A Board Certified Plastic Surgeon in Scottsdale
Posts tagged breast implants Arizona
Ways to Reduce Capsule Contracture.
010 months ago
Scottsdale – Capsule contracture after breast augmentation has been recently discussed on the blog. I would like to share strategies employed to reduce the incidence of capsular contracture with breast implants. Even using these techniques, the incidence of contracture may be up to 5% over the implant’s lifetime.
The most likely reason for this 5% incidence of contracture even when employing the most up-to-date techniques is the lack of complete scientific understanding of the interaction between the human body and breast implants. Currently, additional studies are under way to develop strategies for improvement in the capsular contracture rate.
At this point I will outline the techniques I use to reduce capsular contracture after breast augmentation in my practice:
- Use of a direct visualization technique for the creation of the breast implant pocket.
- Use of techniques which minimize bleeding and trauma to the tissue.
- Antibiotic irrigation of the breast implants for 10 minutes.
- Antibiotic irrigation of the breast pocket.
- Minimal handling of the breast implants.
- Use of brand new sterile gloves when handling the breast implant.
- Use of a sleeve like the Keller Funnel for a true no-touch technique in placement.
- Use of a nipple cover to prevent aerosolization of bacteria from the nipple.
All of the steps outlined above are used in every case involving breast implants. All of these steps can help reduce the incidence of capsular contracture.
Looking at a 3-D Breast Book before Breast Augmentation?
01 year ago
Explore a 3-D Breast Book before Breast Augmentation.
Scottsdale – Just to be fair, I though we should let folks know about a new breast book that uses 3-dimensional technology. According to Amazon, this edition melds two fascinating subjects into one book: 3-D and human breasts. You might recall that a few weeks ago we posted on the blog, a notice about The Big Butt Book and how this might relate to Brazilian Butt Lift. With this blog, we are now going to cover another interesting aspect of human anatomy, the breasts.
With 3DD, viewing in 3-D as opposed to 2-D gives the reader a more realistic perspective on the breast size and shape. For some, this breast book might be useful before undergoing breast augmentation. Especially, if the breast surgery patient is not sure about the size and shape of breast desired.
The book, 3DD comes with a pair of 3-D glasses via Amazon, but some feel these are flimsy paper 3-D glasses. If you want better quality, I would suggests purchasing the book and higher quality 3-D glasses from the website: three-dd.com. It might costs a little more, but the quality is worth it.
On the downside, I did not see many post-breast implant breasts in their collection of photos. On the other hand, for those seeking a more natural result from breast enhancement, and possibly for cosmetic surgery patients seeking silicone breast implants, which generally achieve a softer and more natural appearance, this could be a good option.
Let’s also not forget the book is an about the expression of art, and is not designed for those seeking breast augmentation. On the other hand, you like I, might find it useful as a tool to establish realistic perspective for breast surgery.
International Plastic Surgery.
11 year ago
Travelling to Scottsdale for Plastic Surgery.
Scottsdale – It is said that folks west of Dallas will travel to Scottsdale for plastic surgery. Over the years, we have seen this trend increase.
I can recall many cosmetic surgery patients from the mid central states, Texas, California and New Mexico who have traveled to Scottsdale for our specialized plastic surgery services. This was a major reason that we developed early on, at our main website, an entire section for out-of-town folks.
This website section is called the Fly-in-for-Surgery. What information is available to you if you are considering traveling to Scottsdale?
You will find wonderful places-to-stay in Scottsdale. We list a variety of local hotels for your choosing. We also list in the Restaurants section, some of the best restaurants to enjoy traditional American foods and Southwestern style. Of course, we also have a Shopping section in case you have additional time on your hands after your cosmetic surgery, or if your significant other wishes to do some shopping before going home. We also added information about golf courses and entertainment for our patients and their spouses.
A more dramatic trend in the past 3 years has been the increase in international travelers to Scottsdale for cosmetic surgery services provided at the AB Guerra Plastic Surgery Center. We have now treated patients from every major continent, except for Antarctica. Plastic surgery patients have come to see us from as far away as Asia and the Middle East. Canada remains the second most popular country on our list of out of town visitors.
