As 2011 draws to a close, so do the first 50 years of breast implants. In 1961, American plastic surgeons Thomas Cronin and Frank Gerow, and the Dow Corning Corporation, developed the first silicone breast prosthesis, filled with silicone gel. In 1962, Timmie Jean Lindsey became the first woman to receive silicone breast implants.
Breast Implants Have Come a Long Way in 50 Years
Saline Breast Implants
You might be surprised to find out that saline filled implants did not appear until the French company, Laboratoires Arion, began manufacturing them in 1964. Filled with 0.9% saline, water that is the same saltiness as your body, these implants are filled in the operating room after insertion, allowing for a smaller incision compared to the incision needed for pre-filled silicone gel breast implants. While early models were fragile, contemporary saline breast implants have a stronger silicone elastomer shell. These implants became the most frequently used in the US during the 1990′s, when silicone gel filled breast implants where restricted to reconstructive use only.
Silicone Breast Implants
While saline filled breast implants have changed relatively little over their lifetime, silicone filled breast implants have gone through five distinct generations.
First Generation Silicone Breast Implants
The first generation was tear-dropped shaped. Yes, that’s correct, the first breast implants were silicone filled and tear dropped shaped. These implants have a smooth surface, so to keep them from rotating, a Dacron patch was attached to the back. It had the texture of the soft side of Velco, and allowed the body a point of attachment to prevent rotation. The shell was thick, as was the gel inside. This helped prevent deflation and tearing at the point of fixation. The thicker gel also made it easier to take care of any leaks, as the thicker the gel, the less it migrates.
Second Generation Silicone Breast Implants
In the 1970′s, in an attempt to improve the look and feel after breast augmentation, the shell and the gel inside the implant was made thinner. Unfortunately, new technology doesn’t always mean improved. With these changes came more complications. The thinner shells broke more frequently and the thinner gel could migrate farther after a leak. Even without a leak, silicone gel could “bleed” through the intact shell like Helium through a balloon. This resulted in a class action lawsuit against Dow Corning and other breast implant manufacturers. Other “improvements” which arrived in the 70′s were polyurethane foam coating for the implant shell and double lumen implants.
Polyurethane foam coating reduced the incidence of capsular contracture, but a concern that a breakdown product of the coating (TDA) might cause cancer stopped sales. The FDA later stated the risk was infinitesimally small, but no breast implant manufacturer has sought FDA approval for sale in the US. These implants remain available in Europe and South America.
Double lumen implants have two sections, an inner chamber pre-filled with silicone gel and an outer chamber that can be filled with a varying amount of saline. Double lumen implants were used mostly for breast reconstruction. Unfortunately, the increased complexity of dual chamber breast implants led to increased device failure, and eventual withdrawal from the market.
Third Generation Silicone Breast Implants
Around 1985, breast implants where manufactured with elastomer coated shells. This significantly reduced the number of implant failures and also the problem with gel “bleed”. Since that time the rate of capsular contracture has dropped. Coincidence? Maybe. At the same time the changes in the shell were made, additional improvements in manufacturing and quality control also occurred.
Fourth Generation Silicone Breast Implants
Fourth generation implants are defined by a return to a thicker, cohesive silicone gel filler. Back to the future is the theme for the third and fourth generation breast implants. Like the original breast implants, with thicker tougher shells and thicker less runny filler, the safety and predictability of fourth generation, cohesive gel breast implants has improved. Fourth generation silicone gel filled implants are currently the only FDA approved silicone breast implants currently available in the US.
Fifth Generation Silicone Breast Implants
The next incarnation of silicone breast implants are the gummi-bears. They are filled with a soft, semi-solid silicone with the consistency of gummi-bear candy. They are soft enough to give when compressed, but firm enough to return to their original shape when the pressure is released. Since they are essentially a solid, these implants do not experience problems with leakage or gel migration. Most are made with an anatomical shape. To prevent rotation, the implants surface is textured to allow the capsule to attach to the shell. This works most the time, but implant malposition from rotation can be a problem (not seen with smooth round implants). Overall, the form-stable implants are more firm, but still soft. Somewhat surprisingly, they can still ripple (wrinkle).
