Breast Augmentation

Factors to Consider Before Breast Lift Surgery

breast lift blog postPregnancy, breastfeeding, aging and weight fluctuations commonly take a toll on a woman’s breasts. If you’re noticing yours are sagging or not as full as they once were, it may be time to consider a breast lift (mastopexy). Breast lifts can produce dramatic results with a relatively short recovery.

If you’re serious about it, the first and most important thing on your to-do list should be finding a skilled and experienced cosmetic surgeon. The right surgeon will listen as you describe your desired outcome and talk through all the options. Remember your body is unique—there is no one-size-fits-all procedure. Here are two important factors to consider with your surgeon:

1. What will the scars look like?

Of course, women (and their plastic surgeons) want to minimize scars whenever possible, but the procedure that leaves the smallest scar may not be the best choice for you. One of the keys to getting great results with a breast lift is to match the right scar pattern with your needs.

Types of scar patterns

There are several surgical techniques used during breast lifts that leave different scaring patterns. Some include:

“Donut” (periareolar) lift – This procedure is effective for women who have very mild drooping or who want to reduce the size of their areolas (the pigmented area surrounding the nipple). It yields the smallest scar that runs around the perimeter of the areola.

“Lollipop” (vertical) lift – This is probably the most common breast lift procedure because it addresses moderate drooping and provides more extensive reshaping. The scaring goes around the perimeter of the areola and then straight down from the bottom of the areola to the fold underneath the breast (inframammary fold)—resulting in a lollipop-shaped scar.

“Anchor” (inverted T) lift – With this procedure, the scar goes around the areola, then from the bottom of the areola to the fold underneath the breast (the inframammary fold), and finally along the fold of the breast. The anchor technique is most effective for women with significant drooping and whose breasts have slid down on the chest wall. Most commonly, women who have had multiple pregnancies (with breast feeding), who have lost a significant amount of weight, or who are having a breast reduction require this technique. Although it yields the most scarring, scars can often be placed in areas that can be hidden by bras or bikini tops.

Be careful about pushing your plastic surgeon toward a technique based solely on scar patterns though. Some techniques may not adequately address the issues you’re having. Also, remember that surgeons will always work to place scars in the least noticeable positions possible, like under skin folds.

2. Do I need implants?

Determining if you need breast implants, a lift or both, is often a point of controversy and confusion—but it’s important to think it through. One easy way to narrow down your choice of procedure is to take the size test.

The size test

You need to separate the concept of size and lift, which isn’t always easy. To help, try manually lifting your breasts in front of a mirror. How you feel about the size of your breasts when they’re lifted will guide you toward which procedure is right for you.

Just a lift – If you’re happy with the size of your breasts, or if you wish they were just slightly bigger, a breast lift is probably the right choice for you. Small implants will give you very little (if any) benefit, yet you’ll still incur the cost and potential future surgeries that can come with breast augmentation. Should you decide after your lift that you still want to add volume, you can always have an augmentation down the road. But most women are satisfied with the results of a lift alone.

Just implants – If your breasts are too small or relatively deflated (need volume) but the nipples aren’t too low, breast implants might do the trick. While it’s true that implants will give a slight lift, they will not make up for more significant drooping. Sometimes, women make the mistake of getting bigger implants to avoid getting a lift. Unfortunately, this usually results in the heavy implants sagging and the woman feeling her breasts are too large for her comfort. Often in this instance, a woman will opt to remove or replace the implants and must undergo a more extensive (and complicated) breast lift than she originally needed.

Both – Combining breast implants and a breast lift can give wonderful results. Women who wear “A-” or “B-” cup bra sizes, and who have extra loose skin but not a lot of tissue to droop, do especially well with the combined procedure. Women who have larger breasts can also get implants; however, over time, fuller breasts may “fall off” of the implant, requiring additional surgery.

Emory Aesthetic Center

If you’re considering a breast lift or implants, schedule a complimentary consultation with one of the expert cosmetic surgeons at the Emory Aesthetic Center to discuss your options.

Request an appointmentor call 404-778-6880.

Breast Implants or a Lift: Which is Right for Me?

It’s not uncommon for women to feel dissatisfied with their breasts. Whether your breasts didn’t develop as you’d hoped or you’re unhappy with changes from aging, pregnancy or weight loss, there are many options for helping you achieve a breast size and shape you can enjoy.

First, Pinpoint the Real Issue

Zeroing in on which aspect bothers you — your breast volume or position — will help you choose the best procedure(s) to get the results you want. And, it’s not always as straightforward as it sounds. For example, you can’t assume you need to add volume if your breasts don’t project like they used to, even after extreme weight loss. A breast lift could very well give you the look you want.

