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.
There are cases where some patients are wanting a very unnatural or obviously augmented look. This can be created by placing the implant over the muscle, as it allows you to really define the sharp edges of the implant, which in turn will create a very obviously implanted look. Aside from that, the advantages of going over the muscle can come in terms of the fact that you are preserving the strength of the pectoralis muscle. Some patients who are athletes or weight lifters, may want to ensure that they are maintaining 100% of their power and strength, therefore if the breast implant is placed over the muscle it allows them to maintain their ability to bench press at their highest weight. Furthermore, there are some patients which due to their anatomy, it is required to place the implant over the muscle. For example, if they had a previous breast augmentation where the breast implants was placed under the muscle that left significant scarring or if they had a severe capsular contraction, it would be recommended that they switch the location of the implant. Another benefit to having the breast implant placed about the muscle is that it can offer a more defined round shape if the patient’s breast has tissue that takes on a different shape.
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]

Sun tanning damages your skin. It leads to wrinkling, discoloration, and superficial growths. It can also lead  to serious skin cancer. For these reasons, I recommend you use sun block with an SPF number of 15 or greater at all times. A physical broad-spectrum sun block works best. If you are exposed to the sun, I recommend you protect your breasts for six weeks with clothing such as a T-shirt or pareo. You must carefully protect any scars from sun exposure with clothing, tape or sun block for six months.
Drink only liquids for the first few hours after surgery. Advance slowly to small, light meals. If you experience  nausea or vomiting more than two times, please call me so I can prescribe something to reduce this.  Excessive vomiting and retching can result in bleeding beneath the breast and/or around the implant (if  breast enlargement was done) that will require more surgery.
A breast lift involves both repositioning the nipple higher on the chest wall and reshaping the breast.  A breast reduction does the same but also removes breast tissue to make the breasts smaller.  If you are considering a breast reduction with lift or breast lift alone, I would recommend an in-person consultation with a plastic surgeon to allow for a thorough physical examination and a detailed discussion regarding your options to determine the best treatment plan for you.  Best of luck!
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.
The presence of radiologically opaque breast implants (either saline or silicone) might interfere with the radiographic sensitivity of the mammograph, that is, the image might not show any tumor(s) present. In this case, an Eklund view mammogram is required to ascertain either the presence or the absence of a cancerous tumor, wherein the breast implant is manually displaced against the chest wall and the breast is pulled forward, so that the mammograph can visualize a greater volume of the internal tissues; nonetheless, approximately one-third of the breast tissue remains inadequately visualized, resulting in an increased incidence of mammograms with false-negative results.[102]
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.
The breast cancer studies Cancer in the Augmented Breast: Diagnosis and Prognosis (1993) and Breast Cancer after Augmentation Mammoplasty (2001) of women with breast implant prostheses reported no significant differences in disease-stage at the time of the diagnosis of cancer; prognoses are similar in both groups of women, with augmented patients at a lower risk for subsequent cancer recurrence or death.[103][104] Conversely, 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] That patients with breast implants are more often diagnosed with palpable—but not larger—tumors indicates that equal-sized tumors might be more readily palpated in augmented patients, which might compensate for the impaired mammogram images.[106] The ready palpability of the breast-cancer tumor(s) is consequent to breast tissue thinning by compression, innately in smaller breasts a priori (because they have lesser tissue volumes), and that the implant serves as a radio-opaque base against which a cancerous tumor can be differentiated.[107]
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.
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 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.
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.
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 lift surgery is typically performed as an outpatient procedure using general anesthesia or local anesthesia + intravenous sedation. The procedure takes about 1-2 hours to perform, depending on the extent of surgery. You will be able to go home shortly after surgery to continue your recovery. Your breasts will be bandaged or placed in a surgical bra.
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.

The simple answer to the risk of losing sensation in the breast and nipple is that your chances of this are very low, somewhere between 1-2%. The incision is made in an area that doesn’t have any sensory nerves as a precautionary measure to minimize any potential risk to loss of sensation. Furthermore, the breast tissue itself is not cut. It is moved aside so that a space can be created for the implant, and then the implant is placed in the newly created opening. There have been some cases where sensation has been increased with the nipple and areola due to the implant pushing them forward.
Most experts agree that Botox can also be a preventative measure for some younger clients, ‘It preserves the skin and stops lines developing,’ explains Spyrou. ‘Botox softens and temporarily freezes the muscles, which means the treated area will stay flat. If you can’t physically frown, then over time, the line will smooth out.’ That being said, there's a lack information about the long term effects of starting botox at a younger age. "The long term safety data in these treatments is usually focussed on older individuals." Says Dr. Justine Hextall, Consultant Dermatologist on behalf of The Harley Medical Group. So as with most cosmetic procedures, there are risks.
Most patients say that the first night is painful and that there is a lot of pressure or pain in the anterior chest. This is not a sharp pain but more like a dull throbbing pain which is a result from the muscle being stretched from the implant placement. Most often Surgeons like to place the implant under the muscle because it gives the implant support and there is some evidence that supports a reduction in a capsular contracture when the implant is under the muscle. For implants that are placed above them muscle there is very little pain. As mentioned before, your doctor will give you a prescription for pain medicine and may likely also prescribe a muscle relaxant which helps with the chest pain. Generally, by day three most of the pain is gone. There will be some stiffness which will slowly dissolve over the course of five to seven days.
The ARTOURA™ Breast Tissue Expander or CONTOUR PROFILE® Breast Tissue Expander can be utilized for breast reconstruction after mastectomy, correction of an underdeveloped breast, scar revision, and tissue defect procedures. The expander is intended for temporary subcutaneous or submuscular implantation and is not intended for use beyond six months. Do not use the ARTOURA Tissue Expander nor CONTOUR PROFILE® Tissue Expander in patients where an MRI may be needed. The device could be moved by the MRI causing pain or displacement, potentially resulting in a revision surgery. The incidence of extrusion of the expander has been shown to increase when the expander has been placed in injured areas.
Don't be afraid to ask questions. Make a list of questions you want to ask your physician and bring it with you to your Botox consultation. That way you won't forget what you want to ask. Ask how much the treatment will cost, how many units of Botox you will need, how long the he/she has been giving Botox injections, etc. Ask about side effects, risks, and how you should take care of your skin after Botox and how often someone with your skin condition should get Botox.
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.

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.
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.
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