Background Checks on Plastic Surgeons

Q: I am considering plastic surgery, Can I check up on a potential surgeon?

A: Anyone considering plastic surgery has a right to wonder how legit their potential doctor is. You can now run background checks on physicians with Intelius , a service that compiles information in the public domain, including details on legal actions. Find out everything from whether a doctor has been sued (complaints & verdicts) to his or her criminal record in your state. The price to search isn't cheap. It'll run you about $50.

source from http://beauty.about.com

Cosmetic Plastic Surgery

Procedures At-a-Glance

Table of Contents

• The first step
• Facelift
• Eyelid Surgery
• Nose Surgery
• Brow Lift
• Facial Implants
• Injectable Fillers
• Skin Resurfacing
• Breast Augmentation
• Breast Lift
• Gynecomastia
• Tummy Tuck
• Spider Veins
• Liposuction
• Questions to ask my plastic surgeon

The first step:

Choose a surgeon you can trust

Plastic surgery involves many choices. The first and most important is selecting a surgeon you can trust.

Choosing an ASPS Member Surgeon ensures that you have selected a physician who:

• Has completed at least five years of surgical training with a minimum of two years in plastic surgery.
• Is trained and experienced in all plastic surgery procedures, including breast, body, face and reconstruction.
• Operates only in accredited medical facilities
• Adheres to a strict code of ethics.
• Fulfills continuing medical education requirements, including standards and innovations in patient safety.
• Is board certified by The American Board of Plastic Surgery or in Canada by the Royal College of Physicians and Surgeons of Canada^®.

ASPS Member Surgeons are your partners in cosmetic and reconstructive plastic surgery.

Look for the ASPS Member Surgeon logo.

Related Links

Find an ASPS Member Surgeon

ASPS Member Surgeon Qualifications

Facelift

Get detailed procedural information on facelifts

If you are bothered by the signs of aging in your face, a facelift may be right for you.

Technically known as rhytidectomy, a facelift is a surgical procedure to improve visible signs of aging in the face and neck, such as:

• Sagging in the midface
• Deep creases below the lower eyelids
• Deep creases between the nose and mouth
• Fat that has fallen or is displaced
• Loss of muscle tone in the lower face that may create jowls
• Loose skin and excess fatty deposits under the chin and jaw

A facelift is designed to correct all of these aging features, restoring a more youthful, rested appearance with uplifted contours and improved tone in facial skin and underlying muscle.

Procedural steps: Typical incisions begin within the hairline, above the temple and continue along or just inside the ear, ending behind the ear. This allows access to tighten underlying tissue, remove excess fat and reduce sagging skin.

A second incision under the chin is sometimes necessary. If skin tone is good and only mid-face aging or excess fat in the neck will be corrected, abbreviated techniques with shorter incisions may be used. Liposuction techniques may assist with removal of fat deposits.

Your results: Swelling and bruising should subside within 2-4 weeks. Final results may be apparent in 1-2 months. Incision lines will continue to refine and fade for 1 year.

Eyelid Surgery

Get detailed procedural information on eyelid surgery

Cosmetic eyelid surgery, called blepharoplasty, is a surgical procedure to improve the appearance of the upper eyelids, lower eyelids, or both, restoring firmness to the area surrounding the eyes and making you look more rested and alert.

Specifically, eyelid surgery can treat:

• Loose or sagging skin that creates folds or hides the natural contour of the upper eyelid
• Excess skin that hangs down from the upper eyelid, sometimes impairing vision
• Excess fatty deposits that appear as puffiness in the upper eyelids
• Bags under the eyes
• Droopiness of the lower eyelids, showing white below the iris
• Excess skin and fine wrinkles of the lower eyelid

Procedural steps: An incision within the natural crease of the upper eyelid allows access to remove excess skin, muscle and underlying fatty tissue. Using an incision inside the lower eyelid, fat is removed or redistributed and muscle modified to correct a baggy lower eyelid.

An incision just below the lower lash line allows excess skin to be removed. Laser resurfacing may be used to smooth lower lid skin.

Your results: Bruising should subside in 5-10 days and swelling should subside in 2-4 weeks. Final results may appear in 1-2 months. Incision lines will continue to refine and fade for 1 year.

Nose Surgery

Get detailed procedural information on nose surgery

While the shape of your nose is usually the result of heredity; the appearance may have been altered in an injury or during prior surgery.

Also known as rhinoplasty, surgery of the nose improves the appearance and proportion of your nose, enhancing facial harmony and self confidence. Surgery of the nose may also correct impaired breathing caused by structural defects in the nose.

Rhinoplasty can change:

• Nose size, in relation to facial balance
• Nose width, at the bridge or in the size and position of the nostrils
• Nose profile, with visible humps or depressions on the bridge
• Nasal tip, that is enlarged or bulbous, drooping, upturned or hooked
• Nostrils that are large, wide or upturned
• Nasal asymmetry

Procedural steps: Incisions hidden at the nostril base and/or inside the nose allow access to reshape underlying cartilage and/or bone. This may include lowering humps, narrowing of nasal bones, shaping of the nasal tip or nostril size and improving the angle between the nose and the upper lip.

