Radiant Life – RLM Success Files features breast augmentation by Dr. Joseph A. Mele.
As seen in Radiant Life Magazine. (Click to enlarge.)
Radiant Life® Magazine is The Aesthetic Wellness Magazine, and is dedicated to innovations in cosmetic plastic surgery. The current issue of Radiant Life® features an article by Lindsay Haakenson on the latest innovations in Breast Augmentation entitled Breast Surgery 2.0.
Radiant Life Magazine approached me with a short deadline and the need for an example of modern breast augmentation. My staff contacted a few of our many satisfied patients. Jennifer was the first to respond, and she immediately agreed to both an interview with Radiant Life Magazine and the use of her pictures, and for that she gets my sincere thanks. This is a true testimonial* to how worthwhile breast augmentation surgery has been for her. Thanks goes out to my other happy patients who also graciously responded, and to Lindsay Haakenson for including me.
Jennifer first came into the office for a consultation after noticing her breast volume had decreased after pregnancy. She was interested in restoring what mother nature had both given and then taken away. She expressed a desire to maintain proportions with her body, and wanted a natural look that would be attractive, without being distracting.
The excerpt to the right is from the Breast Surgery 2.0. At the top are her breast augmentation before and after pictures. Before submuscular (subpectoral) breast augmentation, her breasts where asymmetrical, small, had a relatively low set nipple and a constricted base. The distance between the nipple and the inframammary fold was short, and the remaining breast tissue was firm. She had a mild form of what is sometimes referred to as a tubular breast.
The simplest way to correct a tubular breast is with a subglandular breast augmentation. Often a periareolar mastopexy is performed to lift and reshape a protruding nipple/areolar complex at the same time. Okay, that may not sound so simple, and in Jennifer’s case, the easiest way was not necessarily the best way.
Every patient requires careful thought and consideration. In Jennifer’s case, the tubular deformity was mild, and a periareolar breast lift was not needed. The lack of breast tissue higher on the chest meant that the upper pole of the implant was more likely to be seen. A saline implant was placed behind the muscle to help soften the upper pole of the implant, and to give a more teardrop shape. A periareolar incision was used, and this, as is usual, healed very well.
For a more pronounced tubular breast deformity, this approach may not work. Unlike the approach using a periareolar lift, it will not correct a bulging areola that is often seen in concert with the narrow constricted breast base. If you are considering breast augmentation, it is important to seek a qualified and experienced, board certified plastic surgeon, so that the safest and most predictable plan can be constructed.
I want to thank Jennifer for volunteering to share her results with you. The best part of my job is helping my patients. I am thrilled that Jennifer is happy with the results of her breast augmentation.
* As per the latest American Society of Plastic Surgeons Code of Ethics this is a true testimonial. I have not reimbursed my patient in any way for her kind words, and I have not paid Radiant Life Magazine to be included in this article. To read the entire Radiant Life Magazine article, click here. You need to be able to view pdf files in order to display the contents properly. To download the latest version of Adobe Reader for free click here.
Breast Augmentation Revision Surgery, has become an important area of specialization in my Walnut Creek plastic surgery practice. As many as 25% of women undergoing breast augmentation, will require a second surgery in the ten years after surgery.
Breast augmentation revision surgery may be elective, and may be performed to increase or decrease the size of your breast implants. Increasing breast implant size is one of the most common, and simplest forms of breast implant revision.
Breast implant revision surgery may be needed to replace a deflated implant or to revise the scar around the implant (capsular contracture). The major US breast implant manufacturers offer lifetime replacement of their breast implants if a breast implant deflation occurs. They also provide financial support if the breast implant leaks occur within ten years of the primary breast augmentation.
You will find videos on breast augmentation and breast augmentation revision surgery posted on the San Francisco Plastic Surgery Blog. They can be viewed here or on my YouTube channel. Please remember, the 800 number appearing on the video was only for the live show, to contact my office for additional information or to schedule a private consultation appointment, call (925) 943-6353.
