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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Thigh Lift Video (Thighplasty) SF Bay Area

Posted July 01, 2017 in Home, Post-Bariatric Surgery (After Weight Loss), Thigh Lifts (Thighplasty), Videos

The Thigh Lift was performed about 10,000 times last year in the United States alone. It is a specialized procedure that is almost exclusively performed after weight loss or bariatric surgery. As Thighplasty techniques have improved, its popularity has increased. The number of Thigh Lifts performed is up 8% this year compared to last year and up 87% since the year 2000.

Thigh Lifts are most often performed after massive weight loss or bariatric surgery. They can be combined with other skin tightening procedures, such as an abdominoplasty in this case.

Thigh Lifts are most often performed after massive weight loss or bariatric surgery. They can be combined with other skin tightening procedures, such as an abdominoplasty in this case.

Thighplasty Techniques (Thigh Lift)

There are two main techniques used for the Thigh Lift. For reduction of upper inner thigh skin redundancy an Upper Thigh Lift is performed using an incision that wraps around the upper thigh from the groin, along the top of the thighs and underneath the buttocks. This keeps the scar high on the thigh and allows for maximum upper thigh tightening.

The Medial Thigh Lift uses a scar running down the inside of the thigh from the top to the knee. This scar is more exposed than the scar from an upper thigh lifts; however, it can tighten the skin at the knees better. Which type of lift will work best for you depends on where the skin is loose. The following video discusses more Thigh Lift Details.

Thigh Lift Video (Thighplasty)

Thigh Lift Presentation

The Thigh Lift Video Presentation above is a segment from the San Francisco Bay Area’s News Station, KRON 4’s, Body Beautiful. The show discusses the latest in Cosmetic Plastic Surgery, and the topic for the day was Thigh Lifts. Thighplasty Before and After Pictures are displayed and narrated, to demonstrate how the procedure is performed and the results that can be obtained. Individual results will vary depending on the amount of skin laxity, amount of thigh fat that remains and the elasticity of your skin.

Thighplasty Consultations

The American Society of Bariatric Plastic Surgeons was formed by Board Certified Plastic Surgeons specializing in skin tightening after massive weight loss.

The American Society of Bariatric Plastic Surgeons was formed by Board Certified Plastic Surgeons specializing in skin tightening after massive weight loss.

If you are seeking a Thigh Lift, be certain to discuss your goals with a Board Certified Plastic Surgeon, who is familiar with Postbariatric Plastic Surgery. As an active member of the American Society of Bariatric Plastic Surgeons (ASBPS), post weight loss skin tightening is an area in which I specialize.

If you are in the greater San Francisco Bay Area and would like to schedule a personalized consultation appointment for a Thigh Lift, or another Cosmetic Plastic Surgery procedure, call (925) 943-6353 today.

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Breast Augmentation Lifts – Breast Lifts with Implants – SF Bay Area

Posted June 17, 2017 in Breast Augmentation, Breast Augmentation Lift, Breast Lift (Mastopexy), Home, Post-Bariatric Surgery (After Weight Loss), Videos

Breast Augmentation adds volume, while Breast Lifts reshape. What happens when you put them together? You get Cosmetic Plastic Surgery that can enhance both breast volume and shape.

Breast Augmentation adds volume, while Breast Lifts reshape. What happens when you put them together? You get Cosmetic Plastic Surgery that can enhance both breast volume and shape.

Total Breast Enhancement – Breast Aug and Breast Lift

Sometimes a Breast Implant or a Breast Lift alone is not enough to get the results we want. The combination of Breast Augmentation with a Breast Lift, or Augmentation Mastopexy, is used when breast sagging is combined with a loss of breast volume. Board Certified, San Francisco Bay Area Plastic Surgeon, Dr. Joseph Mele, discusses the nuances of Breast Augmentation Combined With Breast Lift on this episode of Body Beautiful, a live television show dedicated to the latest in Cosmetic Plastic Surgery news for the greater San Francisco Bay Area.

Breast Lift With Breast Implants Video

Combining Breast Lifts With Breast Implants

After pregnancy or significant weight loss, Breast Augmentation is combined with Breast Lifts as much as 40% of the time.

Breast Implants Make Breasts Larger

Everyone knows that Breast Implants make breasts bigger. It’s a simple concept. Adding volume behind the breast tissue, often behind the pectoralis muscle, enlarges the breasts you have. While the size of the breast changes, the shape does not. It simply inflates the skin you have.