Allergan Natrelle Style 410 (gummi-bear) breast implants come in 12 shapes and many sizes.
Since they are solid, gummi-bear breast implants require a larger incision for placement. This can be a deterrent when a simple breast augmentation is being considered. The mastectomy incision used for breast reconstruction and the breast lift incisions allow for the insertion of solid implants without additional incision length.
Soft-solid breast implants are figuratively sitting on the shelf at the FDA. Despite some advantages, the approval process has ground to halt over the last several years. The FDA has all the information it has requested, and no new requests for information are forthcoming. Despite this, no vote has been taken. It is increasingly unclear to industry, plastic surgeons and patients alike what the reason is. These fifth generation breast implants have a good record in Europe, where they have been used since 1995, and they have been available since 2000 to our northern neighbor, Canada. Dear FDA, how about approving silicone implants that can’t leak this year?
Earlier this year, the San Francisco Plastic Surgery Blog reported an extremely unusual, but possible association between breast implants and a rare form of Non-Hodgkin’s Lymphoma named Anaplastic Large Cell Lymphoma or ALCL. The tumor is extremely rare. Of the 5-10 million women with breast implants, fewer than 100 cases have been identified. Literature reviews have identified 34 unique cases, and as many as 75 cases may have been identified worldwide. Because of the rare nature of the tumor, it is not clear what the association between ALCL and breast implant is.
Anaplastic Large Cell Lymphoma
Demographics of all Known Reported Cases
Demographics of the cases are as follows:
Age: Median 51 years old, Range 28-87 years old
Implant Type: Silicone 24, Saline 7, Not specified 3
Time from implant to ALCL diagnosis: Median 8 years, Range 1-23 years
Reason for Breast Implant: Reconstruction 11, Cosmetic 19, Not Specified 4
The American Society of Plastic Surgery (ASPS) and the American Society for Aesthetic Plastic Surgery (ASAPS) have partnered with other international plastic surgery societies like the International Society for Aesthetic Plastic Surgery (ISAPS), to provide an organized way to report, and characterize the diagnosis and treatment of ALCL since its discovery.
ALCL is Not Breast Cancer
Breast cancer dwarfs ALCL in both numbers of cases and lethality. Breast cancer has an incidence of 1 in 9 women. This means for a group of nine randomly selected women, one woman would be expected to develop breast cancer in her lifetime. The actual breast cancer rate is a little higher, and this is why routine mammograms after age 40 are so important for early detection. The risk of getting breast cancer is about 700 times higher than the risk of getting struck by lightning.
No Increased Rate of Breast Cancer for Women with Breast Implants
While the association between ALCL and breast implants is still being worked out, there is no increased risk of breast cancer in women with breast implants. In fact, the results of more than seven long-term follow-up studies show that women with implants have a lower rate of breast cancer than is expected in the general population, and higher survival rates, perhaps due to enhanced breast awareness and early detection.
Looks Like ALCL, but Doesn’t Act Like ALCL
ALCL associated with breast implants is not as aggressive as other types of ALCL. It acts more like cutaneous lymphomas than the more systemic form of ALCL. ALCL associated with breast implants has been characterized as a rarely occurring, low-grade lymphoma, that seems to grow slowly and locally. While the risk of breast cancer is 1 in 9, the risk of ALCL is less than 1 in 300,000, and most resources quote ranges of 1 in 500,000 to 1 in a million. The risk of getting ALCL associated with breast implants is 50 to 150 times lower than the risk of getting stuck by lightning.
