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
Conseguir la forma perfecta del cuerpo no es una taza de té para cada uno. Se necesita mucho entrenamiento y, sin embargo, la gente no en eso. Las mujeres que se sienten incómodas debido a sus senos agrandados pueden consultar al Dr. José Luis Daza para la cirugía de mamoplastia en México. Del mismo modo, las mujeres que quieren una figura equilibrada pueden optar por la cirugía de implante mamario en México por el Dr. Daza que es un cirujano plástico de primera categoría.
Considering a breast augmentation? Learn what you need to know from the board certified plastic surgeons at Renaissance Plastic Surgery in Macon, Georgia. For more info visit http://www.renaissanceplasticsurgery.net
The document discusses various cosmetic surgery procedures including breast augmentation, liposuction, nasal surgery, eyelid surgery, tummy tucks, body contouring, chin augmentation, liposuction, otoplasty, breast augmentation, breast lifts, breast reductions, rhinoplasty, and face lifts. It provides brief descriptions of each procedure and what issues they aim to address, such as removing excess skin or fat from specific body areas or lifting sagging skin. The document promotes Medsoulindia as a trusted partner for medical tourism and a one stop solution for all cosmetic surgery needs.
O documento discute ginecomastia, uma cirurgia plástica buscada por homens para remover o excesso de glândula mamária. Ele explica o que é ginecomastia, seus principais motivos como uso de anabolizantes e alterações hormonais, e os passos para realizar a cirurgia, incluindo consulta médica e exames pré-operatórios.
This presentation privdes facts and statistics for non-invasive procedure such as Macrolane.
Macrolane is a Nasha Gel for volume restoration and contouring of body surfaces.
These facelift surgery in India help you lift your face and give u a wrinkle free texture, proper toned skin and the perfect glow and tightness required.
http://www.aestheticsmedispa.in/cosmetic-surgeries/face/face-lift-a-neck-lift.html
Conseguir la forma perfecta del cuerpo no es una taza de té para cada uno. Se necesita mucho entrenamiento y, sin embargo, la gente no en eso. Las mujeres que se sienten incómodas debido a sus senos agrandados pueden consultar al Dr. José Luis Daza para la cirugía de mamoplastia en México. Del mismo modo, las mujeres que quieren una figura equilibrada pueden optar por la cirugía de implante mamario en México por el Dr. Daza que es un cirujano plástico de primera categoría.
Considering a breast augmentation? Learn what you need to know from the board certified plastic surgeons at Renaissance Plastic Surgery in Macon, Georgia. For more info visit http://www.renaissanceplasticsurgery.net
The document discusses various cosmetic surgery procedures including breast augmentation, liposuction, nasal surgery, eyelid surgery, tummy tucks, body contouring, chin augmentation, liposuction, otoplasty, breast augmentation, breast lifts, breast reductions, rhinoplasty, and face lifts. It provides brief descriptions of each procedure and what issues they aim to address, such as removing excess skin or fat from specific body areas or lifting sagging skin. The document promotes Medsoulindia as a trusted partner for medical tourism and a one stop solution for all cosmetic surgery needs.
O documento discute ginecomastia, uma cirurgia plástica buscada por homens para remover o excesso de glândula mamária. Ele explica o que é ginecomastia, seus principais motivos como uso de anabolizantes e alterações hormonais, e os passos para realizar a cirurgia, incluindo consulta médica e exames pré-operatórios.
This presentation privdes facts and statistics for non-invasive procedure such as Macrolane.
Macrolane is a Nasha Gel for volume restoration and contouring of body surfaces.
These facelift surgery in India help you lift your face and give u a wrinkle free texture, proper toned skin and the perfect glow and tightness required.
http://www.aestheticsmedispa.in/cosmetic-surgeries/face/face-lift-a-neck-lift.html
Are you looking for a long-lasting solution to your missing tooth?