The TSA can see your Breast Implants?
01 year ago
Scottsdale - Through an interesting report more and more people have become concerned about the TSA being able to see your breast implants and other “private parts”. According to radiologist, Dr. Kristin Byrne of Lenox Hill Hospital in New York City, the TSA scanners can learn about your health history by just having you pass through the security line.
“The airport scanners show anything on the surface of the skin and very closely under the skin,” Dr. Byrne recently stated.
According to Dr. Byrne, this means TSA workers will see foreign objects close to the skin, including piercings, catheters, colostomy bags, breast implants and prosthetic testicles.
While many believe that body scanners are a necessity, a growing wave of protest seems to be swelling. The issue seems to revolve on the lack of privacy afforded to patients when they are scanned or padded down at the airport. Some feel both methods are too invasive. It may become acceptable to many Americans over time, as long as client privacy is assured. Unfortunately, some of the body scans have made it on websites like Gawker.com. These have been viewed online only to add to the controversy.
Textured versus Smooth: Breast Implants.
01 year ago
Scottsdale – Are textured breast implants falling out of favor with many plastic surgeons?
In some cases, usually for plastic surgery operations of the breasts, in which the patient has experienced capsular contracture – a textured breast implant could be considered. Textured breast implants have a cover that feels like soft sand paper and were designed to reduce the chance of capsular contracture in higher risk situation, such as:
- Use of breast implants larger than 350 cc.
- When the breast implant is placed above the muscle.
- When a breast lift is done at the same time as a breast implant.
- When a breast implant is used for breast reconstruction.
- When there is revision of breast surgery for capsular contracture.
The data to support use of textured implants in the medical literature seems to be waning. The information that is available on a small numbers of patients suggests that textured breast implants reduce the chance of severe capsular contracture. Recent clinical data, however, in a large number of women with Mentor saline and silicone breast implants shows no difference in the likelihood of developing capsular contracture with textured implants compared to smooth breast implants.
Breast Implant Exchange: Tips.
31 year ago
Scottsdale – In certain situations, a woman may want to exchange her breast implants.
Women may request breast implant exchange because of the age of her breast implants. Other women, may decide to upgrade to a bigger cup or from saline breast implants to silicone breast implants.
Other reasons for breast implant exchange:
The most common reason for implant exchange in our practice has been the desire to change the size of the breast cup (usually bigger, but some times to a smaller cup).
Women may also experience sagging of the breasts some years after the original procedure, and may request breast implant exchange and breast lift as a simultaneous procedure.
We also see patients requesting breast implant exchange for an unnatural firmness or capsular contracture, for the treatment of ripples or for deflated implants (more common with saline breast implants.
Basic options during breast implant exchange:
Breast implant exchange: saline to silicone breast implants, larger or smaller.
The Round Block Breast Lift: III.
01 year ago
Advancements in Breast Lift.
Scottsdale – On our third and final section dealing with the Round Block Breast Lift technique we will discuss some of the advancements which have made this a better plastic surgery operation.
The Advancements in Breast Lift Diagram shows a critical step in this cosmetic surgery operation. In the diagram, we see the Gore-Tex suture as it is placed during surgery. Note how the limbs of the suture slide back and forth between the outer incision and the inner areola breast lift incision.
The cosmetic surgery patient has to be able to understand that even with these great advancements, this operation is less than perfect. There are several imperfections. First, tissue heals differently in different patients. In most individuals a suture placed around the areola is not noticeable, but in others this could create some issues which are discussed below.
Before we get to this, why Gore-Tex?
The Gore-Tex suture has become a preferred material for this technique. There are several advantages, including its softness and pliability. The suture is very easy to work with and not as rigid as the original nylon suggested by Louis Benelli. After the swelling is gone and the area has healed, the softer suture is likely to be felt by the patient. There are several sizes of suture and each plastic surgeon must work with the type of suture which they feel is best in their hands. For instance, a CV-4 is a routine size, but occasionally I will use the slightly thicker CV-3 on patients with thicker dermis.
