If you have considerable sagging, pendulous breasts, an anchor lift, which allows a cosmetic surgeon to remove a significant amount of excess skin and sagging tissues, may yield the best results. This technique involves 3 incisions: one around the edge of the areola, one vertically from the bottom of the areola to the breast crease, and one along the inframammary fold, hidden in the breast crease. Your cosmetic surgeon may also use this technique if you are having a breast reduction with lift. While the anchor lift comes with some visible scarring, these typically will fade significantly with proper care, and are easily hidden by a bikini top.
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.
Silicone implant rupture can be evaluated using magnetic resonance imaging; from the long-term MRI data for single-lumen breast implants, the European literature about second generation silicone-gel breast implants (1970s design), reported silent device-rupture rates of 8–15 per cent at 10-years post-implantation (15–30% of the patients).
The fat transfer procedure is fairly similar for all areas of the body, by taking fat from one area of your body, usually your stomach, buttocks, or thighs, through Liposuction, and then transferring it to a desired area. You will not only gain in one area, but lose in another area that you would like to. While the procedure is basically the same for all, the information below will explain how each area will show improvement.
The Summary of Safety and Effectiveness for each of the FDA-approved saline- and silicone gel filled breast implants details safety information known at the time of FDA approval. As the FDA learns of new safety information, it requires companies to update their product labeling. The most current safety information about saline- and silicone gel-filled breast implants can be found in the labeling.
Case 37: Achieving a beautiful, natural change in an already beautiful woman is one of the great challenges we love in rhinoplasty. In front view you see a beautifully defined, natural change that simply looks great. Then on profile and 3/4 views, you see an elegant change where the tip is deprojected (made smaller) but retains a beautiful, natural aesthetic- this is finesse rhinoplasty.
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.
Structured implants were approved by the FDA and Health Canada in 2014 as a third form of breast implant. Structured implants incorporate both saline and silicone gel implant technology. The filler is only saline solution in case of rupture and has a natural feel like silicone gel implants. The implant uses an internal structure which consists of a series of nested shells that support the upper pole with the two lumen being filled with only saline. The implant is inserted empty and then filled once in place which requires less of an incision than pre-filled implants. If one of the lumen of the structured implant ruptures, it leaks and empties. The other lumen remain intact and the implant only partially deflates, allowing for ease of explant and replacement.
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.
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.
Because you’re injecting your body with something produced by your body, some people consider it “natural” plastic surgery, and it’s increasing in popularity. Breast augmentation using fat transfer increased 72 percent in 2016 while buttock augmentation using fat transfer increased by 26 percent, according to the American Society of Plastic Surgeons.
Subglandular: the breast implant is emplaced to the retromammary space, between the breast tissue (the mammary gland) and the pectoralis major muscle (major muscle of the chest), which most approximates the plane of normal breast tissue, and affords the most aesthetic results. Yet, in women with thin pectoral soft-tissue, the subglandular position is likelier to show the ripples and wrinkles of the underlying implant. Moreover, the capsular contracture incidence rate is slightly greater with subglandular implantation.
A fat grafting procedure, or fat injection, transfers fat from areas in which you have excess fat, such as the outer thighs, and injects it into areas that may be lacking in volume, such as your face, hands, breasts or buttocks. This safe, long-lasting, well-tolerated procedure produces natural-looking results. Every year, thousands of people undergo successful fat grafting and are pleased with the results.
A breast lift involves both repositioning the nipple higher on the chest wall and reshaping the breast. A breast reduction does the same but also removes breast tissue to make the breasts smaller. If you are considering a breast reduction with lift or breast lift alone, I would recommend an in-person consultation with a plastic surgeon to allow for a thorough physical examination and a detailed discussion regarding your options to determine the best treatment plan for you. Best of luck!
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.
For the first part, even though you did not post photos, based on your height and weight you would have plenty of fat to be able to take in my opinion. The relative limit on how much can be removed and send you home the same day safely is about 5 liters of liposuction/fat. I think you would easily be able to get to this upper limit based on your height and weight.