This procedure also can correct breathing difficulties caused by structural irregularities.

Your results: You should see a change within 6-8 weeks following surgery, with continued refinement for 6-12 months. Cartilage is a flexible and growing tissue, therefore results following surgery are not fully predictable.

Brow Lift

Get detailed procedural information on brow lifts

If you have expression lines or other signs of aging in the forehead and brow region which you find bothersome, a brow lift (also called a forehead lift) may be right for you.

A brow lift:

• Minimizes the creases that develop across the forehead, or those that occur high on the bridge of the nose, between the eyes
• Improves what are commonly referred to as frown lines
• Repositions a low or sagging brow that is hooding the upper eyelid
• Raises the eyebrows to a more alert and youthful position

A brow lift is designed to correct all of these aging features, restoring a more youthful, rested appearance with uplifted contours and improved tone in facial skin and underlying muscle.

Procedural steps: Brow lift surgery can be performed through multiple limited incisions hidden within the hairline or through a single incision in the natural crease of each upper eyelid.

Results of a brow lift may be enhanced through laser resurfacing or a chemical peel that can further improve skin tone and surface appearance.

When there is significant excess skin in the forehead, an alternate technique using a wide incision across the top of the scalp may be recommended.

Your results: Swelling should subside in 2-4 weeks. Final results may appear within 1-2 months. Incision lines will continue to refine and fade for up to 1 year.

Facial Implants

Get detailed procedural information on facial implants

If you would like to change the contours of your face, you might want to consider implants. They can improve proportion and profiles and correct imbalance caused by injury or hereditary traits.

Procedural steps: Appropriately sized and shaped implants most commonly in the cheek, chin, jaw or nasal region will be carefully selected and placed. Incisions inside the mouth or discreetly placed external incisions create space in soft tissues for implant positioning and support.

Generally performed as an outpatient procedure under local anesthesia with or without sedation; general anesthesia may be recommended.

Your results: Almost immediate, initial swelling should subside in 2-4 weeks and dissipate in 1-2 months as final results appear.

Injectable Fillers

Get detailed procedural information on injectable fillers

If you would like to restore facial contours, or reduce the appearance of lines and creases, injection therapy with soft tissue fillers may be right for you. Injectable fillers can:

• Plump thin lips
• Enhance shallow contours
• Soften facial creases and wrinkles
• Improve the appearance of recessed scars

Procedural steps: A pharmaceutical filler substance or your own fat is injected below the skin surface to fill hollow areas and creases, or plump the lips and back of the hands. Fat is typically taken from the inner thigh or abdomen.

Your results: Swelling should dissipate in 2-5 days, or 1-2 weeks with fat injections. This procedure produces temporary results, lasting a few months to several years or more, based on the filler used, treatment site and individual patient factors. Some products may be permanent.

Skin Resurfacing

Get detailed procedural information on skin resurfacing

If you would like to improve the surface and appearance of your skin, reduce fine lines, surface irregularities such as scarring, uneven pigmentation and sun damage, then skin resurfacing may be right for you.

Procedural steps: A variety of lasers and intense pulsed light devices achieve a wide range of benefits.

Chemical solutions of varying types and concentrations are applied to peel the skin surface allowing new skin to form.

Mechanical resurfacing, dermabrasion or dermaplaning, uses a fine abrasive or scalpel to scrape the skin surface to a controlled depth; generally used to improve an irregular surface, such as acne scarring.

Your results: Any flaking or crusting should resolve in 5-10 days. Results may appear in 10-14 days. Skin is most likely pink or flush for 1-6 months.

Breast Augmentation

Get detailed procedural information on breast augmentations

Breast size is important to many women for a variety of reasons. If you are dissatisfied with your breast size, augmentation surgery is a choice to consider. Breast augmentation can:

• Increase fullness and projection of your breasts
• Improve the balance of your figure
• Enhance your self-image and self confidence

Also known as augmentation mammaplasty, the procedure involves using implants to fulfill your desire for fuller breasts or to restore breast volume lost after weight reduction or pregnancy. Implants also may be used to reconstruct a breast after mastectomy or injury.

Procedural steps: Common incision locations include the breast crease, in the underarm, or around the areola (pigmented skin surrounding the nipple).

Placement of implants beneath the chest wall muscle or directly behind breast tissue using pre-filled implants or implants filled during surgery creates desired volume.

Generally performed as an outpatient procedure under local anesthesia with sedation; general anesthesia may be recommended.

Your results: Immediate. Swelling should subside in 2-4 weeks. Incision lines will continue to flatten and fade for up to 1 year.

Implants may need to be replaced: It’s important to know that breast implants are not designed to last a lifetime. You should plan for an annual examination by your plastic surgeon to see if the implants need to be replaced.