This video comes from a segment of KRON’s Body Beautiful. You can hear:
What is Breast Augmentation Revision surgery?
Who needs Breast Implant Revision surgery?
Do your silicone breast implants or saline breast implants come with a warranty?
Is there an expiration date on my breast implants?
Before and after pictures of Breast Implant Deflation Replacement Surgery?
Can breast implant asymmetry be improved?
How does Capsular Contracture present?
Can breast surgery be performed for a diabetic (a person with diabetes)?
If you are considering Breast Implant Revision Surgery in the San Francisco Bay Area, a Board Certified Plastic Surgeon can help. This first step is a consultation appointment so that existing problems can be defined and achievable goals can be set.
Breast Augmentation Revision Surgery, has become a specialty unto itself. While most women will never require breast augmentation revision, a large minority will. The exact number is difficult to pin down; however, studies have indicated that in the ten years after breast augmentation, as many as 25%, will undergo a second breast augmentation related surgery.
Many times there is no complication, and the primary motivation for breast augmentation revision surgery is to change the size of the implants. Perhaps the most common breast implant revision surgery is to replace breast implants with a larger pair. This is the reason I place so much emphasis on defining the goal size for breast augmentation before surgery. Even so, minds and goals can change with time.
Other times breast implant revision surgery is less volitional, and may be due to gravity (requiring a breast lift), breast implant failure (breast implant deflation or breast implant rupture) or capsular contracture (tightening of the nature scar that surrounds the implant causing movement or firmness of the breast implants).
Other videos on this subject have been posted on the San Francisco Plastic Surgery Blog and they can be viewed here (see bottom of article for links) or on my YouTube channel. When you are watching this video, please note, the 800 number on the video was for the live show, to contact my office for additional information or to schedule a private consultation appointment, call (925) 943-6353.
On this episode of KRON’s Body Beautiful you can learn:
What are the main reasons for Breast Augmentation Revision surgery
Do breast implants wear out?
What is the capsule around the breast implants?
What is Capsular Contracture?
How long is the Breast Implant Warranty?
How many Breast Augmentations are performed each year?
How is Breast Implant Revision Surgery performed?
What is the recovery like after Breast Augmentation Revision?
Breast Augmentation Revision Surgery requires a careful analysis of the existing problem, a thoughtful discussion about the good (and bad) aspects of all available treatments, the ability to adapt the plan to any new findings found during surgery, and a careful recovery, to speed you return to daily life. The first step is a private consultation with a Board Certified Plastic Surgeon.
After children (or weight loss) the breasts lose volume and the abdominal wall is lax.
The Mommy Makeover remains one of the most frequently requested combinations of cosmetic plastic surgery procedures. Often performed to repair the damage after childbirth, the Mommy Makeover most commonly combines Breast Augmentation with the Tummy Tuck.
Depending on what needs to be fixed, however, other procedures can be substituted. Sometimes a Breast lift is added to, or used instead of the Breast Augmentation. If the breasts remain too large after childbirth, a Breast Reduction may be more appropriate. The Mini Tummy Tuck can sometimes replace the full Tummy Tuck, and Liposuction is often used as an adjunct.
The combination of breast enhancement and abdominoplasty is usually performed after childbirth, but is also common after significant weight loss. In both instances the problems are similar. The breasts may lose volume and support, and the abdomen is often left with excess skin and muscle laxity. The Mommy Makeover restores lost volume and support to the breasts and tightens the abdominal wall (skin and muscle).
The woman pictured to the left is lucky. Although she has lost volume in her breasts after childbirth, her nipples remain high above the inframammary fold (the bottom of the breast). This means a breast lift is not needed. Instead, the lost breast volume was restored. Breast implants were placed behind the pectoralis muscle with a natural result.