Dental implants are the most common type of method for replacing the missing tooth. Unlike dentures or bridges, implants are surgically placed in the jawbone. In layman’s terms, a dental implant is similar to the natural root of the tooth. It offers a stable foundation for the artificial tooth giving it the look, feel, and function similar to the natural tooth.
Travel Clinic Cardiff: Health Advice for International TravelersNX Healthcare
Travel Clinic Cardiff offers comprehensive travel health services, including vaccinations, travel advice, and preventive care for international travelers. Our expert team ensures you are well-prepared and protected for your journey, providing personalized consultations tailored to your destination. Conveniently located in Cardiff, we help you travel with confidence and peace of mind. Visit us: www.nxhealthcare.co.uk
Co-Chairs, Val J. Lowe, MD, and Cyrus A. Raji, MD, PhD, prepared useful Practice Aids pertaining to Alzheimer’s disease for this CME/AAPA activity titled “Alzheimer’s Disease Case Conference: Gearing Up for the Expanding Role of Neuroradiology in Diagnosis and Treatment.” For the full presentation, downloadable Practice Aids, and complete CME/AAPA information, and to apply for credit, please visit us at https://bit.ly/3PvVY25. CME/AAPA credit will be available until June 28, 2025.
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
“Psychiatry and the Humanities”: An Innovative Course at the University of Mo...Université de Montréal
“Psychiatry and the Humanities”: An Innovative Course at the University of Montreal Expanding the medical model to embrace the humanities. Link: https://www.psychiatrictimes.com/view/-psychiatry-and-the-humanities-an-innovative-course-at-the-university-of-montreal
DECLARATION OF HELSINKI - History and principlesanaghabharat01
This SlideShare presentation provides a comprehensive overview of the Declaration of Helsinki, a foundational document outlining ethical guidelines for conducting medical research involving human subjects.
Nano-gold for Cancer Therapy chemistry investigatory projectSIVAVINAYAKPK
chemistry investigatory project
The development of nanogold-based cancer therapy could revolutionize oncology by providing a more targeted, less invasive treatment option. This project contributes to the growing body of research aimed at harnessing nanotechnology for medical applications, paving the way for future clinical trials and potential commercial applications.
Cancer remains one of the leading causes of death worldwide, prompting the need for innovative treatment methods. Nanotechnology offers promising new approaches, including the use of gold nanoparticles (nanogold) for targeted cancer therapy. Nanogold particles possess unique physical and chemical properties that make them suitable for drug delivery, imaging, and photothermal therapy.
How to Control Your Asthma Tips by gokuldas hospital.Gokuldas Hospital
Respiratory issues like asthma are the most sensitive issue that is affecting millions worldwide. It hampers the daily activities leaving the body tired and breathless.
The key to a good grip on asthma is proper knowledge and management strategies. Understanding the patient-specific symptoms and carving out an effective treatment likewise is the best way to keep asthma under control.
2024 State of Marketing Report – by HubspotMarius Sescu
https://www.hubspot.com/state-of-marketing
· Scaling relationships and proving ROI
· Social media is the place for search, sales, and service
· Authentic influencer partnerships fuel brand growth
· The strongest connections happen via call, click, chat, and camera.
· Time saved with AI leads to more creative work
· Seeking: A single source of truth
· TLDR; Get on social, try AI, and align your systems.
· More human marketing, powered by robots
ChatGPT is a revolutionary addition to the world since its introduction in 2022. A big shift in the sector of information gathering and processing happened because of this chatbot. What is the story of ChatGPT? How is the bot responding to prompts and generating contents? Swipe through these slides prepared by Expeed Software, a web development company regarding the development and technical intricacies of ChatGPT!
Are you looking for a long-lasting solution to your missing tooth?
Dental implants are the most common type of method for replacing the missing tooth. Unlike dentures or bridges, implants are surgically placed in the jawbone. In layman’s terms, a dental implant is similar to the natural root of the tooth. It offers a stable foundation for the artificial tooth giving it the look, feel, and function similar to the natural tooth.
