In 1998, the U.S. FDA approved adjunct study protocols for silicone-gel filled implants only for breast reconstruction patients and for revision-surgery patients; and also approved the Dow Corning Corporation's Investigational Device Exemption (IDE) study for silicone-gel breast implants for a limited number of breast augmentation-, reconstruction-, and revision-surgery patients.[113]
Rhinoplasty, a surgical procedure commonly known as a “nose job,” has become much more common in recent years. There are several reasons for this. For one thing, increasing media use focuses wide attention on the successful surgeries of celebrities (and even ordinary individuals). For another, the culture as a whole has increasingly accepted various means of improving and enhancing one’s appearance. The third, and perhaps most important, reason for the popularity of rhinoplasty is the astonishing improvements that have been made in the operation itself.
Inframammary: an incision made to the inframammary fold (natural crease under your breast), which affords maximal access for precise dissection of the tissues and emplacement of the breast implants. It is the preferred surgical technique for emplacing silicone-gel implants, because it better exposes the breast tissue–pectoralis muscle interface; yet, IMF implantation can produce thicker, slightly more visible surgical scars.

If you’re hoping your breast implants will be covered by insurance because of something like asymmetry or changes after pregnancy, you probably need to explore other financing options. Breast implants are considered cosmetic surgery, so insurance companies typically won’t cover them. However, “Breast Implants are covered if they are being used as part of reconstruction after breast cancer or mastectomy,” says Houston plastic surgeon Dr. C. Bob Basu in a RealSelf Q&A.
1996 France Agence Nationale pour le Developpement de l’Evaluation Medicale (ANDEM) [National Agency for Medical Development and Evaluation][30] French original: "Nous n'avons pas observé de connectivité ni d'autre pathologie auto-immune susceptible d'être directement ou indirectement induite par la présence d'un implant mammaire en particulier en gel de silicone...."
Nowadays, it’s not uncommon for patients to find doctors via social media like Instagram and Snapchat. These platforms, when used appropriately, can be a good indicator of the kind of doctor you’re getting, says Dr. Rahban. You can get a sense of the doctor’s personality and the kinds of surgeries they do, but “that being said,” he adds, “when a doctor utilizes it as an entertainer or for shock factor, it tells a lot about [their] professionalism.”

MENTOR® MemoryGel® Breast Implants, MENTOR® MemoryShape® Breast Implants, and MENTOR® Saline-filled Breast Implants are indicated for breast augmentation in women (at least 22 years old for MemoryGel® Implants and MemoryShape® Implants, and 18 years old for Saline Implants) or for breast reconstruction. Breast implant surgery should not be performed in women with active infection anywhere in their body, with existing cancer or pre-cancer of their breast who have not received adequate treatment for those conditions, or who are currently pregnant or nursing.
Do not consume any alcoholic drinks (including beer and wine) for 48 hours after surgery. In addition, do not have any alcoholic drinks while you are taking the prescription pain pills. The alcohol can interact with these medicines and lead to serious health problems and death. Finally, drink alcohol in moderation for three weeks. Excessive consumption can lead to a fall that could ruin the results of the surgery.
On average, breast reduction costs between $6,500 and $12,000. This does not include additional expenses that may be involved such as any medical tests that must be done prior to surgery (e.g mammogram) surgical garments and pain medications. Many women who consider breast reduction also have other cosmetic procedures done at the same time such liposuction, breast lift and abdominoplasty to enhance the overall results. If additional procedures are performed at the same time, this could also increase your overall cost. However, there usually is a discounted rate surgeons offer for having multiple procedures performed at the same time.
Silicone gel filled breast implants consist of a silicone elastomer (rubber) shell pre-filled with a cohesive, gelatin-like substance that holds together uniformly while still retaining the natural give of breast tissue. Silicone gel breast implants are available in a wide range of sizes to accommodate women with different body types and aesthetic goals. Projections from moderate to high provide you with choices for the amount of projection of the breast silhouette.
Private surgical suites: these surgical suites tend to be located at the surgeon’s office. They also tend to be the least expensive of the three since the surgeon can control overhead and costs associated with their operating room. One significant benefit to the private surgical suite is the doctor will be very familiar with the layout of the facility and usually uses the same surgical staff.
When doing a consultation there are many factors that need to be considered before deciding on the course of action the Doctor will take. For instance, one of the most important decisions that need to be made before beginning a breast augmentation is determining the placement of the breast implant. Will it be placed above the pectoralis muscle or below it? There are many variables that are involved in this decision. In today’s technological world there is an abundance of information available to anyone who can use the internet. This can be beneficial if you are getting your information from verified and educated sources, but it can also be detrimental as there is an equal abundance of mis-information construed as facts. Even family and friends who offer their thoughts or advice can cause confusion and doubts if their information is not based on facts. The best thing you can do when starting your breast augmentation cosmetic surgery journey is to remember that there is always a choice, and consulting with a board certified and experienced plastic surgeon is the best way for you to be able to make an informed choice that you will be comfortable with.

