Posts Tagged ‘silicone breast implants’

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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Ask the Doctor: Breast Augmentation Surgery & Recovery

Breast AugmentationOK ladies, if you’re reading this blog, most likely, you have been thinking about or at one point have thought about breast surgery. Maybe you’ve even seen a physician for consultation. And maybe the only thing stopping you from having your breast surgery is the concern about your recovery. Let me review what to expect after breast augmentation surgery to help you decide if it is the right time for you.

Breast augmentation surgery is a very popular procedure, and one of the reasons for that is the fast recovery time. The procedure takes about an hour to perform under general anesthesia. It is considered an outpatient procedure because it does not require you to stay overnight in the hospital. Immediately after surgery, you may have some nausea as the anesthesia wears off, but you are treated with medications to prevent this from becoming a major issue. You will not be discharged from the facility until you are feeling well enough to leave and your pain is under control.

These days breast augmentation can be done in a variety of ways, and each of these techniques can affect the necessary recovery. Augmentation can be done with either implants or fat retrieved by liposuction. Implants can be placed above the muscle (sub glandular) or below the muscle (sub pectoral). Having the implants placed below the muscle typically has the longest recovery time, though usually only by a few days. What works well for some of my patients is having surgery on a Thursday or a Friday, and then taking the following week off of work to recover.

As you consider your recovery, it is a good idea to take into account your job requirements or your daily routine. If you have a very physical job, more than a week may be needed for recovery. Similarly, if you are running around after small children, extra hands to help will be appreciated for a longer duration.

As far as returning to exercise, it is reasonable to take walks or ride a bike about a week after surgery. I would wait at least 2 weeks to begin any rigorous exercise routine. You will likely still be sore and won’t want to do it anyhow.

Finally, I caution you not to go out and buy new super pretty bras immediately after surgery. It will be tempting, trust me. After surgery, we provide a supportive bra for comfort. There will be weeks of swelling, and your final breast size will generally result 4-6weeks after surgery. Your physician can guide you during the recovery period as to when it would be a good time to invest in nice ones. What to do with all your gently worn bras that no longer fit? Consider donating them to a worthy cause. Visit www.breastoasis.org for information.

I hope this brief review helps in your decision to undergo breast augmentation surgery. If you have additional questions or would like to be evaluated by one of the board-certified cosmetic surgeons at the Emory Aesthetic Center, call us for a complimentary consultation to determine what would be best for you and your desires.

About Dr. Anderson

Erica Anderson, MDErica 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.

Breast Implants with a Breast Lift: Do You Really Need Both?

Decide on Breast LiftThroughout the years plastic surgeons have often had strong opinions about when to do a breast lift alone, when to just put in breast implants, and when to do both. In addition to this, over the past several years there have been new developments in breast augmentation surgery, including short scar breast lifts (or mastopexy), fat grafting, and new breast implant options. These have provided surgeons with even more tools to help patients obtain more youthful, uplifted breasts. If you look in the mirror and you don’t like what you see – perhaps the breasts have become droopy after children or weight loss, or they just seem to have deflated after breastfeeding – there are now more options than ever before. But how do you know what is right for you – breast implants, a breast lift, or both?

Every surgeon has a different way of guiding patients through these options, but the first, most critical step is to really understand what your goals are. Patients may come in for a consultation saying something like “I’m not sure what I want, really. I just know I don’t like the way my breasts look now. I want to look fuller up top, but I don’t want to be too big either, and I want to look natural.” This is very helpful; however, it doesn’t answer the question about a lift, an implant, or both. Separating a lift or implants in your mind can bring a lot of clarity. One way to do this is to simply hold your breast up (replicating a lift) so that the breast is no longer in a low hanging position. This is something your surgeon can do for you during your consultation, or you can even do at home in front of the mirror. This will help you get a sense of your actual breast volume without an implant. If you like the relative size when the breast is manually lifted up, then you may be a great candidate for a breast lift alone. On the other hand, if the breasts are held up and the size just doesn’t give you what you want, then you need to think about breast implants, either with or without a lift.

To figure out this part, you’ll want to rely heavily on the judgment of your surgeon, who will make some measurements of the breast and note the degree of ptosis, or droopiness. If there is very little ptosis, then an implant alone (without a lift) will probably serve you very well. If the ptosis is severe, then putting in an implant alone will not look right, as the breast will appear to “fall off” of the implant. Therefore, a breast lift would be needed in addition to the implant. Not infrequently, however, a patient may lie in a gray zone somewhere in between: in these cases an implant alone may suffice, however will give a more mature or slightly low hanging appearance. The decision then becomes one of personal preference. If you feel that getting the breast as “perky” as possible is important, then a lift in addition to the implant is in order. If you feel that a more mature look is desirable, then you can forgo the lift and the additional scars that are required.

Of course there are advantages and disadvantages of each of the options – a lift alone, a lift with implants, or implants alone. Implants alone typically have the shortest scar, but have only a limited effect in making the breast look more uplifted. When implants are placed there is also the risk that the implants may become mal-positioned, may become encapsulated (firm with scar), or may need to be replaced, all of which may require additional surgeries in the future. A lift alone typically produces longer scars; however, it doesn’t carry the implant-related risks for additional surgery. A combined implant-lift provides control over both breast size and shape, but it also produces both the longer scars and the risk of additional “maintenance” surgeries related to implants. The differences in recovery between these options are usually small, and most women feel they can return to work in about a week after any of these options.

