The FDA has identified that breast implants may be associated with a rare form of cancer called anaplastic large-cell lymphoma, believed to be associated with chronic bacterial inflammation.[69] Similar ALCL phenomena have been seen with other types of medical implants including vascular access ports, orthopedic hip implants, and jaw (TMJ) implants. As of February 1, 2017, the FDA has received a total of 359 medical device reports of breast-implant-associated ALCL (BIALCL), including 9 deaths.[70] Most cases of breast implant-associated ALCL had implants in for many years prior to the condition, and are usually treated successfully by simple removal of the implant and the capsule surrounding the implant without the need for chemotherapy if no evidence of systemic disease exists. If women with implants present with delayed swelling or fluid collection, cytologic studies and test for a marker "CD30" are suggested. The American Society of Plastic Surgery (ASPS) states, "CD30 is the main diagnostic test that must be performed on the seroma fluid as routine pathology or H&E staining can frequently miss the diagnosis." [71] Diagnosis and treatment of breast implant associated ALCL now follows standardized guidelines established by the National Comprehensive Cancer Network.[72]

“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.
Please call the office between 8:30AM and 4:30PM during the workweek to make arrangements for me to see you one week after your surgery. Please call for appointments for follow up visits at six weeks, six months, and twelve months. The reason for this extended care is because it takes six months to one year for complete healing to occur. There are no charges for any of your aftercare office visits. It would be my pleasure to see you at any time to answer any questions about your breast surgery or any other cosmetic surgery you read or hear about. Finally, please mention me to you family and friends when they bring up the topic of cosmetic surgery or therapeutic injections. It has been my pleasure helping you through this cosmetic surgery experience!
1998 Germany Federal Institute for Medicine and Medical Products Reported that "silicone breast implants neither cause auto-immune diseases nor rheumatic diseases and have no disadvantageous effects on pregnancy, breast-feeding capability, or the health of children who are breast-fed. There is no scientific evidence for the existence of silicone allergy, silicone poisoning, atypical silicone diseases or a new silicone disease."[32]
A breast reduction typically includes a lift.  However, a lift does not necessarily require a reduction.  Both operations have similar incision patterns and resultant scars, but they have different indications.  One of the first questions I ask a patient who desires an improved appearance of her breasts is if she would like to be the same size, smaller, or larger.  The patient who wants to be the same size and is happy with her breasts when wearing a bra but unhappy with the amount of sagging without a bra is a candidate for a breast lift alone.  The patient who desires to be smaller or has one breast noticeably larger than the other, is a candidate for a breast reduction-lift combination.  Sometimes patients feel their breasts look smaller after removal of the excess skin with the lift even though no breast tissue was removed; the reason for this is that some of what fills your bra cup is excess skin.  The patient with sagging who desires to have larger breasts is a candidate for a breast lift with implants.

In some cases, a breast lift alone may not achieve a patient’s desired results. If you feel your breasts look “deflated” or have lost volume due to aging, weight loss, or pregnancy, your cosmetic surgeon can place breast implants during breast lift surgery to restore fullness and shape to the breast. If you have always wanted larger, lifted breasts, a breast augmentation with lift can help you achieve both with a single procedure and recovery.
Both anesthesiologists and registered nurse anesthetists can administer anesthesia. An anesthesiologist is a specially trained physician who will administer anesthesia and monitor your vital signs during surgery. A registered nurse anesthetist has specialized training to do the same.  However, while a registered nurse's services can cost about $300 per hour, an anesthesiologist's services can cost closer to $500 per hour.

From your description, you seem to be a very good candidate for this new technique and should really get the look that you are desiring without implants or any unnecessary visible scars. I would recommend that you search for an ABPS board certified plastic surgeon who is also a member of the American Society of Plastic Surgeons and the American Society of Aesthetic Plastic Surgeons in your area or an area that you would like to travel to on holiday who offers the Bellesoma technique to discuss your breast reduction and possible results.  You've provided great information - the only thing that would be more helpful in order to give you the best advice about your options would be an in-person exam.


Dr. Rahban estimates that 30 percent of the errors made in breast augmentation come down to incorrect size selection. “The most important thing with breast augmentation is to make sure that the implant you select is conservative and not too large for the size of your anatomy.” It’s a red flag if your doctor doesn’t seem concerned with advising you about the maximum size you can reach before developing medical complications.
It is certainly possible to lift a breast without changing the volume or removing any tissue, however, the breast will sometimes appear smaller after this procedure due to its position. It is also possible to reduce breast volume without lifting the tissue (usually via liposuction) but all reductions that are performed by making incisions will also include a lift.

Bellesoma is a new breast reduction and lift technique that seems like it would be a great fit for you.  This procedure utilizes 3-D volumetric scanning and a multi-point measuring system to design a precise surgical blueprint exactly tailored to your body and the reduced breast size that you desire. The Bellesoma procedure reduces the sagging and weight of your breast, lifts your breast and reduces areola diameter, preserves the nipple sensation and ability to breast feed.  After Bellesoma, your breasts will look as full and perky as if an implant had been placed without using any implant, so no need to compromise.  One of the huge positives of this technique is that there is NO vertical incision traveling down the front of your breasts.