Breast Lifts Make Breasts Perkier

Breast Lifts (Mastopexies), on the other had, are all about breast shape. Lifts do not make breasts bigger or smaller. Breast Lifts reshape the skin envelope. Mastopexies reposition the nipples/areolae into a more attractive position and reduce the amount of breast tissue that sags below the IMF (inframammary fold).

Breast Augmentation Lift Consultations

The subtleties of the procedures, whether considered separate or together, are beyond the scope of one San Francisco Plastic Surgery Blog post, though you will find other posts on the topic here and on my other web sites. But rather than learning everything there is to know about both, why not learn about the aspects of the procedure that apply to your body?

Breast Augmentation Lift Consultations are the best way, and really the only way, to get the information specific to your needs. They focus on your breasts and your goals. You won’t waste time learning about options that won’t do what you want, and you will learn what to expect from the procedures that are most likely to help you.

If you would like to schedule a personalized and private Breast Enhancement Consultation, call my office today at (925) 943-6353. Get specific information that is tailored to address your needs, not generic information meant for the masses.

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Mommy Makeover Video SF Bay Area

Posted June 11, 2017 in Breast Augmentation, Breast Augmentation Lift, Breast Lift (Mastopexy), Breast Reduction (Women), Home, Liposuction, Mini Tummy Tuck (Mini Abdominoplasty), Mommy Makeover, Post-Bariatric Surgery (After Weight Loss), Tummy Tuck (Abdominoplasty), Videos

The Mommy Makeover combines the most common body shaping procedures into a single operation for maximum breast and belly shaping.

The Mommy Makeover combines the most common body shaping procedures, breast augmentation and tummy tuck, into one, maximum result, breast and belly shaper.

The Mommy Makeover is one of my favorite combos. The ability to reshape the damage done to a woman’s body after childbirth or weight loss, in a single operation, makes it one of the most satisfying Cosmetic Plastic Surgery procedures.

What Is A Mommy Makeover?

The Mommy Makeover is not a specific procedure, but rather the combination of breast and belly enhancement performed in a single operation. Breast Enhancement may include Breast Augmentation, Breast Lift, Breast Augmentation with a Lift or Breast Reduction. It all depends on what needs fixing. Belly Enhancement is usually a Tummy Tuck; however, for the patient who needs less, Mini Tummy Tucks or Liposuction may be the procedure of choice.

Mommy Makeover Video Presentation

Recently, I had the opportunity to discuss Mommy Makeovers with the San Francisco Bay Area television audience. Body Beautiful airs on KRON 4, the San Francisco Bay Area’s News Station. The Mommy Makeover features the best and the latest in Cosmetic Plastic Surgery. This week, the spotlight is on Mommy Makeovers.

Mommy Makeover Video

More About Mommy Makeovers

The Mommy Makeover Video segment featured above reviews many of the available options and outcomes of the procedure for several of my patients. Additional Mommy Makeover Videos are available here, on the San Francisco Plastic Surgery Blog, and on my main site’s Mommy Makeover Video Page.

Mommy Makeover Consultations

When you are considering a Mommy Makeover, be certain to consult with a Board Certified Plastic Surgeon. Call (925) 943-6353 today, to schedule a private, personalized Mommy Makeover consultation in our San Francisco Bay Area Plastic Surgery Clinic.

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Body Beautiful Today at Noon Watch KRON 4

Posted June 07, 2017 in Brazilian Butt Lift, Breast Augmentation, Breast Augmentation Lift, Breast Lift (Mastopexy), Home, Mini Tummy Tuck (Mini Abdominoplasty), Mommy Makeover, Thigh Lifts (Thighplasty), Tummy Tuck (Abdominoplasty)

Learn the latest plastic surgery news on the Bay Area's News Station's, KRON 4's, Body Beautiful with Dr. Mele.

Learn the latest plastic surgery news on the Bay Area’s News Station’s, KRON 4’s, Body Beautiful with Dr. Mele.

