I find it pretty amusing that most plastic surgery web sites give you the same information. Once youhave read one of them,...
On the other hand, if the nipple is at or below the fold, stretching of the breasts by the implant willcreate an opposite ...
would potentially end up having biopsies to rule out cancer. However, more recently, some surgeonsdemonstrated more succes...
Mentor is one of the oldest and most reputable ones. The other one is Natrelle made by Allergan.Allergan is the same compa...
surgery on my office and it is still legal. I do not have training to do brain surgery, and my malpracticewould not cover ...
number, but if the answer is 1 or 2, you have your answer. They may be well trained in plastic surgeryand have proper theo...
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Breast Implant Answers you need to know before you get your surgery. Call 732-641-3350 to learn more

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Boris Volshteyn MD, a board certified plastic surgeon provides answers to some breast implant questions the patients need to know. breast implant in marlboro, breast implant in new jersey, breast implant in central new jersey, breast implant in woodbridge, breast implant in freehold, breast implant in howell, breast implant in jackson, breast implant in monroe, breast implant in manalapan, breast implant in monroe, breast implant in amboy, breast implant in brunswick, breast implant in new brunswick, breast implant in east brunswick, breast implant in aberdeen, breast implant in keyport, breast implant in union beach, breast implant in red bank, breast implant in holmdel, breast implant in old bridge, breast implant in tinton falls, breast implant in englishtown, breast implant in eatontown, breast implant in long branch, breast implant in ocean, breast implant in toms river, breast implant in little silver, breast implant in rumson, breast implant in shrewsbury, breast implant in lincroft, breast implant in highland park, breast implant in piscataway, breast implant in heights, breast implant in franklin park, breast implant in south river, breast implant in kendall park, breast implant in monmouth, breast implant in middlesex, breast implant in somerset, breast implant in sayreville, breast implant in parlin, breast implant in perth amboy, breast implant in staten island, breast implant in brooklyn, breast implant in king, breast implant in new york, breast implant in new york city, breast implant in nj, breast implant in nyc, breast implant in manhattan, breast implant in metuchen, breast implant in plainfield, breast implant in milltown, breast implant in millstone, breast implant in dayton, breast implant in princeton, breast implant in heathcote, breast implant in windsor, breast implant in robbinsville, breast implant in cream ridge, breast implant in new egypt, breast implant in lakewood, breast implant in nj turnpike, breast implant in raritan, breast implant in manville, breast implant in bound brook, breast implant in warren, breast implant in scotch plains, breast implant in rahway, breast implant in iselin, breast implant in colonia, breast implant in carteret, breast implant in clark, breast implant in winfield, breast implant in elizabeth, breast implant in roselle park, breast implant in linden, breast implant in westfield, breast implant in bridgewater, breast implant in basking ridge, breast implant in bernardsville, breast implant in lyons, breast implant in gillette, breast implant in berkeley heights, breast implant in downtown, cheap breast implant in, affordable breast implant in, free breast implant in, free breast implant in new jersey, cheap breast implant in new jersey

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Transcript of "Breast Implant Answers you need to know before you get your surgery. Call 732-641-3350 to learn more"

  1. 1. I find it pretty amusing that most plastic surgery web sites give you the same information. Once youhave read one of them, it is very difficult to find useful additional information on the others. It almostseems like most of the doctors offices use the same templated script with minimal changes. Wedecided to do something different.The goal of this web page is provide you with enough information about breast augmentation, so thatyou feel comfortable coming to either our office or any other plastic surgeons office and being ready tospeak about breast enhancement surgery almost as an expert. You should be able to better spot whenyou are getting straightforward answers or being up sold on something you do not need.We will tell you how to look at the online pictures as an expert, what to look for, how to select a propersize, how to select between saline and silicone implants, how to decrease your chances of capsularcontracture, what to expect from surgery and even how to negotiate with your plastic surgery officewithout offending them and much more.We want you to be able to refer to this page before and after the surgery with questions and we ask youto contribute your advices to other patients.Lets start, we will start with the basics of breast augmentation.What is Breast Augmentation, or