What patients should know about breast augmentation in New Jersey

Many women who are considering a breast augmentation in New Jersey begin their search on line and may be confused by the choices of implants that are available today.  Since 2006 both saline filled and silicone filled breast implants have been available to women in the United States.  In general, implant choices include both saline and silicone devices.  But there are also other choices to consider.  Silicone implants are manufactured as both round and shaped devises and they may have either a smooth or textured surface. So first let’s discuss the fill of an implant.  Although saline implants were popular for a really long time, many women and their plastic surgeons were unhappy with the feel of the implants and the rippling that could be felt or seen. They are still an option for many patients, but silicone gel implants are now the most popular implants in most of the world.

What is important for patients to know about implants for breast augmentation?

Silicone Gel implants for breast augmentation can be further divided into two groups:

• First there are the round gel implants. These implants are made slightly underfilled to make them soft and the gel is more cohesive, slightly thicker, than it was in earlier generations implants.  They come with both a smooth and textured surface on the outer shell of the implant, as texturing of the surface was thought to reduce capsular contracture, a tightening of the pocket around the implant.  There are many studies underway to determine if texturing of implants makes a real difference, but for now we do know that texturing may help with maintaining the position of an implant
• The newest generation of Form Stable Highly Cohesive Gel breast implants are nicknamed the “Gummy Bear” implants.  They are also called the Style 410 Silicone gel implant. These implants remain investigational in the United States until their FDA approval.  Gummy bear implants are very different from the round gel implants.  First of all the gel is thicker, or form stable.  This makes the implants just firm enough to resist folds and creases, yet soft enough to still feel like a breast.

Studies over the last 10 years in the US and since 1993 in Europe have shown considerably lower rupture and capsular contracture rates, however, studies are still ongoing until these implants are FDA approved. Finally, many web sites and plastic surgeons are creating “cohesion confusion” and women are often mislead by practices and sites advertising for “gummies” or “highly cohesive implants” that are just round gel devices.  Keep in mind the following when learning about your implant choices:

• Round silicone gel breast implants were FDA approved in 2006 after a 15 year moratorium.  They come with both a smooth and textured surface and should be available at all plastic surgeons’ offices.
• The newest generation of highly cohesive form stable implants, also known as “Gummy Bears” are always shaped, and always textured.  Patients must enroll in a FDA approved clinical trial, agree to a long-term 10 year follow-up, and these implants are only available from plastic surgeons who are approved investigators.

Dr Glicksman has been in practice for 20 years in New Jersey. Breast augmentation is a primary area of  expertise for her and she  has  presented nationally and internationally on this subject as well as published peer reviewed articles on breast augmentation. Remember a better educated breast augmentation New Jersey patient will make safer decisions and achieve longer lasting results.

Plastic Surgery Channel expert Dr. Bruce Van Natta talks about breast lifts / mastopexy in Indianapolis, Indiana.

What exactly is a breast lift/mastopexy?

As a member of The American Society of Plastic Surgeons and The American Society for Aesthetic Plastic Surgery, Bruce W. Van Natta,M.D. has expertise in a variety of cosmetic and reconstructive plastic surgery procedures.

This is a commonly requested procedure that is often misunderstood. Generally when a woman has excess skin around the breast often after pregnancy or weight loss, the breast size has reduced and there is a lot of skin around the area. This can be viewed as a deflation effect in the breast and the treatment for this would be to conduct an operation to remove some of that excess skin. Following pregnancy many women feel that their breast deflate, loose volume and become saggy. Dr Van Natta has been in practice for 20 years in Indianapolis, Indiana. Breast lifts / mastopexy have been one particular area that Dr Van Natta has specialized in his practice.

Who needs a breast lift/ mastopexy?

Dr. Van Natta finds that a lot of times women come in thinking that they need a breast implant or breast lift/ mastopexy when they that would not automatically be the right procedure for them. At times like this, it is important to sit down with the patient and really understand what their goals are in terms of how they want to look and appear without involving names of procedures and technical terms. Sometimes after such consultations, the surgeons can determine that all the patient really wants is a little more fill in the upper part of the breast and this can be achieved easily with an implant. Really taking the time to talk to patients and asking to see before and after pictures can help a surgeon understand what the patient’s goals are and allow them to do the right procedure. Seeking consultation with a board certified plastic surgeon is the 1st important step in patients getting the best outcome with breast lift / mastopexy. Asking questions and also talking to other patients who have use the same surgeon for a breast lift/ mastopexy can be helpful.

Dr. Keyes is heavily involved in research and studies related to data collection and patient safety. He is double board certified by The American Board of Plastic Surgery and The American Board of Otolaryngology – Head and Neck Surgery. Dr. Keyes is a renowned international lecturer on safety during surgery.