Her abdominal wall had been stretched, resulting in loose skin and weakened abdominal muscles. There is a small amount of fat behind the lower abdominal skin, but this will be removed when the skin is tightened. Overall she is in good shape, and a good candidate for a Mommy Makeover.
Starting at the Top – Breast Augmentation
Before Mommy Makeover, the breast have lost volume and are smaller than before pregnancy.
After Mommy Makeover, breast volume has been restored to a pre-baby state.
Breast augmentation was performed to restore volume. The goal was to restore the lost volume, and just a little bit more. Smooth round implants where placed behind the muscle via a periareolar (below the nipple) approach. This gives a nice teardrop shape the the breasts. By selecting the appropriate size, a very natural appearance can be obtained.
Around the Middle – The Tummy Tuck (Abdominoplasty)
Before Mommy Makeover, the abdominal muscles and skin are over stretched.
After Mommy Makeover, the abdominal muscles and skin have been tightened.
The Bottom Line – Restoring Proportions
After children (or weight loss) the breasts lose volume and the abdominal wall is lax.
After Mommy Makeover, the abdomen is flat and the breast's proportions are restored.
The art of plastic surgery has a lot to do with proportions. By giving volume to the breasts and taking volume from the abdomen, an aesthetic balance is achieved. But, there is more benefits than just looking nice. Clothing fits better and the energy wasted on feeling self conscious can be used for more productive endeavours. Having children is something to be proud of, not looking like you’ve had children … priceless.
The base width diameter (BWD) of the breast is an import measurement for selecting the best breast implant. For my San Francisco Bay Area breast augmentation patients to achieve the best breast augmentation, the width of the breast must correlate with the width of the implant.
I am often asked what is the best breast implant profile or best breast implant volume for a certain bra size. The answer depends on many specifics, but the base width diameter (BWD) of the breast is one of the most important measurements used to determine the optimal breast implant diameter.
This patient desired restoration of her lost breast volume. Note the patient's left breast is higher than her right breast prior to breast augmentation.
After breast augmentation. Breast implant diameter was selected to enhance cleavage without overly enhancing width.
There is more to choosing the best breast implant than just picking an implant with a diameter that matches the chest, but it is a great place to start. While no implant is the perfect breast implant, choosing one that is proportional to the body is the best way to get a full and natural result.
It’s like Goldilocks. If the beast implants are to wide, they will hang over the sides and you will be bumping into them with your upper arm. If the breast implants are too narrow, they will tend to fill the outside of the breast and leave a space between the beasts. If the implants are just right, the breast can be filled over the entire base width and create a naturally full cup.
After choosing the appropriate beast implant diameter, the volume can be adjusted by choosing the appropriate profile. Low profile breast implants are flatter than high profile breast implants. The larger the volume desired, the higher profile selected and the more projection obtained.
Prior to breast augmentation. The breast maintains a low projection but more volume is desired.
After breast augmentation. Enhanced projection is obtained by using a higher profile implant.
When I trained as a Plastic Surgery fellow at Saint Francis Memorial Hospital in San Francisco, California, only moderate profile saline breast implants were available for breast enlargement. Today, saline breast implants come in three different profiles: Low, Moderate and High. The variation in projections is even greater for silicone breast implants with five profiles available. When the form-stable gummy-bear beast implants are finally approved, even more choices will be available.
Choice is good. When you are choosing, be certain to pick a Board Certified Plastic Surgeon who can help you make the most of your options.
For more information on how to choose the correct breast implants see these links:
The previous example of scar revision was a keloid scar revision. Keloid scars tend to be raised and larger than the original injury. The following scar revision is for an irregular, hypopigmented and wide-spread scar. It may have been more hypertrophic in the past, but was mature, soft, flat and pale prior to revision. This patient presented over a year after breast implant placement. The implants were inserted through an incision normally placed around the lower edge of the areola (the pigmented skin around the nipple). In this case, the scar was too high, and did not heal well.
Wide spread periareolar scars below the nipples after breast augmentaion.
