Dana M Goldberg, M.D.
BREAST AUGMENTATION
DISCUSSION
www. DrDanaMD.com
Dana M Goldberg M.D.
561-691-8088
www.DrDanaMD.com
A PERSONAL DECISION….
“I want to get back
what I used to have
before I had my
children…”
“My breasts
are two
different
siz...
Todays Discussion
• History And Evolution
• Silicone Moratorium
• Present Day Options
• Statistics
• The Procedure….And De...
MATERIALS ONCE USED TO
AUGMENT THE BREAST
Stone
Ivory
Metal
Bone
Liquid Paraffin
www.DrDanaMD.com
•1st Generation silicone implant introduced 1962
•The FDA put a moratorium on the use of silicone
implants until they coul...
IMPLANTS AVAILABLE TODAY
Saline Silicone Gel Textured Gel
200
Sizes and
Options
www.DrDanaMD.com
Breast augmentation was the #1 cosmetic surgery
procedure performed in 2010
60% Of all breast augmentations in 2010 used
s...
We will discuss your desires, options,
and possible risks….
You will also be given important
information about what to exp...
Under the breast fold:
Inframammary
In the armpit: Transaxillary
Around the nipple areola: Peri-
Areola
DECISION 1 –
INCIS...
Submuscular: Under the pectoralis (chest) muscle
Subglandular: Under the breast tissue, above the muscle
DECISION 2 –
IMPL...
DECISION 3 –
IMPLANT TYPE
Gel implants feel more like breast tissue, but are limited to women over 22 years of age
Saline ...
Medical Clearance
What to avoid before surgery…
Aspirin and Ibuprofen/Motrin
Smoking and all nicotine
Fish Oil and Vitamin...
The surgery lasts from 1-2 hours.
Afterwards you will stay in the
recovery area until released to
your family or other car...
Restrictions on heavy lifting and
exercise
Don’t put your elbows above
your shoulders for 2 weeks
Swelling and tenderness
...
1.How do I know what size I should be?
2.What type of implant should I get?
3.Is the surgery going to hurt?
4.Can I breast...
Dana M Goldberg M.D.
561-691-8088
www.DrDanaMD.com
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Breast Implants West Palm Beach Plastic Surgeon Dana M. Goldberg M.D. discusses West Palm beach breast augmentation

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West Palm Beach Cosmetic Surgeon Dana M Goldberg M.D. Shares insight into west palm beach breast augmentation, breast implants, and what the breast augmentation process is like from your first free breast augmentation consultation through your post op healing. Find out why over 300,0000 Breast Augmentations were done last year alone.

Dana M. Goldberg M.D., <a>cosmetic plastic surgeon </a> in West Palm Beach Florida.
http://www.drdandmd.com

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  • Hello. I’m Dr. Dana Goldberg, and I’m a plastic surgeon specializing in breast surgery in Jupiter, Florida. I meet with patients every day about breast augmentation surgery, and this presentation is an in-depth overview of what we talk about during a consultation.
  • There really is no typical breast augmentation patient. Some of my patients are teenagers who have abnormal development of one or both breasts, and some just want to get back to their pre baby body. I even have patients in their seventies looking to enhance their appearance. Everyone has their own reasons… I have to confess that I LOVE clothing, and I had my own breast augmentation surgery largely because I wanted to fill out my clothing better and stop buying different sized tops and bottoms.
     

  •  
    Today I’m going to review the evolution of breast implants, including all of the drama about silicone. I’ll also talk a bit about what to expect before, during, and after breast augmentation surgery.
  • Believe or not, the first breast augmentation was performed over 1000 years ago. Some of the materials that have been used include stone, metal, bone, and wax! The first modern surgical reports are from the 1800s where paraffin wax, sponge, and even tumors from other parts of the body were implanted into the breasts! As you can imagine, some of these attempts were disastrous.

    In the 1890s, Dr. Robert Gersuny began to use paraffin injections for breast augmentation. Complications were numerous, with high infection rates, so the procedure almost obsolete by World War I. In 1943 Dow Corning Corporation pioneered the development of silicone as an engine lubricant. Because it was a nonreactive material that could be easily sterilized, Japanese cosmetologists began injecting the liquid silicone directly into women’s breasts. The “procedure” became so popular that silicone actually became difficult to find! In the US, the procedure was popular, but complications such as discoloration and infection were soon being noticed and many patients required mastectomy due to hard lumps and scarring in the breast tissue. Medical grade silicone became regulated and limited to very small studies, which led to the underground market for silicone injections. Believe it or not, despite the numerous reports of complications and the availability of safe implants today, some people, most of whom aren’t even doctors, continue to inject silicone.
  • Formal saline and silicone implants were developed in the 1960s. In 1961, American surgeons Cronin and Gerow developed the first silicone breast implants. If you’re interested, there’s actually a movie with David Schwimmer that tells the whole story. Shortly after that, in1964, French surgeon developed saline implants so he could make his incisions smaller.

