Posts Tagged ‘breast augmentation’
Monday, April 12th, 2010
Q: I am interested in getting breast implants. I am 34 years old, have had three children and my breasts are just not what they used to be. They are smaller and now droop. They are disgusting to look at and are nothing like they used to be when they were nice C cups and round. I want to get implants so my breasts can look like they did before. Is this possible?
A: The concept of looking like you did before is an understandable one but may not always be possible. The reason is that the breast skin and breast tissue you now have is different than what it used to be.
Women considering breast augmentation almost always fall into two main types; those who have always had little breast tissue whether they have ever been pregnant or not (type 1)…and those women who have lost their natural breasts and have developed droopy smaller breasts due to childbearing and nursing. (type 2) The results of placing a breast implant will be different for each type of patient. Type 1 patients will do fine with a breast implant alone and will often get the more ideal breast shape result. Type 2 patients may need a breast lift in addition to an implant to get a better shape with a good nipple position. It is this consideration of a lift and breast mound scarring that will often catch the Type 2 patient by surprise.
It is important to appreciate what a breast implant can and can not do. Implants do a superb job of making the breast mound bigger. But they have very little ‘lifting’ ability. The only lift effect that can occur is from inflation of the breast mound and this will move the nipple up a little. The operative word here is…a little. Significant movement upward of the nipple for most breast ptosis patients is a matter of at least several centimeters, not millimiters.
Dr. Barry Eppley
Tags: braest ptosis, breast augmentation, breast implants, breast lift, dr barry eppley, indianapolis, plastic surgery
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Friday, April 9th, 2010
Q: Hello, I have a few questions.I’m interested in getting my leftover fat from my entire body put into my boobs. I’d like to get my bmi to be just at 18, although it is at a 20 right now. I was just wondering if anyone would be willing to even work with me since I weigh around 115 and am 5′3″.
A: Breast augmentation using injectable fat rather than a synthetic implant remains in an ‘experimental’ or an investigative phase currently. Since it does not involve an implant and uses your own natural tissue, it is understandable to think that it is a safer and perhaps better procedure.
While fat may be natural, it is not a predictable implant material particularly in the volumes needed for breast augmentation. No standard techniques exist for fat preparation or injection methods and very different results can occur in various hands. At the least, much if not all of the fat can be absorbed rendering it a waste of time. At the worst, the fat may make the breast lumpy with cyst formations or develop sterile pools of liquid fat. What impact fat injections have on mammogram imaging and breast cancer detection remains unknown and not studied.
While much of this discussion sounds negative, the concept of using fat for breast augmentation has appeal and work is ongoing in this area. The only FDA-approved clinical trial that I know of is with the BRAVA system in which injectable fat is stimulated after surgery with an external low-level suction device. Otherwise, any clinical work that is being done is occurring in an independent fashion as an individual-precribed surgery amongst a handful of practitioners.
With the low BMI and body fat that this patient has, she would not be a good candidate for the procedure even if it was proven and widely used. A simple breast implant is so much easier and more predictable that fat injections, which for now, remain as a more complicated and morbid approach for breast augmentation.
Dr. Barry Eppley
Tags: breast augmentation, dr barry eppley, fat injections, indianapolis, injectable breast augmentation, plastic surgery
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Friday, April 9th, 2010
Identity theft is a growing problem that now threatens just about everyone, even if you don’t spend a lot of time online. It is a huge problem with risks that are estimated to place most Americans as having a 1 in 4 chance of being victimized in the next five years. With credit card and social security numbers flying around in cyberspace by the billions, it is a wonder that those risks are not even higher.
Plastic surgery faces its own identity theft problem but of a different nature. In the most noteworthy case of plastic surgery identity theft to date, an American in the Middle East was recently arrested posing as a renowned U.S. plastic surgeon. Shockingly, he had operated on scores of patients in his Dubai villa. There he allegedly performed numerous cosmetic surgery procedures with primitive surgical equipment and lack of any sterile conditions. To no surprise, several of his patients (victims) have suffered serious complications requiring additional surgery and medical care.