All patients experience some pain in their breasts, chest and/or back after surgery. Most patients take only plain acetaminophen  (Tylenol) and Celebrex as prescribed for pain control. If you are unable to take Celebrex, acetaminophen  alone may be sufficient. Begin taking acetaminophen elixir (liquid) or tablets for pain as soon as possible after surgery.  If this is not sufficient to control your pain, begin taking any prescribed narcotic(Vicodin, Percocet, Darvocet, Tylenol  #3) pain pills as directed. If you did not receive a prescription for narcotic pain medication and you feel you need something  stronger for pain control, please contact us as directed below. Prescribed narcotic pain medications can make you sick to your stomach. Take them only after you have had something to eat. I recommend you take a dose of either  acetaminophen or narcotic pain medication before you go to bed the first night or evening after surgery. Set an  alarm clock to wake yourself up 4 hours after you go to bed. Take a second dose of the same pain medication then  resume your rest until morning.  Ice application during the first 24 hours after surgery will also reduce pain and swelling. Apply ice bags to  your breasts for 20 minutes at a time followed by 10 minutes of rest. In other words, apply ice to your  breasts for 20 minutes of every half an hour. When applying the ice bags make sure there is a small amount  of water in with the ice at all times. Your skin should feel cool to the touch. Do not use frozen gel packs.  It is not necessary to apply ice while you are sleeping at night.
In the 1980s, the models of the Third and of the Fourth generations of breast implant devices were sequential advances in manufacturing technology, such as elastomer-coated shells that decreased gel-bleed (filler leakage), and a thicker (increased-cohesion) filler gel. Sociologically, the manufacturers of prosthetic breasts then designed and made anatomic models (natural breast) and shaped models (round, tapered) that realistically corresponded with the breast- and body- types of women. The tapered models of breast implant have a uniformly textured surface, which reduces the rotation of the prosthesis within the implant pocket; the round models of breast implant are available in smooth-surface- and textured-surface- types.
Adam R. Kolker, MD, explains: Although silicone breasts feel similar to real breasts, they are still man-made and don’t feel like natural breast tissue. You’ll be more likely to notice there’s an implant in a woman who began with little breast tissue than a woman who had more breast tissue to begin with. Smaller implants and those that are placed below the muscle are harder to detect.
You will want to spend some time researching a qualified surgeon and examine their before and after rhinoplasty photos so see the quality of their work. Scheduling a consultation with the surgeon would be a great next step to speak to them about their credentials and what their recommendations may be. During the consultation process you can also discover where the procedure would be performed. This will also play a role in total cost.
Traveling long distances or for long periods of time can be problematic after surgery. Generally, I do not recommend traveling longer than one hour for one week after surgery. When you do travel you must have help at all times with your baggage (do not lift more than five pounds for three weeks) and you must get out of your seat and walk for five minutes every hour. Remember, even small vibrations during travel can increase the amount of pain you experience. Finally, you will not have the same energy level as you did immediately before your surgery.