So how do you pinpoint the real issue? I make this simple suggestion to all my patients to help determine if they’re truly unhappy with the size of their breasts:

Lift your breasts up or wear your favorite bra in front of a mirror and ask yourself, “Do I like the size of my breasts now with this additional support?”

If so, you’ll probably be happy with the results of a breast lift. But if you feel your breasts are too small even when lifted, you’ll likely want implants.

Now, Choose the Right Procedure For You

 Determining which type of procedure will achieve the best results, implants or a lift, can be confusing. But now that you’ve narrowed the issue down to size or position, you can make a better decision about which procedure you want.

Breast implants add volume and may give a subtle lift, but not enough to combat significant drooping.

If you’re happy with your size, but want a ‘perkier’ look, a breast lift can be the answer.

A Dual Procedure

If you’re unhappy with your size and have a significant amount of drooping, you’ll likely want a dual procedure — breast implants and a breast lift at the same time — to get the shape you desire. Since two things are happening at once during this dual procedure, it does require some surgical finesse. So, it’s important to have an experienced and skilled cosmetic surgeon. In my experience, women with smaller breasts tend to have better and more predictable results from the dual implant and lift procedure than women whose breasts are larger. With larger breasts, there’s an increased possibility the lifted breast tissue may droop from the implant over time.

A Staged Approach

If you’ve chosen to get implants, but aren’t sure if you want a lift too, you might consider a staged approach. With this strategy, you get your implants first and see if you like your results. If you’re satisfied, you saved yourself from an unnecessary procedure. If you’re not satisfied, you can choose to get a breast lift later. The drawback is if you decide you need the lift after all, you’ll have to endure two surgeries and two recovery periods instead of one.

A Word of Caution

Some women (and the occasional cosmetic surgeon) will push for very large implants to get more of a lifting or filling effect to the breasts without having a breast lift. I’ve seen many women over the years with overly augmented breasts who still feel their breasts aren’t as perky as they’d like. These women then need both a breast lift and a downsizing or removal of their implants to get to their desired look.

Emory Aesthetic Center

Emory Aesthetic Center has years of experience helping women achieve their ideal breast size and shape. As part of Emory, we are one of Atlanta’s most trusted names in health care. If you’re considering a breast enhancement procedure, but just aren’t sure which procedure is right for you, come see us for a complimentary consultation. Make an appointment using the request an appointment button below or call 404-778-6880 to schedule your personal consultation.

Augmentation, Reduction or Lift? – Your Breast Surgery Questions Answered

breast-aug-emailHave you been contemplating breast surgery? Whether you are considering breast augmentation (enhancement), breast reduction or breast lift surgery, it is important to understand the full extent of the procedure.

During our live chat on Thursday, November 17th, hosted by Emory Aesthetic Center’s plastic surgeon, Dr. Felmont Eaves, we answered questions about the different types of breast surgery options available. Dr. Eaves discussed what to expect during surgery and the recovery process. He also gave advice on choosing the right plastic surgeon to obtain the natural looking results you desire.

The response was so great that we had a few questions we were not able to answer during the chat so we will answer them below for your reference. A full list of questions and answers can be found on our chat transcript. You can also visit emoryaesthetic.org for a full list of services and treatments offered by the Emory Aesthetic Center.

Question: Do you typically do a reduction and a lift at the same time?

Dr. Eaves: Yes, a breast reduction always includes a breast lift, but you can lift without reducing if a reduction is not needed.

Question: If I get breast implants now, will I likely need a lift down the road?

Dr. Eaves: You may or may not. Many women with breast implants never need a lift, although it might be that after a decade or two that the extra size could contribute to the breast becoming more droopy. A lot of it will be related to how much breast tissue and the elasticity of the breast skin at the time of augmentation. It is certainly something to discuss at the time of consultation.

Question: Hi Dr. Eaves, I am set for a consultation in a few weeks, but am not sure which option to have – a breast lift (BL) or breast reduction (BR). My breast size is a 34F and I am a medium body frame with small bulge on the lateral aspect of my breast. Not sure if I can live with the post scarring from the breast reduction. Do you think for the best cosmetic look I would be a good candidate for periareolar BR or would a BL be better?

Dr. Eaves: In thinking through your individual circumstance, it is important to remember that a reduction always comes with a lift – that is just part of it. If a patient needs a lift, that lift can be done alone with no change in breast size, or the breasts can be reduced (a little or a lot, depending on what is needed), or the breast can even be augmented. The one thing is that – in general – a periareolar reduction or mastopexy is often ill-advised, unless the deformity is absolutely minimal. Although it sounds great to have a smaller scar, in reality that periareolar scar often looks very abnormal if trying to do any significant lifting or reduction, so that both the scar and breast shape will be poor. Be cautious – except in very limited circumstances, a peri-areolar only approach can be problematic.

