall contour will still remain improved though.

  1. Will breast augmentation surgery affect my ability to breastfeed?

BBA (bilateral breast augmentation) techniques involve incisions made under the fold of the breast or through the armpit, and are unlikely to affect your ability to breastfeed. There may be more risk with a “smile” incision around the areola, which could injure nerves and decrease the feeling in your nipple area, reducing your let-down response.

During breast augmentation, implants are placed behind the pectoralis chest muscle or behind the breast gland. There is no invasive cutting of the gland tissue, as there would be in breast reduction surgery. We can also safely say that silicone does not find its way into the breast milk when using silicone implants.

  1. What makes a facelift natural looking?

In the past, skin was used to pull up the sagging soft tissue of the face in an attempt to ‘lift’ it back to its original position. The problem with this technique is that skin is designed to cover the face and not  ‘support it’, so this created an unnatural or windswept appearance.

The SMAS (or superficial musculo-aponeurotic system) is the underlying supportive structure of the face and acts as a 3D scaffolding for the overlying skin. The High SMAS facelift technique elevates the SMAS and repositions it to its former, more youthful position allowing us to re-drape the skin naturally over the new, more chiseled contours of your face. Importantly, the skin is sutured without tension and because of this, scars have a smoother healing process and with time, appear seamless.

My advice to those interested in having plastic surgery?

Don’t think having a procedure will suddenly make you love yourself. Experience has shown me that women who are over-critical of their looks and who are generally unhappy with their appearance will still be critical, no matter how well the surgery goes. At some point, you have to learn to love yourself, imperfections included.

At my surgery, we’re passionate about helping our patients feel their most confident selves. Find out more at or call us on 021 851 4339 with any questions.

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