Breast reconstruction may be performed after mastectomy, to rebuild injured or congenitally deformed breasts, or as part of gender reassignment surgery. As part of the reconstruction process, a breast tissue expander may be used to stretch the patient's tissue for insertion of an implant or the patient's own tissue. Tissue expanders are like thick-walled silicone balloons, come in different sizes and shapes, and may have a smooth or textured outer surface. They are implanted under the breast skin, tissue, or chest muscle, and are regulated by the FDA as medical devices. In immediate reconstruction, the expander is inserted immediately following mastectomy. For patients who choose delayed reconstruction, the expander is implanted in a separate surgery months or years later.
Because a breast implant is a Class III medical device of limited product-life, the principal rupture-rate factors are its age and design; Nonetheless, a breast implant device can retain its mechanical integrity for decades in a woman's body. When a saline breast implant ruptures, leaks, and empties, it quickly deflates, and thus can be readily explanted (surgically removed). The follow-up report, Natrelle Saline-filled Breast Implants: a Prospective 10-year Study (2009) indicated rupture-deflation rates of 3–5 per cent at 3-years post-implantation, and 7–10 per cent rupture-deflation rates at 10-years post-implantation.
In 2006, for the Inamed Corporation and for the Mentor Corporation, the U.S. Food and Drug Administration lifted its restrictions against using silicone-gel breast implants for breast reconstruction and for augmentation mammoplasty. Yet, the approval was conditional upon accepting FDA monitoring, the completion of 10-year-mark studies of the women who already had the breast implants, and the completion of a second, 10-year-mark study of the safety of the breast implants in 40,000 other women. The FDA warned the public that breast implants do carry medical risks, and recommended that women who undergo breast augmentation should periodically undergo MRI examinations to screen for signs of either shell rupture or of filler leakage, or both conditions; and ordered that breast surgery patients be provided with detailed, informational brochures explaining the medical risks of using silicone-gel breast implants.
In general, silicone-gel-filled implants are smoother, softer and feel more like natural breast tissue than their saline-filled counterparts. Silicone implants feel like a semisolid gel, while saline implants are often likened to water balloons. Silicone-gel implants are also less likely to wrinkle and ripple than saline breast implants. Wrinkling is actually considered one of the major disadvantages of saline implants. The thinner the woman and the less breast tissue she has, the more likely the saline implant's crinkles and wrinkles will be felt and even seen.
In addition to the financial cost of breast implants, women need to be aware of the emotional cost when asking how much do breast implants cost. Not knowing the status of their implants can take a toll on woman’s peace of mind. Recent survey findings* showed over 98% of women reported feeling concerned about silent rupture, including many women who already had silicone gel implants. When rupture is detected, it can result in feelings of insecurity and anxiety, as they don’t know how long it has been going on or whether they could have found out sooner. Both the worry and reality of silent rupture take a real toll on a woman’s overall well being, yet too many women don’t have all the facts before making a decision about their choice of implant.
In surgical practice, for the reconstruction of a breast, the tissue expander device is a temporary breast prosthesis used to form and establish an implant pocket for the future permanent breast implant. For the correction of male breast defects and deformities, the pectoral implant is the breast prosthesis used for the reconstruction and the aesthetic repair of a man's chest wall (see: gynecomastia and mastopexy).
Case 29: Major concerns for this patient were widening of the tip with a marked lack of projection which made his nose feel flat and washed out. Nostril thickness and rounding was also something he wanted addressed. In this case, irradiated donor rib cartilage was used to project and support the tip along with alar base reduction removing a significant amount of nostril flare to create a natural tip and nostril contour that is ethnically appropriate. Fat transfer to the cheeks helps to balance out his flat mid-face to strengthen the cheek contour which can be seen nicely on the profile view.
Saline-filled breast implants contain a silicone outer shell filled with a sterile saltwater (saline) solution. Some are pre-filled and others are filled during the implant operation. Saline-filled implants come in different sizes and have either smooth or textured shells. The FDA approved saline-filled breast implants for breast augmentation in women age 18 or older and for breast reconstruction in women of any age. They are also used in revision surgeries, which correct or improve the result of an original surgery.