Breast enhancement?Breast augmentation, also known as mammoplasty, is a surgical procedure designed to accentuate thesize and shape of a womans breasts. Breast augmentation, or BAM, is tremendous help to patients whodesire a fuller profile, who have lost breast volume due to pregnancy or nursing, or who have undergonebreast reconstruction and want to gain a more natural look again. Breast augmentation surgery willmake the breasts larger.Can Breast Augmentation surgery alone lift up the breasts at the same time?Most surgeons will tell you that breast augmentation surgery alone will not produce a significantelevation of the breasts. It is true Fortunately, it is only partially true. Our chest wall (rib cageunderneath) is not vertical. It looks more like a cone, wider at the base and narrower at the top. Whenplastic surgeon places an breast implant, the soft tissues of the breast stretch out forward and a little bitup. The taller the implant, the more elevation of the breast the patient will get. So, the correct answeris that the breast implant surgery always produces a little bit of breast tissue elevation. The larger theimplant is, (high profile implants), the more breast elevation the patient will get as the result of breastenlargement surgery. However, breast elevation alone does not mean a breast lift yet. Confused? donot be. Keep reading.When most surgeons talk about breast elevation, they focus on position of the nipple and areola inrelation to the center of the breast. If the nipple is positioned above the fold before breastaugmentation surgery and the breasts are not saggy, the stretching of the skin and breast tissue by theimplant will move both breast tissue and the nipple up, creating a nice lift. This is perfect for patientswith small non-saggy breast. Most of these patients will need only breast implants to get great result.
  2. 2. On the other hand, if the nipple is at or below the fold, stretching of the breasts by the implant willcreate an opposite result. The breast tissue will stretch by the implant but the nipple will actually turndownward and point to the toes, making the breasts looking worse. Some patients call it snoopy breast.These patients usually need a breast lift surgery. Some surgeons can perform these surgeries together.The others prefer to separate them. There is no universally correct way, it all depends on complexity ofsurgery, consistency of the breast, associated risk factors, patient preference and risk tolerance. We willtalk about details later.What are the options for Breast enhancement, or breast augmentation surgery?There are several options for breast augmentation. Some are medical, the others are surgical. Overall,there are 4 options: medications, non surgical systems, minimally invasive techniques with fat graftingand, most commonly, breast implant surgeries.Medications. There are plenty of medications on the web claiming to provide natural breastenhancement without surgery. The idea is great. However, the only way the natural medication canproduce breast enlargement is by stimulation estrogen receptors, just like it happens during pregnancyin women or gynecomastia in older men with increased level of estrogen in the bloodstream. Most ofthese natural medications are derived from yam, soy or other herbs. They create increased levels ofestrogen or estrogen like substances in the bloodstream. The breasts may actually increase in size butthese medications (even though most internet promoters call them harmless) can also affect menstrualcycle, ovarian function, promote uterine problems, interfere with activity of birth control pills and so on.Long term effect of these substances is not clear but it is far from benign. There are no FDA or any otherstudies, there are no government regulations, the promoters have no liability for any problems these socalled natural and benign substances can cause you. My advice, stay away. You do not want to find outthe you have a higher risk of fibrocystic breast disease or even potentially breast cancer many yearsfrom now because you were taking them.Non-surgical systems. The best known system is called BRAVA. It looks like 2 plastic cups attached to asuction device. The patients would place them on their breast overnight and the device with create anegative pressure. This pressure stimulates formation of connective and breast tissue and overtimeincreases the breast size. This is not a new technology. We have been skeptical about it for years.Most doctors do not use it because the results are not predictable, it does not create elevation of thebreast, like implant and because the maximal increase is about 1/2 cup size. However, over the last 5years or so, the advances in fat grafting brought this device back to life. Keep reading, you will see howit works next.Fat grafting. Fat grafting is not new. Surgeons have attempted fat grafting for facial rejuvenation, handrejuvenation for years and more recently for breast enlargement and breast reconstruction aftermastectomy (surgery to remove the breast because of cancer). Original efforts of fat grafting onto thebreasts were not very successful. The survival of the fat was unpredictable, the fat cells would die andform cysts filled with liquified fat, causing pain and deformation. Another concern was that the fatglobules could calcify and on mammograms to radiologist they could look like cancer. The patients
