San Francisco Breast 2.0 Enhancement (Augmentation, Lift and Reduction)

Posted July 09, 2017 in Areolar Reduction, Breast Asymmetry, Breast Augmentation, Breast Augmentation Lift, Breast Implant Options, Breast Implant Revision Surgery, Breast Lift (Mastopexy), Breast Reduction, Breast Reduction (Men), Breast Reduction (Women), Capsular Contracture, Home, Inverted Nipples, Nipple Reduction, Tubular Breasts

New Breast Enhancement Content

SanFranciscoBreast.com has been completely updated. This update includes new content, and it is artfully illustrated with new breast enhancement videos and more before and after pictures. In addition, the fresh content is wrapped in a new skin, improving navigation for the small screen and the desktop alike.

New Breast Augmentation Information

The site includes new pages featuring the most requested Breast Enhancement Procedures. For example, the Breast Augmentation Information has been exploded into a dozen detailed pages including:

  • Breast Augmentation
  • Breast Implant Options
  • Breast Augmentation Incisions
  • Breast Implant Placement
  • Today’s Breast Implants
  • History of Breast Implants
  • Breast Implant Warranties
  • Breast Implant Care
  • Breast Augmentation Lift
  • Breast Augmentation Revision
  • An Expanded Breast Augmentation Photo Gallery
  • And Hours of Breast Augmentation Videos

Breast Implant Revision Surgery

The Breast Augmentation Revision Section includes pages devoted to specific problems like:

  • Capsular Contracture
  • Breast Implant Deflation
  • Breast Implant Infection
  • Breast Implant Malposition
  • Breast Implant Removal
  • Breast Implant Rippling
  • Breast Implant Scar Revision
  • Breast Implant Replacement
  • Breast Lifts (Mastopexy)

    The Breast Lift section includes details about five main options for Mastopexy. There are also pages dedicated to the combination of Breast Lift using Breast Implants and Areola Reduction.

    Breast Reduction for Women and Men

    Options for Breast Reduction for Women are also reviewed, as several techniques have evolved during the 20+ years I have been in practice. Breast Reduction for Men, also known as Gynecomastia Reduction, is covered with attention paid to the causes and the most current treatments available.

    Specialty Breast Procedures

    A section on the often overlooked details of Breast Enhancement is also included. San Francisco Breast’s Specialty Breast Pages include:

    • Inverted Nipple Correction
    • Areola Reduction
    • Nipple Reduction
    • Tubular Breasts
    • Poland Syndrome
    • Other Congenital Breast Abnormalities
    • Areola Reconstruction
    • Nipple Reconstruction

    A Plastic Surgery Web Site Dedicated to Breast Enhancement

    I have tried to create an all inclusive Breast Enhancement site designed to provide detailed information about the many Plastic Surgery options available for Breast Enhancement, whether that be Breast Enlargement, Breast Reduction or Breast Reshaping.

    While the San Francisco Breast web site in meant to provide information, it is just a starting point. The Internet cannot take the place of a thoughtful, in-person consultation with a qualified Board Certified Plastic Surgeon. If you would like to schedule a private, personalized consultation appointment call (925) 943-6353 today. My San Francisco Bay Area Plastic Surgery clinic specializes in helping you obtain the best possible results.

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Breasts, Belly and Bootie Lifts – SF Bay Area Plastic Surgery

Posted June 04, 2017 in Areolar Reduction, Brazilian Butt Lift, Breast Asymmetry, Breast Augmentation, Breast Augmentation Lift, Breast Implant Revision Surgery, Breast Lift (Mastopexy), Breast Reduction, Breast Reduction (Women), Butt Lifts, Fat Grafting, Home, Inverted Nipples, Liposuction, Mini Tummy Tuck (Mini Abdominoplasty), Mommy Makeover, Post-Bariatric Surgery (After Weight Loss), Thigh Lifts (Thighplasty), Tummy Tuck (Abdominoplasty)

The Mommy Makeover is the most popular, and one of the most satisfying, combination cosmetic plastic surgery procedures. With the ability to reshape the breast and flatten the belly, the Mommy Makeover is the procedure of choice to rejuvenate the female form after pregnancy or weight loss.

