You may have noticed that the silver and black are wearing pink this month. For the last few Octobers, the National Football League has teamed up with the American Cancer Society to highlight breast cancer awareness and raise funds for breast cancer research.
Who Gets Breast Cancer?
One in nine women will develop breast cancer. That’s 12% of the female population, and women make up 99% of the cases of breast cancer. Less than 1% of people with breast cancer are men, and a man’s chance of a breast cancer diagnosis is about one in a thousand.
How Does Breast Cancer Spread?
By definition, breast cancer starts in the breast. Theses abnormal breast cancer cells begin to grow uncontrollably and invade the normal breast tissue. It takes months, sometimes years, for enough cells to amass to be felt. A one centimeter lump contains about a billion cancer cells. As the cells grow they continue to directly invade their neighbors, but cancer cells can also float through the circulatory system.
The most common place that breast cancer cells are found outside the breast are in the axillary lymph nodes. Let me translate that from medicine to English. Lymph is the liquid part of the blood, also called plasma. It slowly leaks out of the blood vessels from the capillaries and needs to be collected and returned to circulation. If lymph is not returned to circulation, we swell. If you ever looked at pictures of Elephantiasis as a kid (maybe it was just me) this disease is what happens when lymph does not return to circulation. In Elephantiasis, the lymph vessels become clogged and the lymph fluid become trapped in the legs. The legs begin to resemble elephant’s legs as the lymph fluid continues to build up and inflate the skin.
What Are Lymphatics (Lymphatic Blood Vessels)?
The lymphatic vessels are a third type of blood vessel, the first two being arteries and veins. Lymphatics are found throughout the body, including the breasts. Breast cancer cells can float through the lymphatic system and migrate to other organs. For cancer cells, this migration is called metastasizing. After a breast cancer lump reaches a critical size, the chances of a metastasis increases rapidly. This is why breast cancer awareness and early detection are so important.
What Are Lymph Nodes?
The breast’s main drainage system is through the axillary lymph nodes.
Lymph is only fluid, so unlike other blood vessels, it is not normal to have a lot cells traveling through the lymphatic blood vessels. In fact, the body has filters along the lymph vessels, called lymph nodes, which trap unwanted cells, preventing them from moving freely throughout the body. The two types of undesirable cells that lymph nodes filter most frequently are bacteria and cancer cells. In both cases, the lymph nodes present the invaders to the body’s immune system, it’s police force if you will. When the immune system recognizes the invaders as bad, it kills them, and prevents any further invasion. This probably happens all the time without us being aware of it. Unfortunately, sometimes the immune system cannot handle the invasion, and the problem spreads.
The majority of the lymph from the breast drains to the armpit (the axilla), so the most common place we find breast cancer outside the breast is in the lymph nodes of the armpit or the axillary lymph nodes. This is why checking the axillary lymph nodes is so important in staging breast cancer. No nodes involved (negative lymph nodes) is good, and means there is a higher chance that the cancer has not escaped the breast and thus a higher chance of curing the breast cancer. Breast cancer found in the lymph nodes (positive lymph nodes) are a worse sign, and often means additional treatment will be recommended to try and kill any cells that have escaped the breast.
Why The Push For early Detection?
If you understand how breast cancer usually spreads, then the emphasis on early detection becomes clear. The sooner breast cancer is detected, the smaller it is and the less likely it is to have spread. Small tumors found in the breast early can often be cured by simply excising them. Larger tumors will be more likely to require a mastectomy, but once the tumor has left the breast, surgery alone is not enough. Additional treatment is needed to kill the cells that have escaped. Unfortunately, the more cells that have escaped, the harder it is to cure breast cancer. The goal of breast cancer awareness and early detection is to find tumors when they are small are treatable and to prevent the larger tumor that cannot be cured.
Different Breast Cancers Require Different Treatment
Since there is more than one cell type in the breasts, there is more than one type of breast cancer. The most common types of breast cancer behave as described above, the majority of the time. However, there are exceptions to every rule. For example, some less common tumors that arise in the breast spread directly through the blood stream, bypassing the lymphatics. Moreover, tumors that develop at the edge of the breast can directly invade the skin, muscle or bone of the chest wall. In every case though, the earlier it is detected, the better your chances of survival. If you don’t do monthly breast exams, I hope this makes you reconsider how such a small chore can prevent an enormous amount of suffering.