Breast Lift

Get detailed procedural information on breast lifts

Also known as mastopexy, a breast lift raises and firms the breasts by removing excess skin and tightening the surrounding tissue to reshape and support the new breast contour. Sometimes the areola becomes enlarged over time, and a breast lift will reduce this as well.

Procedural steps: Excess skin is surgically removed to raise the nipple and tighten the breast tissue. Incision patterns vary, depending on degree of excess skin and amount of lifting required as well as patient and surgeon preference.

Your results: Swelling should subside in 2-4 weeks. Breast shape may take 1-3 months to fully refine. Incision lines will continue to flatten and fade for up to 1 year.

Gynecomastia

Get detailed procedural information on breast reduction for men

Enlarged male breasts, also known as gynecomastia, can cause emotional discomfort and impair your self confidence. Gynecomastia is characterized by:

• Excess localized fat
• Excess glandular tissue development
• A combination of both excess fat and glandular tissue
• Gynecomastia may present unilaterally (one breast) or bilaterally (both breasts)

Gynecomastia can be surgically treated by removing excess fat, glandular tissue and/or skin. The result is a better proportioned, more masculine-contoured upper body and the freedom and self confidence to lead an active life.

Procedural steps: Surgical removal of excess tissue is performed by excision and/or liposuction. This procedure can include areola reduction.

Your results: Initial swelling should dissipate in 2-4 weeks. Final results may appear in 2-4 months. Incision lines will continue to fade for up to 1 year. Significant weight gain can reverse results.

Tummy Tuck

Get detailed procedural information on tummy tucks

If you want a tighter, flatter abdomen, then a tummy tuck may be appropriate to help achieve your goals.

Also known as abdominoplasty, a tummy tuck removes excess fat and skin, and in some cases restores weakened or separated muscles. This creates an abdominal profile that is smoother and firmer, often enhancing your body image and confidence.

Procedural steps: A tummy tuck involves the surgical removal of excess abdominal fat and skin and includes tightening of the abdominal wall where muscles have weakened.

A full tummy tuck requires a horizontal incision in the area between the pubic hairline and navel. Incision size is largely dependent on the amount of excess skin to be removed.

Where correction is isolated to the area below the navel, a limited or mini tummy tuck with a shorter incision at the pubic bone may be recommended.

Liposuction may be performed with a mini tummy tuck where excess fat is the only factor.

Your results: Swelling should subside and initial results may appear in 2-4 weeks. Final results could appear in 8 weeks. Incision lines will continue to flatten and fade for up to 1 year.

Spider Veins

Get detailed procedural information on spider veins

Also known as sclerotherapy, this cosmetic procedure reduces or eliminates surface vessels or spider veins, commonly on the face and legs.

Procedural steps: Sclerosing solution is injected directly into a vessel, causing it to slowly fade or disappear and may be used in conjunction with Doppler ultrasound device for larger veins.

Laser or intense pulsed light therapy reduces tiny surface vessels on the face and legs.

Your results: Veins gradually fade, usually in 7-10 days for significant improvement, and the final results will be apparent in 2-6 weeks.

Liposuction

Get detailed procedural information on liposuctions

Despite good health and a reasonable level of fitness, some people may still have a body with disproportionate contours due to localized fat deposits. These areas may be due to family traits rather than a lack of weight control or fitness.

Liposuction slims and reshapes specific areas of the body by removing excess fat deposits, improving your body contours and proportion, and ultimately enhancing your self-image.

These techniques may be used to reduce localized fat deposits of the:

• Thighs
• Hips and buttocks
• Abdomen and waist
• Upper arms
• Back
• Inner knee
• Chest area
• Cheeks, chin and neck
• Calves and ankles

Procedural techniques: There are three common variations to the procedure:

• Traditional liposuction is surgical suctioning of excess fat deposits
• The tumescent or super-wet technique requires an infusion of saline solution with adrenaline and possibly anesthetic prior to removal of excess fat
• Ultrasound-assisted lipoplasty uses ultrasonic energy to liquefy excess fat prior to surgical suctioning

Your results: Swelling should subside, bruising should fade and initial results may appear in 2-4 weeks. Final results could appear in 2-6 months. Significant weight gain can cause recurrence of fatty deposits.