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Augmentation, Reduction or Lift – Join Our Breast Surgery Live Chat

Join us for a live chat on November 17th as we discuss different types of breast surgery options and answer questions about what to expect from surgery.Have you been contemplating breast surgery? Whether you are considering breast augmentation (enhancement), breast reduction or breast lift surgery, it is important to understand the full extent of the procedure. Join us for a live chat with Emory Aesthetic Center plastic surgeon, Dr. Felmont Eaves, on Thursday, November 17, 2016 at 12:00 p.m. EST as he discusses these different types of breast surgery options and answers all of your questions about what to expect, the surgery and recovery. He will also give you advice on choosing the right plastic surgeon to obtain the natural looking results you desire.

If you have been wondering if a breast surgery procedure is right for you, you won’t want to miss this chat.

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About Dr. Eaves

eaves-iii-felmontDr. Eaves recently returned to Atlanta, Georgia, to head the Emory Aesthetic Center as Medical Director, having previously completed his plastic surgery residency as well as a fellowship in endoscopic and minimally invasive plastic surgery at Emory University, The Emory Clinic, and associated hospitals. Before joining the Emory Aesthetic Center, Dr. Eaves was a partner in Charlotte Plastic Surgery for more than fifteen years and served as group president from 2010-2012.

His professional and institutional committee memberships and offices include an impressive list of national, international and local plastic surgery organizations, societies, boards, task forces, advisory councils, coalitions and foundations, including having served as President of the American Society for Aesthetic Plastic Surgery (ASAPS) from 2010-2011 and Trustee (2011-Present).

Dr. Eaves’ primary areas of academic inquiry have been in minimally-invasive and endoscopic aesthetic surgery, patient safety, system and process improvement in plastic surgery, evidence-based medicine applied to plastic surgery and recontouring surgery after massive weight loss. He has received several patents for new medical devices he developed, and has made major clinical service contributions to his field. Dr. Eaves has published more than 100 articles, book chapters and book reviews on plastic surgery in peer reviewed publications, as well as manuals, videos, computer programs and other teaching aids and has coauthored the first textbook on the topic of endoscopic plastic surgery.

Mommy Makeover: When Is the Right Time?

A mommy makeover can reshape your body to help you look more like yourself again. But when is the right time to do it?The “mommy makeover” is on the rise. Women want to reclaim their bodies from the changes brought on by pregnancy and breastfeeding. But a common question is “when is the right time to do it?”

What Is a Mommy Makeover?

A mommy makeover is a procedure, or combination of procedures, that help reshape a woman’s form after pregnancy. Each woman’s needs and goals are unique, but mommy makeovers typically involve any combination of the following:

  • Tummy tuck
  • Liposuction of the tummy or other areas such as the back, thighs or arms
  • Breast procedure:
    • Breast augmentation with implants to add volume
    • Breast lift to address low-hanging (sagging) breasts
    • Combination of both breast lift and augmentation to lift breasts and add fullness

When Is the Time Right for a Mommy Makeover?

While you may be in a hurry to reclaim your pre-pregnancy body, there are several factors to consider before scheduling your procedure(s).

Is My Body Ready?

It’s important to give your body time to return to “normal” following pregnancy. It’s best to wait until the stretched tissue returns to its typical state and until you’ve lost your pregnancy weight. Not only is surgery safer when you’re at a good weight, but the results are also better.

What If I’m Breastfeeding?

Breastfeeding is a factor to consider, especially when a breast procedure is part of your plan. You shouldn’t have elective breast surgery until your baby is fully weaned and your milk has completely dried up. Most surgeons prefer to wait at least three months after you stop breastfeeding, regardless of the procedure you’re considering.

How Much Time Will I Need to Recover?

As a mom, you have lots of responsibilities — caring for your family being only one of them. So you’ll want to consider when you’ll have the time and support you need before scheduling your procedure(s). Most women need a few weeks to recover.

Can I Have Another Baby After I Get a Mommy Makeover?

Results of your mommy makeover will be compromised by a pregnancy. So, you shouldn’t consider getting procedures done if you’re planning to have another child.

That being said, life is complex. Sometimes circumstances change. Typically, you can safely have another baby after you have a mommy makeover. However, you may wish to have some additional surgical procedures done following the pregnancy to address the new changes to your body.

Another thing to consider is that depending on the type of breast surgery you had, you may or may not be able to breastfeed.

Are You Ready to Consider a Mommy Makeover?

The board-certified plastic surgeonsat Emory Aesthetic Center  can help you determine the right timing and combination of procedures for your mommy makeover.

