What is BIA-ALCL?                                                                                                                                  BIA-ALCL stands for Breast Implant Associated Anaplastic Large Cell Lymphoma. It is a rare lymhoproliferative disorder that is associated with breast implants. Very rarely, it may lead to form of cancer of the capsule surrounding the implant.                                                   It is important to not confuse BIA-ALCL with breast cancer.                                                        BIA-ALCL involves swelling of the breast due to an accumulation of fluid, or more rarely presents as a lump, and typically appears between 3 to 14 years after surgery. It has been seen with all implant surfaces but the risk with smooth implants is the smallest.

What is the risk of developing BIA-ALCL?                                                                                    The risk of developing this disorder is low, with diagnosed cases being present in less than 1 to 1000 patients. To put this in perspective, the risk for any Australian woman, with or without implants, of developing breast cancer in her lifetime is 1 in 8.                                 Most patients who do develop ALCL have a mild, non-invasive version which is completely cured by removing the implant and its capsule. Invasive disease is extremely rare and is also treatable with surgery and sometimes chemotherapy and radiotherapy. The risk of death from BIA-ALCL is estimated at less than 1 in 1 million.

What actions should you be taking?                                                                                                 If you are not experiencing swelling or lumps in your breasts then the advice is to do nothing, except continue to monitor and perform regular checks on your breasts. There is no need to get your implants removed nor do you need regular ultrasound scans. Mammograms should be performed as usual. If you are experiencing swelling or changes to your breasts, you should contact your GP or your breast implant surgeon.

More information on BIA-ALCL can be found here

Cosmetic Procedures: here’s why non-surgical facial rejuvenation is often a good choice


Hi! I am Dr M Szalay and today I am going to talk about wrinkle injections.

There’s no denying that a significant number of people are not satisfied with their natural look. The ageing process has got a lot to answer for!

Wrinkles, fine line, sagging skin and loss of facial volume that appear as signs of ageing not only affect the facial appearance but can become a source of concern for many.

The good news is there are cosmetic treatments designed to improve various facial flaws and achieve a more youthful appearance.

However, the choices are many and varied and people can easily get confused about the roles of non-surgical and surgical procedures. As someone who has significant experience in performing both non-surgical and surgical facial rejuvenation, I have a good understanding of the pros and cons of both types of procedures.

This article focuses mainly on the uses of non-surgical facial rejuvenation. Non-surgical facial rejuvenation is gaining popularity as a safe yet effective way to enhance facial skin and appearance.

Here are some reasons why patients may opt for non-surgical facial rejuvenation:

Minimal commitment, minimal stress

Non-surgical procedures can yield rewarding results that last for months. Since these results are not permanent, you can always try a certain procedure and repeat them if you are happy with the results. In case the results don’t meet your expectations, you can have a different procedure done after the effects of the previous treatment fade away.

Minimal downtime

There are some patients who aren’t willing or able to invest the required time in recovering from a surgical procedure. Non-surgical procedures have minimal downtime, with side effects typically limited to mild redness, swelling or bruising. The procedure can be performed during the lunch hour and the patient can often get back to their normal life immediately.

Non surgical rejuvenation may be the best cosmetic choice

There can be situations where non surgical treatment can provide a superior cosmetic result. One example is with patients with mild bags of their lower eyelids. If lower eyelid surgery is performed in these patients, it is possible for the lower eyelid to appear hollow. A better option in these patients is to inject some filler to plump out the areas surrounding the bags. This can make the bags less obvious and will not result in hollowness of the lower eyelid.

If you are considering non surgical facial rejuvenation, it is important to consult with an experienced cosmetic doctor who can provide you with balanced advice, taking into account your goals, expectations, age and current facial appearance.

5 Things You Must Know When Considering Wrinkle Injections


Hi! I am Dr Michael Szalay and today I am going to talk about wrinkle injections.

Wrinkles, frown lines and crow’s feet are natural signs of ageing that unfortunately we can’t prevent.

However, advancing cosmetic technology has made it possible for people to reduce the unsightly appearance of their wrinkles and to improve the appearance of their facial skin as they age.

Wrinkle injections is a commonly performed procedure aimed at rejuvenating facial skin and achieving a younger looking appearance.

Before you rush in to a treatment, here are a few things you should know that will help make your decision easier.

Wrinkle injections work by relaxing muscles

People often confuse muscle relaxing wrinkle injections with dermal fillers. However,  these treatments are different and work in different ways.

Whilst dermal fillers are injected to achieve more youthful skin by plumping out the tissue, muscle relaxants aim at relaxing certain facial muscles that cause wrinkles.

Wrinkle Injections are simple and quick

The fear of painful injections prevents many people from getting anti-wrinkle treatments and achieve a refreshed, youthful appearance. The truth is wrinkle injections are a simple and quick procedure.

