Fill Filled with a highly cohesive gel for durable shape retention designed to give a youthful feel. Filled with a proprietary cohesive gel that hold together uniformly while retaining the natural give that resembles breast tissue. Filled with a saltwater solution similar to the fluid that makes up most of the human body; slightly firmer feel than gel.
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.
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’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 cause of capsular contracture is unknown, but the common incidence factors include bacterial contamination, device-shell rupture, filler leakage, and hematoma. The surgical implantation procedures that have reduced the incidence of capsular contracture include submuscular emplacement, the use of breast implants with a textured surface (polyurethane-coated);[55][56][57] limited pre-operative handling of the implants, limited contact with the chest skin of the implant pocket before the emplacement of the breast implant, and irrigation of the recipient site with triple-antibiotic solutions.[58][59]
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]

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.
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.
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.
Implants come in various sizes, and your surgeon will guide you on choosing the right size to help you achieve the look you desire. In addition, your surgeon will help you decide whether you want a more natural, teardrop shape or a more rounded look. Implants also come with either smooth our textured shell surfaces, and your surgeon will help you decide which is best for you.

In the past, concerns emerged that silicone implants posed health risks, including an increased risk of systemic diseases such as lupus and arthritis. The Food and Drug Administration (FDA) placed a moratorium on silicone implants in 1992 so the safety of these devices could be studied. However, in 2006 the agency concluded that there was no evidence of risk and lifted the moratorium.


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. 

Despite their differences, most patients who have these procedures to attain their specific goals are highly satisfied with their results. Both procedures are relatively easy to recover from and require 2 to 4 weeks of downtime. Even though both procedures address different issues, it is not unusual for women to encounter both excess breast tissue and sagging. Commonly, these women get the best results by receiving a combination of breast reduction and breast lift procedures. If you are considering a breast reduction, breast lift or a combination of the two, do your research and find a skilled board-certified plastic surgeon to discuss which one is right for your specific goals.


Smooth breast implants are round in shape, come in many sizes and are available with different profiles, which is the amount of projection of the breast silhouette from the chest. The shells of smooth breast implants are slightly thinner than textured implants. Smooth implants are less likely to cause rippling of the implant shell and are less likely to rupture.
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.
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]
The cause of capsular contracture is unknown, but the common incidence factors include bacterial contamination, device-shell rupture, filler leakage, and hematoma. The surgical implantation procedures that have reduced the incidence of capsular contracture include submuscular emplacement, the use of breast implants with a textured surface (polyurethane-coated);[55][56][57] limited pre-operative handling of the implants, limited contact with the chest skin of the implant pocket before the emplacement of the breast implant, and irrigation of the recipient site with triple-antibiotic solutions.[58][59]

Implants come in various sizes, and your surgeon will guide you on choosing the right size to help you achieve the look you desire. In addition, your surgeon will help you decide whether you want a more natural, teardrop shape or a more rounded look. Implants also come with either smooth our textured shell surfaces, and your surgeon will help you decide which is best for you.


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.
However, if a patient underwent surgery in another country, but experiences post-operative complications, he or she will need to pay to travel back to the same destination if they wish to have the same doctor oversee any revisions. Revision surgery performed by a different surgeon is extremely difficult, and thus more expensive. In fact, it can cost 50 percent more than the original surgery. Therefore, it can actually be far more economical to pay for a surgery within the U.S.
Structured implants were approved by the FDA and Health Canada in 2014 as a third form of breast implant.[97] Structured implants incorporate both saline and silicone gel implant technology. The filler is only saline solution in case of rupture and has a natural feel like silicone gel implants.[98] The implant uses an internal structure which consists of a series of nested shells that support the upper pole with the two lumen being filled with only saline. The implant is inserted empty and then filled once in place which requires less of an incision than pre-filled implants.[97] If one of the lumen of the structured implant ruptures, it leaks and empties. The other lumen remain intact and the implant only partially deflates, allowing for ease of explant and replacement.[97]