What Can I Do About Breast Cancer?
Awareness is the first step. Next comes action. Do your monthly breast self-exams, get your mammograms as recommended, and if you find something, don’t be scared, be proactive. Most breast lumps are not dangerous, cysts and benign fibroadenomas are the most common, but if you find one that is not benign, the sooner it’s identified the better your chances. Do it for yourself. For men, the most common breast lump is Gynecomastia.
Early detection means you increase your chances of living a longer, cancer-free, life.
If you want to help others there are many avenues available. The American Cancer Society accepts donations, which are used to accelerate breast cancer research, and many volunteer opportunities are available if you can spare a little time. If you want more information on how to get involved check out the Get Involved page on the American Cancer Society’s website.
If your are feeling that your Breast Implants are too big, like the bowling balls Holly Madison is holding at the Bowling For Boobies Fundraiser in Hollywood, CA, it might make sense to have them reduced or even removed. About 1% of women who get Breast Implants have them removed at some point in their life.
Breast Implant Removal is not the most popular Cosmetic Plastic Surgery procedure. In fact, for most of my Breast Augmentation patients, Breast Implant Removal is unthinkable. Longterm plastic surgery statists show that only about 1% of women who get Breast Implants have them removed. Sometimes it is elective; sometimes it is medically necessary.
Why Have Breast Implants Removed?
Breast Implant Removal Before and After: This patient has great breast skin elasticity, so she has no skin sagging after her Breast Implant Removal. Breast Implant Remova surgery is just as personal as Breast Augmentation surgery, and the reasons for it vary. Only 1% of all Breast Augmentation patients have their Breast Implant removed.
While it is not common, there are many reasons for Breast Implant Removal. Since Breast Implants are used for both an elective and reconstructive procedure, the reasons for Breast Implant Removal can also range from elective to required.
Elective Reasons: Changes in one’s personal physique preference, body image and physical changes associated with weight, pregnancy or aging can all lead to a desire for less breast augmentation. Elective reasons For Breast Implant Removal include:
Breast Implants were placed at a young age and things have changed
Increased breast size after pregnancy
Increase in breast size associated with menopause
Planning to get pregnant and don’t want breasts to have a head-start in getting stretched out
Breast Implants are just no longer desirable or wanted
Required Reasons: Required reasons for Breast Implant Removal is more common for Breast Reconstruction patients than for elective Breast Augmentation patients. Reasons include:
Breast Implant Deflation (In most cases the Breast Implant is replaced rather than left out)
Breast Implant Infections
Breast Implant Exposure
Other severe complications of Breast Implants where the pocket needs to be reconstructed
Uncommon forms Breast Cancer treatment which include Hyperthermia
How Are Breast Implants Removed?
Breast Implant Removal Before and After Photos: Larger implants and less native breast tissue increase the desire for a Breast Lift after Breast Implant Removal Surgery. This patient above had large volume breast implants, small natural breast tissue volume, but good skin tone and nipple placement. She elected not to have a Breast Lift.
Uncomplicated Saline Breast Implant Removal can be performed under local, local with sedation or general anesthesia, depending on the motivation and tolerance of my patient. Silicone Breast Implant Removal is more often performed under general anesthesia. The reason for the difference is in the filling.
Saline Breast Implant Removal
Saline Breast Implants are filled with water essentially. The implants can be opened, the contents suctioned out and the implants’ silicone shell can be removed without fear of spillage through a small incision. While many saline breast implants were placed via a peri-areolar incision, they are often removed via the infra-mammary fold incision (IMF) to decrease the risk of dimpling at the areolar incision.
