Platinum is a catalyst used in the making of silicone implant polymer shells and other silicone devices used in medicine. The literature indicates that small amounts of platinum leaches (leaks) from these implants and is present in the surrounding tissue. The FDA reviewed the available studies from the medical literature on platinum and breast implants in 2002 and concluded there was little evidence suggesting toxicity from platinum in implant patients.[67] The FDA revisited this study and additional literature several years later, reaffirming prior conclusions that platinum catalysts used in implants is likely not ionized and therefore would not represent a risk to women.[68]
Tell your doctor about all your medical conditions, including: plans to have surgery; had surgery on your face; have trouble raising your eyebrows; drooping eyelids; any other abnormal facial change; are pregnant or plan to become pregnant (it is not known if BOTOX® Cosmetic can harm your unborn baby); are breast-feeding or plan to (it is not known if BOTOX® Cosmetic passes into breast milk).

“The biggest difference between the open and closed rhinoplasty is a small incision on the columella (bottom) of the nose,” says Dr. Kent V. Hasen, a Naples, Florida plastic surgeon, in a rhinoplasty Q&A. “This 6 mm incision allows the surgeon to peel the skin of the lower nose back to fully visualize the tip and dorsum of the nose. In the closed procedure, there is not as much visualization since the skin is not peeled back.”


While more experienced surgeons may charge more for their expertise, that’s not always the case. “You should not choose a qualified surgeon based on high fees any more than you should choose one based on low fees,” says Boca Raton, Florida plastic surgeon Dr. Hilton Becker in a RealSelf Q&A. “The most important factors should be education, experience, certification, and your ability to feel comfortable with your surgeon.”
In the early 1990s, the national health ministries of the listed countries reviewed the pertinent studies for causal links among silicone-gel breast implants and systemic and auto-immune diseases. The collective conclusion is that there is no evidence establishing a causal connection between the implantation of silicone breast implants and either type of disease. The Danish study Long-term Health Status of Danish Women with Silicone Breast Implants (2004) reported that women who had breast implants for an average of 19 years were no more likely to report an excessive number of rheumatic disease symptoms than would the women of the control group.[26] The follow-up study Mortality Rates Among Augmentation Mammoplasty Patients: An Update (2006) reported a decreased standardized mortality ratio and an increased risk of lung cancer death among breast implant patients, than among patients for other types of plastic surgery; the mortality rate differences were attributed to tobacco smoking.[27] The study Mortality Among Canadian Women with Cosmetic Breast Implants (2006), about some 25,000 women with breast implants, reported a 43 per cent lower rate of breast cancer among them than among the general populace, and a lower-than-average risk of cancer.[28] 

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.

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.
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.
Breast implants are not lifetime devices and breast implantation may not be a one-time surgery. The most common complications for breast augmentation and reconstruction with MemoryGel® Implants include any reoperation, capsular contracture, and implant removal with or without replacement. The most common complications with MemoryShape® Implants for breast augmentation include reoperation for any reason, implant removal with or without replacement, and ptosis. The most common complications with MemoryShape® Implants for breast reconstruction include reoperation for any reason, implant removal with or without replacement, and capsular contracture. A lower risk of complication is rupture. The health consequences of a ruptured silicone gel breast implant have not been fully established. MRI screenings are recommended three years after initial implant surgery and then every two years after to detect silent rupture. The most common complications with MENTOR® Saline-filled Implants include reoperation, implant removal, capsular contracture, breast pain, and implant deflation.
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.
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.
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. 
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 last thing and the most important decision you will have to make is selecting the right plastic surgeon to perform your breast augmentation surgery. It is critical that you choose somebody who not only has the experience in these types of surgical procedures but maybe more importantly, the credentials. Here in the United States, the best thing you can do is look for a board-certified plastic surgeon who is not only experienced and credentialed but also has the qualities and qualifications that make you feel confident in their abilities.
She advises me that there are many conspiracies around botox- staying up right for more than two hours, is false for starters. ‘The solution takes 20 minutes to settle in your muscles, so I do advise you to stay upright for then, any longer wont make a difference’. She does however advise me not to undertake exercise that’s too strenuous or hot following the treatment (fine by me) and to carefully wash my face when I get home, not scrubbing or rubbing too hard.
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.
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]
There are a few alternatives to breast augmentation with implants. Fat grafting breast augmentation involves harvesting fat via liposuction from another area of your body and injecting it into your breasts. Fat grafting is typically used to improve the appearance of your breasts after surgery to treat breast cancer, to correct a congenital breast deformity or to even out any imperfections occurring after breast augmentation with implants, such as wrinkles or ripples. The long-term effects of fat grafting to a normal breast are not fully understood, and the degree of augmentation possible via grafting is only modest at best. For these reasons, fat grafting for cosmetic breast augmentation is still considered experimental by many plastic surgeons.
Because a breast implant is a Class III medical device of limited product-life, the principal rupture-rate factors are its age and design; Nonetheless, a breast implant device can retain its mechanical integrity for decades in a woman's body.[39] When a saline breast implant ruptures, leaks, and empties, it quickly deflates, and thus can be readily explanted (surgically removed). The follow-up report, Natrelle Saline-filled Breast Implants: a Prospective 10-year Study (2009) indicated rupture-deflation rates of 3–5 per cent at 3-years post-implantation, and 7–10 per cent rupture-deflation rates at 10-years post-implantation.[40]
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.
When estimating your cost for breast augmentation surgery, make sure to account for all of these fees. You should ask the surgeon directly if these are all the costs involved in your estimate. Since there are no set costs for any of these expenses, it is important to explore multiple options by meeting with several surgeons and getting estimates for not only their surgeon fees but also the additional surgical-related expenses.