Getting ready for today’s live show with Janelle Marie. Body Beautiful airs at noon (June 7, 2017) on the San Francisco Bay Area’s News Station, KRON 4. Tune in to hear the latest plastic surgery news. Today’s topics include:

  • Mommy Makeovers
  • Breast Augmentation Lifts (Augmentation Mastopexy)
  • Brazilian Butt Lifts (Fat Grafting to the Buttocks)
  • Thigh Lifts (Thighplasty)

The previous post has more details about the topics to be covered. If you are reading this after the show airs, segments from the show will be posted on the San Francisco Plastic Surgery Blog.

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

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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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Mommy Makeovers San Francisco Bay Area

Posted May 21, 2017 in Breast Augmentation, Breast Augmentation Lift, Breast Lift (Mastopexy), Breast Reduction, Breast Reduction (Women), Home, Liposuction, Mini Tummy Tuck (Mini Abdominoplasty), Mommy Makeover, Tummy Tuck (Abdominoplasty)

The most common Mommy Makeover combination is the one depicted above: Breast Augmentation and a Tummy Tuck. Breast Implants restore lost breast volume, while the Tummy Tuck flattens and tightens the abdominal wall.

The most common Mommy Makeover combination is the one depicted above: Breast Augmentation and a Tummy Tuck. Breast Implants restore the lost breast volume, while the Tummy Tuck flattens and tightens the abdominal wall.

Mommy Makeovers remain one of the most popular body shaping combinations for women. The combination of Breast Enhancement and Belly Embellishment is often performed after childbirth and/or weight loss, with the goal of reestablishing more shapely and youthful proportions. While Breast Augmentation with a Tummy Tuck is the most common combination, it is important to pick the procedures most appropriate to your needs. Below, I discuss the options for rejuvenation of the breasts and the belly.

Breast Enhancement

Breasts often change with pregnancy and breast feeding. Variations are common, but typically breasts increase with pregnancy and then end up smaller after lactation ceases. The problems come when the postpartum breasts are too small, too saggy or remain too large (less common but, can be just as annoying).

Breast atrophy after pregnancy is very common. Breast Implants can restore lost volume and restore the proportions that enhance the breasts' shape both in and out of clothing.

Breast atrophy after pregnancy is very common. Breast Implants can restore lost volume and restore the proportions that enhance the breasts’ shape both in and out of clothing.

It is best to wait at least three months after lactation ceases before having any breast procedure. This allows the breasts to settle down to a consistent shape, providing more predictable and safer surgery. Depending on your experience and goals, options for Breast Enhancement include:

Belly Embellishment

Bellies, too, get stretched out during pregnancy. Subsequent pregnancies tend to increase injury, especially if close together. Working out and abdominal exercises help, especially if you are in good shape before pregnancy and maintain a healthy weight during pregnancy. Even under the best circumstances, a big healthy baby can trump a flat healthy belly. The options for tummy rejuvenation include:

After pregnancy, or weight loss, the abdominal muscles, skin and fat can all be compromised. Fortunately, the Tummy Tuck can repair all three areas. Be certain to find a Board Certified Plastic Surgeon with experience for your belly rejuvenation.

After pregnancy or weight loss, the abdominal muscles, skin and fat can all be compromised. Fortunately, a Tummy Tuck repairs all three areas. An experienced Board Certified Plastic Surgeon is the best choice for your Mommy Makeover.

Liposuction can also be used in combination with either of the Tummy Tucks, and the fat removed with Liposuction can be repurposed to enhance other curves, like the buttocks when combined with a Brazilian Butt Lift. If you are wondering which procedure is best for you, an in-person consultation is the best way to find out. I have a page on my main website that explains some of the decision points when trying to decide: Liposuction or Tummy Tuck?

Mommy Makeover Consultations

To explore all your body rebuilding options, call (925) 943-6353, and schedule a personal consultation appointment in our San Francisco Bay Area plastic surgery clinic. A Board Certified Plastic Surgeon is your best guide for explaining what Cosmetic Plastic Surgery can offer. Since we offer a wide variety of procedures, we can offer you the best choices for your Mommy Makeover.

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Surgical Plastic Surgery

Posted May 06, 2017 in Botulinum Toxin (Botox Dysport Xeomin), Fillers (Restylane Juvederm Perlane Radiesse), Home, Wrinkle Reduction (Non-surgical)

Botox and Fillers are by far the most common cosmetic plastic surgery procedures in the United States, but operative plastic surgery procedures are also on the rise.

Botox and Fillers are by far the most common cosmetic plastic surgery procedures in the United States, but operative plastic surgery procedures are also on the rise.

