BIA-ALCL or breast implant-associated, a typical large cell lymphoma is a tumour condition that develops in the capsule surrounding breast implants. It's incredibly rare and it's most akin to non-Hodgkin's lymphoma.

It is actually a cancer, but it develops from what's thought to be an interaction between the textured surface of some breast implants and the body's immune response to that breast implant. So it definitely does not happen with every breast impact, the more textured the breast implant, the more likely you are to develop this very rare cancer.

However, even with textured implants, it's not a given. So the rights vary according to how textured those implants are and can be as common as one in 3,000 or thereabouts, out to one in 87,000 or thereabouts. So with a range that's that divergent, there's obviously a lot of room for interpretation and confusion. Particularly in the eye and mind of the public.

Dr JSK Video interview with Bondi Beauty TV's Renae Leith-Manos on what do you need to consider when choosing a plastic surgeon

Below is a transcription of the video

Renae: I’m here with Dr. James Southwell-Kelly from Darling Point who is a plastic surgeon who has come to lift the veil on all things plastic surgery and explain what everything is. Now welcome.
James: Thank you. Thank you so much.
Renae: So please explain to us, how do you choose the right plastic surgeon? I mean we all have seen the stories on, you know, 60 minutes of these cowboys who are posing globally as plastic surgeons and they’re not. So please tell us what are the [inaudible 00:35] make sure we choose the right person, when you’re not available.
James: Very good. Alright. Well, qualifications and word of mouth, I think, are the safest means to choose your plastic surgeon.
Renae: Hang on, hang on. Word of mouth in the eastern suburbs, I don’t know a woman in the eastern suburbs who will ever admit to having any injectable. So there’s no way [inaudible 00:55] around here, James.
James: There’s sometimes a special friend, maybe there’s a secret handshake, something like that.
Renae: Shall I start a website?
James: Possibly.
Renae: The Secret Handshake.
James: That’s right.
Renae: Who we recommend.
James: There you go.
Renae: But what qualifications do we look for to make sure that it’s the right person? Is a nurse okay, for example, to inject my face?
James: Look, technically, a nurse under supervision of a doctor is okay.
Renae: Okay.
James: As to the letter of the law.
Renae: Because that would be a bit cheaper, right?
James: It is a bit cheaper, a hundred percent. Yeah. My personal opinion is that you want the person doing your injection or applying the therapy that can deal with any problem that may arise.
Renae: Absolutely.
James: Yeah.
Renae: So, how many years of study have you got? You were telling us earlier.
James: Yeah, that’s right. My gosh. [inaudible 01:39] to be thinking about it.
Renae: 16 years or something?
James: About that, about that.
Renae: Globally, Paris, London, Leon.
James: Yes. All of those international centers because they do things slightly differently over there. Ultimately, the pool of medical knowledge is the same but the nuances are different.
Renae: Well, on that global scale, why are people going to China and South America and why are things so much cheaper there? Is that just an economic thing or is it a…?
James: It is an economic thing. It’s a really good question. So there’s a question of labour cost which is always cheaper over there, so the cost of running an operating suite, the cost of nursing staff, the cost of the trucks delivering the anaesthetic drugs, the oxygen's, everything. All the infrastructure, everything, is cheaper, and so you can fly over there and have your surgery and go home, maybe having had a little holiday as well, for probably 80% of the cost that [inaudible 02:38] have it here.
Renae: How do you feel about that as a practitioner working in Australia?