The Mommy Makeover is the most popular, and one of the most satisfying, combination cosmetic plastic surgery procedures. With the ability to reshape the breast and flatten the belly, the Mommy Makeover is the procedure of choice to rejuvenate the female form after pregnancy or weight loss.

This Wednesday, June 7, 2017, I will be on the San Francisco Bay Area’s News Station, KRON 4’s Body Beautiful. The show airs live at noon. As usual, the discussion is focussed on the latest Cosmetic Plastic Surgery News for the San Francisco Bay Area.

Body Beautiful Plastic Surgery Topics

This week’s half-hour television show discusses Cosmetic Plastic Surgery of the Body. Planned topics include:

Mommy Makeovers SF Bay Area

The Mommy Makeover Before and After Pictures that leads this post demonstrate the most popular combination cosmetic plastic surgery. By combining Breast Augmentation and Tummy Tucks, the two areas the often sag after pregnancy, the breasts and the belly, are both addressed. Of course, the procedures can be performed without having had children. The term Mommy Makeover was coined because of the frequent request from mommies to repair the damages of pregnancy on their breast and bellies. Another common situation in which Mommy Makeovers are performed is significant weight loss.

EDIT – The first Plastic Surgery Video segment on Mommy Makeovers is up and live right here: Mommy Makeover Video.

Breast Augmentation Mastopexy (Breast Implants with Breast Lifts)

Breast Augmentation remains the most popular single plastic surgery procedure. Breast implants can provide volume, and as many as 40% of patients also benefit from a breast lift. Breast lifts can improve breast shape in ways the Breast Augmentation alone cannot.

Breast Augmentation remains the most popular single plastic surgery procedure. Breast implants can provide volume, and as many as 40% of patients also benefit from a breast lift. Breast lifts can improve breast shape in ways the Breast Augmentation alone cannot.

Breast Augmentation is still one of the most frequently performed cosmetic plastic surgery procedures, but what happens if the breasts are saggy, or the nipple is very low on the breasts? Breast Augmentation in these situations may provide larger breasts, but not necessarily perky ones. As many as 40% of Breast Augmentations combine some sort of Breast Lift. The most common reasons for this are low set nipples or saggy breasts due to excess skin.

Additional procedures can also be added to correct other breast problems, Fine details of the breasts that are often targeted for improvement are: Areola Reduction, the improvement of Breast Asymmetry, Breast Implant Revision for women who had Breast Implants before pregnancy and Inverted Nipple Repair. Breast Reduction, perhaps paradoxically, can also be combined with Breast Augmentation Mastopexy when heavy lower breast tissue is distorting the shape of the breasts.

Brazilian Buttocks Lift

The fastest growing procedure is the Brazilian Butt Lift. The procedure takes fat from areas where it is not desired and repurposes it, to enhance the shape of the buttocks.

The fastest growing procedure is the Brazilian Butt Lift. The procedure takes fat from areas where it is not desired and repurposes it, to enhance the shape of the buttocks.

A newer body procedure is allowing Board Certified Plastic Surgeons to shape an area that traditionally has been difficult. The Brazilian Buttock Lift (BBL), allows us to remove fat with Liposuction and reuse it to enhance the buttock contours. Pioneered by Brazilian Plastic Surgeon, Ivo Pitanguy, the procedure allows for customized augmentation of the buttocks, and shape that is more pleasing to the eye than Buttocks Implants can provide.

Thigh Lifts in the SF Bay Area

The Thigh Lift is used most often after weight loss. Excess skin and fat from the inner thigh is removed to reduce the size of the thighs and tighten the skin.

The Thigh Lift is used most often after weight loss. Excess skin and fat from the inner thigh is removed to reduce the size of the thighs and tighten the skin.

Thigh Lifts are one of the less frequently performed cosmetic plastic surgery procedures. The numbers have risen in response to Bariatric Surgery and the massive weight loss associated with it. As weight is lost, the thigh skin that is stretched during weight gain becomes loose. As the volume of the thigh decreases, so does the support that the extra fat provides the thigh skin. As a result, the skin can hang like drapery. The Thigh Lift removes this excess skin, and helps to tighten the thigh, especially the upper, inner thigh.