This is noticeable because the scar is white, wide and irregular within the tan skin of the areola. This incision was not placed at the edge of the areola, making the white scar even more noticeable. This is also a poor scar. It is very wide for this location. This scar not a fine line, it’s not a line at all, but rather, an irregular blotch.
The periareolar incision is one of my favorite incisions for breast augmentation because a nice, fine, discrete scar is the normal result. The original scar was not of my making. Since I’ve done hundreds, if not thousands of breast augmentations using this approach, I felt very confident that this particular scar could be improved.
The plan was to excise the previous scar, and obtain a narrow scar that follows the contour of the areola. With the new scar placed at the junction between the areola and the normal skin, the scar’s location is disguised.
After scar revision the periareolar scars are thin, fine and follow the natural contours.
This scar revision was performed in the office, under local anesthesia, without complications. The resultant scar is narrow and follows the natural contour of the areolas. Close up views are included below for comparison.
Before scar revision - Right breast with wide white irregular misplaced scar.
Before scar revision - Left breast with wide spread hypopigmented scar.
After scar revision - Right breast with thin soft pale scar following the natural curve of the areaola.
After scar revision - Left breast with less noticeable and improved scar.
Scar revision can be a very rewarding procedure. The scars cannot be completely erased, but by making scars less noticeable, they can be forgotten.
Whether you are considering breast enhancement, or already have breast implants, this video discusses the most frequent reasons why corrective surgery is needed and includes before and after pictures and live viewer questions.
This is part two of two from an episode of KRON 4’s Body Beautiful with Vicki Liviakis that aired last month. This video discusses breast augmentation revision surgery, including before and after pictures and viewer questions.
Specific examples are shown. The first patient (shown below) had breast augmentation in her twenties. Years later, she had children and was not happy with the changes in her breast resulting from pregnancy and breast feeding. Before and after breast augmentation revision surgery pictures are shown. In her case a breast implant exchange and breast lift and were performed to adjust for lost volume and improve the shape of the sagging breasts.
A different patient had breast implant bottoming out. In her case the implants had fallen below the inframammary fold leaving the nipples high and flattening out the normal curve beneath the breast. Corrective beast augmentation surgery included breast implant implant exchange to adjust the volume, and the inframammary fold was reconstructed internally to raise the implant and form a distinct curve beneath the breast.
The caller in this video had a question about ruptured silicone gel implants that were placed in the 1970’s. If any breast implant has ruptured, it needs to be removed. Most frequently, a ruptured breast implant is replaced at the same operation. Silicone gel implants in particular should be removed sooner than later. A ruptured silicone gel implant, over time, can cause increased scarring and hardening of the breasts, as the body tries to wall off the free gel. If not treated promptly, this type of scarring can lead to further problems than may not be correctable.
Silicone gel filled implants placed before 1985 seem to have a higher deflation rate than the new silicone breast implants. In fact, the outer shell of silicone breast implants has changed twice since the 70’s. The first change, in the mid 80’s, was to decrease the rupture rate. The second change, in the mid 90’s, was to reduce gel bleed (the ability of the silicone gel to leak through outer shell without a rupture). Both US FDA approved breast implant manufactures, Allergan and Mentor, offer lifetime replacement of their implants should they fail, and often provide financial support should this occur within ten years of your breast augmentation procedure. For details of the Mentor and Allergan (Natrelle) Breast Implant Warranties click on the manufactures names. It is best to get the information direct from the manufacturer; however, the Mentor site has been going through some changes, perhaps with the merger with Johnson & Johnson, so if you can’t link there, JustBreastImplants.com also has information on breast implant warranties.
Breast Augmentation is currently the most frequently performed cosmetic plastic surgery procedure. Whether you are considering breast enhancement, or already have breast implants, this video discusses the most frequent reasons why corrective surgery is needed.