Travel Clinic Cardiff: Health Advice for International TravelersNX Healthcare
Travel Clinic Cardiff offers comprehensive travel health services, including vaccinations, travel advice, and preventive care for international travelers. Our expert team ensures you are well-prepared and protected for your journey, providing personalized consultations tailored to your destination. Conveniently located in Cardiff, we help you travel with confidence and peace of mind. Visit us: www.nxhealthcare.co.uk
Co-Chairs, Val J. Lowe, MD, and Cyrus A. Raji, MD, PhD, prepared useful Practice Aids pertaining to Alzheimer’s disease for this CME/AAPA activity titled “Alzheimer’s Disease Case Conference: Gearing Up for the Expanding Role of Neuroradiology in Diagnosis and Treatment.” For the full presentation, downloadable Practice Aids, and complete CME/AAPA information, and to apply for credit, please visit us at https://bit.ly/3PvVY25. CME/AAPA credit will be available until June 28, 2025.
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
“Psychiatry and the Humanities”: An Innovative Course at the University of Mo...Université de Montréal
“Psychiatry and the Humanities”: An Innovative Course at the University of Montreal Expanding the medical model to embrace the humanities. Link: https://www.psychiatrictimes.com/view/-psychiatry-and-the-humanities-an-innovative-course-at-the-university-of-montreal
DECLARATION OF HELSINKI - History and principlesanaghabharat01
This SlideShare presentation provides a comprehensive overview of the Declaration of Helsinki, a foundational document outlining ethical guidelines for conducting medical research involving human subjects.
Nano-gold for Cancer Therapy chemistry investigatory projectSIVAVINAYAKPK
chemistry investigatory project
The development of nanogold-based cancer therapy could revolutionize oncology by providing a more targeted, less invasive treatment option. This project contributes to the growing body of research aimed at harnessing nanotechnology for medical applications, paving the way for future clinical trials and potential commercial applications.
Cancer remains one of the leading causes of death worldwide, prompting the need for innovative treatment methods. Nanotechnology offers promising new approaches, including the use of gold nanoparticles (nanogold) for targeted cancer therapy. Nanogold particles possess unique physical and chemical properties that make them suitable for drug delivery, imaging, and photothermal therapy.
How to Control Your Asthma Tips by gokuldas hospital.Gokuldas Hospital
Respiratory issues like asthma are the most sensitive issue that is affecting millions worldwide. It hampers the daily activities leaving the body tired and breathless.
The key to a good grip on asthma is proper knowledge and management strategies. Understanding the patient-specific symptoms and carving out an effective treatment likewise is the best way to keep asthma under control.
2024 State of Marketing Report – by HubspotMarius Sescu
https://www.hubspot.com/state-of-marketing
· Scaling relationships and proving ROI
· Social media is the place for search, sales, and service
· Authentic influencer partnerships fuel brand growth
· The strongest connections happen via call, click, chat, and camera.
· Time saved with AI leads to more creative work
· Seeking: A single source of truth
· TLDR; Get on social, try AI, and align your systems.
· More human marketing, powered by robots
ChatGPT is a revolutionary addition to the world since its introduction in 2022. A big shift in the sector of information gathering and processing happened because of this chatbot. What is the story of ChatGPT? How is the bot responding to prompts and generating contents? Swipe through these slides prepared by Expeed Software, a web development company regarding the development and technical intricacies of ChatGPT!
Product Design Trends in 2024 | Teenage EngineeringsPixeldarts
The realm of product design is a constantly changing environment where technology and style intersect. Every year introduces fresh challenges and exciting trends that mold the future of this captivating art form. In this piece, we delve into the significant trends set to influence the look and functionality of product design in the year 2024.
How Race, Age and Gender Shape Attitudes Towards Mental HealthThinkNow
Mental health has been in the news quite a bit lately. Dozens of U.S. states are currently suing Meta for contributing to the youth mental health crisis by inserting addictive features into their products, while the U.S. Surgeon General is touring the nation to bring awareness to the growing epidemic of loneliness and isolation. The country has endured periods of low national morale, such as in the 1970s when high inflation and the energy crisis worsened public sentiment following the Vietnam War. The current mood, however, feels different. Gallup recently reported that national mental health is at an all-time low, with few bright spots to lift spirits.