Last week, news of the first reported death from ALCL associated with breast implants hit the French news. The details are not known at this time, and unfortunately, the case is further complicated by the use of fraudulent breast implants that were filled with industrial grade silicone instead of the required medical grade silicone. The implants were manufactured by Poly Implant Prothèses (PIP) at La Seybe-sur-Mer in the Var. The company was forced to close in March of 2010, after it was determined that the implants were filled with non-medical grade silicone gel. These implants have more gel bleed, and are ten times more likely to break. Even though the company was forced to withdraw its products from the market when the discovery was made, thousands of French women are known to still have the defective implants. These implants have never been FDA approved in the US. Only Allergan’s Natrelle and Mentor’s Memory Gel breast implants are currently FDA approved.
The Latest ALCL News
The best information currently available on the topic is a review of opinions by a panel of experts from RAND Health, UCLA’s department of medicine’s division of hematology-oncology, the University of Michigan Health System’s department of surgery’s division of plastic surgery and others. The article has been accepted by ASPS’s Plastic and Reconstructive Surgery Journal, but has not yet been published. The results are based on the small number of cases known to exist, represent the opinions of the seven panel members and are not based on prospective randomized evidence. A copy of the article can be found here. The article’s disclaimer reads: Support for this study was provided by the Plastic Surgery Educational Foundation (PSEF) and the Aesthetic Surgery Education and Research Foundation (ASERF) through unrestricted grants from Allergan, L.L.C.; Mentor Worldwide, L.L.C.; and Sientra, Inc. Neither the study sponsors nor the listed companies had roles in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript.
As more information becomes available, I will post more updates. It is important to remember that this is an extremely rare problem. It is a sensational story though, so it is sure to hit the mainstream media soon. The ASPS, ASAPS and ISAPS are actively seeking all known cases of ALCL found around breast implants to determine what, if any association exists, if there is a causal relationship and how best to treat the disease when discovered. If you have, or know someone who has, ALCL associated with breast implants, please contact one of these plastic surgery societies and the FDA.
More Information About ALCL
A current summery of ALCL cases appeared in the June issue of Plastic and Reconstructive Surgery. The abstract can be read here.
The FDA has an ALCL and breast implants FAQ page here. Moreover, all confirmed cases of ALCL in women with breast implants should be reported to Medwatch, the FDA’s safety information and adverse event reporting program. Report online here or by calling 1-800-332-1088.
How to Detect ALCL Associated with Breast Implants
The chances of getting breast implant associated ALCL are extremely remote. I have thousands of patients with breast implants, and chances are that I will go my entire career without seeing one case. This, however, will not keep me from looking for it.
Most cases of ALCL in patients with breast implants have presented with a seroma (fluid collection) around the breast implant more than six months after the initial surgery. To try and detect ALCL as soon as possible, experts are recommending aspirating (draining) seromas around breast implants when they occur later than six months after breast augmentation or breast augmentation revision surgery, and also sending the fluid for cytologic analysis to check for abnormal cells. If you feel you have a problem with your breast implants, do not delay; seek the advice of a Board Certified Plastic Surgeon in your area.
This month, Sparkah.com has named the Top 100 Cosmetic Surgeons / Plastic Surgeons in San Francisco of 2012 and Beyond, and I am happy to share with you my inclusion in the top 10. The San Francisco Bay Area is home to some of the best trained plastic surgeons in the nation, and a big Thank You goes out to all my patients who placed me among the very best, and or course to Sparkah for including my private plastic surgery practice at the top of its list.
It’s certainly not the cheapest place to live, but like plastic surgery, you get what you pay for: great weather, great culture, beautiful scenery and a large variety of what makes life worth living. From beaches to mountains, sports to the arts, there is something for everybody. It’s a great place to live, work and play. I am glad that my Walnut Creek Plastic Surgery practice has been included as a part of what is great in our San Francisco Bay Area neighborhood.
Thank you for the opportunity to continue to contribute. Whether you are looking for facial plastic surgery like a facelift, eyelid lift or rhinoplasty, or body work like a breast augmentation, tummy tuck or liposuction, Joseph A. Mele, III, MD, Inc., will be here for you in 2012 and beyond.
