Gummy Bear Implants

After 10 years in practice I am finally getting around to starting a blog. I think this can be a great way to relay information as it pertains to all things cosmetic surgery.

One thing that has been on my mind a great deal lately is the new-ish ‘gummy bear’ implant. This is also often referred to as a ‘shaped’, ‘anatomic’ or ‘tear drop’ implant. These implants are slightly firmer than the standard ‘smooth, round’ options that we as plastic surgeons have been using for the past 10 years or so. However, this new design allows for much greater control (in my hands) of the final breast shape. For some types of patients this can actually help to achieve a far better result than the standard round implants. A great example of this is in our photo gallery.

Not only do I feel we can achieve a better breast shape for many cases, but, I also feel that the special surface of these implants (called ‘texturing’) helps prevent implant related complications such as bottoming out, high riding position, lateral drift and ‘capsular contracture’ (which is where the tissues around the implant can get hard). Because of this I am predicting that by 2016 I will be using close to 100% textured implants. In cases where we feel a round implant would be better than the tear drop design I will be offering a textured round device as my preferred option (for the reasons listed above). Stay tuned for my next blog post coming up soon!

Is a Revision of Silicone Breast Implant Surgery Advisable?

Question: Is a revision of silicone breast implant surgery advisable?

In 2006 I got silicone breast implants and a breast lift. In 2009 I had a mammogram and was told the implants were not positioned correctly. They are not in a “pocket”, instead, they are positioned sideways of the breast not in the front. I want to have a tummy tuck in the near future and wonder if it would be advisable to have a revision of the implants at the same time. Will the original implants be reused or should I get new ones?

Answer: Combining the procedures is do-able

Assuming there is no health issue that would preclude you from having a surgery that would last 4-5 hours, it would be a good time to perform the breast revision at the same time as the tummy tuck.

However, the first thing to do is get examined by a plastic surgeon board certified by the American Board of Plastic Surgery to figure out what type of revision is necessary. It is difficult to figure that out based on a mammogram.

Can Under the Muscle Implants Be Moved to Over?

Question: Can Under the Muscle Implants Be Moved to Over?

I am 5’8″ in height and weighing 138 lbs. I’m in good shape–I jog, do push ups, and light weights. I’ve nursed 3 children for the last 5 years. I have 425 cc implants placed partially submuscular a year ago. The slightest flex of chest muscle makes my breasts appear unnatural. It makes the implants move upward while the bottom part ripples out. It’s becoming more obvious over time. Overall, my breasts look natural and pleasant when the muscle is relaxed. But to keep this from worsening, can one go from under the muscle implants to over?

Answer: Definitely possible, but, is it the best idea?

A ‘plane switch’ from behind to in front of muscle is do-able. However, the long term result could be compromised with excessive stretching, etc. There is a technique called ‘subfascial placement’ which is ‘sort of’ above muscle, but, might help prevent the above muscle downsides. The place I would suggest looking into would be Dr. Richard Baxter in Seattle. Whenever I come across a consult that I feel could be better served by one of my colleagues I am happy refer there.

Uneven Nipples After Breast Augmentation and Lift

Question: Uneven Nipples After Breast Augmentation and Lift

Uneven-nip

I had breast lift and implants (200 cc, 1 cup size bigger, age 26, no kids) 2 weeks ago, and my nipples look like something out of a child’s coloring book. They’re completely uneven, choppy, and not at all near perfectly circular. Will these eventually fix themselves? I also thought the breasts would be higher. Does this look like a well executed lift?

A: Too early to tell

This is actually a very good result. You will be amazed at how much things soften and smooth out/even out over the first 3-6 months. Things can be quite easily revised later on if necessary, but, based on the photos, you are right on track 🙂

How Much Does Breast Implant Revision Cost?

Question: I had Breast implants done 1 year ago and I think one has bottomed out. What’s an average price? I had 430cc’s under the muscle.

revision-blog

Answer: revisions are unfortunate, but, are a part of all of our practices

This is definitely something that I see and tell all of my pre-op patients that this is one of the risks of this surgery. I actually do not charge anything in the first year post-op for any revision. However, this is a bit unusual. Most docs here will waive the surgeon’s fee and still charge for the facility fee, anesthesia, etc. Your best bet is to return to the original surgeon to discuss the options.