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or call us at 404-778-6880 to schedule a consultation

Your Body Contouring Questions Answered: Getting Ready for Swimsuit Season

swimsuit-chat-260x200-emailAs we kick-off the summer months and have officially reached bathing suit season, it is natural that many of us take a look in the mirror and think about how we might change our body. In addition to keeping a healthy diet and exercising regularly, there are now more choices than ever in how we might achieve our goals. But with so many choices, both surgical and non-surgical options, choosing what body contouring procedure is best for you can be difficult.

During our live chat on Tuesday, March 22nd, hosted by Emory Aesthetic Center’s plastic surgeon, Dr. Felmont Eaves, we answered your questions around body contouring options to help shape your body for summer and tighten excess or loose skin. Dr. Eaves discussed both surgical and non-surgical procedures – including liposuction, tummy tucks, and thigh lifts.

Below are just a few highlights from the chat. A full list of questions and answers can be found on our chat transcript. You can also visit emoryaesthetic.org for a full list of services and treatments offered by the Emory Aesthetic Center.

Question: How do you get rid of a stomach belly fat?

Dr. Eaves: If diet and exercise don’t get you what you want, then there are three main ways to address belly fat, non-surgical fat reduction, liposuction, or abdominoplasty. Which one is best for a patient depends on their individual circumstances.

For instance, non-surgical treatments like Coolsculping® work best in patients with smaller amounts of fat and youthful, elastic skin. Liposuction works best in similar patients, however is more aggressive in terms of fat removal. The tummy tuck is the “king” of tummy contouring – it can tighten muscles, reduce fat, and tighten skin. Tummy tucks are more common in patients that have had pregnancies or who are a bit older and have developed some skin laxity.

Question: I have 2 weeks until I have to be in a bathing suit. What are some quick fixes that can be done with belly and thigh bulges?

Dr. Eaves: That doesn’t give much time! I’m afraid that neither surgery nor non-surgical fat removal would work and get you ready in such a short period of time.
One thought, however. We often think about concentrating on getting our bodies (or faces) ready for a big event. However to get your body where you want, it really takes a sustained, consistent approach. Crash diets and hours in the gym for short periods of time doesn’t really get you anywhere . . . a good, healthy, balanced and sustainable diet coupled with a reasonable exercise routine that you can stick with is the key. Of course surgery can help a lot, but the patient gets the very best results when they get their weight and health to a good place.

Question: Is there such a thing as a “mini” tummy tuck which does not have to go all the way across the abdomen?

Dr. Eaves: Not only is there the mini-tummy tuck, but some patients are candidates for tummy tucks with even shorter scars – the endoscopic tummy tuck. However before you get excited about these options, be aware than only a very small percentage of patients are candidates for these procedures. In order to be a candidate, you need to have good, elastic skin and relatively small amounts (or not) excess fat.

These procedures are ideally suited for patients who have experienced some spreading of the muscles of the abdomen from pregnancy, which we call a diastasis recti. If you have any significant amount of loose skin, or more significant fatty deposits, you are unlikely to get a good result with a limited scar approach. That being said, we now use techniques to help the scar appear better, such as special sutures that take the tension off of the skin. There sutures also eliminate the need to have surgical drains with a tummy tuck, which is a big plus.

Question: I need help with both my tummy and my breasts. Can I have both surgeries at the same time?

Dr. Eaves: Not only can you treat both the tummy and the breasts at the same time, but this is a very common procedure. For the tummy, most often this involves a tummy tuck due to the effects of the pregnancy. What we might do in the breasts depends on how the breasts recovered after pregnancy and maybe breast feeding. For instance, if the breast lost volume but didn’t become saggy (we call that “ptosis”), then a breast augmentation is a great option.

If you like the size of the breasts but they have become too droopy, then you would likely want a mastopexy, or breast lift, but without implants. It is also quite common to do both breast augmentation with implants and a lift. If you have a consultation with a plastic surgeon, he/she can help you sort through these options and see which is best for you.

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or call us at 404-778-6880 to schedule a consultation

If you have additional questions for Dr. Eaves, please feel free to leave a comment in our comments area below.

Choosing the Best Breast Implant for You

implant-250x250Silicone gel? Gummy Bear? Highly Cohesive? Saline? Round? Anatomical? Teardrop? Smooth? Textured? There are many choices when it comes to breast augmentation surgery and breast implants. Not only do we have choices for the implants themselves, but there are also choices around techniques to inserting them, as well as where the incision site will be placed. We have subglandular, subfascial, and submuscular positions which can be combined with transaxillary (in the underarm), periareolar (between the pigmented skin around the nipple and the normal breast skin), and inframammary (in the fold underneath the breast). But we’re not done yet . . . you also have to decide what size of implant you want, and in some cases, whether or not you need a breast lift. There are so many options when it comes to breast augmentation with implants that the choice may seem overwhelming.

