Stay still but pay attention - If you are afraid of needles, don't make yourself writhe with discomfort by thinking about them. Set your mind on something random, like monkeys juggling pineapples. The Botox will be over before you know it. Stay still but pay attention and follow your doctor's instructions. He/she will tell you to smile, relax, frown, etc. during the injection process.
In 1997, the U.S. Department of Health and Human Services (HHS) appointed the Institute of Medicine (IOM) of the U.S. National Academy of Sciences (NAS) to investigate the potential risks of operative and post-operative complications from the emplacement of silicone breast implants. The IOM's review of the safety and efficacy of silicone gel-filled breast implants, reported that the "evidence suggests diseases or conditions, such as connective tissue diseases, cancer, neurological diseases, or other systemic complaints or conditions are no more common in women with breast implants, than in women without implants" subsequent studies and systemic review found no causal link between silicone breast implants and disease.[113]
Functional breast-feeding difficulties arise if the surgeon cut the milk ducts or the major nerves innervating the breast, or if the milk glands were otherwise damaged. Milk duct and nerve damage are more common if the incisions cut tissue near the nipple. The milk glands are most likely to be affected by subglandular implants (under the gland), and by large-sized breast implants, which pinch the lactiferous ducts and impede milk flow. Small-sized breast implants, and submuscular implantation, cause fewer breast-function problems; however, it is impossible to predict whether a woman who undergoes breast augmentation will be able to successfully breast feed since some women are able to breast-feed after periareolar incisions and subglandular placement and some are not able to after augmentation using submuscular and other types of surgical incisions.[101]
There are two types of breast implants approved by the Food and Drug Administration (FDA): silicone-filled and saline-filled. They come in various sizes and shapes, and with two types of shells: textured shells and smooth shells. A type of silicone-filled implant with a thicker filling, called a form-stable highly cohesive implant, or "gummy bear" breast implant, is currently under investigation and may one day provide another option for women undergoing breast augmentation with implants.
A lot of patients are concerned over whether or not breast implants are safe. The answer to this is yes. To date there has never been a single study performed anywhere in the world that says that breast implants are dangerous or increase your risk of either breast cancer or any other systemic diseases. Furthermore, the new implants whether saline or silicone are manufactured much better than they used to be 10 or 15 years ago which not only makes them safer but has extended their lifetime use. Even the silicone envelope that encompasses the material inside, whether saline or silicone, is much more durable than in the past. If you do chose to go with silicone implants, even in the case of a rupture, the silicone does not leak to a distant site or go into your bloodstream.
Breast reduction involves reducing the size of the breast. A breast lift involves lifting the nipple-areolar complex and reducing the excess skin of the breast. Breast reductions can involve just liposuction in patients who have more fatty tissue than glandular breast tissue. Liposuction alone indeed does reduce the volume of the breasts. However, sagging of the breast can result and liposuction alone is therefore performed usually in highly selected patients.
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.

Thoroughly research surgeons who meet certain criteria before settling on one. First, make sure the surgeon is certified from the American Board of Plastic Surgery. Be wary of other “boards” that are not legitimate. Your doctor should also be a member of the American Society of Plastic Surgeons and American Society for Aesthetic Plastic Surgery, both of which have a very high standard of criteria and maintenance. Then make sure that the surgeon has experience in the type of surgery you’re wanting. Ask to see a body of their work and before-and-after photos. Speak to other patients. Schedule a consultation and get a feel for the surgeon’s approach.
The Cronin–Gerow Implant, prosthesis model 1963, was a silicone rubber envelope-sac, shaped like a teardrop, which was filled with viscous silicone-gel. To reduce the rotation of the emplaced breast implant upon the chest wall, the model 1963 prosthesis was affixed to the implant pocket with a fastener-patch, made of Dacron material (Polyethylene terephthalate), which was attached to the rear of the breast implant shell.[91]

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.