To better understand how Americans are feeling and their attitudes towards mental health in general, ThinkNow conducted a nationally representative quantitative survey of 1,500 respondents and found some interesting differences among ethnic, age and gender groups.
Technology
For example, 52% agree that technology and social media have a negative impact on mental health, but when broken out by race, 61% of Whites felt technology had a negative effect, and only 48% of Hispanics thought it did.
While technology has helped us keep in touch with friends and family in faraway places, it appears to have degraded our ability to connect in person. Staying connected online is a double-edged sword since the same news feed that brings us pictures of the grandkids and fluffy kittens also feeds us news about the wars in Israel and Ukraine, the dysfunction in Washington, the latest mass shooting and the climate crisis.
Hispanics may have a built-in defense against the isolation technology breeds, owing to their large, multigenerational households, strong social support systems, and tendency to use social media to stay connected with relatives abroad.
Age and Gender
When asked how individuals rate their mental health, men rate it higher than women by 11 percentage points, and Baby Boomers rank it highest at 83%, saying it’s good or excellent vs. 57% of Gen Z saying the same.
Gen Z spends the most amount of time on social media, so the notion that social media negatively affects mental health appears to be correlated. Unfortunately, Gen Z is also the generation that’s least comfortable discussing mental health concerns with healthcare professionals. Only 40% of them state they’re comfortable discussing their issues with a professional compared to 60% of Millennials and 65% of Boomers.
Race Affects Attitudes
As seen in previous research conducted by ThinkNow, Asian Americans lag other groups when it comes to awareness of mental health issues. Twenty-four percent of Asian Americans believe that having a mental health issue is a sign of weakness compared to the 16% average for all groups. Asians are also considerably less likely to be aware of mental health services in their communities (42% vs. 55%) and most likely to seek out information on social media (51% vs. 35%).
AI Trends in Creative Operations 2024 by Artwork Flow.pdfmarketingartwork
Creative operations teams expect increased AI use in 2024. Currently, over half of tasks are not AI-enabled, but this is expected to decrease in the coming year. ChatGPT is the most popular AI tool currently. Business leaders are more actively exploring AI benefits than individual contributors. Most respondents do not believe AI will impact workforce size in 2024. However, some inhibitions still exist around AI accuracy and lack of understanding. Creatives primarily want to use AI to save time on mundane tasks and boost productivity.
Organizational culture includes values, norms, systems, symbols, language, assumptions, beliefs, and habits that influence employee behaviors and how people interpret those behaviors. It is important because culture can help or hinder a company's success. Some key aspects of Netflix's culture that help it achieve results include hiring smartly so every position has stars, focusing on attitude over just aptitude, and having a strict policy against peacocks, whiners, and jerks.
PEPSICO Presentation to CAGNY Conference Feb 2024Neil Kimberley
PepsiCo provided a safe harbor statement noting that any forward-looking statements are based on currently available information and are subject to risks and uncertainties. It also provided information on non-GAAP measures and directing readers to its website for disclosure and reconciliation. The document then discussed PepsiCo's business overview, including that it is a global beverage and convenient food company with iconic brands, $91 billion in net revenue in 2023, and nearly $14 billion in core operating profit. It operates through a divisional structure with a focus on local consumers.
Content Methodology: A Best Practices Report (Webinar)contently
This document provides an overview of content methodology best practices. It defines content methodology as establishing objectives, KPIs, and a culture of continuous learning and iteration. An effective methodology focuses on connecting with audiences, creating optimal content, and optimizing processes. It also discusses why a methodology is needed due to the competitive landscape, proliferation of channels, and opportunities for improvement. Components of an effective methodology include defining objectives and KPIs, audience analysis, identifying opportunities, and evaluating resources. The document concludes with recommendations around creating a content plan, testing and optimizing content over 90 days.