Silicone Breast Implant Removal
Silicone Breast Implants are filled with silicone gel. Unlike a Saline Breast Implant, it is sometimes difficult to know before surgery if a silicone breast implant is ruptured. Even MRIs are only 90% accurate. If your silicone breast implant is ruptured, more needs to be done than just remove the implant, so your surgeon will want to have the option, and this is more easier on you, and your surgeon, under general anesthesia. This is especially true of breast implants manufactured before 1994. These can have free silicone gel in the pocket around the implant, even without being ruptured due to “gel bleed.”
After Breast Implant Removal Will I Need A Breast Lift?
Breast Implant Removal Before and After Pictures: The patient above wanted her Breast Implants removed because she felt too big. She also has some bottoming-out of her breast implants. Her breast implants were removed and a special, inferior-pole lift was performed to reduce the amount of skin hanging below her nipple and to move the native breast tissue that she had back up under the nipple.
This is question that can only me answered with a Plastic Surgery Consultation. In general, the larger your implants and the smaller your natural breasts, the more likely you are to need a lift. An option that is always available though is to have the Breast Implants removed, allow the breasts to heal and then evaluate if a lift is beneficial. While this means two operations, it also means that you can make the decision to lift or not to lift without having to guess what your breast will look like without breast implants.
Recovery After Breast Implant Removal
Recovery after Breast Implant Removal is usually pretty quick. Most patients are wearing a firm, jog-type bra immediately after surgery to help the breast implant pocket seal and heal. Light compression provides decreased swelling, increased support and decreased discomfort after surgery. In cases where full capsulectomies are performed, or when free silicone needs to be removed, more surgery is required, so the recovery would be expected to increase proportionately with the amount of additional work required.
To schedule a Breast Implant Removal consultation, give my San Francisco Bay Area Plastic Surgery Office a call at (925) 943-6353. We are centrally located in the SF East Bay city of Walnut Creek, CA.
Dr. Joseph Mele maintains his Board Certifications with two ABMS recognized boards: The American Board of Plastic Surgery and the American Board of Surgery to demonstrate his commitment to excellence in up-to-date Plastic Surgery
Plastic Surgery Board Certification and MOC
Another year, another round of American Board of Plastic Surgery MOC (Maintenance of Board Certification) chores. I have two American Board of Medical Specialties (ABMS) recognized board certifications. One is from the American Board of Plastic Surgery and the second is from the American Board of Surgery. Both represent years of training and hard work and now with the additional MOC requirements, the completion of yearly chores.
Achieving Board Certification
Achieving Board Certification is an important milestone in a doctor’s training. It certifies that they graduated from a recognized residency training program and that they have passed a series of written and oral examinations, and if I had graduated two years sooner, that would have been the end of the story. I graduated and certified in the era of time-limited certification, so every year there are some requirements to fulfill.
Maintenance of Board Certification
The MOC examinations are given at computer based testing centers throughout the nation. All sorts of examinations are given at these centers and most have nothing to do with medicine. The staff at these institutions have strict regulations to enforce. The rules are designed to stop cheating and protect the proprietary information that is contained on the examination. I recently visited one such institution to take my ten-year recertification examination for the American Board of Surgery, and am required to take the American Board of Plastic Surgery MOC examination by 2019.
Why Maintain Board Certification?
This question is becoming more and more controversial as the fees, exams and other hurdles are raised higher and higher each year. It took several days to complete the application and collect the required information, and it’s not cheap. Those in favor of MOC claim that board certification is a way to make sure that your doctor is still good. Those opposed cite the ever escalating cost and time away from the practice required as prohibitive. They are also correct in pointing out the lack of evidence that MOC actually makes us better doctors. Personally, I don’t mind. It is a hassle, and it does not change the way I practice. On the other hand, it shows my patients a clear commitment to being the best Plastic Surgeon I can be. I don’t mind being tested. Plus, when I pass, I will have another lovely certificate to show everyone.
My Board Certifications
I completed a General Surgery residency in 1994. I passed my General Surgery Boards in 1995 and have recertified twice. I am good until 12/31/2025, as long as I complete my yearly chores and pay my yearly fees.
I completed a Plastic Surgery residency in 1997. When I finished my training, it took two years to take the certification exams. I passed my Plastic Surgery Boards in 1999, and have recertified once, so I am good until 12/31/2019. Looking forward to the next exam.