Breast augmentation revision surgery is sometimes necessary even in the best of hands. Revision surgery can range from simple, like changing breast implants after deflation or changing sizes, to more complicated, like when treating breast ptosis (sagging) or capsular contracture. The best way to reduce your risk of needing breast revision surgery is to choose a qualified Board Certified Plastic Surgeon.
If you need breast revision surgery, choosing a well trained Board Certified Plastic Surgeon with a broad experience in breast enhancement surgery is the best way to get a satisfying result. By choosing a Board Certified Plastic Surgeon who specializes on cosmetic surgery, you get a doctor who is well trained and well rehearsed in a wide range of treatment options.
Breast implant revision in San Francisco is no different than in other areas of the United States. Sometimes the results of the breast augmentation where just not what was expected. Other times, the result were great and either the breasts change, the implants change or the desires change. When these situations arise, breast augmentation revision surgery could be your best option to get back into the shape you want.
This is part one of two from an episode of KRON 4’s Body Beautiful with Vicki Liviakis that aired last month. This video discusses breast augmentation revision surgery. Part two will include more discussion, before and after pictures and viewer questions.
The best way to be certain your plastic surgeon is appropriately trained to perform breast augmentation surgery is to make sure that he or she is a Board Certified Plastic Surgeon. By choosing a Plastic Surgeon who is a member of the American Society of Plastic Surgeons (ASPS), you can be certain that their credentials have been verified. ASPS members are held to higher standards in ethical care of patients and continuing medical education requirements. ASPS standards are above and beyond those required by State licensing boards and hospital credentialing committees.
A small percentage of ASPS members are also members of the American Society for Aesthetic Plastic Surgery (ASAPS). ASAPS members are ASPS members who specialize in the cosmetic side of Plastic Surgery. ASAPS members must meet the standards of ASPS, apply independently for membership to ASAPS and demonstrate a commitment to cosmetic plastic surgery both in education and in patient care.
ASPS is the largest plastic surgery specialty organization in the world. Founded in 1931, the society is composed of board-certified plastic surgeons who perform cosmetic and reconstructive surgery. ASAPS is the leading organization of board-certified plastic surgeons specializing in cosmetic surgery of the face and body, and I am proud to be an active member of both.
Next time I will talk more about the reasons for breast augmentation revision surgery and how a qualified Plastic Surgeon can help.
Yesterday I was on NBC Bay Area, KNTV, Living Well with host Peggy Pico. We discussed the Mommy Makeover San Francisco, focussing on breast augmentation, tummy tuck, mini tummy tuck and liposuction. I will be posting several excerpts of the show on the San Francisco Plastic Surgery Blog. This video discusses breast enhancement and the future postings will discuss the belly enhancement, tummy tucks and liposuction. The full episode is also available on line. To view the entire segment, just click on the NBC Bay Area logo above.
Breast augmentation is one component of the Mommy Makeover. It has become the most frequently performed cosmetic plastic surgery procedure in the United States with 400,000 breast enlargement surgeries performed last year. That’s 800,000 breast implants.
This segment discusses the types of breast implants available: saline breast implants, silicone breast implants and even the soon to be available gummy bear solid gel implants. Comparisons area made between smooth round breast implants and textured shaped breast implants. The importance of body proportions is stressed, and before and after pictures are reviewed.
I will add additional video from the show about tummy tucks, mini tummy tucks and liposuction in the near future so stay tuned. If you would like more information on Breast Augmentation San Francisco, click here to visit the Breast Augmentation page on DrMele.com.
Dr. Joseph A. Mele, MD, FACS of Walnut Creek, California, will be appearing this Thursday on KNTV, NBC Bay Area in San Jose. Host Peggy Pico will interview Dr. Mele on NBC’s Living Well about the Mommy Makeover – Breast Augmentation and Abdominal Rejuvenation.
Living Well with Dr. Mele premiers this Thursday, September 24, 2009, at noon. Encore broadcasts will air next month, also at noon, on Thursdays, October 1, 8 and 15. Hope you enjoy the show.