Inclusion in the Top Plastic Surgeons in San Francisco to See In 2012 is based on:
Dermal Filler to Treat Facial Wrinkles - Immediately after Perlane injections to Facial Wrinkles in the Naso-Labial folds with typical post-injection redness and swelling. The redness lasts about 24 hours, and can often be concealed with makeup.
Time flies when you are having fun, and I really enjoy being a Board Certified Plastic Surgeon in the beautiful San Francisco Bay Area. Clear sunny skies the weekend before Thanksgiving, and the rich diversity of the Bay Area’s culture remind me daily that it’s a great place to live, and to practice plastic surgery.
Experienced Hands
I am a board certified surgeon, who after completing my general surgery chief residency, spent three years as a fellow, specializing in plastic surgery right here in San Francisco. As a Board Certified Plastic Surgeon, my practice incorporates a wide variety of plastic and reconstructive surgery, but the majority of my time is spent performing cosmetic plastic surgery in Walnut Creek, San Ramon and Concord, California.
More Than 10,000 Procedures Performed
Time really does fly when you are having fun. A few years ago I performed my 10,000th procedure in private practice. Whether I am performing immediate breast reconstruction in the hospital, complex body shaping procedures after massive weight loss at an accredited surgery center, or a straight forward scar revision in my Walnut Creek plastic surgery office , the goals remain the same: maximum results, minimum recovery and happy patients.
“The noblest art is that of making others happy” – P.T. Barnum
Minimally Invasive Treatments
Sometimes less is all that is needed. A facelift is more than is necessary to correct moderate nasolabial folds (the lines that run from the sides of the nose to the corners of the mouth). As shown in the picture above, we have effective minimally invasive options in the form of dermal fillers like:
Restylane
Juvederm
Perlane
Radiesse
These provide a quick fix with minimal down time. They are called liquid facelifts, but they are not meant to be a substitute for facial plastic surgery. These dermal fillers reduce facial wrinkles in three ways:
Physically filling the wrinkle
Reducing skin folding by thickening the skin
Coercing the body to build collagen
Correction – Right Where You Need It
The beauty of facial fillers is the simplicity with which they work. They do not require an extensive medical work up, and treatments are well tolerated. Brand-name fillers are supplied in pre-filled, single-use syringes that provide a sterile, consistent product. Since Restylane, Juvederm and Perlane are HAs, a normal component of your skin and joints, the risk of allergy is extremely low. They are great products to work with, and they work well, right where I put them.
Experience Counts
Now matter how great the product, the most important factor in having your wrinkles treated, is the person doing the injections. Precise correction is imperative. Enough filler must be used to maximize improvement. Too much will give unnatural results; too little leads to under-corection and minimal results. It is also important to place the dermal fillers smoothly to avoid lumps and bumps.
Injectables, by their very natural, are fluid. Care must be taken in the initial placement, and caution used in the hours after injecting to avoid displacement. Forceful squeezing of Restylane, Juvederm, Perlane of Radiesse can mold the result, for better or for worse. After a few hours, the gel is set, and displacement is unlikely.
Recovery After Injectables
Another attractive feature of injectable fillers is the relatively short recovery period. There may be some initial swelling and redness over the area injected, but this tends to resolve in a day or two. Bruising occurs in 10-15% of injections, and this can take several days to resolve.
Ice and elevation help speed the return to normal activities. It is important to inform your doctor if you are taking any blood thinners, and this includes over the counter pain medications like aspirin, ibuprofen (Motrin, Advil), Aleve, as well as, vitamin and herbal preparations like Vitamin E, Fish Oil, Ginsing, Ginko and many others. It is best to let your doctor know before you show up for your injection to avoid a delay in treatment.