Both saline-filled breast implants and silicone-filled implants have an outer shell composed of silicone elastomer. This shell is basically a flexible envelope that contains the implant filling. In the case of some anatomically shaped implants, the shell also gives the implants shape. Some models of implants have a "double lumen." This is an elastomer envelope inside of another elastomer envelope (sort of like double-bagging your groceries) which may reduce the risk of implant rupture.
The ARTOURA™ Breast Tissue Expander or CONTOUR PROFILE® Breast Tissue Expander can be utilized for breast reconstruction after mastectomy, correction of an underdeveloped breast, scar revision, and tissue defect procedures. The expander is intended for temporary subcutaneous or submuscular implantation and is not intended for use beyond six months. Do not use the ARTOURA Tissue Expander nor CONTOUR PROFILE® Tissue Expander in patients where an MRI may be needed. The device could be moved by the MRI causing pain or displacement, potentially resulting in a revision surgery. The incidence of extrusion of the expander has been shown to increase when the expander has been placed in injured areas.
In 1998, the U.S. FDA approved adjunct study protocols for silicone-gel filled implants only for breast reconstruction patients and for revision-surgery patients; and also approved the Dow Corning Corporation's Investigational Device Exemption (IDE) study for silicone-gel breast implants for a limited number of breast augmentation-, reconstruction-, and revision-surgery patients.
During your initial consultation, you will have the opportunity to discuss what you want to achieve. Your surgeon will evaluate you as a candidate for fat grafting and clarify what fat grafting can do for you. Once the surgeon understands your goals, he or she may suggest additional or related procedures. It is important to be completely honest during the consultation. Bring several photos of yourself at an earlier age; they may serve as a good point of reference for discussing your goals. It’s a good idea to be fully prepared to answer these questions:
The breast cancer studies Cancer in the Augmented Breast: Diagnosis and Prognosis (1993) and Breast Cancer after Augmentation Mammoplasty (2001) of women with breast implant prostheses reported no significant differences in disease-stage at the time of the diagnosis of cancer; prognoses are similar in both groups of women, with augmented patients at a lower risk for subsequent cancer recurrence or death. Conversely, the use of implants for breast reconstruction after breast cancer mastectomy appears to have no negative effect upon the incidence of cancer-related death. That patients with breast implants are more often diagnosed with palpable—but not larger—tumors indicates that equal-sized tumors might be more readily palpated in augmented patients, which might compensate for the impaired mammogram images. The ready palpability of the breast-cancer tumor(s) is consequent to breast tissue thinning by compression, innately in smaller breasts a priori (because they have lesser tissue volumes), and that the implant serves as a radio-opaque base against which a cancerous tumor can be differentiated.
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.
Breast reconstruction with fat grafting: If you have breast defects following lumpectomy for breast cancer, fat grafting is an effective method for filling in these defects. Fat grafting is also an option for total breast reconstruction following mastectomy; however, to achieve sufficient breast volume, this is usually a multistage process that requires at least two to four sequential fat grafting procedures.
When you're in the thick of the recovery, it seems like you're going to look and feel that way forever. But honestly, I moved through it so quickly. Days two and three were the toughest, but witnessing my body heal like that was pretty incredible. Each day, I looked considerably different from the day before, which is strange — you really can't get too attached to any one image in the mirror because you know it's still evolving.
Case 22: This young woman was happy with her profile but wanted to reduce nasal width, tip boxiness, and nostril flare on front and three-quarter views. The combination of narrowing her bridge, tip refinement, and nostril reduction helped bring her nose into balance. At the same time, fat transfer to the under eye hollows did a fantastic job of brightening her eyes and giving her a more youthful look.
In some cases, a breast lift alone may not achieve a patient’s desired results. If you feel your breasts look “deflated” or have lost volume due to aging, weight loss, or pregnancy, your cosmetic surgeon can place breast implants during breast lift surgery to restore fullness and shape to the breast. If you have always wanted larger, lifted breasts, a breast augmentation with lift can help you achieve both with a single procedure and recovery.