This former Oregon physician was impersonating and using the good reputation of a plastic surgeon in Washington, D.C. who performs several surgeries per year at the American Academy of Cosmetic Surgery Hospital in Dubai. Aside from facing legal charges in Dubai, this fake plastic surgeon is wanted in the U.S. by the FBI and Interpol on charges of drug trafficking and numerous other crimes from when he held a medical license in Oregon.
While this identity theft story seems remote and far from the American medical scene, plastic surgery identity theft occurs more regularly here…but it is of a more subtle and insidious nature. With the ongoing erosion of medical fee reimbursements and increasing practice revenues and regulation demands (which is only going to continue to worsen, particularly with the passage of the new Health Care Reform Act), some physicians search for methods of cash only services. No seemingly ‘riper fruit’ currently exists than that of cosmetic services. (although weight loss is a close second) Between public interest and the all-to-willing drug and device manufacturers to sell to anyone with a medical license and a credit card, there is a dearth of cosmetic surgery providers with quite dissimilar education and training backgrounds.
While many of these cosmetic surgery ‘adopters’ are largely involved in office-based injection and laser treatments, some perform invasive surgery which is within their legal right as a licensed physician. As long as you hold a valid medical license, you can do almost anything in your office which is largely unregulated unlike a hospital or surgery center. A great illustration of this phenomenon can be read in the April 7th issue of The New York Times where a California physician (non-plastic surgeon) was interviewed touting his breast augmentation surgery technique under local anesthesia. Claiming that patients can now have a say in the breast implant selection process, he teaches weekend courses to physicians of any background (the articles states mainly family practice and Ob-Gyn docs) who are willing to pay.
The argument that women want to be awake and watch their surgery being performed is fundamentally flawed. I know of no female patients who want to sign up for that experience. But the underlying premise for such surgery under local anesthesia was not revealed in the article. Without proper training and credentials, an uunregulated office environment is the only place he could ever perform such procedures. And without an anesthesiologist, the only option is local anesthesia. Hardly good reasons for choosing a surgical method or even offering the procedure.
Dr. Barry Eppley
Tags: breast augmentation, dr barry eppley, identity theft, indianapolis, plastic surgery, plastic surgery identity theft
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Saturday, April 3rd, 2010
Breast implants are a very common plastic surgery procedure that has not waned in popularity despite the recession. While they are unparalleled in making an instant body change, they have also make news for other interesting and unfortunate reasons. In the past year, these are the noteworthy breast implant stories you may not have read.
This week a California woman was sentenced to six months in jail and required to pay monetary reimbursement for ‘stealing’ breast implants as well as other cosmetic surgery back in 2008. Under an assumed name, the 30 year-old woman used a credit line in someone else’s name to obtain $12,000 in plastic surgery which included breast implants and liposuction at a plastic surgery center in Huntingdon Beach California. She pleaded guilty to burglary, grand theft and identity theft for using another woman’s personal information to obtain the surgery. How did she get caught you may ask? Police tracked her down using the serial numbers from her old implants, which she had removed when the new ones were put in.
In a similar scenario, but much more tragic, you may remember the murder of model Jasmine Fiore last August in California. The Playboy model mysteriously disappeared and was later found mutilated. With missing teeth and fingertips, she was initially unable to be identified as was the intent of the murderer. She was later identified by something her assailant had overlooked…literally…the serial numbers on her breast implants.
Proving that many criminals are dumb, most implantable medical devices today have serial numbers for tracking purposes as an FDA requirement. Usually the benefit of them on breast implants is for replacement and warranty reasons, but they also serve nicely as a human identification method that is more precise than fingerprints or dental records.
On a happier note, it was reported that a silicone breast implant saved the life of a California woman who was shot in the chest. A woman working in a Beverly Hills dental office last July was struck by a bullet after one of the employee’s estranged husband entered the office and killed her with a handgun. On exiting, the gunman ran into another employee and shot her in the chest. Unlike her co-worker, she miraculously survived. According to the Los Angeles Times, one of her breast implants stopped the bullet and prevented any fragments from getting as far as her heart. A physician who took care of her at the hospital stated that the bullet fragments were just millimeters from her heart.