Questions to ask my plastic surgeon

Use this checklist as a guide during your consultation

• Are you certified by the American Board of Plastic Surgery?
• Are you a member of the American Society of Plastic Surgeons?
• Were you trained specifically in the field of plastic surgery?
• How many years of plastic surgery training have you had?
• Do you have hospital privileges to perform this procedure?
• If so, at which hospitals?
• Is the office-based surgical facility accredited by a nationally- or state-recognized accrediting agency, or is it state-licensed or Medicare-certified?
• Am I a good candidate for this procedure?
• What will be expected of me to get the best results?
• Where and how will you perform my procedure?
• What surgical technique is recommended for me?
• How long of a recovery period can I expect, and what kind of help will I need during my recovery?
• What are the risks and complications associated with my procedure?
• How are complications handled?
• How can I expect to look over time?
• What are my options if I am dissatisfied with the cosmetic outcome of my surgery?
• Do you have before-and-after photos I can look at for this procedure and what results are reasonable for me?

source from http://www.plasticsurgery.org

Breast Implants-- Pros and Cons

The Food and Drug Administration (FDA) recently broke from its own scientific advisers and decided not to approve silicone breast implants. The FDA wants more information about what happens when breast implants break or leak. Silicone implants were mostly banned in 1992 over fears they caused autoimmune diseases like lupus. But women and doctors like silicone implants because they look and feel more natural than saline implants.
We asked our community to weigh in on the subject and tell us their experiences.
This is what some of them had to say. (Letters have been edited for clarity in some cases.)

Saline vs. silicone:
I had saline implants done by a top surgeon. I had them removed, as they felt exactly like what they were -- bags of water in my chest. The FDA (and surgeons that hype saline as feeling like breast tissue just to make a buck) cost me two unnecessary surgeries. Silicone feels like breast tissue, not a bag of water. Go to any plastic surgeon and feel both, as there is NO comparison. -- posted by Sandy, AZ

Reconstructive surgery:
I had a breast tumor removed that resulted in a partial mastectomy of about one-third of my left breast. One year later, I finally got my insurance company's approval for reconstruction. In order to reconstruct my left breast, it required that an implant also be placed in my right breast to make them symmetrical. Because of the location of the void in my left breast, which was in the underside, I went with the silicone implants that were placed behind the muscle.
Breast implants, whether silicone or saline, fail (wear out) after about seven years and need to be replaced. With silicone, the FDA requires that they be checked by a surgeon annually. My surgeon also showed me the difference in the coverings of the different implants. She explained that the silicone implants are placed behind the muscle, forming a "scar pocket" so that if they do leak, the silicone stays within that pocket. She told me I would be able to identify if that happens because I will feel a "burning sensation." I am not afraid of my implants at all. They feel and look very natural. Most people tell me they can't even tell I have implants. -- posted by Roberta, Lebanon, IN

I'm worried:
I have wanted implants for years now, but I have always been scared because of the health risks. A friend of mine got silicone implants, and 10 months after she had them, one started leaking. There was no damage, and they just implanted another one. That was a real eye opener! After that incident, if I do decide to get them, it will be saline. I do believe that a woman should be able to choose if she wants them or not. If she wants to take the risk, let her. -- posted by C.H., Victoria, TX

Never had a problem:
I have had my silicone breast implants since 1988 and have never had one day's problem with them. I have never had any scar contractures form, nor have they shown any evidence of leakage. I don't have any autoimmune disorders, nor do I have lupus. I would get them all over again without ever thinking twice. I think getting implants is the best thing I've ever done for my self-image! -- posted by Lori, NC

So pathetic:
Who, in her right mind, would want to go through an operation willingly just for vanity's sake? I'm 18 years old and I'm not a very busty girl, but I am happy the way I am. I think it doesn't matter if silicone implants are safe or not -- women should examine their minds before putting foreign objects in their bodies. What's the use, for crying out loud? Breast implants are just too barbaric for my taste. We should be worried about important things, like cultivating our minds and bodies in natural and harmless ways. -- posted by Dominique, San Juan, PR

Don't people get it?
I have had saline breast implants for one year, with no problems. Silicone scares me, but saline... well, not so much. To those of you who think that women should cultivate their minds instead of getting breast implants, you just don't understand. I have a bachelor's degree, a master's degree and a Ph.D. My mind is flourishing, and finally I have breasts to match! If you are happy with your tiny boobs, fine -- that is fantastic. If you need bigger ones, buy them. It is well worth it. -- -posted by K, San Diego, CA

They're safe:
Speaking from experience, I don't see that there is a problem with silicone. Yes, I do have them, and I went from a small B cup to a small C cup about 18 months ago. I feel a lot more confident about the way I look and have had no problems with the implants. I had the most wonderful surgeon, and although there was a lot of pain for the first couple of weeks, it was well worth it. The silicone implants I have are not liquid; they are crystallized, similar to the inside of a jelly bean, so they don't leak and it would take quite a deal of pressure for them to break. In fact, as my surgeon told me, the only case he has had of one breaking is a woman who was in a serious head-on car accident. -- posted by Tonya, San Diego, CA

What the heck is wrong with small breasts?
I am small-breasted and also very fit and health-conscious. I considered getting implants years ago when I was with a lover who preferred larger breasts, but I arrived at the conclusion that rather than go through surgery and put my own health at risk, I'd find a partner who likes and prefers small breasts -- and there are plenty of people who do like them! This solution to the "problem" makes the most sense to me. My health is intact and I have a partner who likes my body exactly the way it is -- a win-win situation. -- posted by spanartist, FL