The surgeons at the Emory Aesthetic Center are experts in helping you think through all your options. We use the most up-to-date techniques, implants, imaging systems, and adjunct therapies (like scar therapy) to help you achieve the results that you want. We’ll take the time to thoroughly explore your goals and get a deep understanding of your desires. At the same time, we will work hard to make sure you really understand what options will give you the best results in the long run.

About Dr. Eaves

Felmont Eaves, MDDr. 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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Understanding Breast Augmentation Revision Surgery

Breast Augmentation Revision SurgeryStudies show that the vast majority of women are satisfied with the results of their breast augmentation surgery. Women report that the decision to enhance their breasts was a positive process and they would recommend it to others. There are times however, that patients may not achieve the results they were expecting. And more often, as bodies alter with weight loss, gain or pregnancy, the result changes such that a patient may want a revision. There are even cases when implants become hard and painful that women look for alternative solutions. Whatever the reason, physicians at the Emory Aesthetic Center can help you explore your options for breast augmentation revision surgery. Let’s consider some common scenarios to help guide your decision making process.

Scenario 1: You recently had a breast augmentation and you think the size is wrong. Is it too big or do you wish you had gone bigger? Either way, make sure you do not decide too quickly. Allow time for swelling to subside and implants to settle. Allow time for you to incorporate these changes into your body image. If at approximately 6months after surgery you still are unsatisfied, it is reasonable to consider an exchange of implants to better match your desired size. Implant exchange is relatively straightforward and recovery time is minimal, typically less than the recovery of the initial surgery.

Scenario 2: You have been happy with your saline implants but you have a friend with silicone gel implants that feel much more like natural breasts. An exchange from saline to gel can be done with relative ease, particularly if your overall size and shape remains acceptable to you. Recovery time in this case is also minimal.

Scenario 3: Your body has changed after pregnancy and the breasts do not look as they did when they were first enhanced. Sometimes in this case, decisions need to be made about the implants. If you are happy with overall volume, a breast lift – also known as a mastopexy – can be done leaving the implants in place to correct the droop but maintain the volume. If the size of the breasts is now too large, the implants can be removed and a breast lift performed. Alternatively, if you have lost volume in your breasts, implants can be exchanged for larger ones and a lift can also be done to correct the shape. Recovery from a mastopexy combined with changes to implants can be slightly longer than the cases mentioned above.

Scenario 4: There is a progressive hardening to the breasts that has become painful. You are likely experiencing capsular contracture. Though it is reasonable to be concerned about this process, it does not generally cause any significant health problems and it can be fixed. In these cases, the implants and the scar tissue are removed. When replacing the implant, the location is typically changed, i.e. from below the muscle to above or vice versa. Additional materials, such as biologic mesh (e.g. Strattice) can also be used in difficult cases to help prevent recurrence of the problem.

As you can see, there are many reasons for revisional breast augmentation surgery. The basic approach involves identifying the issue and then creating a surgical care plan that addresses the problem. The answer may be a simple solution of implant exchange with little recovery and downtime. Or the solution may be more complicated requiring a breast lift with conversion of the implants. Either way, the surgeons at the Emory Aesthetic Center can help guide your decision process and make breast augmentation revision surgery a success for you. Come in today for a consultation to determine what approach is best for you.

About Dr. Anderson

Erica Anderson, MDErica 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.

Gummy Bear Breast Implants: How are they different?

Gummy Bear Breast ImplantsPatients are calling the Emory Aesthetic Center asking, “Do you offer the ‘gummy bear’ breast implants?” The simple answer is yes, but let’s review what makes this breast implant different and how you know if it is a good choice for you.

“Gummy bear implants” is simply another name for silicone gel breast implants. Although there was a period of controversy concerning silicone gel implants in the early 1990’s, the gel implants currently available today have been extensively studied and shown to be safe. Silicone breast implants, in fact, are now the most studied medical device in all of medical history.

The FDA approved silicone gel implants have a cohesive gel technology. “Cohesive” means that the gel sticks to itself, so even if the implant were to break, the gel typically stays put, in many ways, resembling the consistency of a gummy bear. These gel implants come in two basic covering patterns and two basic shape styles.

The covering pattern for these breast implants comes in both a smooth and a textured cover. While smooth surfaced implants work very well, the textured surface was designed to reduce the chance of capsular scar contracture that may form around the implant and cause it to feel hard. In addition, texturization holds the implant in a particular position within the breast pocket.

The two basic shapes styles of these implants are round and “shaped” (or anatomical). Depending on a woman’s native breast volume, shape, and desires, a round implant may be the best choice in many cases. Round implants can have a smooth or textured surface. In other women, however, a shaped device may represent an excellent choice. There are many different variations, sizes, and heights to the shaped implants so that the choice can be customized for you. In order to maintain their shape, the anatomical designs have a higher degree of cohesiveness than the round devices, and these highly-cohesive, or form-stable, implants are often referred to as “gummy bear” implants in lay terms.

In order to stay in the desired position and orientation, shaped implants are always textured. In addition, they may have an added advantage of less wrinkling in certain patients, though they may feel firmer due to the fill material and volume. They are slightly more expensive as well.

If you are considering breast implant surgery, let the physicians at the Emory Aesthetic Center answer all your questions about implants and the technology behind the devices to help determine which ones are right for you.