Watch Body Beautiful June 7, 2017, on KRON at Noon Wednesday

If you are interested in learning more about any of the above procedures, I have provided links in this post, and I encourage you to watch me live on KRON 4, this Wednesday at noon. Segments from the show will be posted here, on the San Francisco Plastic Surgery Blog, in the coming days. So if you miss the live show, you can still catch up here or on my local San Francisco Plastic Surgery Web Sites.

Internet education can be very helpful, and it is the goal of the San Francisco Plastic Surgery Blog; however, because information on the Internet is designed to apply to the general population, it is generic in nature. Medical advice cannot be giving without the personal contact that an in-person consultation appointment provides. To get “brand name” plastic surgery information, tailored to your specific needs, call my San Francisco Bay Area Plastic Surgery Clinic today, at (925) 943-6353, and schedule an appointment to get your personal, Board Certified Plastic Surgery information.

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Breast Augmentation and Pregnancy

Posted February 12, 2017 in Breast Augmentation, Breast Implant Revision Surgery, Breast Reduction, Home, Mommy Makeover

Breast Augmentation and pregnancy, the combination is the source of many questions in my San Francisco Bay Area Plastic Surgery Clinic. The answers center around a few themes: timing, breast feeding and how breasts change.

Pregnancy brings many changes including changes to the breasts. If you are considering Breast Enlargement, or if you already have Breast Implants, and you are contemplating pregnancy, this post is for you.

Pregnancy brings many changes including changes to the breasts. If you are considering Breast Enlargement, or if you already have Breast Implants, and you are contemplating pregnancy, this post is for you.

Breast Augmentation and Pregnancy: Timing

If you are done having children, the timing is ideal. The dramatic changes that can occur with pregnancy and breast feeding are over, and the focus is on getting back the breasts you had, or the breasts you always wanted to have. Details like size and shape tend to change slowly with age, but may swing widely with pregnancy. Having this behind you is a big plus in the direction of predictability. Additionally, details like inverted nipples, enlarged nipples or enlarged areolae can also be addressed. The Mommy Makeover can also be discussed if your belly has been stretched and has not recovered to your satisfactionx.

If you are planning to have children whether to have Breast Augmentation now depends on how soon you plan to get pregnant. If you are actively trying to get pregnant, you should wait. Your breasts may change with pregnancy. The changes may be small or dramatic, there is no way to predict. Even from child to child, there may be variation. If you get Breast Implants, and then things change dramatically, Revision Breast Augmentation may be needed to restore the breasts’ volume or shape.

If you are planning to have children later, it may make sense to have Breast Augmentation now. If you consider the immediate gratification of the Breast Enlargement, and you feel you will have enough time to enjoy the results, before possibly needing a touch-up, then go for it. The decision is not purely black and white. Breast Augmentation Revision is not always needed after pregnancy, and Breast Implant Revision Surgery may be necessary, even without becoming pregnant.

Before: This young woman had Breast Augmentation before pregnancy. After two children, the skin of her breasts relaxed, dropping the breast tissue off her Breast Implants.  After: Her Breast Implants were exchanged to adjust volume and a Breast Lift was performed to reshape and rejuvenate her breasts.

Before: This young woman had Breast Augmentation before pregnancy. After two children, the skin of her breasts relaxed, dropping the breast tissue off her Breast Implants. After: Her Breast Implants were exchanged to adjust volume and a Breast Lift was performed to reshape and rejuvenate her breasts.

Breast Augmentation and Pregnancy: Breast Feeding

If you have Breast Implants, there is no reason not to breast feed normally. Breast Implants do not taint the milk, and in many cases, the advantage that breast milk gives your infant is significant. Breast Augmentation may decrease the absolute volume of milk produced. The exact mechanism is unknown, but the easiest way to think about it is that the breast may be tricked into thinking it is already full. The volume of the implant may inversely effect the breasts’ milk production. On the other hand, I have had many women who had Breast Augmentation in their twenties, who later went on to breast feed successfully.