Timing of Treatments
Dermal Fillers (Restylane, Juvederm, Perlane, Radiesse) and Muscle Relaxers (Botox, Dysport, Xeomin) last for months. If you are planning your wrinkle treatments around a specific date, do not procrastinate. Since swelling and bruising can last several days, it is ideal to have the treatments three weeks before your goal date. This provides time for correct, recovery and touch-ups in the event that it is necessary.
Dermal Filler Treatments
Dermal filler treatments are offered and performed every day in my office. For new patients, the procedure can be performed at the time of consultation, as long as there are no contraindications. If you are interested in finding out more about dermal fillers, give us a call at (925) 943-6353 or use the contact form on the left.
Also ask about Botox and Dysport. Since the Botox and Dysport not packaged for individual use, treatments are grouped around the first and third Wednesday of each month, or by special arrangement.
Tummy Tuck (Abdominoplasty) can remove excess skin and fat from your belly. It is not weight loss surgery, but a body shaping procedure, designed to optimize your shape.
Tummy Tuck Before and After Pictures (Abdominoplasty)
Tummy Tuck Before and After - Left: Before Abdominoplasty with loose skin, muscle laxity and lower abdominal fat. Right: After Abdominoplasty with tight skin, firm muscles and removal of disproportionate fat. Liposuction (Liposculpture) was also performed on the sides
Sometimes less is more
I am all for using the smallest hammer to get the job done. Sometimes a tummy tuck is more surgery than is needed to get a great result. Sometimes less, a Mini-Tummy-Tuck or Liposuction, is sufficient.
Abdominoplasty and Liposuction are not interchangeable. While liposuction can remove disproportionate fat, a tummy tuck does much more. A tummy tuck can correct loose skin and lax muscle. It is not just a matter of getting better results.
Sometimes Less is Worse
Doing liposuction instead of a tummy tuck is often not a decision between good and better. Liposuction performed on an area with loose skin may make you look worse. Liposuction, even laser liposuction and ultrasonic liposuction, do not shrink skin well enough to convert tummy tuck candidates into liposuction candidates. Liposuction under loose skin can be expected to remove the skin’s support causing additional folding and visible irregularities, lumps and indentations, in the skin.
Remove loose skin from below and above the belly button
Reduce the superficial abdominal wall fat that accumulates on the lower belly
Why do Women and Men have Adbominoplasty?
Common reasons for Abdominoplasty are:
Pregnancy
Fluctuations in Weight
After bariatric (weight-loss) surgery
Stretch marks of the lower abdomen
Aging
Heredity
Previous abdominal surgery
Who is a Good Candidate for a Tummy Tuck?
Abdominoplasty may be a good choice if:
You are healthy.
Your weight is stable.
You have realistic expectations.
You do not smoke.
When not to have Abdominoplasty
Most Board Certified Plastic Surgeons will advice postponing your Tummy Tuck if:
You are trying to become pregnant.
You are planning significant weight loss.
You are continuing to gain weight.
You have uncontrolled medical problems.
You continue to smoke.
Pregnancy and large fluctuations in weight will diminish and potentially undo the benefits of abdominoplasty. Uncontrolled medical problems should always be addressed, but uncontrolled medical problems can significantly increase the risks associated with surgery. Smoking increases the risk of wound healing problems after procedures like tummy tucks, facelifts and breast reduction by 600%. It is best to stop smoking prior to having surgery, and once stopped, why not quit? It will improve your health and appearance.
Tummy Tuck Consultation
If you are considering rejuvenating your belly, make a consultation appointment with a Board Certified Plastic Surgeon. There is no better way to get the specific information you need to make an informed decision. To schedule a personal plastic surgery consultation with Dr. Mele, send us a request via the contact form to the left, or give us a call at (925) 943-6353.
On April 12, 1961, Soviet cosmonaut, Yuri Gagarin, used a space capsule like this to become the first human in orbit. That same year, the first breast implant was developed by American plastic surgeons Thomas Cronin and Frank Gerow.