Our choice:
If we decide that we, as women, want them, it should be our right. It should NOT be anyone else's right to say what we, as women, can and can't have. If I want them, I should be able to get them! -- posted by mydamomas, Los Banos, CA

Strange:
I find it very strange that the FDA allows silicone implants for breast reconstruction, but not for cosmetic purposes. If the implants are so unsafe, why do they allow them to be used on women who have had cancer? I believe that women have the right to choices, and the right to be informed. I live in Canada, where silicone cohesive gel implants (which I have) are legal. I have had these implants for 18 months and am very pleased. This was not a decision that I took lightly. I did a lot of research on implants, specifically saline vs. silicone. I decided that the risks (inherent in any type of surgery, cosmetic or not) were well worth the results. I admire women who are confident with their bodies and do not believe that "bigger is better" when it comes to breasts. My decision was based on my body image, my feelings and my history, and as such should not be judged by anyone else. -- posted by vevelov1

Research first:
I have had saline implants since 1997, and I had a lot of problems in the beginning. I've had capsular contracture since the day I had my surgery. I know that silicone implants look and feel more natural, but I went to a doctor who uses saline. I regret getting saline implants and now I would never want silicone either. I know a lot of women who had their silicone implants removed and had them replaced by saline implants instead. Do your research first -- I assumed my surgeon was board certified and he wasn't! -- posted by Laura, Bradenton, FL

FDA's political decision:
Let women choose for themselves. We women are not as stupid as you think we are. The FDA's response was based on politics rather than science. I am very disappointed. If silicone is safe enough for a woman who is having reconstructive surgery after cancer, it's certainly safe enough for me! I want silicone breast implants, and I'd prefer not to travel to some third-world country to get them. I don't expect implants will increase my self- esteem. I just know that I would enjoy my breasts a lot more if they were larger. I am always for improving myself, and I believe in being/doing/having the best that I can in every way and maximizing my enjoyment of life while I still have it. Now that I am hurtling toward middle age, I am realizing that life is short and I need to make the most of everything. I've always wanted to have larger breasts, and I only have this one life to experience them. Let me at the good ones. Bring back the silicone implants. After all, women will still have the option of getting saline. -- posted by ambrosialdelight, New York,

source from http://beauty.ivillage.com

Breast Augmentation: Pros and Cons of Using Implants

A woman has many choices to make her breasts appear larger, among them wearing a padded bra or silicone bra-enhancing inserts. But if you are looking for a more permanent way to bring balance to the curves of your body, finally fill out your female form or find the figure you lost after breastfeeding, the surgical placement of breast implants is the only proven solution to enhance breast size and shape. (If you're considering breast augmentation, visit Newbeaty.com to find a doctor in your area.)

Most women who seek breast enhancement fall into two groups, according to New York City plastic surgeon Alan Gold, MD: "The younger woman who has always been dissatisfied with the size and proportion of her breasts, and the woman in her late twenties through forties who has lost volume due to pregnancy and whose breast shape may be drooping somewhat, but not enough to warrant a breast lift."

If you're considering breast augmentation, you have several choices. The first and most important is choosing a board-certified plastic surgeon who can explain and address all of your options and performs all of those options regularly. Other choices include:

 Incision location

 Implant location

 Type, size and shape of implant

The decision about incision and implant placement is best made after a physical examination and a conversation with your plastic surgeon. Your body type will dictate the options appropriate for you. Once the incision is made, the breast implant is inserted into the body in one of two positions:

Implant: Above the Muscle (Subglandular)

The implant is placed over the pectoral muscle and under the breast tissue.

PRO A somewhat shorter recovery. Better for patients with mild, preoperative sagging who do not plan to have a lift procedure performed.

CON The implant is closer to the surface and could be more visible under the breast tissue. The appearance of the breasts can be unnaturally high and rounded. There is a greater chance of irregular and hardened scar tissue around the implant (capsular contracture) with this placement.

Implant: Below the Muscle (Submuscular)

The implant is placed below both the pectoral muscle and overlying breast tissue.

PRO Less risk of implant visibility and capsular contracture and less mammography interference. More appropriate when the patient has a small amount of breast tissue. Implants are less palpable and less noticeable in terms of wrinkling. "The breast profile is also much more natural," says Carmichael, California, plastic surgeon Roy Semlacher, MD. "And, if a woman has weight changes, even due to pregnancy, the muscle supports the implant and therefore the breast and implant are less likely to sag."
CON Two to three more days of recovery and somewhat more discomfort. May not be recommended for highly muscular or athletic builds.

When it comes to implant size, Dr. Semlacher advises that patients choose the most conservative implant size to achieve the enhancement they desire. "This will minimize the effects of gravity and weight and decrease the degree and rate of future sagging," he adds.