If you are currently breast feeding, and wondering when you can have Breast Enhancement Surgery, it is recommended to wait until the milk has dried up for a minimum of three months. This allows the breasts to finish their post pregnancy changes, and decreases the risks of operating on a lactating breast. However, it is never too soon to have a consultation with a Board Certified Plastic Surgeon, and in the San Francisco Bay Area, there are many to choose from.

Sometimes Breast Augmentation alone is enough to rejuvenate the postpartum breasts, as demonstrated in the above Breast Augmentation before and after pictures.

Sometimes Breast Augmentation alone is enough to rejuvenate the postpartum breasts, as demonstrated in the above Breast Augmentation before and after pictures.

Breast Augmentation and Pregnancy: Breasts Change

We touched on this a little above, but breasts do change with pregnancy. Some change very little, some quite dramatically, and sometimes one changes more than the other. If your breasts change a little, then Breast Augmentation after pregnancy will be very similar to Breast Augmentation before surgery. On the other hand, if the breasts increase rapidly in size for lactation, and then shrink, often to a volume smaller than their original size, adjustments will be needed in your Breast Enhancement. These adjustments depend on the size and shape of your breasts.

Size is perhaps the easier of the two to understand. If breast lose volume, more stuffing is required to perk them back up to the desired size. In cases when the breasts enlarge, but do not shrink back down to the original size, it may be advantageous to have a Breast Reduction, especially when the sizes are uneven. When the breasts shrink too much, Breast Implants are used to restore volume and improve both the shape of the breasts and the fit of clothing.

The shape of the breasts is determined not just by their volume, but mostly by the breasts’ skin. When the volume of the breast shrinks, but the skin doesn’t, excess sagging occurs. Breast Augmentation alone may not be enough. A combination of Breast Augmentation and Breast Lift is needed in as many as 40% of women after pregnancy. The Breast Lift is used to reshape the breast and remove the skin excess, while Breast Implants can restore volume and increase the bust.

Breast Augmentation Consultations

If you are considering Breast Augmentation, give me a call at (925) 943-6353, and schedule a private, personalized consultation appointment. It is never too early to get the facts, and there is no better way to get a plan tailored to your needs than with an in-person consultation with an experienced, Board Certified Plastic Surgeon.

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Mommy Makeover SF Bay Area

Posted December 26, 2016 in Breast Augmentation, Breast Augmentation Lift, Breast Lift (Mastopexy), Breast Reduction, Home, Liposuction, Mini Tummy Tuck (Mini Abdominoplasty), Tummy Tuck (Abdominoplasty), Videos

Every Mommy Makeover includes enhancement of both the belly and the breasts. The most common combination is Breast Augmentation with a Tummy Tuck (Abdominoplasty). However, other options include:

  • Breast Enhancement
    • Breast Lifts
    • Breast Implants with Breast Lift
    • Breast Reduction
  • Belly Enhancement
    • Liposuction
    • Mini Tummy Tucks
  • Other Body Enhancements
    • Brazilian Butt Lift
    • Lower Body Lift
    • Facial Enhancement

The combination best for you depends on what you need, tempered by safety and predictability.

Mommy Makeover Video Presentation

The television segment included below is all about Mommy Makeovers and includes many of the most popular variations. The Mommy Makeover Video includes Mommy Makeover Before and After Pictures that illustrate what the procedure has to offer.

The following video segment is from my latest appearance on the San Francisco Bay Area’s New Station, KRON 4. The show gives me the opportunity to talk about the latest Cosmetic Plastic Surgery News.

Mommy Makeover Video

Make Your Mommy Makeover Consultation Appointment

When considering a Mommy Makeover, be certain to find a Board Certified Plastic Surgeon in your area who has years of experience with the techniques currently available. If you are in the San Francisco Bay Area and would like to schedule a personalized appointment in my Walnut Creek Plastic Surgery clinic, give me a call today at (925) 943-6353.

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Breast Implant Removal – SF Bay Area

Posted October 15, 2016 in Breast Implant Removal, Breast Implant Revision Surgery, Home

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 will elect to have them removed at some point in their life.

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.

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.

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.

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.