American Board of Medical Specialties
There are many boards out there, but the “real” boards are those under the umbrella of the American Board of Medical Specialties (ABMS). This is the longest standing body for Medical Certification in the US. The American Board of Plastic Surgery was born from members of the American Board of Surgery and the American Board of Otolaryngology who did what is now recognized as Plastic Surgery, and remains the only ABMS Board certifying Plastic Surgeons.
Board Certified Plastic Surgeon
If you are considering Plastic Surgery, be certain to check your doctor’s training. Good training, and the maintenance of that training, are essential for providing the safest and most predictable results.
If you are in the San Francisco Bay Area and would like to schedule an appointment, call (925) 943-6353. And if you want to check out my, or any doctor’s, qualifications, here are some links to help you:
Eyelid Surgery, aka Blepharoplasty, remains one of the most popular Cosmetic Plastic Surgery procedures. Last year, according to the American Society for Aesthetic Plastic Surgery (ASPAS), it ranked number four, ahead of Breast Lifts, and behind Liposuction, Breast Augmentation and Tummy Tucks. The statistics do not break down the number of Occidental vs. Asian Eyelid Surgeries performed, but here in the San Francisco Bay Area, the Asian Blepharoplasty accounts for a significant percentage of all the Eyelid Surgery Performed.
You don’t have to be a Board Certified Plastic Surgeon to see that the Asian and Occidental eyelids have different shapes. These differences are directly related to ethnic changes found in the Eyelid Anatomy. While the goals of Blepharoplasty are the same, the techniques to achieve these goals must be modified for differences in the anatomy between Occidental and Asian Eyelids.
Asian Eyelid Surgery Video (Asian Blepharoplasty)
Below is a segment from my latest KRON 4, Body Beautiful show. Several Asian Eyelid Surgery Before and After Pictures are included, and narrated, to help illustrate what Asian Blepharoplasty has to offer.
Asian Eyelid Surgery Goals
The goals for Asian Eyelid Surgery depend on whether the problem is congenital or acquired. Congenital Eyelid Problems we are born with, and these are often caused by deficiencies in the eyelid’s anatomy. The most common problem is poor connections between the upper eyelid skin and the tarsus, causing a poorly formed eyelid crease and the skin to drop into the eye’s visual field. Acquired Eyelid Problems we earn over time and are caused by aging and relaxation of the soft tissues that protect the eye. Protecting the eye is the primary goal for both types of eyelid surgery. Plastic Surgeons aim to restore the normal anatomy and to provide you with eyelids that look good while they are doing their job.
Asian Eyelid Surgery
If you are considering Asian Blepharoplasty, be certain to choose an experienced and Board Certified surgeon who understands, and knows how to repair, your specific eyelid anatomy and achieve your goals. In the San Francisco Bay Area call (925) 943-6353, to schedule a personalized and private consultation appointment.
Ears come in all shapes and sizes. If you like your ears, Otoplasty is not for you, but if you feel your ears are too big, stick out too much or have an unusual shape, Cosmetic Ear Shaping Surgery may be just what the doctor ordered.
Who Gets Cosmetic Ear Surgery?
I discussed Ear Pinning recently here on the San Francisco Plastic Surgery Blog. The post included several Otoplasty Before and After Photos and answers many of the frequently asked questions about Otoplasty.
Otoplasty Video (Prominent Ear Reduction)
While before and after pictures do illustrate the words, for some, video provides the optimal experience. Below is a segment from my latest KRON 4, Body Beautiful show. More Ear Pinning Before and After Pictures are included, and narrated, to help illustrate what Otoplasty has to offer.
Man Boobs can affect men at every stage of life. All men are all born with them, due to the effects or maternal estrogen on the male breasts. This usually resolves in a few months, but can persist. The most common timing of Gynecomastia is during adolescence. With puberty comes hormone surges that can lead to Male Breast Development. The problem impacts about two-thirds of young men. For half these men, the swelling resolves over a year or two. For about one third of men, the breast tissue persists, and can become tender, annoying and embarrassing. Some men will not develop Moobs (Man Boobs) until later in life, and often as a side-effect of medications.