How to Prepare For a Successful Job Search for 2024Albert Qian
The document provides guidance on preparing a job search for 2024. It discusses the state of the job market, focusing on growth in AI and healthcare but also continued layoffs. It recommends figuring out what you want to do by researching interests and skills, then conducting informational interviews. The job search should involve building a personal brand on LinkedIn, actively applying to jobs, tailoring resumes and interviews, maintaining job hunting as a habit, and continuing self-improvement. Once hired, the document advises setting new goals and keeping skills and networking active in case of future opportunities.
A report by thenetworkone and Kurio.
The contributing experts and agencies are (in an alphabetical order): Sylwia Rytel, Social Media Supervisor, 180heartbeats + JUNG v MATT (PL), Sharlene Jenner, Vice President - Director of Engagement Strategy, Abelson Taylor (USA), Alex Casanovas, Digital Director, Atrevia (ES), Dora Beilin, Senior Social Strategist, Barrett Hoffher (USA), Min Seo, Campaign Director, Brand New Agency (KR), Deshé M. Gully, Associate Strategist, Day One Agency (USA), Francesca Trevisan, Strategist, Different (IT), Trevor Crossman, CX and Digital Transformation Director; Olivia Hussey, Strategic Planner; Simi Srinarula, Social Media Manager, The Hallway (AUS), James Hebbert, Managing Director, Hylink (CN / UK), Mundy Álvarez, Planning Director; Pedro Rojas, Social Media Manager; Pancho González, CCO, Inbrax (CH), Oana Oprea, Head of Digital Planning, Jam Session Agency (RO), Amy Bottrill, Social Account Director, Launch (UK), Gaby Arriaga, Founder, Leonardo1452 (MX), Shantesh S Row, Creative Director, Liwa (UAE), Rajesh Mehta, Chief Strategy Officer; Dhruv Gaur, Digital Planning Lead; Leonie Mergulhao, Account Supervisor - Social Media & PR, Medulla (IN), Aurelija Plioplytė, Head of Digital & Social, Not Perfect (LI), Daiana Khaidargaliyeva, Account Manager, Osaka Labs (UK / USA), Stefanie Söhnchen, Vice President Digital, PIABO Communications (DE), Elisabeth Winiartati, Managing Consultant, Head of Global Integrated Communications; Lydia Aprina, Account Manager, Integrated Marketing and Communications; Nita Prabowo, Account Manager, Integrated Marketing and Communications; Okhi, Web Developer, PNTR Group (ID), Kei Obusan, Insights Director; Daffi Ranandi, Insights Manager, Radarr (SG), Gautam Reghunath, Co-founder & CEO, Talented (IN), Donagh Humphreys, Head of Social and Digital Innovation, THINKHOUSE (IRE), Sarah Yim, Strategy Director, Zulu Alpha Kilo (CA).
Trends In Paid Search: Navigating The Digital Landscape In 2024Search Engine Journal
The search marketing landscape is evolving rapidly with new technologies, and professionals, like you, rely on innovative paid search strategies to meet changing demands.
It’s important that you’re ready to implement new strategies in 2024.
Check this out and learn the top trends in paid search advertising that are expected to gain traction, so you can drive higher ROI more efficiently in 2024.
You’ll learn:
- The latest trends in AI and automation, and what this means for an evolving paid search ecosystem.
- New developments in privacy and data regulation.
- Emerging ad formats that are expected to make an impact next year.
Watch Sreekant Lanka from iQuanti and Irina Klein from OneMain Financial as they dive into the future of paid search and explore the trends, strategies, and technologies that will shape the search marketing landscape.
If you’re looking to assess your paid search strategy and design an industry-aligned plan for 2024, then this webinar is for you.
5 Public speaking tips from TED - Visualized summarySpeakerHub
From their humble beginnings in 1984, TED has grown into the world’s most powerful amplifier for speakers and thought-leaders to share their ideas. They have over 2,400 filmed talks (not including the 30,000+ TEDx videos) freely available online, and have hosted over 17,500 events around the world.