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Breast Implant Revision Video – SF Bay Area

Posted September 11, 2016 in Breast Implant Revision Surgery, Home, Videos

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)
  • Capsular Contracture
  • 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.

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Body Beautiful On KRON4 Wednesday At Noon – Live

Posted September 04, 2016 in Asian Eyelid Lift (Asian Blepharoplasty), Breast Augmentation, Breast Implant Revision Surgery, Breast Reduction, Breast Reduction (Men), Capsular Contracture, Ear Shaping (Otoplasty), Eyelid Lift (Blepharoplasty), Home

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)
    • Capsular Contracture
    • Symmastia
    • Breast Implant Malposition
    • Breast Asymmetry
    • 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 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.

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 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.

As time marched on, the results improved. No additional surgery was performed after stage two. While initially the skin stretched well, the muscle was tight. Over several months the muscle relaxed and the symmetry improved, as expected.

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 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.

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Bogus Breast Implants – PIP President Goes To Jail

Posted August 28, 2016 in Breast Augmentation, Breast Implant Revision Surgery, Home

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

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.

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.

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.

Breast Implant Revision Surgery Consultations

The UK’s National Health Service (NHS) recommendations include seeking immediate care if you have any of the following signs:

  • Lumpiness or swelling in and around the breast
  • A change in the shape of the breast
  • Redness
  • Pain and tenderness
  • A burning sensation
  • Enlarged lymph nodes in the armpit

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.

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Breast Augmentation SF Bay Area with Breast Implants

Posted April 09, 2016 in Breast Augmentation, Breast Implant Revision Surgery, Capsular Contracture, Home, Videos

Breast Augmentation remains one of the most popular cosmetic plastic surgeries year after year. The 2015 Plastic Surgery Statistics show Breast Augmentation was a close second to Liposuction, with 305,856 breast enlargements performed.

Breast Implants

Breast Implants are used both to provide a larger bust and to augment the natural contours of the breast. The primary goal is to improve body proportions and the fit of clothing and bathing suits. Breast Implants can help when the breasts have always been small; however, the loss of breast volume after childbirth is another common reason for Breast Augmentation.

Breast Augmentation On Television

Below is a Breast Augmentation Video. It contains Before and After Pictures of Breast Augmentation with narration. Breast Implants and Breast Enhancement, including primary Breast Augmentation, Breast Augmentation Revision and the treatment of Capsular Contracture are illustrated and discussed on KRON 4, the San Francisco Bay Area’s New Station. The show is Body Beautiful, and many video segments are available here on the San Francisco Plastic Surgery Blog and Dr. Mele’s YouTube Channel. Just click on Videos under categories in the margin or the YouTube logo.

Breast Augmentation Video (Breast Implants)

Breast Augmentation Consultations

Breast Augmentation is a very personal decision. If you have always had small breasts, or your breasts have shrunk due to pregnancy, weight loss or even age, Breast Implants may be an option. To learn more, schedule a private consultation appointment with a Board Certified Plastic Surgeon in your area. If you are near the San Francisco Bay Area, give me a call at (925) 943-6353 to get all your questions answered.

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What is Breast Implant Capsular Contracture?

Posted February 20, 2016 in Breast Asymmetry, Breast Augmentation, Breast Implant Revision Surgery, Capsular Contracture, Home

Breast Augmentation remains the most popular cosmetic plastic surgery procedure year after year. Breast Implants enlarge small breasts, whether you were born with small breast, lost breast volume with weight loss or your children have sucked the life out of your breasts. Capsular Contracture can interfere with good results, but before I explain what Capsular Contracture is, I need to discuss Breast Augmentation and normal healing.

How Do Breast Implants Stay In Place?

During Breast Augmentation surgery, the Breast Implants are carefully positioned. A pocket is made, often behind the pectoralis major muscle, to the dimensions required. The size of the pocket is determined by the dimensions of the breast implant used, and the implant is determined by your anatomy and the amount of augmentation desired.

What is the Breast Implant Pocket?

Breast Augmentation depends of the formation of a proper Breast Implant Pocket for the best results.

Breast Augmentation depends of the formation of a proper Breast Implant Pocket for the best results.