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.

For example, if you have very large breasts, sometimes the only reduction that can be made is to detach the nipples and areolas completely from the underlying tissues. If this is done, you will lose sensation in your nipples. Thus, you must think carefully about what will happen during the surgery – and whether or not you can live with the results.
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.
This is all based on personal preference. Think of boob size in terms of a scale from small to large. Based on breast size before the procedure and desired breast size afterward, there are a number of incision options for a reduction for a huge range of results. You can even choose to get a reduction and an implant to replace some of the volume you’ve lost over time.
Select a doctor who knows what he/she is doing - As I've repeatedly emphasized, choosing a board-certified and experienced doctor is very, very important. Good Botox depends on the skill and technique of the Botox injector, so do your research and find a doctor who specializes in facial anatomy and has been successfully administering Botox (with few patient complaints) for several years already. Ideally, get more than one Botox consultation.
This average total, according to the 2016 statistics from the American Society of Plastic Surgeons, is based on the surgeon’s fee only and does not include the cost of anesthesia, facilities, and materials (stitches, bandages, drapes, etc.). The price will also depend on doctor, patient, and region. The cost of reduction, though, varies greatly patient to patient. A reduction procedure could take three to four times longer than an augmentation, and the cost would reflect that.

In recent years, medical tourism, or going outside the U.S. for a surgery or procedure, has become more popular. Patients go to other countries to have rhinoplasty and other surgery performed at a lower cost. While several other countries, such as South Korea, Columbia, and Italy, may have surgeons willing to perform rhinoplasty at a low cost, the quality and safety standards may not be as closely regulated as they are in the U.S.


“Insurance will typically cover procedures to help improve nasal function (i.e. septoplasty, nasal valve repair, turbinate reduction),” says Dr. Sam Naficy, a Seattle facial plastic surgeon, in a RealSelf Q&A. “The extent of coverage varies based on the details of the insurance plan. Insurance will not cover procedures that improve the appearance of the nose but are not necessary to improve nasal function.”

The weight difference between equal volumes of saline, silicone, and breast tissue is slim to none, so a natural C cup and an augmented C cup are very similar in weight, says Dr. Kolker. If you choose an implant size proportional to your frame, you will see little effect on your posture. However, if you choose large implants, you will feel the effects.


Silicone gel implants were approved by the U.S. Food and Drug Administration for cosmetic breast augmentation in November 2006. The move ended a 14-year moratorium during which silicone gel implants were available in the U.S. only for breast reconstruction, for women who already had these implants and needed a replacement for medical reasons and for use in ongoing clinical trials.
Rhinoplasties, like other surgeries, especially cosmetic ones, can cost vastly different amounts. The price of any surgery varies with the complexity of the procedure, the expertise and reputation of the surgeon, and the geographic region in which the surgery is to be performed. Prices for the surgery can range anywhere from $3,000 to $15,000. Typically, whatever the fee is, the cost of rhinoplasty does not include anesthesia, operating room facilities, or other related expenses.

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]


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.
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.
Since the late nineteenth century, breast implants have been used to surgically augment the size (volume), modify the shape (contour), and enhance the feel (tact) of a woman's breasts. In 1895, surgeon Vincenz Czerny effected the earliest breast implant emplacement when he used the patient's autologous adipose tissue, harvested from a benign lumbar lipoma, to repair the asymmetry of the breast from which he had removed a tumor.[110] In 1889, surgeon Robert Gersuny experimented with paraffin injections, with disastrous results.[further explanation needed]

In general, silicone-gel-filled implants are smoother, softer and feel more like natural breast tissue than their saline-filled counterparts. Silicone implants feel like a semisolid gel, while saline implants are often likened to water balloons. Silicone-gel implants are also less likely to wrinkle and ripple than saline breast implants. Wrinkling is actually considered one of the major disadvantages of saline implants. The thinner the woman and the less breast tissue she has, the more likely the saline implant's crinkles and wrinkles will be felt and even seen.
Meeting with multiple prospective surgeons is also a great way to make your choice. Make sure you are comfortable speaking to the surgeon, and make sure he or she asks you plenty of questions, and does not rush you through any part of the consultation. After you have fully described your goals, the surgeon should provide you with informative, thoroughly explained options.
In the mid-twentieth century, Morton I. Berson, in 1945, and Jacques Maliniac, in 1950, each performed flap-based breast augmentations by rotating the patient's chest wall tissue into the breast to increase its volume. Furthermore, throughout the 1950s and the 1960s, plastic surgeons used synthetic fillers—including silicone injections received by some 50,000 women, from which developed silicone granulomas and breast hardening that required treatment by mastectomy.[112] In 1961, the American plastic surgeons Thomas Cronin and Frank Gerow, and the Dow Corning Corporation, developed the first silicone breast prosthesis, filled with silicone gel; in due course, the first augmentation mammoplasty was performed in 1962 using the Cronin–Gerow Implant, prosthesis model 1963. In 1964, the French company Laboratoires Arion developed and manufactured the saline breast implant, filled with saline solution, and then introduced for use as a medical device in 1964.[88]
Hello and thanks for your post and questions. It seems that you would potentially be a fantastic candidate to have a breast reduction and lift using the Bellesoma technique with NO vertical scar! With this technique you should be able to reach a smaller,  but perky and proportional breast size that fits your frame along with achieving upper pole fullness. You've provided great information - the only thing that would be more helpful in order to give you the best advice about your options would be an in-person exam.