The breast implant has no clinical bearing upon lumpectomy breast-conservation surgery for women who developed breast cancer after the implantation procedure, nor does the breast implant interfere with external beam radiation treatments (XRT); moreover, the post-treatment incidence of breast-tissue fibrosis is common, and thus a consequent increased rate of capsular contracture.[108] The study Breast Cancer Detection and Survival among Women with Cosmetic Breast Implants: Systematic Review and Meta-analysis of Observational Studies, reported an average later stage in the diagnoses of women who developed breast cancer after undergoing breast augmentation, when compared to breast cancer patients who had not undergone breast augmentation, although this did not ultimately affect the patients prognosis. The use of implants for breast reconstruction after breast cancer mastectomy appears to have no negative effect upon the incidence of cancer-related death.[105][109]

Breast reduction surgery, or reduction mammoplasty, can instantly and effectively reduce breast size through the removal of excess breast tissue. Breast reduction is a surgical procedure that involves the removal of excess skin, fat, and glandular tissue to reduce breast size, eliminating the negative issues associated with breasts that are larger than the patient desires.  Usually, the breast is lifted significantly and enlarged areolas are reduced.  The tissue removed can also be sent to a pathologist for breast cancer screening if the patient desires.
Your plastic surgeon's experience and reputation make the greatest difference in the cost of rhinoplasty. Here in Manhattan, it is possible to undergo the procedure for as little as $3,000 when it is performed by surgeons-in-training, supervised by senior surgeons. Meanwhile, there are experienced surgeons who are not performing as many rhinoplasties as they would like, and may be willing to perform the procedure for $5,000 to $7,000. However, if rhinoplasty is your surgeon's specialty, this can provide the best chances of achieving the results you desire. His or her fees will reflect that, and depending on where the practice is located, the total cost of surgery can be upwards of $15,000.

The breast augmentation patient usually is a young woman whose personality profile indicates psychological distress about her personal appearance and her bodily self image, and a history of having endured criticism (teasing) about the aesthetics of her person.[2] The studies Body Image Concerns of Breast Augmentation Patients (2003) and Body Dysmorphic Disorder and Cosmetic Surgery (2006) reported that the woman who underwent breast augmentation surgery also had undergone psychotherapy, suffered low self-esteem, presented frequent occurrences of psychological depression, had attempted suicide, and suffered body dysmorphia, a type of mental illness.
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.

There is no set expiry date on breast implants, but if there are issues with the implants, meaning no structural issues then they could last forever. There is a common misconception that breast implants are only good for 10 years, however, that is only a mathematical average of how long implants last before potentially having complications. There are some cases where patients with implants experience complications within the first year and there are some cases where patients don’t experience any complications until 20 years. This is where the mathematical average of 10 years comes into play. It is important to remember that implants are not infallible. They are human made devices that do sometimes have defects which results in a leak, tear, or rupture. In general, if a patient is able to make it past the first two years without any issues with their implants, there is no need to be concerned about the life expectancy of your implant as it is possible they will last for as long as you want to. Generally, patients with implants will come back 10-15 years later to either change, remove or reduce their implants. Certainly, implants can be adjusted and changed if and when necessary, but if you’re not having any issues with the implants then you likely won’t need to do surgery in 10 years you can leave them alone.
Generally, you can go back to working out two to three weeks after breast lift or breast reduction surgery. This depends on how you feel. Do not lift anything that weighs more than five pounds for three weeks. Avoid contact sports for six weeks. If you had breast enlargement with a breast lift, hereafter avoid all exercises which isolate your pectoralis muscles as these can shift the implant toward you armpit. Workouts must stop if you experience discomfort in your breasts or chest. A balance of rest and reduced activity will speed up your recovery.
From the first half of the twentieth century, physicians used other substances as breast implant fillers—ivory, glass balls, ground rubber, ox cartilage, Terylene wool, gutta-percha, Dicora, polyethylene chips, Ivalon (polyvinyl alcohol—formaldehyde polymer sponge), a polyethylene sac with Ivalon, polyether foam sponge (Etheron), polyethylene tape (Polystan) strips wound into a ball, polyester (polyurethane foam sponge) Silastic rubber, and teflon-silicone prostheses.[111]
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]

The choice between silicone breast implants or saline breast implants is a somewhat subjective question. It really depends on your specific anatomy needs and finances. Both silicone and saline implants are excellent and for most people that have adequate coverage over the breast implant, meaning they have a little bit of breast tissue or a little bit of fat left that is going to cover the implant, saline breast implants work fine. In some instances, where the patient is very thin, it might be better to use the silicone gel breast implant because there are parts of the implant, about a third to one half that are not covered by the muscle and if you don’t have enough coverage over the implant, you will see some rippling and some wrinkling of the implant. This tends to happen especially when you lean over or lean forward. Therefore, in those cases, silicone gel implants are better. In terms of how they look, they are both great breast implants and they look very similar. The silicone implants are a little bit more expensive, so if the finances are a big issue than saline implants generally work very well and can give you the desired results, but again it is more of a personal preference.