But do not despair…when working with a board certified plastic surgeon, getting to the best choice can be a lot easier than you might imagine. The process starts at the beginning of the consultation. Your surgeon should listen to your ideas, goals, and concerns, and then follow-up with a physical examination that will evaluate the volume of your natural breast tissue, the dimensions of the breast, the tightness of the skin, and the position of the nipples. These factors will guide your surgeon toward recommendations that he or she can discuss with you. For instance, the width of the chosen implant needs to match the dimensions of your breasts. The size of the implant needs to fit with your frame and your aesthetic goals. The shape of the chosen implant helps determine the appearance of the upper part of your breasts.

To see how this all works, let’s think through a couple of scenarios together. First, let’s say the patient is thin, the areola and the breasts are quite small, and the soft tissue in the upper part of the breast is very thin. In this case, because a submuscular implant is less likely to show ripples, the surgeon would likely recommend a submuscular implant placement. If the patient wants a fuller upper pole of the breast, a round implant may be chosen, but if she wants a more subtle, smooth transition between the chest and breast, a shaped implant (“anatomical” or “teardrop”) would be the way to go. And since the areola are small and anatomical implants need a bit bigger incision, placing the scar under the breast would be a better choice.

On the other hand let’s consider a different scenario, this time in a patient who is a bit heavier with moderate thickness of the soft tissue of the upper breast and normal sized areola. In this case, the implant could be placed on top of or underneath the muscle, as the thickness of the tissue will hide the implant nicely either way. The shape of the implant also becomes less important with thicker tissue, as the natural breast shape will have a greater effect. Therefore, a less expensive round implant may be preferable. Although this patient might also be a candidate for a saline implant, with the improved designs of silicone gel implants over the years and with a large amount of data showing the safety and efficacy of silicone gel breast implants, the vast majority of women in our practice are choosing silicone gel implants even in this situation. Silicone gel implants of all types tend to feel more natural, look more natural, and are less prone to produce visible waves and ripples than saline implants.

In making your choice of implants, one technology that has proven to be very helpful and popular with patients is 3-D computer imaging. In this process, an array of cameras take a picture of your chest and then an avatar of your chest is produced in the computer. Because the cameras and computers can calculate distances and volume, it ultimately allows the user to simulate different brands, sizes and shapes of implants on an image of your own body. This helps you choose not only the size of the implants that will fit you, but it also helps you see how different styles of implants might look. Of course, this is a simulation only and you cannot be guaranteed that your final result will look exactly the same. However, studies have shown – and our experience has confirmed – that this is a very helpful tool to help patients make choices.

So in the end don’t let yourself be overwhelmed by choices. Come in for a complimentary consultation with one of the board certified physicians at the Emory Aesthetic Center. We’ll help you understand your choices and choose a great implant and technique specifically designed for you.

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About Dr. Eaves

eaves-iii-felmontDr. Eaves recently returned to Atlanta, Georgia, to head the Emory Aesthetic Center as Medical Director, having previously completed his plastic surgery residency as well as a fellowship in endoscopic and minimally invasive plastic surgery at Emory University, The Emory Clinic, and associated hospitals. Before joining the Emory Aesthetic Center, Dr. Eaves was a partner in Charlotte Plastic Surgery for more than fifteen years and served as group president from 2010-2012.

His professional and institutional committee memberships and offices include an impressive list of national, international and local plastic surgery organizations, societies, boards, task forces, advisory councils, coalitions and foundations, including having served as President of the American Society for Aesthetic Plastic Surgery (ASAPS) from 2010-2011 and Trustee (2011-Present).

Dr. Eaves’ primary areas of academic inquiry have been in minimally-invasive and endoscopic aesthetic surgery, patient safety, system and process improvement in plastic surgery, evidence-based medicine applied to plastic surgery and recontouring surgery after massive weight loss. He has received several patents for new medical devices he developed, and has made major clinical service contributions to his field. Dr. Eaves has published more than 100 articles, book chapters and book reviews on plastic surgery in peer reviewed publications, as well as manuals, videos, computer programs and other teaching aids and has coauthored the first textbook on the topic of endoscopic plastic surgery.

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Breast Augmentation: How to Get the Most Natural Looking Breasts

feeling-goodI have found this blog to be somewhat challenging mainly because I had to ask myself…what is meant by a natural looking breast? Is it what you remember pictured in a National Geographic magazine? Those are definitely natural. Or has Hollywood altered our perception so much that we no longer know what it is to have natural breasts. If you are considering an enhancement to your breasts, you are likely interested in additional volume and possibly improvement in shape. Let’s review some of the decisions you will need to make with your plastic surgeon, and help you understand how these decisions may affect the end appearance of your breast augmentation.

Decision #1: Should I get breast implants?