There are several ways to treat Gynecomastia, because it can present in different forms. The Gynecomastia Reduction Video below provides several examples of Gynecomastia Before and After Pictures and a narrative for perspective. This KRON 4 television segment is from Body Beautiful and supplements the information that can be found here on the San Francisco Plastic Surgery Blog and my other web sites. While I hope you find the information useful, it cannot substitute for an in-person consultation with a qualified and experienced Board Certified Plastic Surgeon.
Gynecomastia Reduction Video (Male Breast Reduction)
Male Breast Reduction Consultations
Gynecomastia affects most men at some point in their lifetime. For young teens, it is good to get checked, but waiting is usually recommended unless the problem is extreme or persists. If you have persistent male breast enlargement, and would like to schedule a private appointment, call (925) 943-6353 today, for a personalized consultation in our San Francisco Bay Area Plastic Surgery Clinic.
Breast Augmentation Revision is a specialty unto itself. It includes any Breast Implant Revision for breast implant replacement, deflation or for a change in size or style. Other reasons for Breast Augmentation Revision include correction of capsular contracture and breast implant malposition like bottoming out, symmastia (uniboob), lateral displacement and double bubble. A rare Breast Implant Complication, Breast Implant Erosion, was reviewed in last week’s Body Beautiful Sneak Peek.
Breast Augmentation Revision Video
This Breast Implant Revision Video reviews some of the most common reasons for correction and shows Breast Augmentation Revision Before and After Pictures to illustrate what Breast Augmentation Revision can do.
Breast Implant Complications corrected in this video include:
Breast Implant Deflation
Symmastia (Uniboob or Breadloafing)
Breast Implant Malposition (implants in the wrong place)
Breast Implant Erosion
Adjustment of Breast Implant Size
Breast Implant Revision Video
Breast Augmentation Revision Consultation
Breast Implant Revision covers a wide variety of procedures. If you have had Breast Augmentation, and are considering breast revision surgery to improve your results, call (925) 943-6353, today, and schedule your private and personalized consultation.
Attention Plastic Surgery Television viewers. Body Beautiful will be broadcast live on KRON4 this Wednesday, September 7, 2016, At Noon – Live. So tune-in to get the latest Plastic Surgery News, and see if I get it right on the first take.
Plastic Surgery Topics Will Include…
This week’s show will be thirty minutes packed with what’s new in Cosmetic Plastic Surgery. Topics will some of the most popular procedures here in the San Francisco Bay Area including:
Breast Augmentation Revision for…
Breast Implant Deflation
Breast Implant Exposure (Skin Erosion)
Breast Implant Malposition
Breast Implants too small
Gynecomastia Reduction (Male Breast Reduction)
Otoplasty (Ear Pinning for Prominent Ears)
Asian Blepharoplasty (Asian Eyelid Surgery)
There will be plenty of discussion and Before and After Pictures for illustration. Below is a sneak peek.
Breast Augmentation Revision
The patient below had a rare, but serious Breast Augmentation Complication, requiring staged Breast Augmentation Revision Surgery. Her breast implant nearly eroded through the skin on the bottom of her left breast. Oversized Breast Implants in small breasts with poor soft-tissue coverage are at greater risk. This is more commonly seen after Breast Reconstruction when the breast has been radiated to treat breast cancer. It is unlikely to occur in a young, otherwise healthy woman, but it did.
Breast Implant Revision: Sometimes breast implant revision is urgent. The square shape sticking out of the bottom of this patient’s left breast is her breast implant, and it’s about to fall out.
Breast Augmentation Revision Stage I – The Salvage Operation
The top row of photos are the before and after photos from the first stage of her Breast Implant Revision Surgery. The upper left photo shows that the patient’s left Breast Implant is eroding through the skin of the lower breast. It’s about to fall out, and the current breast implant needs to be removed, urgently. If the Breast Implant becomes exposed, infection quickly follows. After careful discussion, it was decided to proceed with Breast Implant Removal on both sides.