James: Look, ultimately, it’s up to you, the individual, to decide where you go but this is what I would counsel anyone who was thinking about that. After your surgery, you feel a bit low. You’re in pain. You want that support. That’s when you need the most love. And why be away from home? Why be away from family and friends?
Renae: A hundred percent.
James: So that’s one reason I’d say do it locally. The other reason is, if you have a problem and now you’re back in Sydney - two weeks ago, you had your breast augmentation in Thailand or wherever - …
Renae: Brazil.
James: …what do you do? Who do you go to?
Renae: You’ve got to start from scratch then.
James: You can start from scratch.
Renae: Come to someone like you or you have to work at what they’ve done.
James: Or you go to the emergency department at a public hospital and, you know, when it unravels, it’s a disaster. It’s a disaster for everyone.
Renae: Have you seen some of those?
James: A hundred percent. We’d see…I work at St. Vincent’s Hospital in Darlinghurst and I’d see…well, the unit, plastic surgery department, they would see maybe one case every two to three months.
Renae: Wow.
James: And all manner of different things – silicone implants in noses, infected breast implants, implants extruding from the skin, all sorts of horrors.
Renae: So all of those people trying to look more beautiful and be happy within themselves and coming off second best.
James: Coming off second best and, as you alluded to earlier, it’s always harder to deal with the problem than it is to get it right in the first instance.
Renae: So you pay the 20% more?
James: You pay...
Renae: To be sure.
James: It’s always advertised that it’s much much less than that but by the time you’ve had a [inaudible 04:03] travel insurance and all the other little add-ons that are never advertised in the advertised price, it ends up being not that much cheaper but the risks are so much higher.
Renae: That’s for sure. Now I want you to look into the future and tell us how you see plastic surgery, injectable, the whole thing, being a part of life, because who would have thought ten years ago that having botox would be kind of, you know…I don’t know what the stats are. Is it 1 in 2? Probably. Or 1 in 2 women over a certain age? It’s so common.
James: It’s a great stat and I’m going to run with that.
Renae: But what do you see? I mean, are we all going to be lining up for a face-job at 60 in ten years?
James: Well, look, as the surgical techniques progress and as surgical technology and the medical knowledge increases, procedures become less and less invasive and the down time becomes less and less. You’re back to work, back to your normal social activities sooner. So…
Renae: Signs get less, I mean that you’ve had [inaudible 05:04].
James: Signs get less. Absolutely. And so it will become a more readily available and a more socially acceptable commodity, essentially.
Renae: Well, it’s starting to already, isn’t it?
James: It’s starting to already. Absolutely.
Renae: And can you ever see, you know, someone, probably in America, with all due respect, creating a peel that keeps us young? Do you think that’s possible? I mean, there are people working at that. [inaudible 05:26]
James: There are definitely people working on it. I think we’re probably many generations off that.
Renae: Damn.
James: I’m sure.
Renae: So our childrens’ children’s children, maybe.
James: Yeah. Maybe. Maybe getting close.
Renae: Might stay young forever.
James: Might stay young forever. Okay, so, would you want to stay young forever?
Renae: It’s a good question.
James: There’s a hypothetical...
Renae: And that’s a question that’s been addressed historically since time began and I think, you know, it’s okay to get older.
James: It’s okay to get older and…
Renae: But I want to look as good as I can, as fresh as I can while I’m doing that.
James: Absolutely. Be the best you can be.
Renae: A hundred percent.
James: Through every stage of your life.
Renae: Yes. I agree.