There’s definitely no denying, the B word has definitely been a talking point of late, not just in the media, but within my close circle of friends too. Would you? Wouldn’t you? Have you? Has she? I promise it’s not as ‘Real Housewives of Cheshire’ as it sounds... But whilst I'm only 28, the reality is that the constant stream of late nights, binge drinking (sorry Mum) and falling asleep with a full face of makeup on, are all starting to show their effects.
Dr. Larry Fan is a Harvard educated, Board Certified Plastic Surgeon in San Francisco, CA. He is a Master Artist who is known for creating beautiful, stunning, and natural results. Dr. Fan has been named One of America's Top Plastic Surgeons for the past 10 years running and has received several national awards for his work in Plastic Surgery. He has successfully performed more than 10,000 cosmetic procedures of the face, breasts, and body over a 20 year period. Dr Fan has been an invited speaker at the American Society of Plastic Surgeons and the American College of Surgeons, and has been featured in national media outlets such as CNN, NBC, and ABC.
Round breast implants come in a wide array of sizes to accommodate women with different body types. They are also available with a moderate or high profile, which is the amount of projection of the breast profile from back to front. Most round implants have a smooth surface because they can rotate after placement without causing any change in appearance or distorting the breast shape. However, they are available with a textured surface as well.

In 2006, for the Inamed Corporation and for the Mentor Corporation, the U.S. Food and Drug Administration lifted its restrictions against using silicone-gel breast implants for breast reconstruction and for augmentation mammoplasty. Yet, the approval was conditional upon accepting FDA monitoring, the completion of 10-year-mark studies of the women who already had the breast implants, and the completion of a second, 10-year-mark study of the safety of the breast implants in 40,000 other women.[119] The FDA warned the public that breast implants do carry medical risks, and recommended that women who undergo breast augmentation should periodically undergo MRI examinations to screen for signs of either shell rupture or of filler leakage, or both conditions; and ordered that breast surgery patients be provided with detailed, informational brochures explaining the medical risks of using silicone-gel breast implants.[113]
After breast implants surgery, a patient has to apply bandages to protect the chest area. A tube that is inserted in order to facilitate the draining of any expected, temporary fluid discharge. A follow-up appointment is scheduled for approximately 48 hours after breast augmentation surgery. This appointment is in order to complete the routine removal of bandages, dressings, and draining tubes.
However, if a patient underwent surgery in another country, but experiences post-operative complications, he or she will need to pay to travel back to the same destination if they wish to have the same doctor oversee any revisions. Revision surgery performed by a different surgeon is extremely difficult, and thus more expensive. In fact, it can cost 50 percent more than the original surgery. Therefore, it can actually be far more economical to pay for a surgery within the U.S.
Transumbilical: a trans-umbilical breast augmentation (TUBA) is a less common implant-device emplacement technique wherein the incision is at the umbilicus (navel), and the dissection tunnels superiorly, up towards the bust. The TUBA approach allows emplacing the breast implants without producing visible scars upon the breast proper; but makes appropriate dissection and device-emplacement more technically difficult. A TUBA procedure is performed bluntly—without the endoscope's visual assistance—and is not appropriate for emplacing (pre-filled) silicone-gel implants, because of the great potential for damaging the elastomer silicone shell of the breast implant during its manual insertion through the short (~2.0 cm) incision at the navel, and because pre-filled silicone gel implants are incompressible, and cannot be inserted through so small an incision.[75]
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As with any sort of surgery there are always risks involved. The two most common risks for breast implant surgery are bleeding and infection. In general, the risk of bleeding is very low, and if it does happen, it will typically happen within the first 24 hours. Infection on the other hand, can take up to one to two weeks to before it will show itself. However, we take every possible precaution such as; using sterile equipment, sterile gowns, gloves, masks and many other safety precautions. The risk of infection is typically anywhere from two to three percent. So yes, there are risks and they can happen but they are very rare. One other risk that needs to be mentioned is the risk of using anesthesia. So yes, it can happen, but it’s exceedingly rare.
Round breast implants come in a wide array of sizes to accommodate women with different body types. They are also available with a moderate or high profile, which is the amount of projection of the breast profile from back to front. Most round implants have a smooth surface because they can rotate after placement without causing any change in appearance or distorting the breast shape. However, they are available with a textured surface as well.
Tell your doctor if you have received any other botulinum toxin product in the last 4 months; have received injections of botulinum toxin such as Myobloc®, Dysport®, or Xeomin® in the past (tell your doctor exactly which product you received); have recently received an antibiotic by injection; take muscle relaxants; take an allergy or cold medicine; take a sleep medicine; take aspirin-like products or blood thinners.
It is also possible for implants to rupture and leak. If saline implants rupture, the saline will be safely absorbed by the body. A silicone leak may stay inside the implant shell or leak outside of the shell. When a saline implant ruptures, it will deflate. But silicone breast implants may cause no obvious symptoms when they rupture. This is called silent rupture.
The surgical scars of a breast augmentation mammoplasty develop approximately at 6-weeks post-operative, and fade within months. Depending upon the daily-life physical activities required of the woman, the breast augmentation patient usually resumes her normal life at 1-week post-operative. Moreover, women whose breast implants were emplaced beneath the chest muscles (submuscular placement) usually have a longer, slightly more painful convalescence, because of the healing of the incisions to the chest muscles. Usually, she does not exercise or engage in strenuous physical activities for approximately 6 weeks. During the initial post-operative recovery, the woman is encouraged to regularly exercise (flex and move) her arm to alleviate pain and discomfort; if required, analgesic indwelling medication catheters can alleviate pain[80][81] Moreover, significantly improved patient recovery has resulted from refined breast-device implantation techniques (submuscular, subglandular) that allow 95 per cent of women to resume their normal lives at 24-hours post-procedure, without bandages, fluid drains, pain pumps, catheters, medical support brassières, or narcotic pain medication.[82][83][84][85]