There is always a lot of buzz around Non-Surgical Plastic Surgery. The appeal of plastic surgery results, without surgery, is undeniable. If we could truly reshape our bodies with a cream, a pill or a shot, it would seem … too good to be true.

Non-Surgical Cosmetic Procedures

The number of non-surgical cosmetic procedures performed each year out number surgical procedures by more than an order of magnitude. The two most common, Botulinum Injections (Botox and Dysport) and Dermal Fillers (Restylane and Juvederm), work very well to correct smaller cosmetic problems, and they can also provide improvement in the appearance of deeper wrinkles.

It’s Not Surgery

The appeal of these minimally invasive procedures stems from the fact that it is not surgery. The procedures are performed in-office, require minimal equipment and are easier to schedule. Per treatment, there is Less Downtime and a Shorter Recovery Period. These types of procedures appeal to our need for instant gratification.

And It’s Not Surgery

On the other hand, Non-Surgical Procedures require a lot more maintenance. Without surgery, the results will be less dramatic and the longevity of the results is reduced. The half-life of non-surgical interventions is months, so multiple treatments are needed each year. It adds up to additional expense and recovery with each treatment.

The Biggest Problem with Non-Surgical Treatments

Some cosmetic problems respond very well to non-surgical options. In fact, for non-surgical problems, non-surgical techniques work better. A good example is the Minimally Invasion Treatment of fine lines and wrinkles. Botox, fillers, chemical peels, lasers and dermabrasion all may work better than surgery for carefully selected individuals. On the other hand, if you are receiving fillers or botox from someone who only does these minimally invasion procedures, you may never learn what your longer lasting options are.

When Minimally Invasive Means Minimal Results

Non-surgical procedures are complimentary to what I do as a Board Certified Plastic Surgeon; however, when it comes to truly surgical problems, botox and fillers cannot equal surgical results. If your problem is loose skin, or you are interested in more significant augmentation, there is no replacement for surgery. After all, non-surgical surgery is by definition an oxymoron.

When To Get A Plastic Surgery Consultation

If you are interested in maintaining your youthful appearance, or correcting the outward signs of aging, it is never to early to consult an experienced, board certified plastic surgeon. Plastic Surgeons offer a wide range of treatments. From minimally invasive procedures like Botox and Fillers, to Facial Plastic Surgery like Eyelid Lifts and Face Lifts, a qualified board certified plastic surgeon can be your guide and confidant. If you are interested in learning what all your options are, call our San Francisco Bay Area plastic surgery clinic today at (925) 943-6353.

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UC Davis Picnic Day 2017

Posted April 23, 2017 in About Dr. Mele, Home

The Cal Aggie Band-uh leads off the 103rd annual Picnic Day Parade.

The Cal Aggie Band-uh leads off the 103rd annual Picnic Day Parade.

Picnic Day. If you attended the University of California in Davis, you know what I am talking about. Picnic Day is a 103-year-old campus tradition and the highlight of the University’s April social calendar.

UC Davis Campus-Wide Open House

If you have not been to a Picnic Day, it is a campus-wide open house. Every college, every discipline every major has something to share, and there are a lot of them.

UC Davis is the largest campus in the University of California system. It covers the most area both in acreage and in education. The campus supports over one-hundred majors in the four undergraduate colleges: Agricultural and Environmental Sciences, Biological Sciences, Letters and Science and my alma mater, the College of Engineering.

UC Davis is also home to almost 100 Graduate Studies programs, and six professional schools: The Betty Irene Moore School of Nursing, The Graduate School of Management, the School of Education, The School of Law, The worlds best School of Veterinary Medicine and my other alma mater, the UC Davis School of Medicine.

Tradition and Innovation

This year’s Picnic Day theme was “Growing Together.” Not only did the University celebrate their 103rd anniversary, but the city of Davis also celebrated their centennial. Davis is a true college town, and both have grown together.

The Davis Town Council riding in a vintage firetruck.

The Davis Town Council riding in a vintage firetruck.

The theme also included the growth from old to new. Old firetrucks were followed by new police vehicles.