Around the nipple (Periareolar incision)

PRO Usually a well-hidden scar.
CON Nipple or partial-breast numbness is a potential side effect, but this can occur with any breast surgery, regardless of the incision placement. Although usually temporary, the loss of sensation could be permanent in some cases. Dr. Semlacher adds that contrary to previous concerns, Canadian studies demonstrate that this incision does not affect the ability to breastfeed.

Incision location

The decision about incision placement is best done after a physical examination and a conversation with your plastic surgeon.

In the armpit (Axillary incision): This incision requires the help of an endoscope.

PRO A shorter, less visible incision.
CON Can only be used with saline implants because implants must be filled after placement. Some surgeons find it more difficult to obtain reliable symmetrical implant placement using this method. If corrective surgery is ever needed, it will likely be necessary to make a new incision rather than go through the original one

In the fold of the breast (Inframammary incision):

The most widely used incision.

PRO Some surgeons feel that it allows more precision in implant positioning.
CON A short, visible scar in the breast crease.

Do herbal supplements naturally increase breast size?

No scientific data concludes that herbal supplements can increase breast size. More important, according to ASPS, these supplements contain potent herbs in high concentrations. The long-term effects and potential risks to a woman's health are unknown.

source from http://beauty.ivillage.com

Breast Implants: What You Need to Know But Didn't Know Who to Ask

There is one thing that all breast implants have in common. Whether they're used to enhance breast size and shape through breast augmentation in conjunction with a breast lift or to create the breast mound in breast reconstruction--they are hotly debated medical devices. The only way to decide which implant is right for you is to schedule a consultation with a board-certified plastic surgeon.

Breast implants that are approved by the FDA are biocompatible, says Mark Jewell, MD, of Eugene, Oregon. "They are made of materials that have been researched and deemed safe for placement inside the human body." Implants have a smooth or textured silicone shell and the shell shape may be round or contoured. "The varying implant shapes and sizes available allow each woman seeking breast augmentation surgery to obtain optimal long-term results," says Jewell.

If you are receiving breast implants, the brand and type of implant you receive should be defined. Following treatment, you should be given a serial number and a warranty card from the manufacturer for the implants placed. This is the only type of warranty (although limited) you will ever receive with any cosmetic procedure.

The new generation of silicone

In 2005, the FDA issued pre-market approval for two specific silicone implants filled with cohesive silicone, which is a more elastic form of silicone gel that is less likely to migrate should the implant leak or rupture. Among other advantages, Dr. Jewell states, "These also come in a greater variety of shapes that will match each patient's individual needs." These new generation implants, which have not yet been released in the marketplace, should not be confused with the fourth generation of silicone implants, or form-stable cohesive gel devices which are still in clinical trials. Like any implants, silicone implants can develop capsular contracture or other similar implant problems. In addition, these form stable silicone implants are somewhat heavier and more dense than saline or other types of silicone implants." You may have heard them referred to as "gummy bear" implants, but don't be fooled by the novel name--unlike the candy that can be pulled and stretched, the form-stable cohesive gel implants maintain their shape once inside the body, which, Dr. Jewell says, "allows them to produce a nice tapered upper edge of the breast and maximum projection where it's needed most."

Saline implants

Saline (sterile salt water) has been the only FDA-approved implant filler for first-time breast augmentation patients since 1992. Saline implants can be prefilled to a specific size or filled at the time of placement, which has the advantage of allowing smaller incisions to insert the implant and minor size adjustments during placement. If a saline-filled implant leaks or ruptures, it's readily noticeable because breast volume will diminish rapidly. The saline is completely absorbed by the body and naturally eliminated. Saline implants can feel firmer than natural breast tissue, particularly if they are filled to shell capacity.

Silicone implants

Since 1992, silicone implants have been available only to breast-reconstruction patients and those patients replacing older silicone implants. "Patients who were born with a congenital breast abnormality and some patients who have had rippling with saline because of the thinness of the skin may also be candidates for silicone implants," says Dr. Sweis. In addition, a very limited number of first-time augmentation patients participating in approved FDA studies have silicone implants. However, in 2005, the FDA rendered pre-market approval for two types of silicone implants as an option for women seeking first-time breast augmentation. Formal market release is still pending. For the latest information, visit breastimplantsafety.org. Today's silicone implants vary significantly from the earlier, more controversial silicone-gel-filled implants that implant manufacturers voluntarily took off the market for augmentation in the early 1990s. "The concern at that time was the possibility that leaking or migrating silicone gel contributed to autoimmune diseases," says Dr. Jewell. "However, to date, not one major medical study among the hundreds that have been performed worldwide has concluded that there is a link between silicone- or saline-filled breast implants and any form of disease."

How Long Do They Last?

Breast implants are not lifetime devices: They have the potential to leak or rupture, and they do not change as a woman's body ages over time. There is no telling how long your implants will maintain their function and appearance, which is why it's imperative to maintain an ongoing professional relationship with your plastic surgeon. "It is important to follow up with your doctor on the first anniversary of your implant placement, even if you have no concerns," says Joseph J. Disa, MD, of New York City. "Thereafter, you should have your breasts annually evaluated by your plastic surgeon or the doctor who performs your routine breast health exam and mammogram screenings." There are many options should your implants need to be replaced or if you choose to replace them.

