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]

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.
Surgery effects each person’s emotions differently. During the first week you can expect your energy level to be noticeably reduced. This will begin to improve the second week but it will take a full six weeks for you to have the same energy level you had before surgery. Many people say they want to sleep longer or more often. Normal hormone changes after surgery will also affect your emotions. Between 5 to 10 days most patients experience a period of doubt regarding their decision. They may feel down and sometimes cry. Remember, this is normal and will pass with time. If this depression is severe, contact us immediately so we can see you in our office.
It is important for patients considering rhinoplasty to understand that if their nose requires repair due to congenital malformation, illness or injury, at least part of the operation is likely to be covered by insurance. This includes situations like sports injuries, vehicular accidents, or birth defects that result in breathing problems. In most cases of cosmetic surgery, however, performed only to improve the patient’s appearance, the patient should expect to pay out-of-pocket.
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.
The experience and expertise of the surgeon along with their office location will both play a significant role in the overall cost of your rhinoplasty surgery but keep in mind that your comfort level with the surgeon and their surgical experience are more important than how much the procedure will actually cost. Dr. Jacono has performed thousands of rhinoplasties, specializing in primary and revision rhinoplasty, is board certified by the ABFPRS, and is a member of the Rhinoplasty Society; a national organization of leading rhinoplasty specialty surgeons across the country.
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.
Silicone gel filled breast implants consist of a silicone elastomer (rubber) shell pre-filled with a cohesive, gelatin-like substance that holds together uniformly while still retaining the natural give of breast tissue. Silicone gel breast implants are available in a wide range of sizes to accommodate women with different body types and aesthetic goals. Projections from moderate to high provide you with choices for the amount of projection of the breast silhouette.
The good news is that both types of implants are considered safe. The Food and Drug Administration (FDA) removed silicone implants from the consumer market in 1992 as a precautionary measure after conflicting reports of possible complications surfaced. Some of these complications required breast implant removal. However, silicone gel-filled breast implants were fully exonerated and reapproved in 2006. (Read more about implants and the FDA.)

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!


The best candidates for breast enlargement are women who have a thorough understanding of the procedure, including its risks, benefits and costs. Realistic expectations about the outcome are also important. Breast augmentation can improve your figure, but it can't change any other aspect of your life or make a bad relationship better. Women should only consider undergoing breast augmentation for themselves and not at someone else's urging.
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.
Private surgical suites, usually located in the surgeon's office, carry the least expensive facility fees. Usually ranging in cost from $1,000 to $3,000 per procedure, a private surgical facility can offer many advantages. The doctor is very familiar with the facility, and is likely working with the same staff members who have assisted in many previous surgeries. I operate in a certified private surgical facility where my patients enjoy the ultimate privacy and personalized care. In this setting, I am able to hand-pick each of my staff members personally, from nurses to anesthesiologists.
Women all around the world want to have an attractive and proportional body. Many times, women are insecure of the way their bodies look just because they don’t think that their breasts are perkier and fuller. Women with small breast sizes tend to look for options to enhance their body shape. While the market provides various solutions, breast augmentation is the most chosen one for permanent and immediate solution to this problem. Breast augmentation can help you attain your dream body by putting implants in your breasts making them appear perkier and fuller.
Gently get out of bed as soon as possible after your surgery. When you get up, sit with your legs hanging over the edge of the bed or chair for a few minutes before standing. This will help avoid problems with dizziness, light-headedness and fainting. Do not use your arms or upper body to push yourself out of a bed or chair. You may roll to your side and then sit up or stand up. Have an adult assist you the bathroom the first few times. Always get out of bed to go to the bathroom. Begin to walk as much as possible as soon as you can after surgery. Do take it easy the first few days. Do not exert yourself in any strenuous activity. Avoid strenuous activities that involve arm movement such as raising your arms over your head and lifting with your arms. A balance of rest and reduced activity will speed up your recovery.

Prepectoral or subcutaneous: in a breast reconstruction following a skin-sparing or skin- and nipple-sparing mastectomy, the implant is placed above the pectoralis major muscle without dissecting it so that the implant fills directly the volume of the mammary gland that has been removed. To avoid the issue of capsular contracture, the implant is often covered frontally or completely with a mesh in biomaterial, either biological or synthetic.
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.