Wrinkles injections use fine needles that don’t cause much discomfort when they come in contact with your skin. The discomfort caused in the procedure can be compared to a small pinch or the sting of a mosquito.

It is not a permanent treatment

For the average person, the results of wrinkle injections last for about three to six months. Maintenance treatments which can be performed three to four times a year, are necessary to maintain the result.

Wrinkle injections result in smoother skin

Wrinkle injection treatment is performed to weaken the appearance of wrinkles resulting in a smoother appearance.

Getting the treatment performed by a professional, experienced cosmetic surgeon helps ensure optimal results whilst maintaining the natural essence of your face.

Your face will still appear natural

Wrinkle injections inactivate muscles that form crow’s feet and frown lines around one’s face. The treatment will relax the facial expression muscles that cause wrinkles, but without affecting other muscles or sensory nerves deep inside the face. This means you will still have the same facial expressions you had before the treatment (but you will be forming less wrinkles).

The Bottom Line

Though wrinkle injections are effective and widely performed, one needs to understand the procedure and everything involved before they reach a decision. Consult with your cosmetic surgeon to find out if the treatment is a suitable option for you.

Surgical Neck Lift


Hi! I am Dr M Szalay and today I am going to talk about neck lift.

Improving the appearance of the neck is a common reason why patients come to see me. Some patients are bothered by the appearance of their neck and wear a scarf to cover it up, which can be a bit inconvenient in a warm climate such as ours.

When it comes to sagging skin resulting from ageing, many individuals are more concerned about the looseness of their neck than their facial skin. Neck laxity also results in a loss of definition between the neck and jaw, resulting in a more aged appearance of the lower face.

There are some different techniques that can be used to tighten loose neck tissue.

Neck Liposuction

Neck Liposuction involves removing excess fat beneath the chin that is causing a loss of definition of your profile.

In order to be a good candidate for for neck liposuction, there needs to be good elasticity of the skin and this usually means that if you wish to have this procedure without also having a lifting procedure, you need to be less than 40.

Over the age of 40 neck liposuction can still be performed, but it is usually necessary to combine it with a tightening procedure listed below.

Minimally invasive neck lift

A minimally invasive neck lift involves using multiple fine sutures to lift and tighten the tissue of the neck. Excess skin is removed by an incision that carries backwards, behind the ear, into the hairline. The reason that I use this technique is that there is less undermining of the skin than more invasive neck lifts.

Does a minimally invasive neck lift need to be combined with a minimally invasive face lift?
Sometimes it may be necessary to combine a neck lift with a minimally invasive face lift. The reason for this is that the direction of the lift carries backwards, but it may also carry upwards on to the face. In order to achieve a blended result, it may be necessary to improve the loose facial tissues as well as the neck.

Sometimes a neck lift can be performed without a face lift. Dr Szalay can advise you of the options during your consultation.

Platysmal plication

The muscle of the neck is called the platysma. As this loosens, the neck sags and often 2 separate loose bands can be seen travelling downwards from beneath the chin.

A platysmal plication involves a small incision beneath the chin and tightening the platysma muscle with sutures under direct vision.

I find the platysmal plication procedure useful for patients who have early loosening of the neck, and sometimes for patients having revision neck surgery. If the neck loosening is more extensive, the minimally invasive neck lift is a more effective procedure.

Sometimes it can also be useful to combine a platysmal plication with a minimally invasive neck lift.

I have performed over 900 minimally invasive face and neck lifts. The following are a few of the neck lifts which I have performed.


Results may vary among individuals. Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner. For more information visit

Breast Implants or Breast Lift?


Hi! I am Dr Michael Szalay and today I am going to talk about breast lift.

Often I will see patients who wish to have breast implants, but would get a better result with a breast lift.

When considering which procedure is more appropriate for someone, important factors are how loose the breasts are, where the nipples are located and the final size and position the patient wishes to achieve.

Some causes of loose breast tissue can include breast feeding, weight loss and developmental differences.

Many women are fine with the idea of a breast lift in order to achieve a better position and shape of their breasts. Some however are not keen for a breast lift because it entails extra costs and incision lines.


Some women may be suitable for either implants or a lift, depending on the final outcome they are seeking.

These women often have loose breast tissue but a good nipple position. The aim in these cases is to pick an implant which is large enough to fill out the loose breast tissue. If this doesn’t occur, then loose tissue can drape off the implant ( “snoopy” or “waterfall effect”).

Polyurethane implants can be helpful in this situation as they hold their position better than other implants and are less likely to stretch the already loose breast tissue.