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.
Functional breast-feeding difficulties arise if the surgeon cut the milk ducts or the major nerves innervating the breast, or if the milk glands were otherwise damaged. Milk duct and nerve damage are more common if the incisions cut tissue near the nipple. The milk glands are most likely to be affected by subglandular implants (under the gland), and by large-sized breast implants, which pinch the lactiferous ducts and impede milk flow. Small-sized breast implants, and submuscular implantation, cause fewer breast-function problems; however, it is impossible to predict whether a woman who undergoes breast augmentation will be able to successfully breast feed since some women are able to breast-feed after periareolar incisions and subglandular placement and some are not able to after augmentation using submuscular and other types of surgical incisions.[101]
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]

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]
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.” 

"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."
the second technological development was a polyurethane foam coating for the shell of the breast implant; the coating reduced the incidence of capsular contracture, by causing an inflammatory reaction that impeded the formation of a capsule of fibrous collagen tissue around the breast implant. Nevertheless, despite that prophylactic measure, the medical use of polyurethane-coated breast implants was briefly discontinued, because of the potential health-risk posed by 2,4-toluenediamine (TDA), a carcinogenic by-product of the chemical breakdown of the polyurethane foam coating of the breast implant.[92]
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.

For my patients, I also provide a post-operative packet. This includes arnica and other ointments, gauze and tape, an ice pack, and nasal decongestant spray. If your surgeon does not provide these items to you before or after your surgery, they are all helpful during the healing process. I encourage my patients to get anti-nausea medication for the first few days following surgery as well.


Another option is to consider getting your breast implants at a teaching hospital from a learning resident. You won’t get the delicate skill of an experienced, board-certified surgeon, but teaching hospital residents are “assisted by established, experienced, private attending surgeons,” says Beverly Hills plastic surgeon Dr. Robin T.W. Yuan in a RealSelf Q&A.
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.

The preferred incision site is around the areola. You have your nipple, and then you have a circular dark skin around it which is called the areola. Usually the incision that is made is about 3 to 4 centimeters long which is about an inch and a half to two inches. The reason this is the preferred location for the incision is that number one it heals very well after about a week or two weeks, and it’s very difficult to see this incision even if you’re looking for it because it’s camouflaged by the dark skin and the light skin. The incision is right on the border between those two so it’s easily hidden. Another advantage of this incision is that it allows direct access to the implant pocket. The surgeon is able to use fiber optic lighting to look and examine the pocket very carefully to make sure that it’s clean, that there’s no bleeding, and allows for the best control of the implant placement.
Am I happy with my breast size when wearing a bra? A breast lift alone will not significantly change the size of your breasts. It can help your breasts look fuller, rounder, and better in a bra, but if you would like your breasts to be larger or smaller, a breast lift in conjunction with a breast augmentation or reduction may be the right option for you.
“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.”
It has been shown that the rates of capsular contraction are much lower when the breast implant is placed below the muscle. Also, with the implant below the muscle, there is that extra layer of tissue between the visible part of the breast and the implant, therefore making it more difficult to be detected by touch and maintain the natural feeling of the breast. The breast will look more natural with this method as you will not be able to visibly see the edges of the implant.
The saline breast implant—filled with saline solution (biological-concentration salt water 0.90% w/v of NaCl, ca. 300 mOsm/L.)—was first manufactured by the Laboratoires Arion company, in France, and was introduced for use as a prosthetic medical device in 1964. The contemporary models of saline breast implant are manufactured with thicker, room-temperature vulcanized (RTV) shells made of a silicone elastomer. The study In vitro Deflation of Pre-filled Saline Breast Implants (2006) reported that the rates of deflation (filler leakage) of the pre-filled saline breast implant made it a second-choice prosthesis for corrective breast surgery.[88] Nonetheless, in the 1990s, the saline breast implant was the prosthesis most common device used for breast augmentation surgery in the United States, because of the U.S. FDA's restriction against the implantation of silicone-filled breast implants outside of clinical studies. Saline breast implants have enjoyed little popularity in the rest of the world, possessing negligible market share.
A breast lift, also known as a mastopexy, is most beneficial for women who have sagging breasts. This type of procedure reshapes and supports the breast tissue to achieve a more youthful figure. It also helps restore the shape and volume that may have been lost due to age, weight loss or breastfeeding. Because a breast lift repositions the location of the breasts, they can appear smaller. However, only excess skin is removed, not the actual breast tissue. Often with breast lifts, the nipple and areolas are repositioned and reduced in size to create a more natural look.
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