    Both types of implants were used for cosmetic augmentation until the 1990s. A rheumatologist noted that several women with silicone implants were diagnosed with autoimmune diseases (like lupus and arthritis). Plastic surgeons really didn’t have any good studies to prove that implants were safe, so silicone implants were made available for reconstruction only, and thousands of patients were studied very carefully. There was no link found between implants and autoimmune disease, so in 2007 they were released for cosmetic use once again.
  • Modern breast implants have evolved, and now women have the choice of saline or silicone breast implants. There are even shape and texture choices, which really allow each patient to have the implant best suited to her.
  • Breast augmentation was the most common cosmetic surgery performed in 2010, and the majority of those surgeries were with silicone implants.
     
    Over the last decade, the number of procedures has dramatically increased. In fact, there were almost 300,000 augmentations performed last year alone.
  • Now I’d like to talk about what happens before and after surgery. During your initial consultation, we’ll spend a lot of time talking about your desires, your lifestyle, and your medical history to make sure you have the best result and best recovery possible. There are some decisions you need to make about your surgery, and we review what you can expect after surgery. We’ll also discuss the risks and things you can do to minimize your risks, like avoiding aspirin and not smoking. Once you schedule your surgery, you’ll have a second appointment to focus on the details. Bringing pictures can help us choose the perfect implant size. Some patients bring magazine photos or Victorias secret ads and some bring pictures of themselves before weight loss or having kids.

    Next, I’ll talk about the decisions you’ll need to make.
  • The first decision is what type of incision you feel most comfortable with. There’s more to it than just thinking about where you want the scar visually. For example, the incision in the crease below the breast is well hidden and provides good access for larger sized implants.

    The incision under the arm avoids a scar on the breast, but the incision can’t be used again if a second implant surgery is ever needed. The incision around the areola is barely visible due to the natural color change between the areola and the surrounding skin, but it has a higher risk of injury to the nerves of your nipples, and this can affect your nipple sensation and ability to breast feed. For patients who also need a breast lift, different incisions would be needed. Click on the page to learn more about a breast lift. *** insert link to mastopexy or aug/pexy page
  • The next decision to make is whether the Implants go above or below the chest muscle, which is called the pectoralis or pec muscle. Most women have the implants placed under the muscle. This helps camouflage the implant and reduces the risk of capsular contracture. A small amount of scar tissue, called a capsule, forms around every breast implant. With capsular contracture there is too much scar tissue, and it makes the implant feel hard and tight. But for some women, the implant can be placed directly under the breast tissue with excellent results and a slightly easier recovery.
  • Both types of implants come in a silicone shell. Saline implants are filled with a salt water solution similar to IV fluid, and silicone implants are filled with a semisolid silicone gel. Silicone is actually one of the most common elements on earth. It’s found in salt, sand, and even medical supplies like injection needles.

    Silicone implants look and feel more natural, especially for women who have very little breast tissue. They are resistant to showing ripping, which is when the implant can be seen through the skin. Silicone implants are placed through an incision that is around 4cm long or about 1 ½ inches. If a silicone implant ruptures, the gel tends to stay in the scar tissue capsule, so many patients don't even know the implant is ruptured. For this reason, the FDA recommends an MRI every few years after implants to help detect rupture.

    Saline implants are more affordable and can usually be placed through a smaller incision. They also tend to project more and provide more firmness to the breast than silicone implants of the same size. If a saline implant ruptures, the saline is absorbed by the body, and the implant will deflate.
  • If you decide to have surgery, you’ll have a second appointment where we focus on doing everything needed to get you ready for surgery. You’ll need to visit a doctor and get lab work done to make sure you are safe for surgery. We’ll give you prescriptions for after surgery and a list of do’s and dont’s to follow both before and after surgery.
  • You’ll arrive about an hour before surgery and stay to recover for about an hour after surgery. Most patients are comfortable when they wake up because I perform nerve blocks on all my patients during surgery. You will wake up in a surgical bra, which you should wear all the time, except for showering. You’ll have medication for pain and nausea as well as an antibiotic. I give all my patients my personal cell phone, and I’m available by email or cell phone for questions or concerns at any time.
  • For two weeks after surgery, you’ll need to take it easy. You should avoid lifting anything over ten pounds and avoid any activity that makes you out of breath or gets your heart racing. This will help decrease the risk of swelling and bleeding. Right after surgery your implants will be very swollen and higher up on your chest then appears natural. This improves dramatically over the first two months after surgery, and continues to improve for up to six months after surgery.
  • These are some of the most common questions I am asked by patients around the time of surgery. Please Click this page to view a video addressing these questions.
    ***Leave slide out until video done
  • Thanks for watching. Please click the link to visit my site for more information!
  • Breast Implants West Palm Beach Plastic Surgeon Dana M. Goldberg M.D. discusses West Palm beach breast augmentation