The Latest in UC Davis Police vehicles

The Latest in UC Davis Police vehicles

Picnic Day 2017

The first Picnic Days I attended were years before enrolling. My best friend had family who lived next to the campus. We would bring our bikes and ride every mile on the bike paths, and off. As a student, Picnic Day was not to be missed. Friends and family would visit and celebrate the day. It was an easy way for me to share my college and for my friends to see what the UCD campus was about. As an alumnus, Picnic Day is a way to keep in touch with my younger self.

The tradition of learning, innovation and success continues...

The tradition of learning, innovation and success continues… Here are some of the banners that hang over the Aggie basketball court from back in my era. Go Aggies!

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BIA-ALCL is Breast Implant Associated Anaplastic Large Cell Lymphoma

Posted April 09, 2017 in Home, Patient Safety

Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL)

Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL)

Since the last BIA-ALCL update, all the plastic surgery societies and breast implant manufacturers have responded with information sheets. I am encouraged by the free flow of information within the Plastic Surgery profession and the industry that supports us.

ASAPS by the Numbers

The ASAPS has distributed a quick summary of the numbers related to BIA-ALCL. Here are a few.

How Many BIA-ALCL Cases Have Been reported?

Of the estimated 7 million women with breast implant throughout the world, 359 reports have been filed. Since the reports can be filed by patients, physicians or manufacturers, it’s important to note the MDRs (Medical Device Reports) are not individual cases, and multiple reports may be filed for a single case of BIA-ALCL. In contrast, there are currently 139 case reports of BIA-ALCL in the literature. It is also important to realize that this is a very small number in relation to the millions of breast implant patients. Lastly, the number is expected to rise because we are learning how better to identify and diagnose patients with the disease.

Smooth vs. Textured

Of the reported cases, over 90% occurred in patients who had textured implants at the time of their diagnosis. In the US database, there is a single case of a patient with smooth breast implants developing BI-ALCL; however, they had a textured tissue expander prior to the smooth breast implant placement. Unfortunately, the other 27 cases of BIA-ALCL reported in the world databases do not include past breast implant information, so while we can say that BI-ALCL is predominantly a problem with textured breast implants, it is unknown if a case has developed in a person who had exclusively smooth breast implants. Currently, 12.7% of US patients receive textured implants. This includes both textured round and all anatomically “shaped” breast implants, and includes both saline filled and silicone filled breast implants.

How Many BIA-ALCL Deaths Have Been Reported?

Of the 359 cases reported, 9 patients have died. Two patients died from stem cell transplants, one died from development of a second unrelated lymphoma, and 6 patients died from direct extension of the tumor. Early detection is key. Of the deaths, none of them received complete surgical excision at any point in their clinical history, none received targeted therapy, and most were significantly delayed in diagnosis or receiving any treatment (1-2 years from onset of symptoms). On the other hand, 93% of all patients are disease free at 3 years follow up. BIA-ALCL has an excellent prognosis when diagnosed early.

How Do We Diagnose BIA-ALCL?

Early diagnosis is key to successful treatment, so how do we accomplish this? Unilateral (one-sided) swelling or mass should lead to a thorough evaluation. This is common in the months following your breast augmentation. The possibility of BIA-ALCL should be considered in a patient with late onset, peri-implant seroma (fluid collection). The majority of patients present on average 8 years after implantation, but range extends from 2 to 28 years.

Ultrasound imaging followed by fine needle aspiration of seroma fluid should be obtained. Collected fresh seroma fluid should be sent to a qualified lab for immunohistochemistry testing for cluster of differentiation (CD30) testing.  Anaplastic Lymphocyte Kinase (ALK) testing of the seroma fluid can help differentiate BIA-ALCL from systemic forms of lymphoma that may appear in the breast.  

Current BIA-ALCL Treatment

Most patients with BIA-ALCL are cured by removal of the implant and capsule surrounding the implant, however a small number act more aggressively and may require additional treatments. For 2017, the National Comprehensive Cancer Network defines optimal treatment which is total capsulectomy and implant removal for the majority of patients with disease confined to the capsule (35% of patients) or a resectable mass (40% of patients). Advanced disease with lymph node metastasis (14% of patients) or organ metastasis (1% of patients) may require further treatment with chemotherapy using either CHOP anthracycline based-protocol or targeted therapy with brentuximab vedotin. Radiation therapy is only reserved for locally unresectable disease.

BIA-ALCL Perspective

BI-ALCL is not breast cancer. Here are some additional numbers, and some links, to keep the worry about BIA-ALCL in perspective:

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