Sometimes, the breast tissue might be so loose that a very large implant is required to fill it out. If the size of this implant is larger than the patient is willing to have, then she would be better suited by a breast lift.


There are 3 main types of incisions for breast lifts:

  • Peri-areolar (“doughnut”) mastopexy

This type of breast lift is primarily aimed at lifting the nipple and is mainly used when the nipple is low but the breast is not excessively loose.

An incision is made around the areola and the nipple can be lifted up to 2 to 3cm. A periareolar mastopexy is usually used in combination with an implant.

  • Vertical ( “lollipop”) mastopexy

This type of breast lift is the most common type and is used when there is loose breast tissue as well as a low position of the nipples.

An incision is made around the areola as well as down the middle of the front of the breast. Both the nipple and the breast can be lifted significantly with this technique.

  • Anchor Lift

This is a more extensive version of the vertical lift. This technique is used when the breast tissue is very loose as might occur after massive weight loss.

An incision is made around the areola, down the front of the middle of the breast and also in the crease below the breast.


It is possible to have a breast lift without implants if you are just seeking firmer breasts in a higher position with a better nipple position. All of these things can be achieved with just a breast lift.

Following a lift alone however, the breast will be lacking upper fullness. Many women choose to have implants as well as a lift in order to achieve upper fullness.


Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

Things You Should Know Before Getting Dermal Fillers


Hi! I am Dr Michael Szalay and today I am going to talk about dermal fillers.

As people age, they can sometimes notice changes in their skin or appearance which bother them.

Unsightly wrinkles, skin sagging, and fine lines can occur, as well as thinning out of some areas of the face such as the lips and the cheeks. Some patients look towards cosmetic procedures to address these changes.

Dermal fillers are one popular cosmetic procedure to smooth out facial creases, improve wrinkles and plump thin lips in order to restore a younger looking appearance.

As popular as dermal fillers are, many people are unaware how dermal fillers work, what do they do, how long they last and more. So, let’s take an insight into what all you should know before considering dermal fillers.

What can dermal fillers treat?

One can expect dermal fillers to improve a variety of cosmetic concerns including:

  • Smoothing out creases around the nose and the mouth, (also called laugh lines, nasolabial folds or melolabial folds)
  • Adding volume and defining contours of the cheeks to create a fuller appearance.
  • Plump thin lips and soften vertical lines around the edges of the lips.
  • Filling out hollows under the eyes to restore a youthful appearance.
  • Smooth the appearance of scars from acne or other skin disorders.

How do dermal fillers work?

In simplest terms, dermal fillers are chemical substances, synthetic or naturally-derived, injected into human skin in order to improve wrinkling, sagging and depressions that occur due to aging.

How long the effects of your cosmetic procedure would last depends on the type of filler used in the procedure. Generally, temporary fillers would last six to 12 months. Effects of permanent fillers, on the other hand, can persist for years.

The Takeaway

Understanding the basics of dermal fillers is important for any individual intending to undergo the procedure to improve their facial appearance.

Moreover, as with any cosmetic procedure, consulting a professional and experienced doctor is paramount in order to get the best results.

Breast Implants : Revision Surgery


Hi! I am Dr Michael Szalay and today I am going to talk about revision surgery after breast implants.

Sometimes it is necessary to perform revision surgery after breast implants. Helpful information about complications after breast implants has been gathered by Allergan and Mentor, the 2 largest breast implant manufacturers in the world. They have conducted  10 year studies on patients who have had breast implants. Here are the 4 most common reasons why revision surgery may be necessary:

1. Capsular hardening

This refers to hardening and contracture of the capsule around the breast implant. It can result in pain, abnormal shape and abnormal position of the implant. The risk of capsular hardening may be 5% or higher.

2. Rupture

Rupture refers to a tear or hole in the outer shell of the breast implant. Various studies estimate the risk at about 1% per implant per year. So, after 10 years the total risk may be about 10%. There is no evidence that this rate is different for different types of implants.

3. Implant Malposition

This can refer to :

  • the implant moving out of place eg dropping too far (“bottoming out”)
  • the implant rotating if it is a teardrop shape  eg it might turn on its side and look abnormal
  • the implant flipping over on itself if it is round, which also looks abnormal

The Allergan study indicates an implant malposition rate of 7% for their standard smooth and textured implants.

4. Breast Sagginess

This can occur for various reasons including ageing, breast feeding and weight fluctuation. It can also occur due to the weight of the implant stretching the breast tissue which occurs more commonly in the following patients:

1/ Those who have loose breasts to begin with.

2/ Those who fail to properly support their breasts after implants.

3/ Those who have large implants.


Sometimes revision surgery may be necessary with any breast implant.


Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

Teardrop Implants: Is it The Right Breast Augmentation Choice?


