In the 1980s, the models of the Third and of the Fourth generations of breast implant devices were sequential advances in manufacturing technology, such as elastomer-coated shells that decreased gel-bleed (filler leakage), and a thicker (increased-cohesion) filler gel. Sociologically, the manufacturers of prosthetic breasts then designed and made anatomic models (natural breast) and shaped models (round, tapered) that realistically corresponded with the breast- and body- types of women. The tapered models of breast implant have a uniformly textured surface, which reduces the rotation of the prosthesis within the implant pocket; the round models of breast implant are available in smooth-surface- and textured-surface- types.
Hello and thanks for your post and questions. It seems that you would potentially be a fantastic candidate to have a breast reduction and lift using the Bellesoma technique with NO vertical scar! With this technique you should be able to reach a smaller,  but perky and proportional breast size that fits your frame along with achieving upper pole fullness. You've provided great information - the only thing that would be more helpful in order to give you the best advice about your options would be an in-person exam.

The presence of radiologically opaque breast implants (either saline or silicone) might interfere with the radiographic sensitivity of the mammograph, that is, the image might not show any tumor(s) present. In this case, an Eklund view mammogram is required to ascertain either the presence or the absence of a cancerous tumor, wherein the breast implant is manually displaced against the chest wall and the breast is pulled forward, so that the mammograph can visualize a greater volume of the internal tissues; nonetheless, approximately one-third of the breast tissue remains inadequately visualized, resulting in an increased incidence of mammograms with false-negative results.[102]
Case 38: This beautiful young lady is an early 6 month example of a finesse rhinoplasty. On front view you can see the bridge is narrower and the sense of hang is improved. On profile, the tip looks undone, natural and less projected with correction of the slight hanging columella. The result is a beautiful, natural look that corrects the issues but leaves her looking totally natural and undone.
By the next day, I was looking more like a monster and didn't want to see anyone. The bruises around my eyes shined a bright greenish-purple, and I was swollen all over with some intense pressure in my head. I couldn't breathe through my nose anymore, because of all the blood and swelling. I felt congested and uncomfortable, almost like I had a bad cold, but again, nothing Tylenol couldn't handle. But I fully expected this, as Dr. Kolker said it could take two weeks for everything to run its course.
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.
My roommate, Kelsi, who's also my childhood best friend, came with me to Dr. Kolker's office. After a few final checks, Dr. Kolker took more pictures, then marked up my nose. He said people generally puff up under anesthesia, and things can get distorted, so this, in his words, "helps keep him honest." A nurse led me into the OR, and the last thing I remember before going under was this feeling of deep gratitude and thanking everyone there for playing a part in helping me feel better about myself.

A breast reduction typically includes a lift.  However, a lift does not necessarily require a reduction.  Both operations have similar incision patterns and resultant scars, but they have different indications.  One of the first questions I ask a patient who desires an improved appearance of her breasts is if she would like to be the same size, smaller, or larger.  The patient who wants to be the same size and is happy with her breasts when wearing a bra but unhappy with the amount of sagging without a bra is a candidate for a breast lift alone.  The patient who desires to be smaller or has one breast noticeably larger than the other, is a candidate for a breast reduction-lift combination.  Sometimes patients feel their breasts look smaller after removal of the excess skin with the lift even though no breast tissue was removed; the reason for this is that some of what fills your bra cup is excess skin.  The patient with sagging who desires to have larger breasts is a candidate for a breast lift with implants.


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.
Case 26: Narrowing a wide tip can really soften the face. The challenge in Ethnic rhinoplasty is in making a nose smaller while still maintaining good structure and support so that definition is enhanced. In these 15-month photos, you can now see how tip narrowing along with reduction of the bridge convexity has created a very pretty, feminine nose that enhances her beauty.
Many different types of breast lifts are now available in conjunction with a breast reduction, including lifts just around the areola (periareolar), vertical/lollipop mastopexies (incision around the areola and down to the breast fold, and full breast lifts with an anchor incision. For patients who have very loose skin in the armpit or back, axillary or bra lifts are also often combined with breast reductions.
Manufacturer’s warranty programs can mitigate some of the costs of treating complications. But, the warranty payment is only available if a rupture is detected. Some surgeons fail to inform their patients of the need for periodic MRIs, or downplay the FDA recommendation in order to make a sale. “Many women don’t know about the maintenance costs and potential expenses of silicone gel implants,” reports Dr. Ellen Mahony, board-certified plastic surgeon in Westport, CT.  “Because rupture with a silicone gel implant is ‘silent,’ it can go undetected for an extended period, often not becoming obvious until the process of capsular contraction has begun.” Capsular contraction leads to a more complex surgery. That means added surgical costs which your warranty may not cover.
Case 61: The concerns in this case were crookedness and a significant breathing issue due to a severely deviated septum. She also felt her nose was over-projected and a little too big for her face. Here we can see resolution of her crooked septum on base view. The tip has been defined and de-projected and the bump brought down to create a naturally pretty and more balanced contour.
Facial fat transfer: If you have facial creases, such as laugh lines, smile lines, and crow’s-feet, fat can be removed from your abdomen, thighs, or other areas and be injected into your face. Acne scars and sunken areas of the face, lips, and cheeks can also be filled in. Your plastic surgeon can even use grafted fat to minimize lines between your nose and mouth, correct skin depressions or indentations and minimize forehead wrinkles.
The FDA has identified that breast implants may be associated with a rare form of cancer called anaplastic large-cell lymphoma, believed to be associated with chronic bacterial inflammation.[69] Similar ALCL phenomena have been seen with other types of medical implants including vascular access ports, orthopedic hip implants, and jaw (TMJ) implants. As of February 1, 2017, the FDA has received a total of 359 medical device reports of breast-implant-associated ALCL (BIALCL), including 9 deaths.[70] Most cases of breast implant-associated ALCL had implants in for many years prior to the condition, and are usually treated successfully by simple removal of the implant and the capsule surrounding the implant without the need for chemotherapy if no evidence of systemic disease exists. If women with implants present with delayed swelling or fluid collection, cytologic studies and test for a marker "CD30" are suggested. The American Society of Plastic Surgery (ASPS) states, "CD30 is the main diagnostic test that must be performed on the seroma fluid as routine pathology or H&E staining can frequently miss the diagnosis." [71] Diagnosis and treatment of breast implant associated ALCL now follows standardized guidelines established by the National Comprehensive Cancer Network.[72]
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