Breast implant capsules have a bad reputation. Normally, they are only discussed when they are causing problems like capsular contracture or breast implant malposition. However, like a space capsule, the breast implant capsule provides protection, and without breast implant capsules, there would be no breast augmentation.
What is a breast implant capsule?
Whenever a breast implant is used for breast augmentation, your body makes an encapsulating sheet of scar that lines the breast implant’s pocket. This normally thin, soft scar is called the “capsule”, and it is incredibly important in maintaining your breasts’ enhancement.
Have you ever wondered how breast implants stay in place?
The capsule is responsible for keeping the breast implants in the proper position beneath the breasts. It forms in just a few weeks after breast augmentation surgery and keeps the breast implants from freely sliding around. Optimal breast implant position is a combination of careful placement during surgery and a proper capsule. The capsule will quickly line the surgical pocket and provide a smooth, strong interface between the breast implant and the soft tissues of the chest. By reinforcing the pocket, the capsule helps to maintain optimal breast implant placement.
The capsule protects the breast implant.
Not only does the capsule help keep the breast implant in position, it also protects the implant. The interior of the capsule is smooth and allows for nearly frictionless movement within its boundaries. The outer layers of the capsule provide enhanced vascular circulation and helps protect the breast implant from infection.
When good capsules go bad.
So what can go wrong with breast implant capsules? The perfect capsule is firm enough to maintain proper breast implant positioning, but soft enough to not be felt. Problems occur at the extremes, so like Goldilocks the capsule needs to be just right, not too hard and not too soft.
Too soft
When the Breast Implant Capsule is too soft, it does not provide enough support for the implant. Gravity pulls the implants down when standing or to the side when laying down. The larger the breast implants, the greater the force. Stomach sleeping also pushes the implants apart. A healthy capsule can resist the tendency toward Breast Implant Malposition, but a good bra helps too.
Treatment for implant malposition can include a capsulorrhaphy, to tighten the capsule, and close off the areas where the implant should not be going. If an overly large breast implant in compounding the problem, a smaller implant can help reduce recurrence. The use of an acellular dermal matrix (ADM) has also become more popular as a way to line, reinforce and thicken the capsule.
Too hard
When the Breast Implant Capsule is too hard, it can compress the implants, and cause Capsular Contracture. Capsular contracture can also result in breast implant malposition. If the capsule is tight only on one side, it will push the breast implant toward the soft side. If the capsule is tight all the way around, it can make the implant feel hard.
Treatment for capsular contracture includes capsulectomy, removing the thickened capsule, and capsulotomy, incising the capsule to allow it to expand. Both these techniques are performed in the operating room. An older, non-operative technique called closed capsulotomy was a way to split the capsule without surgery by forcefully compressing the implant. This has been largely abandoned as it has less predictable results, may lead to uncontrolled bleeding or implant rupture, and violates most breast implant warranties.
Just Right
The most common types of capsules are grade I followed by grade II. Grade I capsules are soft on not detectable from the outside, Grade II capsules feel firmer, but are not tight enough to cause visual changes. Both usually provide adequate support to allow the breast to age naturally, securely on the chest. If you are considering breast augmentation, or you have breast implants and are considering breast implant revision surgery, give me a call at (925) 943-6353 or contact my Walnut Creek Plastic Surgery Office using the contact form in the left column.
Breast Implant Revision Surgery is performed to improve the results of Breast Augmentation. While Breast Augmentation is both safe and effective, our bodies continue to change as we age. Breasts naturally change size and shape over time. This occurs with or without breast augmentation. While most changes are gradual, changes can happen relatively quickly with pregnancy and changes in weight.
Breast Implant Replacement
Breast implants can wear out too, requiring a new implant to be placed. The major US breast implant companies, Allegan and Mentor, do provide Breast Implant Warranties.
What Are the Common Reasons for Breast Augmentation Revision Surgery?
The most common reasons for Breast Implant Revision Surgery are a desire for a change in size, deflation of the breast implant, capsular contracture and breast implant malposition. It is important to clearly identify what problem(s) are bothersome, and to seek a consultation with a Board Certified Plastic Surgeon.
