“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.”
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.
When talking about the price with your plastic surgeon, it’s important to know exactly what the cost covers. Is it just the surgeon’s fee? Or will it cover anesthesia, facility fees, implant cost, medical tests, pre- or post-op appointments, and medical supplies you’ll need during recovery? Do you need to purchase a specific bra for recovery or will they provide one?
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.
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.
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.
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.
We strongly recommend you choose an implant type with your surgeon, who will be able to match the right type to accomplish your desired results. All available implants are considered good, safe choices. However, this article will explain the pros and cons of each of the three main types of breast implants so you can get an idea of what might be the best fit for you.
Structured implants were approved by the FDA and Health Canada in 2014 as a third form of breast implant. 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. 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. 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.
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.
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.
Saline-filled Breast Implants. Saline-filled breast implants are filled with sterile saline (salt water). They come in both smooth and textured shells and can be round or anatomically (tear-drop) shaped. Saline breast implants are also available in low and high profiles, and in many sizes. A saline-filled breast implant is usually empty before implantation. The doctor moves it into place during your surgery, and then fills it. The saline is administered via a process that ensures the implants remain sterile.
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.
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.
The total cost ranges from $5,000 to $15,000. The cost for the implants is $1,000 to $1,300; the anesthesia fee is typically $600 to $800; the facility fee typically ranges from $800 to $1,200. The remaining cost is the surgeon's fee, which typically varies more than the other fees associated with breast surgery. According to the American Society of Plastic Surgeons, the national average surgeon's fee for breast augmentation is about $3,350.
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.
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!
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. 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. 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."  Diagnosis and treatment of breast implant associated ALCL now follows standardized guidelines established by the National Comprehensive Cancer Network.