Tell your doctor about all your medical conditions, including: plans to have surgery; had surgery on your face; have trouble raising your eyebrows; drooping eyelids; any other abnormal facial change; are pregnant or plan to become pregnant (it is not known if BOTOX® Cosmetic can harm your unborn baby); are breast-feeding or plan to (it is not known if BOTOX® Cosmetic passes into breast milk).


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.
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.
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.
You won’t be feeling 100 percent after that week, but you’ll be in good-enough shape to head back to the office if your job doesn’t require manual labor. However, if the implant is placed behind the muscle instead of on top (many women choose to do this for a more realistic look and less chance of a scar shell forming around the implant), recovery will be a little harder and you might be sore longer.
The last thing and the most important decision you will have to make is selecting the right plastic surgeon to perform your breast augmentation surgery. It is critical that you choose somebody who not only has the experience in these types of surgical procedures but maybe more importantly, the credentials. Here in the United States, the best thing you can do is look for a board-certified plastic surgeon who is not only experienced and credentialed but also has the qualities and qualifications that make you feel confident in their abilities.
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. 
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.
During your consultation, your surgeon will ask about your habits, including whether or not you smoke and what medications you take. You may have to quit smoking for a period before and after surgery to ensure proper healing. You also may have to stop taking certain medications, such as aspirin or other anti-inflammatory drugs such as Motrin or Aleve. Your surgeon will give you instructions about what you need to do.
Your surgeon can take photos of your breasts and detail your physical symptoms caused by enlarged breasts in a letter. Get in touch with your health insurer early and make sure you understand exactly what they will pay for. For example, will insurance cover such things as lab costs or anesthesiologist fees? Asking in advance will help prevent surprise costs after the surgery.
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.
Many patients have concerns that after getting breast implants it may result in less accurate testing for breast cancer, but this is not something they need to worry about. This is a very valid concern but having implants will not make your mammograms less effective. As the rate of women with breast implants has increased, so has the knowledge of the radiologists and technicians, and they have become very adept at performing mammograms on women with implants. During the test and the test films produced, the implants will not obscure or hide any suspicious lesions or growths, but rather appear as a fain shadow. Any experienced radiologist will not have difficulty in viewing and/or diagnosing any suspicious lesions or detecting any breast cancer in a patient that has implants.
Cosmetic surgeons may use the “crescent lift” technique for women who have a very small amount of sagging to correct. This involves a small incision running halfway around the top half of the edge of the areola. Usually, a crescent lift is only done when a patient is also having breast augmentation, and even in these cases the crescent incision type is less frequently used.
The first point is placed at a distance of about one centimeter from the outer corner of the eye. Then the patient is asked to squint, if wrinkles appear above or below the first mark, additional points are applied. There is a danger of too close to the introduction of the drug, which can cause it to hang over, so the expert’s experience should not cause doubts. It is worthwhile in advance to look at the document confirming the qualification of the doctor.
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.
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