Breast Augmentation Revision – Stage I was urgent removal of the left breast implant, which had nearly eroded its way through the lower pole of the breast. It was elected to remove both implants during stage I, because replacing the original saline breast implants with smaller silicone gel filled breast implants was part of the plan to decrease the risk of recurrence.
Having one implant in and one implant out was an option, but would have left her with an almost undisguisable amount of asymmetry. Moreover, the plan was to use smaller replacement implants, to decrease the risk of another breast implant erosion. Leaving both implants out forever would also treat this problem, and completely eliminate any chance of it happening again.
Breast Augmentation Revision Stage II – Asymmetric Breast Augmentation
While the nearly Exposed Breast Implant problem was solved, there were two new problems: 1) obvious breast asymmetry and 2) breasts which are too small for my patient’s preferences. The Breast Asymmetry is two fold. The left breast is smaller than the right, and the left breast is higher and tighter on the chest wall.
Breast Augmentation Revision Surgery – Stage II. The second stage entailed lowering the left implant pocket, expanding the lower, contracted pole of the left breast and asymmetrically augmenting the breasts to decrease the size difference.
Breast Implant Revision Surgery was performed to asymmetrically increase the size of the breasts, and to lower the left breast to match the right. The initial results are shown above, just one week after surgery. An alternative approach would be to raise the right side with a Breast Lift; however, this would require additional, external scars on the right breast.
Breast Augmentation Revision Surgery – Stage II and a patient patient. As time marched on, the results improved. No additional surgery was performed after stage II. While initially the skin stretched well, the muscle was tight. Over several months the muscle relaxed and the symmetry improved, as expected.
The Breast Revision Before and After Photos above show the results after new, smaller Silicone Breast Implants were placed, and the breasts were allowed to heal. The left picture is one week after surgery. In this photo, the left breast mound is firmer, higher and more projecting, as would be expected when more stuffing is placed in a smaller pillow case.
As the breasts heal, the left breast skin and muscle relax, the left breast implant descends and her results improve. The right, after photo shows the results after a few months. A larger breast implant was used on the left, to correct the asymmetry, and while initially it may seem like her Breast Implant Problems are not completely corrected, over time, it settles down. It is a good deal better than the potentially life-threatening complication she presented with originally, as shown below.
Breast Implant Revision Before and After Photos – the left picture is how the patient initially presented. The second picture is a few months after completion of both stages (breast implant removal and breast implant replacement with pocket modifications).
Breast Augmentation Revision Consultations
Breast Augmentation Revision is considerably more complicated than primary Breast Augmentation. If you have problems with your Breast Implants, seek an experienced and Board Certified Plastic Surgeon for your revision surgery. If you are in the San Francisco Bay Area and would like to schedule a personalized consultation appointment call (925) 943-6353, today.
PS – Don’t forget to watch Body Beautiful live at noon, this Wednesday, September 7, 2016, on KRON4, the Bay Area’s New Station.
Two and one half years ago, I posted about Jean-Claude Mas and his substandard PIP Breast Implants. Poly Implant Protheses, PIP for short, had their Breast Implants banned in 2010, after it was revealed that industrial grade silicone was being used, rather than the medical grade silicone that has passed safety tests for use in the human body.
PIP’s Jean-Claude Mas Goes To Jail
PIP founder, Jean Claude Mas, loses appeal in French court, and goes to jail. Photo credit: Guillaume Horcajuelo
In 2013, Jean-Claude Mas was convicted of fraud. His sentence included: four years in prison, a75,000 euros ($86,000) fine and that he be banned for life from working in medical services or running a company. This year, a French appeals court upheld the decision.
Plastic Surgeons Blew The Whistle First
Plastic Surgeons were aware there was a problem years before the government took action, because PIP Breast Implants leaked about ten times as often as FDA approved breast implants. In fact, the US FDA refused PIP’s application for Silicone Breast Implant sales in the US.
Unfortunately, the Pre-filled Saline version of PIP Breast Implants was sold here for a short time. They also leaked at much higher rates than those seen with the other FDA approved Saline Breast Implant manufacturers at the time: Allergan and Mentor.