We strongly recommend you choose an implant type with your surgeon, who will be able to match the right type to accomplish your desired results. All available implants are considered good, safe choices. However, this article will explain the pros and cons of each of the three main types of breast implants so you can get an idea of what might be the best fit for you.
There’s saline, silicone, “gummy bear” (aka cohesive gel), and autologous fat, explains Dr. Rowe. For the latter, you’ll need around two to three pounds of fat to inject into the chest, and patients often need touch-ups to achieve symmetry. With saline, the implant ripples more, and some patients think that it feels heavier. If a saline implant ruptures, it’s absorbed into your body safely; however, the difference is very noticeable, so you’d likely want to see a doctor ASAP anyway, explains Dr. Doft. Silicone tends to feel more natural, hold its shape, and ripple less. Dr. Doft says the majority of her patients choose silicone.

The study Safety and Effectiveness of Mentor’s MemoryGel Implants at 6 Years (2009), which was a branch study of the U.S. FDA's core clinical trials for primary breast augmentation surgery patients, reported low device-rupture rates of 1.1 per cent at 6-years post-implantation.[49] The first series of MRI evaluations of the silicone breast implants with thick filler-gel reported a device-rupture rate of 1 percent, or less, at the median 6-year device-age.[50] Statistically, the manual examination (palpation) of the woman is inadequate for accurately evaluating if a breast implant has ruptured. The study, The Diagnosis of Silicone Breast implant Rupture: Clinical Findings Compared with Findings at Magnetic Resonance Imaging (2005), reported that, in asymptomatic patients, only 30 per cent of the ruptured breast implants are accurately palpated and detected by an experienced plastic surgeon, whereas MRI examinations accurately detected 86 per cent of breast implant ruptures.[51] Therefore, the U.S. FDA recommended scheduled MRI examinations, as silent-rupture screenings, beginning at the 3-year-mark post-implantation, and then every two years, thereafter.[22] Nonetheless, beyond the U.S., the medical establishments of other nations have not endorsed routine MRI screening, and, in its stead, proposed that such a radiologic examination be reserved for two purposes: (i) for the woman with a suspected breast implant rupture; and (ii) for the confirmation of mammographic and ultrasonic studies that indicate the presence of a ruptured breast implant.[52] 

All of us at the Bashioum Cosmetic Surgery Center are proud of the postoperative care of our patients. We want  you to have the very best surgical result possible! We are here for you. If you have any questions of any kind  at any time, please call us. It is our pleasure to help you through your convalescence. It is your responsibility  to follow these important instructions. They have been developed to reduce your risk of complications and  they will help with the postoperative healing. Working together we will succeed in our goal for you!  What you have accomplished is no small achievement. You have not only overcome a sensitivity you had with  your physical appearance but also you have overcome the fears of completing cosmetic surgery to correct this  problem. You are a person of courage and you can now demand great deeds of yourself.
For detailed indications, contraindications, warnings, and precautions associated with the use of all MENTOR® Implantable Devices, which include MENTOR® Saline-filled Implants, MemoryGel® Implants, MemoryShape® Implants, ARTOURA™ Expanders, and CONTOUR PROFILE® Expanders, please refer to the Instructions for Use (IFU) provided with each product or visit www.mentorwwllc.com.

It is most common with saline breast implants for the implant to be placed beneath the muscle. When the implant is placed below the pictorial muscle it is technically only partially under the muscle. Generally, the top half of the implant is beneath the muscle, as the chest muscle does not extend down far enough to cover the entire implant. Therefore, it doesn’t cause any significant distinction for the patient. This method is more commonly used for the saline implants due to the fact that the saline implants have the tendency to wrinkle and become brittle more often than if you were to use a silicone gel implant. However, the wrinkling and rippling is not typically visible in the lower portion of the implant, so the fact that it is not completely covered by the chest muscle does not affect its aesthetic appearance. Even when wearing certain articles of clothing where the heel or the inner portion of the breast is exposed you will not see any wrinkling.