A forearms expert was later quoted as saying that the breast implant probably slowed down the bullet enough that it caused it to stop short of the heart. While its an appealing story, that is not likely. A silicone gel or saline breast implant would not slow any bullet fired at close range. Breast implants have the stopping power similar to that of Jell-O. More likely her sternum or ribs was the reason that the bullet was deterred from going any deeper. The intervening breast implant, however, is happy no doubt to take the credit.
Breast augmentation and the implants needed to do them have weaved their way into the mainstream of American society, sometimes in ways not exactly as intended.
Dr. Barry Eppley
Tags: breast augmentation, breast implants, dr barry eppley, indianapolis, plastic surgery
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Friday, March 26th, 2010
You wouldn’t normally consider the concepts of plastic surgery and terrorism in the same sentence. If you did, you would assume that it had something to do with surgical changes of a terrorist’s face to alter their identity. Plastic surgery amongst drug dealers in different parts of the world, for example, is well known. Why wouldn’t it be the same for terrorists?
Perhaps terrorists are getting their noses reshaped and other facial reshaping surgeries, but that is not the association that is currently news worthy. It is now reported that female suicide bombers are being fitted with breast implants containing explosives which are all but impossible to detect by current airport scanning machines. Similar approaches are apparently being also considered for men by using buttock implants The discovery of these methods was made after the recent airliner incident on Christmas Day where a Nigerian had stuffed explosives inside his underpants.MI5, the famous British spy unit, has reported that such movie-like plots for bringing down airliners do really exist.
While breast implants do have a controversial material history, it has never been one of a lethal and nefarious nature. Explosive experts say that an implant containing as little as five ounces of certain explosives (a B cup breast size) can open a hole in the skin of an airplane that can take it down.
While an exploding breast implant is not a concern for the typical woman in the U.S. who undergoes breast augmentation, understanding implant rupture is. Implant rupture is not the same as an ‘exploding breast implant’. This is the one lifelong implant-related risk which every breast implant patient should know. While the bag or shell of a breast implant does not explode, it can develop a tear or hole in it over time. Such an implant defect is not the result of anything the patient does, it is the result of natural fatigue of the implant material as it flexes and folds over time from external displacement forces. It is always best to not think of breast implants as permanent although we all hope that they are.
Patients of course want to know how likely is implant rupture and what happens if it does. The true incidence of breast implant failure is really only known from past history with older device designs that are no longer used. While the manufacturers provide statistics of a 1% risk per year for the lifetime of the implant, numbers are just…numbers. That statistic is meaningless when it happens to you. You just have to know that it can happen and the longer they are in place, the more likely it can occur. Rupture of saline implants are immediately obvious, like a flat tire. Silicone implant failure usually never results in any external change and may only be found on a routine mammogram.
The good news is that breast implant rupture is medically harmless, no scientific evidence has ever linked a medical disease with implant filler materials. Rupture is an issue of inconvenience and economics. For saline implants, it will be a cosmetic ‘emergency’. For silicone implants, it is more of a dilemma of whether anything needs to be done at all if the breast feels and looks fine.
While terrorists might come up with lots of different ways to try and kill US citizens, using breast implants against us is definitely not one that we might have expected.
Dr. Barry Eppley
Tags: breast augmentation, breast implant rupture, breast implants, dr barry eppley, indianapolis, plastic surgery
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Monday, March 15th, 2010
While plastic surgery is comprised of hundreds of different procedures that are used to correct problems all over the body, they are all true medical operations and treatments. Yet some of the most popular cosmetic treatments have almost as much in common with a retail or commercial product as they do with being a medical procedure.