First Slide: Areola Incisions.
The operation starts by marking the breasts and areola for the procedure. The areola is to be reduced and the outer and inner marking on the areola are placed appropriately. In the Round Block Breast Surgery Diagram, we see this sequence as it begins with the incisions around the areola (First Slide).
Second Slide: Excess Skin Removal.
The Second Slide demonstrates the technique for removing the excess skin around the areola. Only the excess is removed and the dermis edge is prepared for the Gore-Tex suture implantation.
Slide Three: Dermis Preparation.
In the Third Slide Breast Lift, we see the completed removal of the areola skin judged to be excessive. This slide also shows how the two dermis edges are prepared. The wide incision is prepared using a different technique when compared to the inner areola incision.
Fourth Slide: Suture Implantation.
The Fourth Slide, shows the Gore-Tex suture placed, held by the clamps, and ready for tying by the plastic surgeon. Once the new, smaller areola size is set, then the suture can be tied at its new diameter.
Final Slide: Areola Incision Closure.
The Final Slide, demonstrates the final intra-operative view. This incision was closed with the Gore-Tex suture implant setting the diameter of the areola at 4.0 centimeters during breast lift and saline breast implant placement.
The Round Block Technique is very versatile. The operation can be used on those who desire a breast lift with and without breast implants, during breast implant exchange, during breast reduction, and just as well, when only an areola reduction is indicated.
Before: Areola Breast Lift and Saline Breast Implants.
In the before photos we see a typical cosmetic surgery patient with deflated breasts, slightly saggy, and with wide and unattractive areola size. The patient was treated with the sequence outlined in the above slides. While this patient received saline breast implants, it is not a problem to use silicone gel breast implants.
After: Areola Breast Lift and Saline Breast Implants.
It is important to understand this is the best that is available, in terms of allowing the cosmetic surgeon, at this present time to control as many factors about the operation as possible. Some of the downsides include the ability to feel the suture itself or the suture knot around the areola, tenderness and pain around the areola, swelling and bulging around the areola with prominence of the nipple, continuous pleating, and the occasional patient who experiences recurrent areola stretching, which is far more likely to occur when the operation is used in combination with a larger-than-recommended breast implant. Not to worry, many of these side effects can be treated with suture removal. We do not recommend removal until 1 year after breast surgery so as not to cause stretch of the areola.
Fall Weather Plastic Surgery
11 year ago
Fall Weather Plastic Surgery
Scottsdale – We are finally turning the page on Summer and heading into the Fall Season. Plastic surgery is traditionally very popular in the Fall. For instance, over the past three years the trend is for cosmetic surgery patients to get breast augmentation around this time. We are not sure why, but the number of breast implants used in September, October, and November usually increases each month in the Fall and Winter.
Fall Uptrend in Breast Implants and Tummy Tucks
One theory is that may ladies went to the beach, and had some fun in the sun, this past Summer. They noticed their friends and acquaintances who did get plastic surgery of the breasts and mommy makeovers. These friends looked great and had a lot of confidence because of the way the looked after last year’s cosmetic surgery. Our clients during the Fall, often times, make reference to their friends, who by the way, are our number one source of referrals for future patients. After waiting for their turn, many new clients are ready for the breast surgery or tummy tuck by the beginning of November.
Fall Uptrend in Facelift and Eyelid Lift Surgery.
We also see an uptrend on the number of facial plastic surgery cases we perform. I have always said that facelift, eyelid surgery, and necklift are a lot easier on patients during cooler weather. The weather in Scottsdale, Arizona start getting really good during late October and many patients take advantage of this fact. To make it easy on patients looking into facial rejuvenation surgery, we are having a Facelift and Eyelid Lift Seminar on Wednesday the 22nd of September, in our office, at 6 PM sharp!
Breast Asymmetry: Causes and Treatments.