Below is number four of four of my latest Breast Implant Revision Videos. They appeared on KRON4′s Body Beautiful. The series covers Breast Augmentation, Breast Implants and Breast Augmentation Maintenance. The television show was broadcast live, so viewers could call in during the broadcast to have their questions answered. The (415) number shown in the video was only for the show; however, if you have Breast Augmentation or Breast Implant Revision questions, please call our San Francisco Bay Area Plastic Surgery Office directly at (925) 943-6353. If you prefer, you may also use the contact form on the left.
San Francisco Bay Area Breast Implant & Breast Augmentation Revision Video
San Francisco Bay Area Breast Implant Revision Questions
This Breast Augmentation and Breast Implant Revision Surgery video includes:
The type of trauma most likely to cause breast implant deflation
Common reasons for breast implant revision surgery
Changing breast implant size
Breast implant leaks
Capsular Contracture
Breast Implant Malposition
Breast Augmentation and Breast Implants Revision Resources
You are viewing number three of four Breast Implants Revision Video segments from Dr. Mele’s recent Body Beautiful television appearance. Here are links to the other segments:
October was national breast cancer awareness month. The NFL celebrated with NFL Pink’s A Crucial Catch. By teaming up with the American Cancer Society, and by wearing pink caps and gloves, the focus is on the importance of annual screenings, especially for women who are 40 and older.
Who Gets Breast Cancer?
Worldwide, 1.5 million people are expected to be diagnosed with breast cancer in 2011. The importance of self-examination and mammograms cannot be overstressed. The earlier breast cancer is detected, the better the cure rates, and the smaller the need for mastectomy. Controversy in the timing and number of mammograms has been highlighted here on the San Francisco Plastic Surgery Blog, and as new technology and detection strategies develop, these recommendations will change. We will continue to add our voice to San Francisco Breast Cancer Awareness.
What Can a Plastic Surgeon Do?
Plastic surgeons usually get involved after the diagnosis of breast cancer is made. I have been involved on both sides of the stethoscope, personally and professionally. The diagnosis is made worse by not knowing what to expect. Once the diagnosis is made, and the plan is selected; however, being able to contribute with breast reconstruction can be a big positive.
What Options Are Available for Breast Reconstruction?
Breast reconstruction in 2011 consists of two main options: Breast implants or breast flaps. Breast reconstruction with a breast implant is often begun at the time of mastectomy. The advantage of this immediate reconstruction is the ability keep a breast mound despite the mastectomy. Sometimes the reconstruction is better delayed until after the initial other treatments like chemotherapy or radiation.
Breast flaps include local rearrangement of skin, fat and even muscle from the abdomen and back, as well as microvascular transplantation. These operations can also be either immediate or delayed. They require additional surgical time and the healing of a “donor site”, but can avoid some of the complications associated with a breast implant.
What’s on the Horizon for Breast Reconstruction?
New technologies are also being explored. Fat and stem-cell grafting are being explored as “less invasive” methods of breast reconstruction, but these still remain controversial and should only be performed as part of a well planned and IRB reviewed investigation until more is known.
Another novel method involves a little of all the above. An Australian company, Neopec, uses a temporary implant, a flap of fat and a special gel to enhance cell growth, in an attempt to fill the space created by the implant and eventually form a new breast mound made of the patients own fat cells.
Breast Cancer Awareness Month – All Year Long
While it is nice to help restore that which is lost, it is better to treat breast cancer early before a mastectomy is necessary. So as Breast Cancer Awareness month draws to a close, and we continue to Walk for Breast Cancer and Race for the Cure, please remember your mammogram and to do a brief monthly self breast exam for the other eleven moths too.
Breast Augmentation remains one of the procedures that I perform most frequently. Whether you’ve always had small breast and want them larger, or you had larger breast and want them back, Breast Augmentation can help you achieve your goals.