Botox as a non-surgical procedure and breast augmentation as a surgical operation have begun to acquire many retail product characteristics over the past decade. Both are highly marketed and promoted, so much so that few people in the world would not recognize what they are. From billboards to magazines, and endless exposure on the internet, the offering of services and the recruitment for paying customers is extensive. Some of these are from the commercial product suppliers on a national front and many others are from physicians on a local basis. Such enticements are right in line with what has also occurred in the pharmaceutical industry by the manufacturers for certain prescription medications.
Unlike most drugs, however, Botox and breast augmentation largely targets the fee-for-service customer. These are cosmetic services which are either paid for at the time the treatment is done (Botox) or some time in advance. (Breast Augmentation) With the allure of immediate cash payment comes the inevitable price war and the potential slide into a commodity service. Ads are a plenty for Botox at specific per unit prices and flat low-end fees for breast implant surgery. Dysport, the recent competitor to Botox, has offered incentives if you are unhappy with your Botox results. Breast implant manufacturers have lifelong replacement warranties and even $3500 cash for surgical costs should an implant need to be replaced in the first ten years after surgery.
But unlike most commodity services or pure retail products, these medical procedures do have other intrinsic values. It is obviously important to be able to receive these services with the lowest risk possible and be able to get the desired outcome. The intrinsic value is in the expertise and experience of whom is performing it. Lowest price for medical services is not always the best value. Price alone is not the best barometer to judge whom and where these services should be received.
Competition amongst cosmetic providers has fueled the reduction of services like Botox and breast augmentation into partial commodities. Prices amongst them in any community usually stays within a fairly narrow range as a result. Such competition is not necessarily bad. It keeps all providers sharp and makes sure that their prices, no matter how much intrinsic value they may have, stay within a reasonable range. Be wary, however, of really low prices that are different from the community average. There may be a good reason why they are priced that way and it is not usually for your benefit. You do not want inferior quality medical services when it comes to having something injected or implanted into your body.
Dr. Barry Eppley
Tags: botox, breast augmentation, breast implants, cosmetic surgery, dr barry eppley, dysport, indianapolis, plastic surgery
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Friday, March 5th, 2010
When spring just around the corner, this is the time of year when many people start thinking about their body again. Warm weather and less clothing cause some women to think about their ‘curves’. Perhaps to the surprise of some, spring is the peak season when the greatest number of breast augmentation surgeries are done. This is a seasonal trend that is very unique to this type of cosmetic surgery.
When considering breast augmentation, most women today opt for silicone gel breast implants. Since they have become available again for human use in late 2006, they rapidly have become the preferred implant for many breast augmentations. Yet, despite FDA-approval, many patients understandably ask about their safety. Even if one was not old enough to even be aware of what transpired in the early 1990s with the previous generation of silicone breast implants, there remains some lingering concerns that are easy to find on the internet.
Since silicone gel breast implants are FDA-approved, and they would not be available if they were not, that speaks to their safety. But most do not know the extent of information that goes into that type of approval process. And because of their history, silicone gel breast implants have become the single most studied implantable device in the world. As a result, the most common questions that women may have about this type of breast implant has well known answers.
Can breast implants make me sick? In 1997, the Federal government (Department of Health and Human Services) appointed the National Academy of Science to study the likelihood of medical complications after breast implant surgery. After reviewing years of evidence and research concerning silicone gel-filled breast implants, they found that health problems such as connective tissue illnesses, cancer, and other diseases were no more common in women with breast implants than in women who had never had the surgery.
In the 1990s, thousands of women claimed that they had become ill from their implants. Some studies around that time suggested that these health symptoms of women with implants may improve when their implants are removed. We now know conclusively that this is not true. The relationship between autoimmune diseases and breast implants is coincidental…both largely occur in women between the ages of 20 to 50…but one does not lead to the other. The FDA has even gone so far as to conclude that there is link between fibromyalgia and breast implants either.
Will breast implants cause cancer? Reviews of research and medical studies on silicone breast implants show that breast cancer is no more common in women with silicone breast implants than in those without. In fact, for reasons different than one may think, women with breast implants actually have earlier breast cancer detection. This has nothing to do with the implant per se, it is a function of breast awareness. Women with breast implants are more likely to be ‘attuned’ to their breasts and how they feel.