Breast Surgery: What You Need to Prepare For

Anesthesia: Either under general anesthesia or local anesthesia with sedation.

In or Out: Breast augmentations, lifts and, in many cases, reductions are commonly outpatient procedures. Surgery takes place in an office-based surgical suite, a freestanding ambulatory facility or a hospital surgical facility. For some women, an overnight hospital stay is occasionally recommended.

After Surgery: You'll wake up after surgery wearing a support bra that was either purchased before surgery or supplied by your plastic surgeon. In the case of breast reconstruction, you may be simply wrapped with a surgical dressing like gauze. You may have small, thin tubes placed in your incisions to drain any excess fluid, or a tube that is attached to a pain pump. You'll be stiff and sore; however, alert your doctor immediately if you experience severe pain or develop a tense, swollen breast. You should be up and walking around the day of surgery. If you are not staying in the hospital overnight, you will need a responsible adult to care for you and monitor your condition for at least 24 hours after you arrive home.

Risks: Capsular contracture; unexpected milk production following surgery (which is rare and usually temporary). All breast surgery carries the risk of anesthesia-related problems.

Side Effects: Breast tenderness; swelling and bruising; regional tightness or discomfort; redness, discomfort or itching at the incision sites; heightened or decreased breast sensation

Special Considerations: Sleep on your back in a reclining position for the first few days following surgery. During recovery, follow all instructions for proper breast support, including sleeping in your support bra if instructed. A cotton bra that closes in the front may be the most comfortable. Do not wear underwires until your plastic surgeon gives you the green light. Long-term support is essential for the well-being and longevity of your new breast appearance. Start walking around and doing light activity as soon as possible, but avoid pushing, pulling, lifting, twisting and strenuous exercise until your plastic surgeon gives you the go-ahead.

Back to Work: Return to work within a week or two, give or take a few days, depending on the extent and type of procedure. Scars begin to fade within three months; topical steroid cream or silicone gel can promote healing and reduce the chance of developing raised, red or irregular scars.

Cause for Concern: Hematoma, or blood pooling beneath the skin (to minimize risk, avoid taking anti-inflammatory medications, blood thinners, aspirin, ibuprofen or certain herbs and vitamins before surgery); breast asymmetry (call your doctor immediately if you notice dramatic differences in breast size, shape and nipple position); skin or tissue loss and infection (occurrence is very rare, antibiotics may be prescribed preventively).

source from http://beauty.ivillage.com

Uplifeting: The Facts Behind Getting a Breast Lift

Do you stand in front of the mirror without your bra on or are you unwilling to try? For some women, it's not easy to face flat, droopy breasts that were once round and perky.

Key reasons for changes in breast shape include age, hormonal fluctuations, pregnancy, weight loss or gain and genetics, says Miami plastic surgeon Ary Krau, MD. There is no one skin or body type that causes breasts to sag. It is quite simply the changes in a woman's breast volume that cause the skin to stretch and subsequently sag. Sagging (called ptosis) results in flattened breasts with an elongated shape and a nipple/areola complex that is pointed downward. In profile views of more pronounced cases of ptosis, the nipple/areola complex of an unsupported breast hangs visibly lower than the breast crease. When breasts sag this deeply, wearing a support bra is necessary for maintaining a more normal appearance.

"The best technique used for a woman's breast lift must address several issues: shape, location of scars, quality of scars, longevity, sensation of the nipple/areola complex and preservation of lactation," says Dr. Krau. Equally important is the degree of sagging, the elasticity of your skin and the amount of excess skin that your plastic surgeon plans to remove.

To correct sagging and create a perkier breast, incisions are made to sculpt the breast to a new position, reduce excess skin and raise the nipple/areola complex. Incision patterns are typically the same as those used for breast reductions. In addition, Dr. Krau states that areola size may be reduced "to a circumference average of four centimeters."

A breast lift does not change the amount of breast tissue a woman has, but it does change the shape and position, which can affect overall breast size. To understand what final breast size may be following a breast lift, plastic surgeon Foad Nahai, MD, of Atlanta advises that patients look in the mirror and use a finger to elevate the breast until the nipple is brought to the new position, then fold any tissue hanging over the finger inward to approximate final breast size. If size is important to you, an implant can be inserted during the breast lift to enhance size or firmness. To approximate this, Dr. Nahai states, "I have the patient wear a bra without padding to assess size, then add an implant to give an idea of the final size after a breast lift with implant placement."

The new shape and position of your breasts will be visible immediately after surgery, but the new look will settle a bit over the following few weeks. Breast lift surgery is the only permanent way to restore a youthful body contour to the breasts. No amount of exercise, breast-firming cream or laser treatment has been proven to produce measurable, visible results. For most patients, a breast lift is a one-time procedure; but if another lift is necessary, the same incisions can usually be used.