Dr JSK Video interview with Bondi Beauty TV's Renae Leith-Manos on "A plastic surgeons tips to naturally improve looks" view this video and more from Bondi Beauty Bondi Beauty

Below is a transcription of the video

Renae: I’m here with Dr. James Southwell-Keely from Darling Point who is a plastic surgeon who has come to lift the veil on all things plastic surgery and explain what everything is. Now, welcome.
James: Thank you. Thank you so much.
Renae: And what I want you to tell us is maybe five, if we can come up with them, but a few ways to enhance your appearance. You were talking about keeping your teeth clean, maybe your hairstyle. What are some things that we can do in everyday life to, you know, keep ourselves as fresh and young as possible?
James: So you’ve already said a couple of...
Renae: Sorry.
James: ...very obvious ones there but very good ones. So, bad teeth don’t look great.
Renae: Right.
James: [inaudible 00:43] getting your teeth fixed are very expensive but certainly whitening them will freshen up [inaudible 00:47].
Renae: I had mine done by zoom.
James: Really?
Renae: Yeah.
James: Amazing.
Renae: Really good.
James: Look how good that is.
Renae: I know. It was great. Really good experience. So I recommend it.
James: Yeah. There you go.
Renae: Hair.
James: Hair.
Renae: Yeah.
James: Hair is another...
Renae: So what should we do with our hair?
James: Well, look after your hair.
Renae: Yeah.
James: So...
Renae: How for men, if they’re losing it…because…
James: It is. It is, but you can change your hairstyle.
Renae: Okay.
James: Or shave it.
Renae: Yeah. Okay. Go for that Bruce Willis look.
James: Bruce Willis look. He’s kind of timeless.
Renae: Yeah, he gets away with it.
James: A lot of people get away with it.
Renae: Yeah. Okay.
James: I like that. Very good.
Renae: There was an article in The Telegraph a couple of weeks ago where it mentioned a lot of people who don’t age, celebrities who don’t age, like Judie Dench, like Christie Brinkley, like Elle Macpherson, and it was saying that sure, you know, they’ve had some [inaudible 01:29] their hairstyle they’ve generally kept the same from, say, their twenties, which does something to the eye or something so that you still relate to them as being younger. What do you think?
James: I think that’s probably a really good suggestion but I’d also suggest that it might have taken Elle Macpherson’s hairstylist an hour…
Renae: [inaudible 01:49].
James: …back in the day, and now it might take a few more hours. So as we age, every part of us ages and having your [inaudible 01:57] look as good as it can takes time.
Renae: And another tip that you can give us?
James: Makeup. So, you’ve got to adjust your makeup. As you get older, you’ve got to highlight the highlight-able features of your skin and your face and you want to detract from those that are aging.
Renae: We talk a lot about changing your foundation for women. [inaudible 02:16] same products. A lot of women keep the same products from their twenties to their forties and that’s not a good idea.
James: No. No. Change your products with changing ages and stages of life.
Renae: Absolutely.
James: Yeah.
Renae: And what about glasses? Men particularly seem to get, you know, case in point, you look great in glasses but a lot of men get really anxious about having to wear glasses because I’m single when you go on a date and they go, oh you know I wear glasses. It’s like, so what? But what do you think? Should we all be getting contact lenses or…? I had laser. There you go.
James: Look, I’ve considered laser and I’m waiting for ten-, twenty-, thirty-plus year data to say that it’s safe.
Renae: Oh gosh.
James: And I’m sure it is. It’s like a 1 in 10, 1 in 100, maybe more, 1 in a 100,000, chance of a problem. I [inaudible 02:58] with my eyes. So I [inaudible 03:02] my work every day.
Renae: Yes.
James: But look, glasses are great.
Renae: Yeah, I agree.
James: It’s just a fashion thing, you know?
Renae: Yes.
James: I didn’t need them until I was sort of mid-twenties and I was a little bit upset when I had to get them but now that I have them, it’s just a part of life.
Renae: And as a doctor, it’s kind of cool.
James: It’s kind of…yeah.
Renae: Makes you look smarter.
James: Yeah.
Renae: Not that you’re not but…
James: Everything helps.
Renae: And sunscreen. Do we still need sunscreen as we get older?
James: Always.
Renae: Are you wearing it today?
James: I’m always wearing it.
Renae: Really?
James: Yeah. [inaudible 03:29]
Renae: And what do you wear? What’s your favourite sunscreen? Can we ask you that?
James: It’s nothing fancy.
Renae: That’s what we want to hear.
James: Good. Skin Cancer Council.
Renae: Excellent. That’s a really good product.
James: 50+.
Renae: It’s endorsed by them. We know it works.
James: Has to.
Renae: Fantastic. Well, thank you for coming to talk to us today.
James: Absolute pleasure.
Renae: The world of plastic surgery is so interesting. We might invite you back again.
James: It would be my pleasure.
Renae: When there’s some breakthroughs and, you know, we’d love to hear what’s happening, and we loved your input on all the celebrities out there. Thank you.
James: Any time.
Renae: Okay.
James: Any time.
Renae: See you soon.
James: Bye.

Hi there it’s Dr JSK here. Going to talk to you this afternoon about SMAS facelifts. Now the SMAS is the most common type of facelift. The SMAS is a layer in the face. Our bodies are organised in layers and one of these layers is the SMAS. Now that is S-M-A-S that stands for Superficial Musculo Aponeurotic System, it’s a complicated medical term but really what it means it’s a tough fibrous layer that when elevated gives the patient excellent longevity for their facelift and a nice natural result without unnatural tightness on the skin surface. It can be done in various different ways it can be tightened by itself, a small sliver can be removed and closed back up or it can elevated, redraped and secured to itself again. There are some of the finer points of SMAS facelift surgery. I hope to see you soon.