With over one billion views in a year, it’s no wonder that so many speakers are looking to TED for ideas on how to share their message more effectively.
The article “5 Public-Speaking Tips TED Gives Its Speakers”, by Carmine Gallo for Forbes, gives speakers five practical ways to connect with their audience, and effectively share their ideas on stage.
Whether you are gearing up to get on a TED stage yourself, or just want to master the skills that so many of their speakers possess, these tips and quotes from Chris Anderson, the TED Talks Curator, will encourage you to make the most impactful impression on your audience.
See the full article and more summaries like this on SpeakerHub here: https://speakerhub.com/blog/5-presentation-tips-ted-gives-its-speakers
See the original article on Forbes here:
http://www.forbes.com/forbes/welcome/?toURL=http://www.forbes.com/sites/carminegallo/2016/05/06/5-public-speaking-tips-ted-gives-its-speakers/&refURL=&referrer=#5c07a8221d9b
ChatGPT and the Future of Work - Clark Boyd Clark Boyd
Everyone is in agreement that ChatGPT (and other generative AI tools) will shape the future of work. Yet there is little consensus on exactly how, when, and to what extent this technology will change our world.
Businesses that extract maximum value from ChatGPT will use it as a collaborative tool for everything from brainstorming to technical maintenance.
For individuals, now is the time to pinpoint the skills the future professional will need to thrive in the AI age.
Check out this presentation to understand what ChatGPT is, how it will shape the future of work, and how you can prepare to take advantage.
The document provides career advice for getting into the tech field, including:
- Doing projects and internships in college to build a portfolio.
- Learning about different roles and technologies through industry research.
- Contributing to open source projects to build experience and network.
- Developing a personal brand through a website and social media presence.
- Networking through events, communities, and finding a mentor.
- Practicing interviews through mock interviews and whiteboarding coding questions.
Google's Just Not That Into You: Understanding Core Updates & Search IntentLily Ray
1. Core updates from Google periodically change how its algorithms assess and rank websites and pages. This can impact rankings through shifts in user intent, site quality issues being caught up to, world events influencing queries, and overhauls to search like the E-A-T framework.
2. There are many possible user intents beyond just transactional, navigational and informational. Identifying intent shifts is important during core updates. Sites may need to optimize for new intents through different content types and sections.
3. Responding effectively to core updates requires analyzing "before and after" data to understand changes, identifying new intents or page types, and ensuring content matches appropriate intents across video, images, knowledge graphs and more.
A brief introduction to DataScience with explaining of the concepts, algorithms, machine learning, supervised and unsupervised learning, clustering, statistics, data preprocessing, real-world applications etc.
It's part of a Data Science Corner Campaign where I will be discussing the fundamentals of DataScience, AIML, Statistics etc.
Time Management & Productivity - Best PracticesVit Horky
Here's my presentation on by proven best practices how to manage your work time effectively and how to improve your productivity. It includes practical tips and how to use tools such as Slack, Google Apps, Hubspot, Google Calendar, Gmail and others.
The six step guide to practical project managementMindGenius
The six step guide to practical project management
If you think managing projects is too difficult, think again.
We’ve stripped back project management processes to the
basics – to make it quicker and easier, without sacrificing
the vital ingredients for success.
“If you’re looking for some real-world guidance, then The Six Step Guide to Practical Project Management will help.”
Dr Andrew Makar, Tactical Project Management
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. Todays Discussion
• History And Evolution
• Silicone Moratorium
• Present Day Options
• Statistics
• The Procedure….And Decisions
• After The Procedure
• Questions?
5. MATERIALS ONCE USED TO
AUGMENT THE BREAST
Stone
Ivory
Metal
Bone
Liquid Paraffin
www.DrDanaMD.com
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
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. Under the breast fold:
Inframammary
In the armpit: Transaxillary
Around the nipple areola: Peri-
Areola
DECISION 1 –
INCISION LOCATION
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. 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. 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. 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. 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. 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
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.
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