A great question that comes up often.  A breast reduction will both reduce the breast size and improve the shape of the breast while lifting it.  During this surgery, breast tissue is removed while preserving the tissue around the nipple.  The breast is then shaped and nipple placed in a higher, more ideal position.  This is essentially the breast lift component of this surgery.  With the reduction, we are accomplishing both. Hope this helps. 
Most people who consider a nose job don’t want to look like someone else, they just want to look like the best version of themselves. A nose job, also known as rhinoplasty, is an outpatient surgery to change the size or shape of your nose. It often addresses the size of your nose in relation to the rest of your face, the width of the bridge, and asymmetry. It can also adjust the appearance of humps or depressions, the shape and position of the tip of your nose, and the size of your nostrils.
Complications after breast lifts are relatively rare. The main three are bleeding, infection, and scarring. Your surgeon will give you instructions for preparing that will help lower your risk of complications. Those instructions will include such things as not smoking, making sure you are off medications that may make bleeding more likely, and taking antibiotics if necessary.

The first step toward finding out if you are a candidate is a thorough consultation with a board-certified plastic surgeon who has extensive experience performing breast augmentation. He or she will examine your breasts, your skin tone and the rest of your anatomy to help determine if you are an appropriate candidate. You also may have the option of viewing plastic surgery photos from past patients to better gauge expectations. Other factors, including breast augmentation cost and whether your lifestyle and commitments will allow you to take enough time off to recuperate properly, also play a role in determining your candidacy. 

By and large, there is no 'perfect type' of breast implant. What looked stunning on one of your best friends doesn't necessarily mean that the same implant will be the best choice for you. This is why we recommend face-to-face consultations; an honest discussion with an experienced, knowledgeable plastic surgeon about your desired enhancement is a must. And you'll want to consider your surgeon's opinion and recommendations based on your existing body type and physical assessment.
Rhinoplasty can be performed in one of three places: private surgical suites, ambulatory surgical centers, or hospitals. You should speak with your surgeon and make certain that their chosen venue has been accredited by an organization such as the American Association for Accreditation of Ambulatory Surgical Facilities (AAAA), the Accreditation Association for Ambulatory Health Care (AAAHC), or the Joint Commission for Accreditation of Healthcare Organizations (JCAHO).

When a silicone breast implant ruptures it usually does not deflate, yet the filler gel does leak from it, which can migrate to the implant pocket; therefore, an intracapsular rupture (in-capsule leak) can become an extracapsular rupture (out-of-capsule leak), and each occurrence is resolved by explantation. Although the leaked silicone filler-gel can migrate from the chest tissues to elsewhere in the woman's body, most clinical complications are limited to the breast and armpit areas, usually manifested as granulomas (inflammatory nodules) and axillary lymphadenopathy (enlarged lymph glands in the armpit area).[41][42][43]

Drink only liquids for the first few hours after surgery. Advance slowly to small, light meals. If you experience  nausea or vomiting more than two times, please call me so I can prescribe something to reduce this.  Excessive vomiting and retching can result in bleeding beneath the breast and/or around the implant (if  breast enlargement was done) that will require more surgery.
While you can read about all of this online, it's best to hear it straight from your doctor's mouth. Also, ask about what your doctor will do on the off chance that something goes wrong with your Botox treatment. If you have significant bruising, will he give you a discounted v-beam laser treatment to minimize the bruising? If you end up with Spock brows, will he fix them free of charge? What if your Botox wears off in a week, will he give you an additional touch-up for free? Do not be afraid to ask questions! It's better to have answers before than after.