You're a good candidate for a lift if...

• Your breasts are pendulous, but of satisfactory size
• Your breasts lack substance or firmness
• Your nipples point downward and are positioned below the breast crease

What you must know before breast surgery

• Your doctor is certified by the American Board of Plastic Surgery and a member of ASPS or ASAPS.
• Your plastic surgeon shares your goals for your body and your health and has thoroughly explained your breast enhancement options.
• The number of breast surgeries your plastic surgeon has performed. Ask to see several sets of photographs showing before-and-after results of exactly the same procedure you will undergo. Photographs, however, are not a guarantee that you will obtain the same result.
• The details of your breast surgery procedure with a full understanding of the technique and goals recommended for you, and where the incisions and resulting scars will be located.
• Where your breast surgery will be performed, including accreditation of the facility, the anesthesia provider and his or her qualifications, and the medical staff that will be responsible for your health and safety.

"I lost a lot of weight--more than 100 pounds. As a result, my breasts now sag. I'm only 22 years old and I've have never had children. Can a breast lift help me?"

For women who undergo gastric bypass or lose significant weight through other means, the breast is undoubtedly going to sag or change shape. By restoring a natural and youthful shape, a breast lift can be of important psychological benefit to a young woman who feels very self-conscious about the appearance of her breasts.

source from http://beauty.ivillage.com

Breast Reduction: Is it Right for You?

Large breasts are not just a fact of life for some women. They can negatively affect self-esteem, health and overall quality of life.

A breast reduction is more than removing excess tissue and fat. The breast itself needs to be sculpted into a smaller shape, and this can only be done through incisions on the breast. "While an important goal of surgery is to have as few scars as possible, it is not the single most important factor," says New York City plastic surgeon David Hidalgo, MD. "Using a minimal scar on the wrong candidate can result in inadequate reduction or poor shape." Incision placement may include all, or any combination of these incisions:

• Concentric or donut-shaped around the areola
• Vertically down from the areola to the breast crease
• Horizontally at the breast crease

Breast fat and tissue are removed through these incisions. The nipple is repositioned (while remaining attached to its nerve and blood supply), and the entire breast is reshaped. The overall breast skin is reduced, and the size of the areola (the dark skin surrounding the nipple) will likely be smaller to match the shape, position and proportion of the new breast. In some cases, liposuction may be used as part of breast reduction to remove fat in and around the breast.

The results of breast reduction are seen and felt immediately but are not always permanent: After reduction, significant weight gain or loss and pregnancy can affect breast size and the results of your surgery. When timing a breast reduction, there are a few considerations to keep in mind. Many women experience difficulties with breast-feeding, but a breast reduction can make it even more difficult. Be sure to tell your doctor if you anticipate having children, and together you can determine the best timing for your breast reduction. Dr. Sweis states that breast reduction is not for postpartum women alone. "More people are recognizing the health and quality-of-life benefits of breast reduction, including pediatricians who refer 15- to 17-year-old girls for reduction due to the stress that excessively large breasts place on the back and neck of a young woman."

Insurance reimbursement for breast reduction is defined by the individual insurance companies, says Dr. Spear. However, many doctors are finding that coverage is arbitrary at best. "Breast-reduction coverage is not threatened across the board, but can be rejected despite recognized standards for coverage relative to a woman's physical build and the amount of breast tissue reduced," he says.

pain

Whether you have your reduction scheduled or you're just starting to think about it, these tips can help alleviate back pain caused by large breasts.

• Soak in a hot bath, which can relieve tension and ease muscle pain. Try adding menthol, a natural anti-inflammatory, to the bath water.
• Avoid squeezing into a small bra. This is not only painful, it's unhealthy for your breast tissue, back and shoulders.
• Invest in a support bra to distribute your breast weight across your shoulders and back.
• Walk--don't run--on a treadmill wearing well-cushioned sneakers to minimize bouncing. Sand or soft dirt are better surfaces than asphalt for outdoor walking.
• Stretch as much as possible to open up the back muscles. Try this simple exercise: Hold a can of soup in each hand, keeping your arms straight by your side. Lift your shoulders straight up toward your ears for a count of two. Pull the shoulders back, pinching your shoulder blades together. Relax and repeat 8 to 12 times.

Post Breast Reduction Scars: What Can You Do?

Most patients heal well after breast reduction, but normal, visible scars on the breast are a tradeoff for better proportion between your breasts and body and for an improved physical and emotional quality of life. Scars usually improve and fade over a matter of months, but you must accept that they will always be present. Unsightly scars--those that are raised, red, wide and misshapen--are a risk of surgery but in many instances can be controlled. Smoking can greatly reduce oxygen in the body and result in poor healing that produces unsightly scars. Poor postoperative breast support and wound care, hereditary factors and even significant weight gain or loss can cause less-than-desirable scars.

source from http://beauty.ivillage.com