This is the first basic question to consider if you are at all concerned about a natural result. Breast implants are just not natural. Look at yourself in the mirror with a bra or swimsuit top on. Do you like your breasts overall? Is there enough volume in clothes? If you are happy with the volume in clothes, consider a breast lift as opposed to placing implants.

Small increases in volume can also be performed using fat from other areas of your body, called fat transfer or fat grafting. This avoids implants but has limitations as to how much volume increase you can expect. A breast lift with or without fat grafting is a way to improve your breasts and definitely get a natural result.

But if you feel there is not enough volume, and a small increase from fat grafting would not be enough, read on…

Decision #2: Implant choice

  • Saline or Silicone?
    Saline versus silicone for the implant fill material is really about how it feels and less about appearance. They are both breast implants therefore they both look basically the same once placed. Since silicone feels more natural, I think more patients associate them with appearing more natural, but truthfully either device is fine. The incision required for silicone implants is a little longer and the cost is slightly higher, but that is the major difference between the two devices. However, if you want a natural feel as well as appearance, silicone implants are the better choice.
  • What about profile?
    Implants come in a variety of profiles known as moderate, moderate plus or high profile. This is a way to classify the implant as to how much projection it has. Projection is how much the implant sticks out from the chest wall. The moderate profile has the least projection and the high profile the most. The more projection an implant has, the more round the result may end up. In general, a high profile implant will have a less natural appearance. If you want a more natural result, a moderate or moderate plus device would be a better choice.
  • Volume?
    It’s simple. A larger breast implant is more likely to look artificial than a smaller one. Common sense really. But there are not definitive numbers that guide you as to what a large implant is. Is 300cc large? Or do you cross the line at 500cc? This is the art of breast augmentation. And this is where your body proportions play a role. If you have a narrow frame and are short to average height, a large implant for you may be 300cc. If however you are tall with broad shoulders, your frame can easily carry a volume of 450cc. The amount of native breast tissue you have also plays a role in these decisions. The chosen projection of the implant is also considered when choosing the implant volume. When you meet with your surgeon, a breast width measurement is taken. This number guides what implants will likely fit you the best. From that range of implants, if your focus is on a natural result, choose an implant with the least volume. In general, smaller implants produce more natural results.
  • Tear drop/Shaped Implants?
    Anatomically shaped implants are a newer device on the market that allows for a more sloped appearance to the breast after enlargement. Like it sounds, the implant is not round and there is more volume in the inferior portion of the device than the superior. If you are relying on the device to give additional volume and provide an improved shape, an anatomical implant may be a good choice. The disadvantage of the device is that it can rotate and need revision surgery. I typically think of using a shaped device in someone who has lost volume after weight loss or having children, has a slight degree of droop to the breast and has a flat upper portion of the breast. In these cases, a natural and improved result can be obtained.

Decision #3: Implant location

There are two locations typically used for placement of implants for breast augmentation. They are either placed in a subglandular plane, directly under the breast tissue or in a submuscular plane, under the pectoralis major muscle. Advantages and disadvantages are associated with either location. In general, the implant placed below the muscle will give the most natural result as it is providing more soft tissue coverage.

Decision #4: Plastic Surgeon

This is key. First, you have to be honest with yourself about what you want and then you have to find the right board-certified plastic surgeon to execute your wishes. You should interview many surgeons, and find the one who you feel understands what you are trying to accomplish and what you want. Preoperatively an implant is chosen and the surgery is planned, but adjustments may have to be made in the operating room while you are asleep. You need to feel confident that your surgeon is thinking about what YOU want. I use sizers in the operating room after I create the implant pocket and then make a final decision on the implant once I see it in place. Whether you want natural or not, be sure that you trust the surgeon doing your surgery.

Breast augmentation surgery can be exciting and scary all at the same time. My advice is to meet with one of the board-certified surgeons of the Emory Aesthetic Center. We can help you understand your options, walk you through the process and get you the natural result you want.

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or call us at 404-778-6880 to schedule a consultation

About Dr. Anderson

anderson-ericaErica Anderson, MD, is board certified by the American Board of Plastic Surgery and currently holds an appointment as Assistant Professor in the Division of Plastic Surgery at Emory University. Dr. Anderson completed her general surgery residency and plastic surgery residency at the University of Colorado Health Sciences Center and associated hospitals in Denver, CO. She completed a year of advanced training in Aesthetic Surgery at Grotting Plastic Surgery in Birmingham, Alabama.

Dr. Anderson returns to Emory University after being in private practice in Arlington, Virginia. While there, she maintained a busy aesthetic and reconstructive practice and also served as Medical Director for the Wound Healing and Hyperbaric Center at Virginia Hospital Center.