When trying to determine the implant sized for your body, it can be a tricky question but also a very important question. This is the question that you and your surgeon will spend the most time discussing during your consultation. Breast size and Implant size is very subjective, since what you may consider attractive and desirable may be very different from what others consider attractive, but in the end the surgeon wants to do what is best for you and you will be pleased with. Now with that being said, it is important to remember that not all expectations can be met. This is why it is important to discuss this in detail so that the surgeon can give you feedback and recommendations that are proportional to your body frame. There are instances where patients want to go slightly over what would be considered proportional, and that is fine so long as it is safe for the patient. The operation is relatively similar regardless of the implant size, but it is crucial that you choose the implant size and the resulting breast size that will make you the happiest and attain your desired results. As stated earlier, there are certain limitations. For example, you may not have enough skin, or you may have a breast shape that precludes a very large implant. So, this is something that you and your surgeon can discuss, and they will be able to help guide you to the best decision for you and your desired results.

One investigation from 2003 tried to decide if Botox infusions under and around the eyes could diminish the presence of wrinkles in these regions. Nineteen female members gotten infusions. The individuals who had them in the lower eyelids and crow’s feet territory will probably report positive outcomes than the individuals who just gotten infusions in their lower eyelids.


Contoured implants, also called anatomical or teardrop-shaped implants, are shaped like a natural breast and create a sloped shape when placed over the chest muscles. Round breast implants have that, well, "round" Victoria's Secret or Playboy model shape. Contoured implants may flip over if the surgeon does not create the pocket correctly, resulting in a misshapen breast. Not true with round implants. If a round breast implant flips, it still looks the same. Your decision on implant shape should be based on how you want your new breasts to look.
Having a breast lift is similar to resetting the clock for sagging. Your breasts will still undergo natural changes due to the aging process, although with proper care you should not experience your previous level of sagging for many years. However, it is important to understand that certain life events, such as future pregnancy or weight fluctuations can negatively affect your results. If you are planning to have more children or you would like to lose weight, it is best to achieve these milestones before having a breast lift.
The first step in the breast implant surgery process is a consultation with a board-certified plastic surgeon who has extensive experience performing various types of breast surgery. During this meeting, the surgeon will perform an examination of your breast tissue, discuss your goals for surgery and tell you what you need to know about breast implants. Based on his or her examination, the surgeon will determine whether you are a candidate for surgery.
"Sometimes, a good reputation is well deserved, and sometimes it's merely hype and marketing," Dr. Naderi said. "There are reality show plastic surgeons who charge high fees, for example, based on their television exposure and publicity. Then, there are well-known plastic surgeons in the field who focus mainly on nose surgery and are true specialists."
1998 Germany Federal Institute for Medicine and Medical Products Reported that "silicone breast implants neither cause auto-immune diseases nor rheumatic diseases and have no disadvantageous effects on pregnancy, breast-feeding capability, or the health of children who are breast-fed. There is no scientific evidence for the existence of silicone allergy, silicone poisoning, atypical silicone diseases or a new silicone disease."[32]
You and your surgeon will decide together which incision choice is best for you: underarm incision, incision in the crease of the breast (inframammary fold), or through removal of the areola. Your doctor will take into consideration your beginning breast size and shape, breast tissue, and a number of other factors before recommending which options are best for you and your body.

Prepectoral or subcutaneous: in a breast reconstruction following a skin-sparing or skin- and nipple-sparing mastectomy, the implant is placed above the pectoralis major muscle without dissecting it so that the implant fills directly the volume of the mammary gland that has been removed. To avoid the issue of capsular contracture, the implant is often covered frontally or completely with a mesh in biomaterial, either biological or synthetic.
This average total, according to the 2016 statistics from the American Society of Plastic Surgeons, is based on the surgeon’s fee only and does not include the cost of anesthesia, facilities, and materials (stitches, bandages, drapes, etc.). The price will also depend on doctor, patient, and region. The cost of reduction, though, varies greatly patient to patient. A reduction procedure could take three to four times longer than an augmentation, and the cost would reflect that.
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