  3. 3. would potentially end up having biopsies to rule out cancer. However, more recently, some surgeonsdemonstrated more success by perfecting fat processing techniques and adding BRAVA system to theprocess. Newer methods of autologous breast augmentation is a two step process. First the patientwears BRAVA system, stretching the breast tissue from outside and improving the blood supply. Thenthe surgeon would take some fat from the abdomen, hips or thighs with micro-liposuction method(using very small cannulas) and carefully inject them into the breast. According to some surgeons, theresults are much better, it does require a bit of experience, more than one session may be needed andthere is no implant. However, because of complexity of the surgery and multi-step process andadditional liposuction, the cost of autologous breast augmentation with fat is usually quite a bit higherthan the implant surgery. Because the surgeon is able to control where the fat is injected, some breastelevation is possible. Most surgeons believe that this procedure is limited to 1 cup breast size increase.The calcification concern had been also partially resolved. Apparently, the cancer related calcificationsare different on X ray to those coming from fat grafting. Overall, it is a great technique, it is gaining thepopularity in patients who are opposed to implants but it does have significant limitations and mostplastic surgeons are not actively doing it because of safety and longevity concerns.Breast Implants. This is the most recognized and accepted method of breast augmentation. Theimplants filled with either saline (salt water) or silicone are inserted above or below the muscle forincreasing the bust size. The surgery is most commonly performed on an outpatient basis at a hospitalor state-of-the-art surgical unit while the patient is under a general anesthesia and asleep.There are several possible locations for the small incision that will be used for inserting the breastimplant. The most frequent technique utilizes an incision made in the lower portion of the breast.Another technique, though less frequently used, involves making an incision in the armpit. A thirdtechnique makes an incision around the areola (the darker skin surrounding the nipple). Anothertechnique uses an incision in the belly button, thus reducing the chance of scarring in the breast area.The best technique is usually decided together between the patient and the surgeon during theconsultation.During surgery, the breast tissue is raised to create an open pocket under the breast tissue or beneaththe chest wall muscle. Inserting an implant behind each breast can increase a womans breast size byone or more bra cup sizes.We will discuss the differences, advantages, disadvantages and selection criteria later on.Which Implants is better, saline or silicone?This is a loaded question. These is no perfect implant. If there was one, every surgeon would use it.Each implant has its own pros and cons.Which brands of breast implants is better?There are 3 main companies in US manufacturing FDA approved breast implants.
  4. 4. Mentor is one of the oldest and most reputable ones. The other one is Natrelle made by Allergan.Allergan is the same company that makes Botox and Juvederm. Natrelle implants were previouslyknown as Inamed and McGhan. Natrelle brand is of the same quality as Mentor.Both companies have superior product, similar size and shape selection, similar pricing and warranteestructure. I honestly cannot tell you that one is better or worse than the other. Some surgeons arefaithful to one of these brands, the others use both. You cannot go wrong with any one of them. In thecar world, it is like comparing Mercedes and BMW, for example. It is a matter of personal choice.The third company is Sientra. It had been approved by FDA in March of 2012. I do not have personalexperience with the company or their product, however, in casual conversations with my colleagues, theproduct quality appears to be about the same. Lets hope that in the future we can say that we added aLexus to our car fleet of implants.Where is the surgery usually performed?Most breast augmentation, or breast implant, surgeries are performed by board certified plasticsurgeons in the hospital or accredited surgery centers. This is a very important question. You have tomake sure that your breast implant surgery is done at an accredited institution.The hospitals are usually accredited by JCAHO. The outpatient surgery centers have to be accredited byone of the 4 main agencies: Medicare, JCAHO, AAAHC, or AAAASF. If you do not see one of these 4emblems on the surgery center, DO NOT DO IT THERE regardless of what you are told. No reputableboard certified plastic surgeon would perform breast augmentation surgery in a plain office, or plainprocedure room because of sterility concerns associated with breast implant surgery. This is true even ifthe procedure is performed under local anesthesia only.If you are traveling abroad for your surgery, consider looking for certification by JCI, Joint CommissionInternational.Who can perform my breast augmentation surgery?There is a significant difference between what is legal and what is appropriate.By law any MD or DO can do your breast augmentation surgery as long as they have a medical license.As a doctor, they do not have to have any surgical training at all. No reputable physician will performthis surgery without proper training, however, it does not mean that all breast augmentation surgeriesare performed by trained surgeons. As a board certified plastic surgeon I can potentially do brain