Dr. Anderson’s academic and research interests are largely focused on clinical outcomes with regards to cosmetic surgery. Her areas of clinical interest are diverse including cosmetic surgery of the breast and body as well chest wall reconstruction and wound care.

Dr. Anderson is married with 3 children, Trent, Connor and Fiona, and 2 vizslas, Max and Mimi.

How To Get Cosmetic Surgical Results Without Surgery

natural-beautyNo one really wants to have surgery if they don’t need it; therefore, it isn’t surprising that cosmetic surgeons are asked quite often how someone can get surgical results without actually having surgery. Well, it certainly sounds good . . surgical results without surgery, right? The problem is that it really doesn’t work that way. The long and the short of it is in order to get the dramatic results of surgery, you have to have surgery. But with all of the new non- and minimally-invasive treatment options that have become available in recent years, the answer isn’t always so cut and dry, and there are options. It is not a matter of good versus bad, but really understanding the differences between the surgical and the non-surgical options, and figuring out which one is going to best help you achieve your goals.

The facial region is the area with the greatest number of non-surgical options, from Botox® to dermal fillers and chemical peels to lasers and micro-needling. Non-surgical treatments can be quite effective in the face when you are treating the right problem. Botox® does a wonderful job of temporarily softening wrinkles in the forehead, between the brows, and the sides of the eyes. Dermal fillers can plump up the cheeks and minimize creases around the mouth. Skin products, in-office chemical peels, Intense Pulsed Light (IPL), micro-needling, and lasers can do a superb job of improving the fine wrinkles, texture, and pigment in the skin. However, if you are looking to reduce the jowls, tighten the neck or lift droopy brows or eyelids, then non-surgical treatments won’t provide the results that you seek. It is extremely common patients will undergo a blend of surgical and non-surgical procedures to take advantage of the strengths of both. In younger patients who are not yet ready for surgery, non-surgical options may provide them exactly what they want.

For breast augmentation, the surgical versus non-surgical comparison doesn’t work, because there really aren’t non-surgical options to do the things that patients want. At the present time you can’t increase the breast size, reduce the breast size, or lift up drooping breasts without surgery. In the breast, though, the discussion is often around full length or reduced incision approaches. Like non-surgical treatments, reduced scar approaches sound really positive – and of course who wouldn’t want that? However, in some cases a full scar approach is required to get the degree of results that a patient wants or needs.

Only recently have significant non-surgical options emerged for treatment of the abdomen, flanks, and thighs. These treatments are directed at two primary goals – reducing the fatty layers and tightening the skin. Infrared therapy, external ultrasound, and cryolipolysis (fat freezing) are all energy devices approved to reduce the thickness of the fatty layer. CoolSculpting® is a fat freezing treatment currently available, and it is the treatment that we have chosen to offer at the Emory Aesthetic Center due to the level of comfort experienced by patients and the medical studies that support its use. But not all patients get the results that they seek. And while a few patients don’t seem to achieve much of a result, a small number of patients are “super-responders” who can get a dramatic result, sometimes with just one treatment. But overall, most patients will see a 10-20 percent improvement in an area with a single treatment, but for additional improvement they will need repeat treatments. Liposuction is the surgical counterpart to fat freezing. Not surprisingly, liposuction allows us to treat more areas at a time, be more aggressive in fat removal, and depending on the number of areas to treat and the number of CoolSculpting® sessions, sometimes liposuction can be less expensive as well.

At this point, non-surgical treatments seem to do a better job at fat removal than skin tightening. For this reason, there isn’t much in the way of non-surgical options for patients that may have significant skin laxity, for example when they need a tummy tuck or thigh lift. In these instances, surgical resection can be combined with liposuction to not only tighten the skin, but to sculpt the tissues as well. It is because of this combined strategy that tummy tucks, for instance, can produce some of the most dramatic improvements of any of the surgeries that plastic surgeons perform. However, if a patient is young and has generally good skin quality, with limited fatty deposits, fat freezing without the need for surgery can be a great option.

To pull it all together, there are some things that surgery can do that non-surgical treatments simply can’t do. In other cases non-surgical treatments can be highly effective and can provide for you the results you want – without the need for a surgical procedure or significant recovery period. What is best for you depends on your specific appearance, your tissues, and your goals. At the Emory Aesthetic Center, we are happy to be able to offer the entire spectrum of surgical and non-surgical options. Our board-certified physicians can work with you to determine the best solution for you and your desired result.

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About Dr. Eaves

eaves-iii-felmontDr. Eaves recently returned to Atlanta, Georgia, to head the Emory Aesthetic Center as Medical Director, having previously completed his plastic surgery residency as well as a fellowship in endoscopic and minimally invasive plastic surgery at Emory University, The Emory Clinic, and associated hospitals. Before joining the Emory Aesthetic Center, Dr. Eaves was a partner in Charlotte Plastic Surgery for more than fifteen years and served as group president from 2010-2012.