Hi! I am Dr Michael Szalay and today I am going to talk about teardrop implants.

Women today are conscious about their breast appearance. Many are not happy with their natural breast shape or appearance, which has made breast augmentation a common cosmetic procedure for women wishing to improve the shape, size and contours of their breasts.
Teardrop implants, also known as anatomical breast implants, are designed to create gentle contours and the fullness of a natural breast and are therefore an ideal choice for women seeking a smooth and natural-looking breast enhancement.

Here are some common benefits of Anatomical Implants;

  • Provides a natural shape and look to the breast
  • Creates a subtle-looking breast enhancement with less volume at the top and more at the base.
  • Because of their customised shape, they are more suited to women who have breasts that are wider or narrower than average.
  • They are useful when women have breasts which are droopy because they are fuller at the bottom, which helps fill out the loose breast tissue at the lower part of the breast.

What are Anatomical Implants?

Teardrop implants have elastomer shells that are filled with cohesive silicone gel and have an asymmetrical shape with a well-projected, full lower pole and a tapered upper pole. This provides a natural shape and look to the breast.

Anatomical Vs. Round

Round implants are also filled with cohesive silicon gel and as their name suggests, are round in shape. Round implants are usually chosen by women who are seeking more upper fullness.
The choice between round implants and teardrop implants is often a difficult decision for many women. The best way to make your choice is to try on both round and teardrop implants in a firm singlet or t-shirt in front of a full length mirror.
As part of your decision making process, it is important to choose a doctor who has significant experience in performing both anatomical and round implants. An experienced doctor can help advise you as to whether you would be a good candidate for your preferred choice.

Here is an example of a teardrop implant which I performed.


Results can very among individuals. Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

Chin augmentation for improving your profile


Hi! I am Dr Michael Szalay and today I am going to talk about chin augmentation.

The increased popularity of chin augmentation

Both men and women of different age groups are considering chin augmentation to improve their profile.

What are the benefits of chin augmentation?

Chin augmentation can improve your profile when you are viewed side-on. It does this in two ways. Firstly, enhancing the size of an underdeveloped chin improves the profile by providing more projection to the chin.

Secondly, the improved projection of the chin stretches the neck skin underneath the chin which may be loose. This also improves the profile.

How is chin augmentation performed?

There are two ways chin augmentation can be carried out.

The simplest way is to inject filler in the region of the chin on achieve the desired projection. Both temporary fillers and permanent fillers can be used. This is convenient for the patient as it can be carried out on a walk-in, walk-out basis and is relatively quick. A possible disadvantage is that if your chin is particularly recessed, large volumes of filler may be required which may not be cost-effective.

A second way to augment the chin is to surgically have a silicone implant inserted. An advantage of this method is that significant enhancement can be achieved which is permanent. A possible disadvantage is that finer nuances, dents or asymmetries cannot be corrected with a chin implant. If this concerned a patient, some filler could be added following the chin implant.

Consulting the right doctor

It is important to consult with a doctor who is experienced in performing the procedure. Your doctor should be able to show you examples of previous chin enhancements which he has performed.

Following is an example of a chin augmentation performed by Dr Szalay. More examples can be seen at


Results can very among individuals. Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

Making Right Cosmetic Enhancement Decisions


Hi! I am Dr M Szalay and today I am going to talk about breast enlargement surgery.

Every woman is special and it’s their right to look gorgeous and there are number of reasons why they decide to have breast augmentation.

Underdeveloped breasts are an area of concern for some women and sometimes it can impact on their self esteem. Sometimes asymmetry can also occur.

Over the period of pregnancy and breast-feeding, there are changes that can occur to the breasts. They can lose their elasticity thereby causing sagging. This is another reason why women choose  to undergo breast augmentation.

Understanding & Considering Breast Enlargement Surgery 

Breast Augmentation is a popular procedure throughout the world. It involves placing silicone implants under the breast or chest muscle which expands the breast area thereby giving a better contour and appearance.

Some women don’t like the idea of implants and may try alternative solutions such as specially designed undergarments.

The following are some reasons why women choose to undergo breast augmentation:

  • If you are dissatisfied with having smaller breasts
  • If you feel your breasts are uneven or saggy
  • When your breasts size doesn’t match your body type/shape
  • When you are unhappy with the physical changes after the pregnancy

Choosing a doctor very experienced in the breast augmentation is important in order to obtain an optimal result. It is also important to feel comfortable with your choices prior to having the procedure.

There are occasions when it may be wise to postpone your decision to have breast augmentation. These can include weight fluctuation, untreated anxiety or depression or other psychological illness. Another reason might be if you suffer from a medical condition that may increase your risk of a complication. For this reason, it is important that a detailed medical history be taken by your doctor prior to your procedure.


Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.