PIP – Cheaper Is Not Better
You have likely heard the expressions, “You get what you pay for,” and that, If something is too good to be true, it is false.” Well both these expressions apply to Plastic Surgery. It is not an area that you want to get the cheapest price.
PIP’s appeal was that they were cheap. While they claimed to be equivalent to other manufacturers, they were not. They cost less, because they were made cheaply. Industrial silicone is not the same grade or cost as medical silicone, and the company substituted industrial grade silicone for medical grade silicone for years without regulators catching on.
Jean-Claude Mas posing at his manufacturing facility. Only a few knew what was really going on with PIP’s breast implant quality control.
Plastic Surgeons complained for years that something was wrong with PIP Breast Implants, but the final straw was when the company supplying the large quantities of industrial grade silicone raised their suspicions also. Even the people selling the industrial grade silicone knew there was nothing good about these Cheap Breast Implants.
PIP Knew The End Was Coming
PIP Breast Implants manufacturing was headquartered in La Seyne-sur-Mer, France. Since they were not FDA approved, they were not subject to FDA rules, like surprise inspections. Incredulously, European inspectors had to give 10-days notice prior to an inspection. During this grace period, PIP would remove drums of industrial silicone from their manufacturing facility and quickly order the medical grade silicone they should have been using all along. After the inspection, the industrial silicone was brought out again and cheap manufacturing resumed.
When it was clear that the end was near, PIP slashed its prices further. Knowing that their inventory was going to be confiscated, they sold in bulk, and they sold quickly. PIP flooded the market with cheap “European Approved” breast implants throughout Europe and South America. In the end, between 300,000 and 400,000 women in 65 countries are believed to have received PIP implants. Europe was a major market, but more than half went to South America. Fortunately, they were not sold in the United States.
Medical Tourism – Buyer Beware
Poly Implant Protheses was founded in 1991 and shut down in 2010. It is thought that the manufacture of the Bogus Breast Implants, those made with industrial grade silicone, began in 2001.
It Is Recommended That All PIP Silicone Breast Implants Be Removed
PIP Silicone Breast Implants were never sold in the US; however, if you took advantage of cheap overseas breast augmentation early this millennium, you need to check if you have PIP Silicone Breast Implants.
Breast Implant Removal Before And After Photos: One option is to have the breast implants removed and not replaced. Another is to replace your PIP breast implants with FDA approved breast implants, the later options will also preserve the size of your breast. Be certain to ask your Board Certified Plastic Surgeon about your options for treatment.
PIP Silicone Breast Implants have a higher risk of leaking than approved models, as well as being implicated in several deaths due to systemic toxicity and several cases of induced breast cancer. If you have these breast implants, the current world-wide recommendation is to have them removed, and if you desire, replaced with approved Medical Grade Silicone Breast Implants.
If you have PIP Silicone Breast Implant’s, find an Experienced Board Certified Plastic Surgeon in your area and get the information about the benefits, and risks, of having them removed. I have removed several. The Ruptured Saline Breast Implants are easy to remove. The saline is absorbed by the body, and all that remains is the solid shell. Ruptured Silicone Breast Implants, especially those filled with the less cohesive gel, are a much bigger problem.
When Breast Implants are ruptured, the gel that fills them can migrate. Most the PIP silicone Breast Implants I have removed were ruptured. The longer the Leaking Breast Implants remain in your body, the less likely it is that all the industrial silicone gel can be removed. Like most problems, the sooner it is addressed the better the outcome. Breast Augmentation Revision is a better option. If you are in the San Francisco Bay Area, call (925) 943-6353 today.
Gynecomastia is normal breast tissue and fat in the male chest, that is often disproportionate. When large enough, it causes a feminization of the chest, and in the case above, puffy nipples. Direct excision of the excess breast tissue creates a more masculine appearance, and less embarrassment at the beach.
More men are having Cosmetic Plastic Surgery. Since starting my practice in 1997, the number of cosmetic procedures performed among men has increased over 325%, according to the American Society for Aesthetic Plastic Surgery (ASAPS). Liposuction remains the number one requested procedure; however Male Breast Reduction, or Gynecomastia Reduction, has the fastest growth rate.