There are four general types of breast implants, defined by their filler material: saline solution, silicone gel, structured and composite filler. The saline implant has an elastomer silicone shell filled with sterile saline solution during surgery; the silicone implant has an elastomer silicone shell pre-filled with viscous silicone gel; structured implants use nested elastomer silicone shells and two saline filled lumen; and the alternative composition implants featured miscellaneous fillers, such as soy oil, polypropylene string, etc. Composite implants are typically not recommended for use anymore and, in fact, their use is banned in the United States and Europe due to associated health risks and complications.
Transaxillary: an incision made to the axilla (armpit), from which the dissection tunnels medially, to emplace the implants, either bluntly or with an endoscope (illuminated video microcamera), without producing visible scars on the breast proper; yet, it is likelier to produce inferior asymmetry of the implant-device position. Therefore, surgical revision of transaxillary emplaced breast implants usually requires either an IMF incision or a periareolar incision.
Silicone implant rupture can be evaluated using magnetic resonance imaging; from the long-term MRI data for single-lumen breast implants, the European literature about second generation silicone-gel breast implants (1970s design), reported silent device-rupture rates of 8–15 per cent at 10-years post-implantation (15–30% of the patients).[45][46][47][48]
When compared to the results achieved with a silicone-gel breast implant, the saline implant can yield acceptable results, of increased breast-size, smoother hemisphere-contour, and realistic texture; yet, it is likelier to cause cosmetic problems, such as the rippling and the wrinkling of the breast-envelope skin, accelerated lower breast pole stretch, and technical problems, such as the presence of the implant being noticeable to the eye and to the touch. The occurrence of such cosmetic problems is likelier in the case of the woman with very little breast tissue, and in the case of the woman who requires post-mastectomy breast reconstruction; thus, the silicone-gel implant is the technically superior prosthetic device for breast augmentation, and for breast reconstruction. In the case of the woman with much breast tissue, for whom sub-muscular emplacement is the recommended surgical approach, saline breast implants can produce an aesthetic result much like that afforded by silicone breast implants, albeit with greater implant palpability.[90]
Women who are experiencing mild sagging, yet still will benefit from a breast lift, are often good candidates for a peri-areolar lift. This involves a circular incision running around the edge of the areola, and like the crescent lift, is commonly performed in conjunction with breast augmentation. This lift can also be effective in helping reduce areola size. The resulting scar traces the edge of the areola.
Silicone-filled Breast Implants. Silicone-filled breast implants are filled with a silicone gel. Over the years, the consistency of this silicone filling has changed. The first silicone breast implants were filled with a very thin, oily silicone. Currently, the silicone used in implants is a gel that is less likely to leak out of the shell if it ruptures. This gel is referred to as "cohesive." Some breast implants — called gummy bear breast implants — are even more cohesive, or "form-stable," and have the consistency of a gummy bear, thus the nickname.

The current lifetime risk of BIA-ALCL in the U.S. is unknown, but estimates have ranged between estimated to be between 1 in 70,000 to 1 in 500,000 women with breast implants according to MD Anderson.[73] Certain geographic locations have demonstrated variable risks. For instance, a December 2016 update from the Therapeutic Goods Administration of Australia and New Zealand reported a risk of 1:1,000 to 1:10,000 for textured implants.".[71] To date (2017), there has not been a case of BIAL reported where the patient had only implantation of smooth shell breast implants or a textured tissue expander that was exchanged for a smooth implant. The paucity of cases reported in Asian populations has raised the possibility that there may be a range of genetic susceptibility to the phenomena, or alternatively merely reflect differences in how cases are identified and reported.

Post-operative patient surveys about mental health and quality-of-life, reported improved physical health, physical appearance, social life, self-confidence, self-esteem, and satisfactory sexual functioning. Furthermore, the women reported long-term satisfaction with their breast implant outcomes; some despite having suffered medical complications that required surgical revision, either corrective or aesthetic. Likewise, in Denmark, 8 per cent of breast augmentation patients had a pre-operative history of psychiatric hospitalization.[3][4][5][6][7][8][9][10][11]
Women who are experiencing mild sagging, yet still will benefit from a breast lift, are often good candidates for a peri-areolar lift. This involves a circular incision running around the edge of the areola, and like the crescent lift, is commonly performed in conjunction with breast augmentation. This lift can also be effective in helping reduce areola size. The resulting scar traces the edge of the areola.