His professional and institutional committee memberships and offices include an impressive list of national, international and local plastic surgery organizations, societies, boards, task forces, advisory councils, coalitions and foundations, including having served as President of the American Society for Aesthetic Plastic Surgery (ASAPS) from 2010-2011 and Trustee (2011-Present).

Dr. Eaves’ primary areas of academic inquiry have been in minimally-invasive and endoscopic aesthetic surgery, patient safety, system and process improvement in plastic surgery, evidence-based medicine applied to plastic surgery and recontouring surgery after massive weight loss. He has received several patents for new medical devices he developed, and has made major clinical service contributions to his field. Dr. Eaves has published more than 100 articles, book chapters and book reviews on plastic surgery in peer reviewed publications, as well as manuals, videos, computer programs and other teaching aids and has coauthored the first textbook on the topic of endoscopic plastic surgery.

What Every Woman Considering Breast Augmentation Should Know

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Breast augmentation is one of the most popular cosmetic surgery procedures worldwide. In the United States, it is second to liposuction in popularity with approximately 300,000 women undergoing breast enlargement each year. The results of breast augmentation are immediately apparent and the patient satisfaction rates are very high. However, as with any cosmetic procedure, there can be problems. I have pulled together a list of information every woman should know when considering breast augmentation. This will help prepare you when making the decision, as well as help to avoid any surprises along the away.

  • Breast implants are not permanent. All implants will eventually leak and have to be replaced. The typical lifespan is 15 to 20 years, although I have seen many last beyond 25 years.
  • The procedure is not maintenance free. There is a risk of “capsular contracture” or hardening of the breast if scar tissue builds up around the implant. This may necessitate further surgery to soften the breast.
  • There are differences between saline filled and gel filled implants. Although the outer shells are similar, saline implants are filled with saline after they are placed under the breast. Gel implants are filled with silicone gel by the manufacturer. Saline implants cost less and may have a less “natural” feel. In general, gel implants result in a more natural feel and appearance, especially in thinner women. Leaks are easier to detect with saline than with gel.
  • The current “5th generation” of gel implants, some of which are known as “Cohesive Gel”, “Gummy Bear” or “Form Stable”, are superior to previous gel implants.
  • Beyond saline or gel there are other options to include when choosing an implant – a smooth or textured surface implant, a shaped or round implant. Each one actually has a purpose. Your surgeon will be able to discuss the differences with you, and make a recommendation based on your individual anatomy, breast shape and size.
  • Scarring will result. There are four “scar” options for placement of the implant – these include incisions in the armpit, around the nipple, in the crease below the breast and even through the belly button. Your surgeon will be able to suggest which incision is best suited to your breast.
  • Breast implants can be placed over or under the chest muscle (pectoralis major). Generally in thin women the placement under the muscle is best, as it adds a layer of the muscle as cover over the implant. Your surgeon will be able to discuss placement with you as recommendations for location are best made on an individual basis.
  • Breast implants will not affect your ability to breastfeed.
  • Breast implants may obscure small parts of the breast on mammography. This is less so when the implants are placed under the muscle.
  • After age 40, a mammogram is advisable prior to breast augmentation.

If you are considering breast surgery, come in for a complimentary consultation with one of the board certified cosmetic surgeons of the Emory Aesthetic Center. We can help you define your goals and determine what would be best for you and your desires.

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About Dr. Nahai

Foad Nahai, MDFoad Nahai, MD, FACS is internationally recognized as an innovator in the field of plastic surgery where he has developed and refined many procedures. He has co-authored ten books and published over 190 scientific articles on all aspects of plastic surgery. The latest book he authored and edited, published in 2011, is the second edition of his three volume text entitled The Art of Aesthetic Surgery.

He has been invited to lecture and demonstrate plastic surgical procedures all over the world. In addition to numerous professional honors and awards, he is listed in the “Best Doctors in America”, the “Best Doctors in the U.S.”, Town & Country Magazine, Good Housekeeping, More Magazine and Atlanta Magazine as one of the country’s top plastic surgeons. He has been listed in W Magazine as one of the top plastic surgeons in the world. Dr. Nahai is in demand internationally to speak at plastic surgery meetings and to demonstrate surgical procedures.

Dr. Nahai served as the 2008-2010 president of the International Society of Aesthetic Plastic Surgery (ISAPS), he is a past president of the American Society of Aesthetic Plastic Surgery (ASAPS), a former director of the American Board of Plastic Surgery, and is currently Editor-in-Chief of Aesthetic Surgery Journal.

His primary area of expertise is in Face, Neck and Eyelid surgery where he has made significant contributions to the advancement of the art and science of Facial Rejuvenation.