Saline-filled Breast Implants. Saline-filled breast implants are filled with sterile saline (salt water). They come in both smooth and textured shells and can be round or anatomically (tear-drop) shaped. Saline breast implants are also available in low and high profiles, and in many sizes. A saline-filled breast implant is usually empty before implantation. The doctor moves it into place during your surgery, and then fills it. The saline is administered via a process that ensures the implants remain sterile.
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.
Breast reduction surgery will take about two to five hours, sometimes longer. Your surgeon will make a cut around your nipple then downward on the breast in the form of a keyhole. The operating team will remove extra skin, tissue, and fat from your breasts and reposition your nipple. Your surgeon may use drainage tubes and then stitch up your breasts and wrap them in a special gauze. You may also need to wear a surgical bra.
4. Last but not least, your preference matters a lot! Before surgery, I ask my patients to bring photos of buttock shapes that they like. This helps me understand how much of a buttock size increase and shape each patient desires. Some patients like a more curvy, rounded shape with wide hips (hour-glass figure) while others prefer a more projected or athletic shape. Your preference of buttock outcome is a very important factor in the decision of how much fat is transferred, so I spend a lot of time with each patient before surgery to understand your goals and express what I think can be achieved. Good communication between patient and surgeon is very important to achieving optimal surgical outcomes.
Of course, the breast reduction vs. breast lift question is not really cut and dry because every woman is unique. You may be unsure of what volume you would like with the breasts in a more favorable position. Breasts may be different sizes (asymmetric). The position of the nipple may be out of proportion to the amount of breast sag. Breasts may be ‘deflated’ after pregnancy. You may have heard that breast implants are the only reliable way to lift breasts. These questions can easily be addressed at the time of your consult.
Am I happy with my breast size when wearing a bra? A breast lift alone will not significantly change the size of your breasts. It can help your breasts look fuller, rounder, and better in a bra, but if you would like your breasts to be larger or smaller, a breast lift in conjunction with a breast augmentation or reduction may be the right option for you.
This photo gallery represents a cross-section of my rhinoplasty practice and includes patients of different age, gender, nasal shape, and ethnic background. This gallery is not a collection of my best rhinoplasty outcomes, but rather a representative sampling of my typical cosmetic result. In addition, a majority of these patients also had simultaneous correction of severe nasal breathing difficulties, which cannot be appreciated in photographs.
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.
Cosmetic surgeons may use the “crescent lift” technique for women who have a very small amount of sagging to correct. This involves a small incision running halfway around the top half of the edge of the areola. Usually, a crescent lift is only done when a patient is also having breast augmentation, and even in these cases the crescent incision type is less frequently used.
For detailed indications, contraindications, warnings, and precautions associated with the use of all MENTOR® Implantable Devices, which include MENTOR® Saline-filled Implants, MemoryGel® Implants, MemoryShape® Implants, ARTOURA™ Expanders, and CONTOUR PROFILE® Expanders, please refer to the Instructions for Use (IFU) provided with each product or visit www.mentorwwllc.com.
Case 71: Tip and nostril width and overall nasal projection made the nose feel dominant for this young woman. Rhinoplasty involved making her whole nose smaller by deprojecting, refining the tip, and removing some nostril flare. At the same time, a nasal fracture and breathing concerns were addressed. Neck Liposuction also helped to define and re-balance her jawline to create the improved facial proportions that she desired.
One of the main factors that influences how much breast implants cost is whether you choose silicone or saline breast implants. Saline implants cost between $800 and $1,000. Silicone cost between $1,800 and $2,000. On average, silicone implants cost up to $1,000 more than saline implants. While the prices of implants are set by the implant manufacturer, you can always expect that your procedure will cost more if you choose silicone over saline. Newer implant designs, such as IDEAL® implants, also tend to cost more. IDEAL implants, in particular, cost more because they are designed with a special shell that prevents silent rupture. Implant surgery costs by type
A curvature and droopy tip brings undue focus to this young man’s nose. Although there is still some swelling in these early post-operative photos, we can already see a nose that is now straight, has a smooth profile and no longer droops. A sense of length is preserved to match his oval face. More than that, because of these positive changes, he also looks younger.