Areolar Incision After Breast Lift

Question: There’s a “hole” around my areolar incision after Breast Lift, Is this normal? (photo)

aereola

Keep in mind that I am quite pale and even the smallest scrapes look red and terrible when I get hurt! That being said, I had a breast lift done exactly 3 weeks ago and now notice this spot around my areolar incision. I had something similar underneath my breast last week which has since cleared up. Does this look alarming or should it heal on its own as the other “hole” did?

Answer: Not uncommon

I generally tell all patients to expect some minor wound healing issues at the top and bottom of the vertical incision after a breast with with implants. They generally are extremely small in nature but sometimes can get quite large especially in smokers At this point, I assume your plastic surgeon is actively involved. However, this is likely a situation that would only require a topical antibiotic cream and extra healing time. In the end, it should look very good.

Silicone Implants with Lift, Too Big?

Question: 425 cc High profile silicone implants with lift, too big? Measurements and pics attached.

blog-question

I was very persistent on getting the mod plus 371 but my surgeon said that I would benefit from the 425 Hp due to my loss of volume. (With circumareolar lift) 36 years old, 5’8″ tall, 125lbs. Breast fed for over a year. Currently deflated A-B cup. I am active, gym, weights, yoga, surfing. Measurements/ pics attached. Every body is different, we have different starting points, my starting point is with very deflated breasts. He said that the 425 hp won’t look too big because of my volume loss.

Answer: Needs more than a Benelli

I personally feel that, in order to get the best result, you would need more than just the circumareolar lift.

In my opinion, you need at least the lollipop scars if not more. I would highly recommend asking your surgeon to review with you photos of women with similar anatomy. This is very much surgeon dependent. In my experience, the circumareolar lift does very little actual ‘lifting’.

How Can My Asymmetry Be Fixed And Do I Need A Lift?

Question: Follow up to my previous question: How can my asymmetry be fixed and do I need a lift?

asymmetry

I asked if I need a lift previously and posted a side view to hide my tattoos. Most Doc comments requested front view. Sorry for the scarf! Might as well ask how to address my asymmetry as well. What procedures do you recommend? I will be scheduling my breast aug for next summer when I find the right doctor.

A: Breast Asymmetry

Thanks for the question. A few things to consider. Based on the photo, it does not look like the left side needs a lift. The right side very well may need it. I always tell my patients, with pre-op asymmetry, to really expect asymmetry post-op despite all of our efforts. However, you still should like the final results.

Another thing to consider is checking out an office that uses the 3D imaging (like ‘Vetra’) which can give you an idea of what to expect with just implants. Best thing to do is ask the surgeon to show specific examples of before and afters of patients with similar asymmetries.

Should I get a Benelli Lift?

Question: I scheduled for a Benelli Lift and 600cc Implants…..good idea?

breast-blog

I’ve always had some droop to my breasts….now after 3 kids I want to have a pair to be proud of! One dr said a vertical scar lift with 500cc gummy bear implants and the other 2 I went said a benelli lift with 600cc implants…I wear a D cup bra already…

Answer: Benelli?

The Benelli lift is a procedure that is loved by some surgeons, disliked by most (in my area, at least). The problem is that the (IMO) the benelli doesn’t really ‘lift’ anything. I feel it’s best for circumferential skin removal without really moving the nipple that much.

In your case, my guess is that you want the breasts as high and full as possible. In my hands, this would definitely require a vertical scar. Additionally, whenever I contemplate a breast lift with implants that big I always have the discussion with the patient as to the increased risk of complications. Many surgeons would suggest doing the lift or implant first f/b a 2nd stage.

One thing to consider is to ask for specific before and afters with each of those surgeons on cases with a similar anatomy.

Am I a Candidate for Breast Augmentation?

Question: I have lost all volume. Am I a candidate for breast augmentation, lift, and areola reduction?

aug-blog

I’m 5’6. A cup. 110 lbs. I would like to know what my options are and if I could have a nice result before I waste money and time going to see doctors. I would like to have full round (flattish) closer together breast. I’ve had kids and they’ve just got worse over the years. Thank you.

Answer: Breast augmentation will probably work out great here

With those photos it doesn’t appear that a lift would be necessary. Rather a breast augmentation without the lift would likely be the best option.

As far as the areolar reduction, that is a possibility, but, with the implant in there you may not need it. Plus, that is an extra scar that might not turn out great.

Best thing is to look at multiple before and after photos of the surgeons you are researching. Also, check out 3D imaging with the Vectra (only available at select offices).