  5. 5. surgery on my office and it is still legal. I do not have training to do brain surgery, and my malpracticewould not cover it, but it is legal.So, what do you need to look for?First is training. Your surgeon needs to be trained as a plastic surgeon. Not radiologist, pathologist, orear nose and throat doctor, not family physician or cosmetic gynecologist. You are looking for a plasticsurgeon. It is important not only because they are trained to do the breast augmentation surgery anddeal with complications. If you have a complications, like infection, for example, and need to beadmitted to the hospital, a cosmetic gynecologist will have to look for a plastic surgeon to admit you.The hospital will not allow them to admit you because the hospital does not recognize their training asbeing appropriate for this surgery. The simple question to ask your doctor is this: Are you trained as aplastic surgeon?Second, board certification. Look for a board certified plastic surgeon. You may verify it on the internet.Make sure that the doctor is certified by American Board for Plastic Surgery. There are plenty of otherboards, like Cosmetic Surgery, Breast surgery, Esthetic Surgery and so on. Make sure you are askingabout the correct board. The question to ask is: Are you certified by American Board for Plastic Surgery?Some non plastic surgeons may try to confuse the public. Some will have ads like that: CosmeticSurgeon, 20 years of experience, Board Certified. Sounds ok, right? Wrong! The doctor is not a plasticsurgeon. Cosmetic surgeon is not a trained specialty but a self designation. Board certification may be inPathology or Emergency Medicine, so is the experience. For all you know, this may be a boardpathologist, who for 20 years was doing autopsies, then took a weekend course on how to do breastimplants and opened a cosmetic surgery office. The states are becoming more aware of these tacticsand introducing more stringent regulations. I have nothing against family docs or pathologists I wasusing in this example, but as an educated consumer you have to make sure that the surgeon you areabout to pay thousants of dollars for your surgery is actually properly trained to do it. A weekendcourse is not enough from my standpoint.Third, having active and unrestricted hospital privileges. Especially if your surgeon is offering to do yoursurgery at the accredited office facility, make sure that he or she has privileges at local hospital in caseof unforseen problems. The question to ask is: What hospital do you have your privileges at? Anotherterm that I just used was "unrestricted". If the doctor had demonstrated to the hospital administrationand colleagies that his training and expertise are below standart, some hospitals could introduce"restricted status". It means that the doctor cannot operate at the hospital without supervision byanother physician.Fourth, experience. Some board certified plastic surgeons had been doing wound care surgeries, burns,and skin grafts for 20 years. Unfortunately, it does not mean that they have enough experience toperform breast augmentation surgery, especially if you have a complex case, tuberous breast deformity,significant asymmetry, of trying to combine breast aumentation with a breast lift and or fat grafting. Askthem how many of these surgeries they performed over last year, or last 6 month. There is no magic
  6. 6. number, but if the answer is 1 or 2, you have your answer. They may be well trained in plastic surgeryand have proper theoretical knowledge, but may be lacking practical experience in this specific surgery.What is a typical consent for Breast augmentation surgery? Why is it so long?Most plastic surgeons will use similar consents for plastic surgery procedures that had been developedby our professional society. The reason they are so lengthy is because they explain in writing everythingthat you might or might not have been informed of during your visit with your doctor in greater detail.It is not designed to confuse you or release the doctor from responsibility for negligence. It is designedto inform you about the procedure you selected, its alternative treatments, risks and complications aswell as it describes the financial and other agreements to avoid misunderstanding later on. We actuallyask our patients to read it in advance at home and write down any questions they might have about it.This way our office visit is far more productive.

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