The procedure is accomplished by using the skin of the lower pole of the breast (the part below the nipple that sits in the bra cup) to shape the whole breast into a perky dome, then straps are made of the extra skin, anchoring it to the underlying chest muscle so that there is virtually no chance of repeat sagging.  The skin that above your nipple and below your collar bone is utilized to cover the perky, lifted dome that has been created and then a new (usually smaller) circular opening for the areola is placed at the high point of the cone, creating your new lifted, full and shapely breast.
“At this point, they are unsure as to what causes it but believe it is somehow related to the texturing of the implant surface,” explains Dr. Rahban. It also seems that removing the implant along with any scar tissue can be curative. So far, statistics are rare, with 626 cases and 17 deaths reported worldwide. If you’ve gotten implants in the past, don’t freak out yet. “It is something to be aware of. While I don’t think it’s super alarming, it’s good to know what is on the horizon,” says Dr. Rahban.
Periareolar: a border-line incision along the periphery of the areola, which provides an optimal approach when adjustments to the IMF position are required, or when a mastopexy (breast lift) is included to the primary mammoplasty procedure. In periareolar emplacement, the incision is around the medial-half (inferior half) of the areola's circumference. Silicone gel implants can be difficult to emplace via periareolar incision, because of the short, five-centimetre length (~ 5.0 cm) of the required access-incision. Aesthetically, because the scars are at the areola's border (periphery), they usually are less visible than the IMF-incision scars of women with light-pigment areolae; when compared to cutaneous-incision scars, the modified epithelia of the areolae are less prone to (raised) hypertrophic scars.
They are essentially very similar procedures. The difference is in the amount of breast tissue removed. In a breast lift procedure, the nipple areolar complex is lift to a better position on the breast, and some breast tissue is removed and the breast envelope tightened. In a breast reduction, the nipple areolar complex is also lifted, but much more breast tissue is removed. 
Breast implants are available in two basic shapes: round and contoured. Contoured implants were originally designed to be used for breast reconstruction, but are now used for cosmetic breast augmentation as well. Contoured implants are shaped like a teardrop to simulate the natural shape of the breast and are made with a textured surface to help prevent movement or rotation. Round implants can also be used to create a very natural appearance, especially when placed under the muscle.
Constance Chen, MD, board-certified plastic surgeon and breast reconstruction specialist, adds that the FDA is currently looking into fat grafting to see if there’s a risk of breast cancer associated with it. Other nonsurgical augmentations with saline or injectable fillers are extremely dangerous and not recommended, says Lara Devgan, MD, board-certified plastic surgeon and RealSelf Chief Medical Officer. “We do not understand how injectable fillers interact with breast tissue in the long run,” she explains.
Most patients say that the first night is painful and that there is a lot of pressure or pain in the anterior chest. This is not a sharp pain but more like a dull throbbing pain which is a result from the muscle being stretched from the implant placement. Most often Surgeons like to place the implant under the muscle because it gives the implant support and there is some evidence that supports a reduction in a capsular contracture when the implant is under the muscle. For implants that are placed above them muscle there is very little pain. As mentioned before, your doctor will give you a prescription for pain medicine and may likely also prescribe a muscle relaxant which helps with the chest pain. Generally, by day three most of the pain is gone. There will be some stiffness which will slowly dissolve over the course of five to seven days.
These placements vary from shallow (subglandular) to deep (complete submuscular). The right placement for your breast implants is based on your anatomy as well as your goals and expectations. You should express your desires to your surgeon, but make sure to take his or her expert opinion into account. Improper implant placement can create complications such as breast augmentation double bubble, wrinkles and rippling.
Breast implants are available in a variety of sizes. You should decide the cup size you want if you are considering breast augmentation. It is also important to make sure that you are not opting for a size that will be too large for your breasts. Breast implants are inserted by making an incision under the breast. So make sure you don’t opt for a size that is too big for your body and chest.
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