    1. 1. Dana M Goldberg, M.D. BREAST AUGMENTATION DISCUSSION www. DrDanaMD.com
    2. 2. Dana M Goldberg M.D. 561-691-8088 www.DrDanaMD.com
    3. 3. A PERSONAL DECISION…. “I want to get back what I used to have before I had my children…” “My breasts are two different sizes.” “I want a body that looks good in T-Shirts…” www.DrDanaMD.com
    4. 4. Todays Discussion • History And Evolution • Silicone Moratorium • Present Day Options • Statistics • The Procedure….And Decisions • After The Procedure • Questions?
    5. 5. MATERIALS ONCE USED TO AUGMENT THE BREAST Stone Ivory Metal Bone Liquid Paraffin www.DrDanaMD.com
    6. 6. •1st Generation silicone implant introduced 1962 •The FDA put a moratorium on the use of silicone implants until they could be carefully studied •After intense FDA scrutiny found silicone gel to be safe and effective and released them to the market •The gel implants used today are fourth generation WHAT ABOUT SILICONE? www.DrDanaMD.com
    7. 7. IMPLANTS AVAILABLE TODAY Saline Silicone Gel Textured Gel 200 Sizes and Options www.DrDanaMD.com
    8. 8. Breast augmentation was the #1 cosmetic surgery procedure performed in 2010 60% Of all breast augmentations in 2010 used silicone gel implants Between 2000 and 2010 breast augmentation procedures increased by over 39% Over 296,203 Breast Augmentations were performed in 2010* BREAST AUGMENTATION STATISTICS *Report of the 2010 Plastic Surgery Statistis. Annual SASPS Procedural Statistics represent procedures performed by ASPS member surgeons certified by The American Board of Plastic Surgery® as well as other physicians certifi ed by American Board of Medical Specialties-recognized boards. ©ASPS, 2011
    9. 9. We will discuss your desires, options, and possible risks…. You will also be given important information about what to expect leading up to surgery and after… YOUR FREE CONSULTATION www.DrDanaMD.com
    10. 10. Under the breast fold: Inframammary In the armpit: Transaxillary Around the nipple areola: Peri- Areola DECISION 1 – INCISION LOCATION
    11. 11. Submuscular: Under the pectoralis (chest) muscle Subglandular: Under the breast tissue, above the muscle DECISION 2 – IMPLANT PLACEMENT Breast after subglandular augmentation Breast after submuscular augmentation Breast before augmentation Before Breast Augmentatio Breast After Subglandular Augmentation Breast After Submuscular Augmentation
    12. 12. DECISION 3 – IMPLANT TYPE Gel implants feel more like breast tissue, but are limited to women over 22 years of age Saline filled implants involve a smaller incision, and are available to women 18 and older www.DrDanaMD.com
    13. 13. Medical Clearance What to avoid before surgery… Aspirin and Ibuprofen/Motrin Smoking and all nicotine Fish Oil and Vitamin E Discussion of the Risks Infection Bleeding Implant related complications Injury of nerves and breast tissue PRE OP APPOINTMENT www.DrDanaMD.com
    14. 14. The surgery lasts from 1-2 hours. Afterwards you will stay in the recovery area until released to your family or other care giver You will be given medication and follow-up instructions, and an appointment to come back for an office visit You will probably experience some degree of discomfort…. but the amount of discomfort you experience can not be predicted SURGERY DAY www.DrDanaMD.com
    15. 15. Restrictions on heavy lifting and exercise Don’t put your elbows above your shoulders for 2 weeks Swelling and tenderness AFTER SURGERY www.DrDanaMD.com
    16. 16. 1.How do I know what size I should be? 2.What type of implant should I get? 3.Is the surgery going to hurt? 4.Can I breast feed after Breast Augmentation? 5.Will I lose sensation in my nipples? 6.How soon can I resume my exercise program? 7.Can I still have a Mammogram after Augmentation? 8.How soon can I wear a bra after surgery? 9.How long do the implants last? 10. Is anesthesia safe? www.DrDanaMD.com
    17. 17. Dana M Goldberg M.D. 561-691-8088 www.DrDanaMD.com

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