How Common Is Male Breast Reduction Surgery?
In 1997, according to the American Society of Plastic Surgeons (ASPS), around 20,000 men underwent Gynecomastia Reduction. Last year, over 30,000 men did the same, representing a 5 to 7% increase from the previous year’s data. The word is out. You don’t have to live with man boobs anymore.
What Is Gynecomastia?
Gynecomastia is the medical term for enlargement of the male breast. Enlargement can as small as a lump under the areola, to large enough to look like a well endowed female breast, and everything in between.
When Does Gynecomastia Arise And Will it Go Away?
Gynecomastia Reduction: In this case, direct excision of the glandular tissue from under the areola not only smooths the chest’s contour, but also reduces the apparent size of the areolae — the pigmented skin that surrounds the nipple. The darker color is simply a result of the same amount of pigment distributed over the new, significantly smaller, area.
Gynecomastia normally becomes a problem at puberty. It is estimated that two-thirds of men suffer from some degree of breast enlargement during adolescence, and that for half of them, it persists into adulthood. If you are a young man with a new lump in your breasts, it is a good idea to have it checked by your family doctor to be certain the tissue and your hormones are normal. The best early treatment for true Gynecomastia is usually observation, as half the cases with resolve on there own within two years of developing.
What Is Gynecomastia Made Of?
Just like in the female breast, there are two tissue types found in the enlarged male breast: glandular tissue (breast) and adipose (fat). The amount and location of these tissues determines how best to treat the gynecomastia. Glandular tissue is firm, tough and sometimes painful. Adipose is soft, weak and non-tender. Glandular tissue is most often found under the nipple and areola, with a tail extending to the side, while fatty tissue is more peripheral. Both are more likely to be found in the lower pole of the male chest. Too much of either can stretch the skin to the point that extra skin may also need to be removed.
How Is Gynecomastia Treated?
Gynecomastia Reduction: Sometimes the amount of breast tissue on the chest is enough to completely feminize the chest. Liposuction, combined with direct excision of the glandular components, restored the flat chest that this young man is expected to have. Again, the reduction in areolae is due to the skin’s elastic contraction after the breasts are unstuffed.
So how do I treat Gynecomastia? The answer depends on several factors and the best way to find out what can be done in your specific case is to schedule a personal consultation appointment with an experienced, Board Certified Plastic Surgeon in your area.
For adolescents, usually the best treatment is to wait a few years and see if it goes away. On the other hand, all new lumps should be checked by your primary medical doctor to be safe. If the area has persisted for several years, and is not resolving, Gynecomastia Reduction may be the best next step.
For adults, first you must be healthy. Male Breast Reduction is an elective procedure and needs to be held to a higher standard. If treatment is safe, there are the components to breast reduction that need to be evaluated and treated: the amount of gland, the amount of fat and the amount of skin.
Glandular tissue, true breast tissue, responds best to direct surgical excision. It is tough, so the cannulas used for Liposuction often just bounce off it. Fatty tissue, on the other hand, is soft and responds well to Liposuction. Both methods reduce the amount of “stuffing” in the chest, and allow the skin to shrink.
Gynecomastia Reduction: Sometimes the skin enveloping the breasts is redundant. This man has breast enlargement and sagging from his gynecomastia and loose skin. In this case, the breast tissue and the excess skin were removed through an incision that runs along the bottom of each breast. Without this, the skin would sag further over the inframammary fold from the loss of support caused by removing the chest’s stuffing, just like deflating a balloon causes the balloon to fall over.
In most cases, the skin and the areola will shrink proportionately, to reveal the contours of the pectorals major muscles. In cases of extreme gynecomastia, or after large weight loss, the skin may be loose, and direct excision of the excess skin may be necessary. This needs to be determined at an in-person consultation.
Gynecomastia Reduction Consultations
If you are suffering with embarrassing, or painful, male breasts, treatment is available. Call my San Francisco Bay Area office in Walnut Creek, CA at (925) 943-6353 today, and schedule your private, informative consultation appointment. More information is available on line through the links embedded in this article and on my San Francisco Breast web site’s Gynecomastia Page.