Can I breast feed with breast implants? For the younger women, this is a frequent question. The issue is not whether one can physically do it, but will any harm come to the baby by doing so. The American Academy of Pediatrics concluded in 2001 that having silicone breast implants is not a contraindication to breastfeeding nor does it pose any health risks to the infant. Similarly, epidemiological investigations have not found any increased risk of health problems in children born to women with silicone breast implants.
Dr. Barry Eppley
Tags: breast augmentation, breast implants, dr barry eppley, indianapolis, plastic surgery, silicone gel braest implants, silicone gel breast augmentation
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Saturday, January 30th, 2010
Enhancing one’s bust size through breast implants today is easier than ever before!….That is certainly the marketing hype and there is a lot of truth to it. But to call the recovery after breast augmentation as….no recovery….or painless… as some advertisements suggest does not quite convey an accurate picture. All surgery induces some pain, swelling, and bruising. Breast augmentation is no different.
Breast augmentation is most commonly done today by placing the implant under your big chest muscle known as the pectoralis. (although there is a recent trend back to above the muscle for some plastic surgeons as silicone gel implants have become available again) By putting the breast implant under the muscle, it is stretched, bruised, and even some fibers are cut. This makes the muscle sore, swollen and difficult to stretch. This also makes the upper arm hard to lift up very far. In essence, breast augmentation makes the muscle stiff and sore. It is not the incision that causes any discomfort, it is the muscle.
While breast augmentation can not be completely pain and recovery free, rebounding from the surgery and getting back to normal activities definitely can be accelerated. This is made possible by doing something to the muscle after surgery…early and aggressive physical therapy. Breast augmentation physical therapy starts the night of surgery and consists of range of motion exercises of the arm. By early stretching of the arm in circles and by raising the arm from one’s side to the level of the shoulder and above, the pectoralis muscle is mobilized. Stretching helps loosen up the injured muscle fibers and prevent restrictive scar formation. The more you move, the quicker you will recover. Just like pulling a leg muscle, the earlier you begin to stretch and use it the quicker you will get over it.
This form of pectoralis physical therapy, combined with anti-inflammatory drugs such as Alleve and Ibuprofen, allows one to get moving very early. While swelling, a little bruising, and some pain can be expected, early physical therapy can lessen its effects to just a few days. Even in the worst-case scenario, one should have a significant recovery by one week after surgery.
One other helpful recovery aid I use in my Indianapolis plastic surgery practice is the ActiPatch anti-inflammtory device. This is a small battery-operated battery device that emits pulsed electromagnetic fields that penetrate the breast tissue and help reduce swelling and inflammation. I have started my patients wearing it for the first 36 hours after surgery. It is easy to wear it inside one’s bra as the loop fits over much of the breast mound.
Rapid recovery breast augmentation is a reality through a combination of early physical therapy, anyi-inflammatory medications, and the ActiPatch device. Significant recovery should now be a matter of days not weeks.
Dr. Barry Eppley
Tags: breast augmentation, breast implants, dr barry eppley, indianapolis, plastic surgery, rapid recovery after breast augmentation
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Tuesday, January 26th, 2010
Breast Augmentation continues to be one of the most sought after of all cosmetic procedures. While the idea of making a breast larger is conceptually simple, there are several choices that women have to make. What type of implant (saline vs. silicone), what size implant, what amount of implant projection, and whether to have it placed above or below the muscle are the major decisions. Women are also interested in knowing what the experience was like afterwards. Dr. Eppley discusses breast augmentation in this Doc Chat radio show and interviews several women about their experiences and feelings about having been through the procedure. Listen to this show to hear what actual patients have to say about their breast implants and what the process was like for them!
Dr. Barry Eppley discusses Breast Augmentation
Tags: breast augmentation, breast implants, dr barry eppley, saline breast implants, silicone breast implants
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