After Breast Augmentation surgery, your body will naturally form a pocket, lined with collagen, that encapsulates the breast implant. Ideally, the capsule is tight enough to keep the implant from moving, but not so tight that the augmentation feels hard.

With Breast Implants, Size Matters

The size and shape of the Breast Implant is important to get the optimal breast shape. Your cosmetic result is determined by a combination of a good plan, good surgery, good healing and little good luck doesn’t hurt either.

  • A Good Plan is formulated before surgery, during your consultation appointment. It should be tailored to your anatomy and your goals. Good communication is critical. It takes teamwork to get a good result, so the best way to start your Breast Augmentation journey is with an experienced plastic surgeon whom with you communicate well.
  • Good Surgery is only possible after a good plan is agreed upon. Just like the consultation, there is teamwork involved with the surgery, too. As the patient, you have to prepare yourself properly before surgery, and after surgery, you need give your body time to heal and adjust to the breast implants. The surgeon is responsible for the actual Breast Augmentation procedure. While exact results can never be guaranteed, choosing an experienced, Board Certified Plastic Surgeon maximizes the predictability and safety of your procedure.
  • Most patients have Good Healing. The majority of healing is how your body responds to the procedure. Following your surgeon’s postoperative instructions and cooperating with their aftercare helps improve your outcome. Each surgeon will have individual variations in care, depending on the technique they use, their experience and most importantly, you. The Internet is unlikely to provide you with a better plan, so any knowledge you receive online, even from the San Francisco Plastic Surgery Blog, should be discussed with your surgeon prior to implementation. Even if you are my patient, I will construct a specific plan for you. Given the specifics of your situation, I will adapt your surgery to you, rather than the generic Internet breast aug patient.

The Breast Implant Pocket

When it comes to great results, the Breast Implant Pocket is second only to selecting the proper implant in importance. The proper breast pocket supports the breast implant and protects it. The pocket needs to be both in the proper place and of the proper size. A pocket in the wrong position means your implant is in the wrong position, but the size of the pocket matters equally.

With Breast Pockets, Size Matters Too

A pocket that is the wrong size will diminish your results. A pocket that is too large results in a implant that moves around too much. The implants in a pocket that is too large may fall under your armpits when you lay down, or bottom-out when you stand.

When the Breast Implant Pocket is too big, the breast implant does not have sufficient support. The result is breast implant malposition with Bottoming-Out when standing. A capsulorrhaphy was performed to close the lower pocket and increase the breast implant's support.

When the Breast Implant Pocket is too big, the breast implant does not have sufficient support. The result is breast implant malposition with Bottoming-Out when standing. A capsulorrhaphy was performed to close the lower pocket and increase the breast implant’s support.

A pocket that is too small squeezes the implant, and makes it immobile. A tight pocket makes the breast implant feel hard and may over time move the implant away from its ideal position. When this happens it is called Capsular Contracture.

Capsular Contracture

So, Capsular Contracture is when the normally helpful breast implant pocket becomes too tight. It is one of the most common reasons for Breast Augmentation Revision. Unfortunately, it is also one of the most unpredictable problems associated with Breast Implants.

Capsular Contracture results in a compressed breast implant that looks, smaller, feels harder and in the worst case scenario hurts. A capsulectomy and breast implant exchange was performed to provide this patient with softer, larger, painless breasts that look and feel better.

Capsular Contracture results in a compressed breast implant that looks, smaller, feels harder and in the worst case scenario hurts. A capsulectomy and breast implant exchange was performed to provide this patient with softer, larger, painless breasts that look and feel better.

Treatments for Capsular Contracture vary with the problems it is causing. Thin, tight capsules can often be opened by dividing them with a Capsulotomy. Thick, tight capsules may require complete removal with a Capsulectomy. Sometimes replacement of the breast implant is recommended, and sometimes ADM patches are recommended, to help prevent recurrence of the Capsular Contracture.

Breast Augmentation

If you are considering Breast Augmentation, or if you have breast implants and are considering Breast Augmentation Revision Surgery in the San Francisco Bay Area, give me a call at (925) 943-6353. A brief consultation appointment is usually all that is needed to review the details of your case and to formulate a plan that makes sense for you.

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