The main advantage of an open surgery, he said, is that it increases exposure of the anatomy for improved visualization, which allows the doctor to be more precise in his surgical maneuvers, and eliminates a key risk associated with the closed rhinoplasty, which is a distortion of the results when instruments are retracted through the nostrils. He believed the open method would be safest and most effective for me since he’d essentially be reworking my entire nose — refining not just the bridge but the tip as well.
Case 39: The facial plastic surgeons at PROFILES Beverly Hills tailor every Rhinoplasty to achieve just what you are looking for. Sometimes, the most subtle of changes take just as much effort as the most dramatic ones. This pretty model didn’t want to drastically change her look. Her Los Angeles Finesse Rhinoplasty gave her the refinement she wanted, especially on her front and three-quarter views. Along with fat transfer to the lower eye area, her overall look was softened to make her that much more camera ready.
If you’re researching “how much do breast implants cost,” chances are you are imagining all the benefits they offer. Breast augmentation is the top cosmetic plastic surgery procedure performed in the United States for a reason. Breast augmentations have a high rate of patient satisfaction according to research. In a study published in the May 2013 issue of Plastic and Reconstructive Surgery, researchers gathered information from 225 women after their breast augmentations. The study revealed that 91.1% of women felt improved self-esteem, 64.3% had an improved quality of life, and 98.7% would repeat the surgery. But there is another side to breast implants, one you should know about before scheduling your plastic surgery consultation. While the initial costs and satisfaction rates are similar between implant types, the long-term maintenance costs and emotional toll differs in important ways. Silicone gel breast implants carry a high rate of certain complications and an increased anxiety when compared to the newest breast implant on the market, IDEAL IMPLANT® Structured Breast Implants.
The procedure is accomplished by using the skin of the lower pole of the breast (the part below the nipple that sits in the bra cup) to shape the whole breast into a perky dome, then straps are made of the extra skin, anchoring it to the underlying chest muscle so that there is virtually no chance of repeat sagging. The skin that above your nipple and below your collar bone is utilized to cover the perky, lifted dome that has been created and then a new (usually smaller) circular opening for the areola is placed at the high point of the cone, creating your new lifted, full and shapely breast.
Case 21: For our patients who are in image-centered occupations such as modeling or acting, nasal refinements often focus on small changes that will enhance the overall look and remove subtle cues about the nose that preoccupy or distract the eye. This successful model had a look that really worked for her but had always felt that her tip and nostrils were too wide, flared, and slightly droopy. Creation of a slightly narrower and more structured tip draws unwanted attention away from her nose and, instead, enhances her overall look.
The IDEAL IMPLANT Structured Breast Implant is often compared to silicone gel breast implants because they both offer beautiful, natural looking results. But, beyond the aesthetic comparisons, the IDEAL IMPLANT Structured Breast Implant and silicone gel breast implants are very different. The IDEAL IMPLANT Structured Breast Implant is filled with saline for a woman’s peace of mind. Saline is naturally absorbed by the body in case of a rupture, and a rupture can be easily detected by simply looking at the breasts. Without silicone gel inside there is no need for repeated MRIs and no anxiety about silent ruptures. The risk of complications such as rupture and capsular contracture are also much lower with the IDEAL IMPLANT based on clinical trial results at 8 years. That means the cost of your primary breast augmentation is likely the only cost you need to consider when asking how much do breast implants cost.
Case 43: Rhinoplasty in this pretty professional woman was all about removing the bump she had hated for years and correcting the tip droop and asymmetry that had worsened with age. Relatively small changes here have created a real sense of refinement while maintaining her long, elegant profile. A lower face and neck lift along with facial fat transfer helped to round out the enhancements in her already beautiful appearance.
Deciding how much fat to transfer to a patient’s buttocks is a decision made by the surgeon that takes safety, cosmetic result, and patient’s goals into account. I recommend reviewing your goals of surgery, by showing photos, or performing Vectra imaging in office, with your surgeon and listening to their recommendations for the safest, best-looking results possible.