Breast Implant Revision Surgery is performed to improve the results of Breast Augmentation. While Breast Augmentation is both safe and effective, our bodies change as we age. Breasts naturally change size and shape over time, and this happens even after breast augmentation. Changes can certainly be exacerbate by pregnancy and changes in weight, but most of the time the changes are gradual and sneak-up on us.
What’s New in Breast Implants and Breast Augmentation?
If you are considering Breast Augmentation or Breast Implant Revision surgery, you should know that new breast implants are available and more are on the horizon. New techniques are also being developed to help make your Breast Enhancement simpler, safer, more predictable and easier overall. Be certain to seek a Board Certified Plastic Surgeon for all your Cosmetic Breast Surgery needs.
Below is part three of four of my Breast Implant Revision Video that appeared on KRON4′s Body Beautiful. Options in Breast Augmentation, Breast Implants and Breast Augmentation Maintenance are reviewed. The television show was broadcast live, so viewers could call in during the broadcast to have their questions answered. The (415) number shown in the video was only for the show; however, if you have Breast Augmentation or Breast Implant Revision questions, please call our San Francisco Bay Area Plastic Surgery Office directly at (925) 943-6353. If you prefer, you may also use the contact form on the left.
San Francisco Bay Area Breast Implant & Breast Augmentation Revision Video
San Francisco Bay Area Breast Implant Revision Questions
This Breast Augmentation, Breast Implant Revision Surgery video includes:
The Breast Implants currently available
Saline Breast Implants – Natrelle (Allergan) and Mentor (J&J)
Silicone Gel Breast Implants (Natrelle and Memory-Gel)
Soft-Solid Silicone Breast Implants (GummiBear Implants)
Natrelle 410′s*
Mentor Contour Profile Gel (CPG)*
*The 3 yr and 5 yr data for the 410′s and CPG breast implants surpasses that of the breast implants that are already approved in this country. Why are they not approved? Only your FDA knows for sure.
Breast implant deflation
What are the signs and symptoms associated with a leaking breast implant?
How to check for a breast implant leak
How long do Breast implants last?
How are breast augmentation and breast lifts combined?
Breast Augmentation and Breast Implants Revision Resources
You are viewing number three of four Breast Implants Revision Video segments from Dr. Mele’s recent Body Beautiful television appearance. Here are links to the other segments:
If you are considering surgery for a Tummy Tuck, or Abdominoplasty, you may be interested in a post-surgical incision care research study.
General Information
We are now enrolling patients in a clinical research study to look at an investigational post-surgical incision care dressing used in scar healing. If you are thinking of having a tummy tuck (also called abdominoplasty), you may qualify for the clinical research study. The investigational dressing will be applied to one side of your abdominoplasty incision and the other side will be treated will be treated per the normal standard of care.
To Qualify You Must
To qualify you must:
be a man or woman between the ages of 18 and 65
be willing to participate in the study to evaluate a new dressing 1 week after a tummy tuck procedure
not have any known reactions to medical tapes or adhesives
not have a history of collagen vascular disease, cutis laxica, connective tissue disease, psoriasis, or lupus
not be diagnosed with scleroderma
not have a BMI > 30
not have had weight loss of >100 lbs. within six months of the tummy tuck procedure
not be a current smoker
not be taking steroid therapy within 2 months from the date of study enrollment
Study Participation Involves
Study participation involves:
study-related procedures and investigational dressing at no charge
weekly office visits (lasting approximately 20 minutes) for up to 12 weeks post surgery with application of a new dressing at each visit
photographic record taken of the incision at several visits
follow-up visits and photographic record at six and 12 months post surgery
Enrolled participants will be compensated for their time and travel at the completion of the study. To learn more about this study give us a call, (925) 943-6353, and schedule a free consultation appointment. We are conveniently located in the San Francisco East Bay Area community of Walnut Creek, California.
This is an IRB controlled study. More information about this clinical trail is also available here.