Soya bean oil filled implants were introduced to allow better visualization and analysis of mammograms in the presence of breast implants. This is why the material inside the shells is less dense than both saline and silicone gel implants. Since the material is less cohesive the problems with these implants are similar to that of the saline implants.


2000 European Union European Committee on Quality Assurance & Medical Devices in Plastic Surgery (EQUAM) "Additional medical studies have not demonstrated any association between silicone-gel filled breast implants and traditional auto-immune or connective tissue diseases, cancer, nor any other malignant disease. . . . EQUAM continues to believe that there is no scientific evidence that silicone allergy, silicone intoxication, atypical disease or a 'new silicone disease' exists."[34]


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.
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.

Both breast reduction and breast lift surgeries are similar in that they both serve to reshape the breasts. Breast lift, through any of the various techniques, basically serves to reposition the breast and nipple on the chest to reverse the effects of time and gravity. The same changes that are noted in ptotic, or sagging, breasts are often seen in large breasts that require reduction: the nipple position is often low and there is excess skin (in addition to the excess breast tissue). The breast reduction then combines a lift with removal of extra tissue to create a breast that has a higher nipple position, reduced extra skin, and smaller and more balanced breast size.
After surgery, patients should be prepared for the cost of any pain medication they will take during recovery. These costs are not typically included in the overall cost of surgery. At my practice, we provide homeopathic medications as part of our total surgical package. Your surgeon can explain to you any prescription or homeopathic medications you may be prescribed and discuss their cost.
Placing the breast implants on top of the muscle, which has been the traditional procedure, can result in a slightly higher risk of contraction. This issue is a cosmetic problem, rather than a medical or health issue. Gel/Silicone implants have been placed both above and below the muscle without a significant difference in the rates of having contraction.
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.
Does the nipple/areola sit below the crease underneath my breast? One trait cosmetic surgeons frequently look for when evaluating a breast lift candidate is the position of the nipple/areola in relation to the inframammary fold, or crease beneath the breast. Try this test: slide a plain sheet of paper underneath your breast (no bra) so it sits against the breast crease. When looking in the mirror, do your nipples sit below the top edge of the paper? If so, this is a good indication that you have enough sagging to warrant a breast lift. 

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!
“Patients who undergo open rhinoplasty typically have more edema (swelling) that persists longer compared to patients in whom closed rhinoplasty techniques were used,” says Dr. C. Spencer Cochran, a Dallas, Texas facial plastic surgeon, in a rhinoplasty recovery Q&A. “If the nose was surgically broken by performing osteotomies, then there is usually more swelling and bruising."
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