When Kelsi took me home shortly after I woke up, I felt fine. We talked and watched TV, then I dozed off for a bit. I couldn't stay awake for more than an hour or two before needing to rest. My throat was raw from the breathing tube. And it hurt to laugh. When the hospital meds wore off, I had a full-on headache, almost like severe caffeine withdrawal. But the discomfort never got so bad that I needed Percocet; Tylenol alone made it manageable. That first night, I thought I'd sleep terribly, but I was out cold from 9:30 p.m. to 6 a.m. It was tricky settling in, though, because I had to sleep with my head propped up on several pillows to minimize swelling, which isn't exactly easy for a side sleeper.
Does the nipple/areola sit below the crease underneath my breast? One trait cosmetic surgeons frequently look for when evaluating a breast lift candidate is the position of the nipple/areola in relation to the inframammary fold, or crease beneath the breast. Try this test: slide a plain sheet of paper underneath your breast (no bra) so it sits against the breast crease. When looking in the mirror, do your nipples sit below the top edge of the paper? If so, this is a good indication that you have enough sagging to warrant a breast lift.
Make sure your cosmetic surgeon is board certified; this ensures that he or she is specifically trained and experienced in cosmetic surgery and that your procedure will take place in an accredited facility, which is essential for your safety. Finally, don’t choose a cosmetic surgeon based on price alone. Your safety & results are too important. Most cosmetic surgeons offer financing options to help patients budget procedure costs.
The surgical scars of a breast augmentation mammoplasty develop approximately at 6-weeks post-operative, and fade within months. Depending upon the daily-life physical activities required of the woman, the breast augmentation patient usually resumes her normal life at 1-week post-operative. Moreover, women whose breast implants were emplaced beneath the chest muscles (submuscular placement) usually have a longer, slightly more painful convalescence, because of the healing of the incisions to the chest muscles. Usually, she does not exercise or engage in strenuous physical activities for approximately 6 weeks. During the initial post-operative recovery, the woman is encouraged to regularly exercise (flex and move) her arm to alleviate pain and discomfort; if required, analgesic indwelling medication catheters can alleviate pain Moreover, significantly improved patient recovery has resulted from refined breast-device implantation techniques (submuscular, subglandular) that allow 95 per cent of women to resume their normal lives at 24-hours post-procedure, without bandages, fluid drains, pain pumps, catheters, medical support brassières, or narcotic pain medication.
Case 94: This patient was seeing the early signs of facial aging including loss of skin tone and elasticity, early jowling, and heaviness under the chin. A lower facelift along with fat transfer to the under eye and cheek area substantially improved the contour and even apparent texture of her skin, making her look noticeably younger. In addition, the overall effect was completed with a rhinoplasty focused on reducing the width, rounding, and thickness of her tip and nostrils which is a challenge in the setting of thick skin.
In the early 1990s, the national health ministries of the listed countries reviewed the pertinent studies for causal links among silicone-gel breast implants and systemic and auto-immune diseases. The collective conclusion is that there is no evidence establishing a causal connection between the implantation of silicone breast implants and either type of disease. The Danish study Long-term Health Status of Danish Women with Silicone Breast Implants (2004) reported that women who had breast implants for an average of 19 years were no more likely to report an excessive number of rheumatic disease symptoms than would the women of the control group. The follow-up study Mortality Rates Among Augmentation Mammoplasty Patients: An Update (2006) reported a decreased standardized mortality ratio and an increased risk of lung cancer death among breast implant patients, than among patients for other types of plastic surgery; the mortality rate differences were attributed to tobacco smoking. The study Mortality Among Canadian Women with Cosmetic Breast Implants (2006), about some 25,000 women with breast implants, reported a 43 per cent lower rate of breast cancer among them than among the general populace, and a lower-than-average risk of cancer.
By and large, there is no 'perfect type' of breast implant. What looked stunning on one of your best friends doesn't necessarily mean that the same implant will be the best choice for you. This is why we recommend face-to-face consultations; an honest discussion with an experienced, knowledgeable plastic surgeon about your desired enhancement is a must. And you'll want to consider your surgeon's opinion and recommendations based on your existing body type and physical assessment.
After reviewing the medical data, the U.S. Food and Drug Administration concluded that TDA-induced breast cancer was an infinitesimal health-risk to women with breast implants, and did not justify legally requiring physicians to explain the matter to their patients. In the event, polyurethane-coated breast implants remain in plastic surgery practice in Europe and in South America; and no manufacturer has sought FDA approval for medical sales of such breast implants in the U.S.