Rhinoplasty is one of the most difficult surgeries to perform in cosmetic surgery. There are some plastic surgeons that specialize in Rhinoplasty more than any other surgery. One thing to make sure when undergoing a Rhinoplasty is to choose a surgeon who does this procedure frequently and is well versed with all the possibilities and techniques in the procedure. The surgeon must have a great deal of skill specific to Rhinoplasty. Rhinoplasty can be life changing surgery as it really does change the appearance of the face dramatically. Having said that, this is exactly why patients must be cautious in choosing the right surgeon since their entire facial appearance is at stake. The look arrived at after the rhinoplasty must have harmony with the rest of the patient’s face. It is therefore very important to understand the credentials of the plastic surgeon before undergoing the surgery.

This is one of the most controversial and confusing topics from a patients standpoint. Most patients have heard different things from friends and from physicians about the placement of breast implants. He clarifies that there are three ways to place a breast implant:   Subpectoral, Subglandular and Subfacial.

There is really no one correct way to place a breast implant and each type of placement has its own benefits and is more suited to some patients. There are some patients who benefit from placing the implant under the muscle, at other times, unde rthe  breast or under the pectoralis fascia may be an option.

There are other aspects that must be factored in when deciding where to place the implant. The most important thing is to have a surgeon that takes the time to do a complete evaluation taking into consideration the size and shape of the original breasts, the size and shape of the desired breast, how much soft and subcutaneous tissue there is above the implant once it is placed, whether the implant is gel or saline, smooth or textured. All of these things have a part to play in the decision process.

Dr. Thornton dispels the myth that mammograms are much easier to read when implants are placed under the muscle. He clarifies that more and more evidence is becoming available that in the absence of scarring around the implant, or what is called a capsule contracture, mammograms are equally easy to read whether the implant is placed under the muscle or under the breast.

Zeltiq removes fat by freezing the fat cells.  Zerona  acts in combination with diet and exercise and thus is difficult to know what actually produces the effect.  High frequency ultrasound (HIFU) uses ultrasonic energy to  reduce the fat cells.

Dr. Peter B. Fodor, M.D., F.A.C.S. is an internationally recognized aesthetic plastic surgeon from Beverly Hills and Los Angeles who specializes in innovations in plastic surgery, particularly in the areas of minimally invasive facial rejuvenation and body contouring surgery.

A recent article in American Health and Beauty talked about how surgeons prefer the usage of body jets for harvesting fat during liposuction. The article talked about the benefits of using body jet and had a couple of surgeons validating the usage of the same. Dr. Fodor cautions that science does not fully support the fact that body jet is the best alternative for fat harvesting during liposuction. He has never himself used body jet on a live patient as he always fully checks his techniques in the laboratory before trying them out on patients.

Body jet was initially introduced as a method of liposuction and claimed some superiority over other methods. It was an attempt to improve on processes or methods that were already working very well, but may have needed some improvement.

Recently the focus of the body jet was then changed to fat collection. There are many different methods of fat collection however; the defining question here is whether the fat will survive when it is transplanted to another part of the patient’s body. Dr. Fodor enjoys a very good success rate when it comes to redo liposuction where a lot of fat is required to be transported from one part of the body to another.

As a member of The American Society of Plastic Surgeons and The American Society for Aesthetic Plastic Surgery, Dr. Bruce W. Van Natta,M.D. has expertise in a variety of cosmetic and reconstructive plastic surgery procedures.

Recently an article in the Orange County Register titled “Breast Implants lead to return visits to the OR” started a discussion about the life of breast implants. According to the article, about one third of breast implant patients, i.e roughly 33% have a follow up operation within 4 years. Dr. Van Natta corrects this number saying that the actual figure is around 23.5% which is almost 10% lower than the reported number. 23.5% is still admittedly a high number but it is much lower than what it has been made out to be.

The other controversial discussion in the article was about the fact that breast implants need to be changed/ replaced or removed after 10-15 years. This has certainly not been the case that Dr. Van Natta has observed in his practice. He does caution that breast implants are most certainly not “forever devices”. As with any other device that is inserted into the human body such as knee replacements and pacemakers, the device wears out with age and if the patient lives long enough, the device would need replacement. The breast implants functions in pretty much the same way and may need replacement if the patient lives long enough. However, there is absolutely no restriction of 10-15 years on the life of breast implants

Our skin is exposed to many environmental factors and chemicals that cause it to deteriorate. Over time, sun exposure, wind, dust and cosmetics ruin the top most layer of the skin making it look dull and lifeless.  Skin resurfacing is a combination of techniques, one or all of which are used to basically remove the top, dull layer of the skin and allow the new layer of skin to heal and form good scar tissue.

Dr. Elliott,  board certified plastic surgeon from Meridian Mississippi explains that the biggest problem is that people come in for a procedure with the expectation that the procedure will last just a few minutes and they will have no downtime and can go home the very same day. With such unreasonable expectations, it is difficult to be able to deliver the best results. Dr. Elliott’s approach is usually to talk to the patient and to figure out what the patient’s original problem was and diagnose the same and figure out the best course of action. This might be dermabrasion, chemical peel or laser resurfacing and then he tries to find a solution that will fit their problem as well as be able to work around their schedule so that he can provide the most satisfactory solution to the patient.