01 year ago
Scottsdale – Breast development usually results in some unevenness of the breasts. Breast asymmetry, in fact, is normal and natural, but it is usually only acceptable to most patients when the difference is subtle. When examining the human shape, is is normal to visualize some differences in our bodies from side to side. Many patients request silicone breast implants to improve breast asymmetry.
The cause of breast asymmetry can be divided into two groups:
- Asymmetry may result from natural development, which includes pubescent growth, pregnancy, lactation and weight fluctuations.
- The second group of causes includes asymmetry caused by external factors such as disease, trauma, reconstructive or cosmetic surgery. During development, the female breasts increasing in size and projection, responding independently to hormonal and growth stimulation. For most women, the differences that exist at the end of this process are typically minor. Exceptions can occur when conditions such scoliosis and Poland’s syndrome.
The Developed Breast and Breast Implants:
The developed breasts have similar volumes with the infra-mammary folds in a similar position, nipple position is close to being at the same level, and the nipples are at the center of the breast and above the infra-mammary fold. Volume differences are very common and are often associated with differences in nipple position and diameter as well as differences in elevation of the IMF.
When the nipple position is below the ideal location the breast is said to be saggy. This is especially true when the nipples fall below the IMF. Breast augmentation and breast lift can improve the asymmetry in such cases. Perfection cannot be achieved. It is believed that breast should be like sisters but not identical twins.
Pregnancy and Weight Fluctuations and Breast Implants:
Pregnancy and weight fluctuations can lead to asymmetry. Pregnancy and lactation typically creates an increase in the size of the breasts. After the baby, there is a deflation and a loss of volume in the breasts. Usually, the breast shrink back to near pre-pregnancy size, although some experience an additional decrease in overall breast volume.
Similarly, significant weight changes can increase the saggy appearance and asymmetry. As weight increases, the fat portion of the breast increases and with the extra weight, the breast falls. This process can occur unevenly on each side leading to asymmetry which can also be compounded by the same stretching of the skin..
Breast augmentation may help those who are not very saggy, but a breast lift is better when the breasts are very saggy. As in cases involving other types of breast asymmetry, perfection cannot be achieved. Before and after plastic surgery, breasts are like sisters, not identical twins.
Choosing a size for breast augmentation.
01 year ago
by Dr. Aldo
in Breast Augmentation
Scottsdale – Breast augmentation is the most popular plastic surgery procedure. A priority, for most women, when seeking breast augmentation is to choose a breast implant size that best suits their goals. We also believe that deciding on your new breast cup is the most important decision when it comes to creating satisfactory outcome after cosmetic surgery of the breasts. Fortunately, the final breast cup can be derived at, using common sense advice.
Common sense advice for Breast Augmentation.
First, we must look at what the patient brings to the consultation. We must consider the height and weight of the patient. We also look at the proportions. We must consider the current bra size and chest measurements. Patients who are taller and wider can accept and look great with bigger breast implants. The more petite the person, the more difficult it becomes for them to accept bigger implants.
Factors in choosing a certain breast implant size.
Second, we must consider what looks good on your body. This is determined by two important factors. The first factor has to do with your actual physical proportions. The second factor is more dependent on society, where you live, and what sizes are considered acceptable. For instance, living in Scottsdale, patients spend plenty of time outside in the sun and larger breast implants are more acceptable. The situation might be different if you live on the east coast. Patients usually choose smaller implants in this part of the country because outdoor activities are not as popular.
Bigger breast implants not always better.
Third, having a consultation with a board certified plastic surgeon, is one of the most important decisions you can make. During the consultation we rely on three basic techniques to derive our recommendation for a certain size. We will perform clinical measurements of your breasts, we provide a variety of breast implant sizers for you to try on while in clinic, and we will show you before and after photos of previous patients and their results.
We will encourage you to choose the size you believe will make you the happiest, but review the pros and cons of that size. We encourage all patients to consider the downside and upside of bigger breast implants. When you are in our office, you will have plenty of time to tell us your desired cup and when you leave, you will be very confident about the size you have chosen.