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]

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]
Be on the same page as your doctor - Make sure both you and your physician are clear about what facial areas you want to treat, how you ideally want them to be fixed, and what the ideal final result may be. Different people have different aesthetics. For instance, if the "frozen face" look is your doctor's definition of successful Botox but you disagree, you better make sure both of you are aiming for the same target or you'll end up with a result your doctor thinks is beautiful but you think is horrific.
A breast reduction with lift surgery combines two procedures to improve the size and shape of the breasts. A reduction involves decreasing the size of overly large breasts by removing excess tissue and skin. A breast lift is done in order to raise and reshape the breasts. The breast reduction and lift procedure helps to alleviate problems caused by overly large, sagging breasts, including: 

A rhinoplasty procedure, also referred to as a nose job or nose reshaping, is one of the most popular cosmetic surgeries performed in the United States. Rhinoplasty procedures are generally performed to help with redefining the size of your nose, the shape of your nose, and the overall appearance of your nose. The vast majority of rhinoplasties and performed for cosmetic purposes. However, when there is a breathing issue involved, then functional rhinoplasty is performed to correct the structure of the nose and help alleviate any breathing related issues.
Many patients return to work within the first week after breast lift surgery, depending on the nature of their jobs, and resume most daily activities after a week or so. You will need to limit exercise other than walking for the first 2-6 weeks after a breast lift; your cosmetic surgeon will provide you with detailed instructions about when it is safe to resume any activity.
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.

Healing from a breast implant surgery is not a set timeline. Each patient is different and their body heals at different rates. The actual incision made on the breast will typically heal in about 3-5 days. There will also be absorbable sutures that typically can be removed after 45 days. There will also be bruising present after the surgery, and it can take about one to two weeks to completely disappear. Most pain felt from this surgery is from the muscle being stretched. Generally the patient will be prescribed a pain medication, and depending on their situation their Doctor may also prescribe a muscle relaxant to help the muscle adapt to the new implant. Most patients have reported that after three to four days the pain has significantly subsided and they are able to resume normal activities, such as, driving. The Doctor will also be able to show you various exercises that will help the muscle stretch and assist the implants with settling not the new space more quickly.


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. 
Breast implants have gotten a bad reputation from the past and the fact that they had been known to rupture. The modern-day breast implants are very well made, and it’s almost impossible to cause them to rupture. This doesn’t mean that it can never happen, but it’s exceedingly rare. The rippling and wrinkling however, is a more difficult problem to address. This tends to me more common in the saline implants than with the silicone implants due to the filling. The saline implant is just water which is less dense then the silicone gel. The gel is denser and more closely resembles the actual breast tissue. Even when if the implant is placed below the muscle, it only covers about a half to two-thirds of the implant. Therefore, along the sides or underneath the implant you may see some wrinkling or rippling, however, depending on the size of implant used it may not even be noticeable. The larger the implant used the more visible any wrinkling or rippling could become. Typically, silicone implants are recommended because the risk of any wrinkling or rippling is lower and the implant feels more natural.
I needed very little convincing before making my way down to the Cadogan Clinic, one of the very best locations in London (might I add) to speak to Nurse Libbie Wallace, a master in her field. After filling in a short consultation form, Nurse Libbie asks me how old I am. After replying 28, she chuckles a little, but continues… I’m not the youngest client she’s had walk through the door, but she does tell me that she would only ever treat those that actually can benefit from the treatment, ‘It’s important that I manage patients expectations’.
Breast reduction surgery will take about two to five hours, sometimes longer. Your surgeon will make a cut around your nipple then downward on the breast in the form of a keyhole. The operating team will remove extra skin, tissue, and fat from your breasts and reposition your nipple. Your surgeon may use drainage tubes and then stitch up your breasts and wrap them in a special gauze. You may also need to wear a surgical bra.
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.
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.
Adam R. Kolker, MD, explains: Although silicone breasts feel similar to real breasts, they are still man-made and don’t feel like natural breast tissue. You’ll be more likely to notice there’s an implant in a woman who began with little breast tissue than a woman who had more breast tissue to begin with. Smaller implants and those that are placed below the muscle are harder to detect.
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.
How long you are off work depends on your occupation. If you do clerical work (i.e. stockbroker, teacher, or programmer), you can return to work when you feel up to it. This usually takes about two to three days. Do not go to work for three weeks if you do manual labor (i.e. entertainer, truck driver or personal trainer). Regardless of your employment, do not lift anything weighing more than five pounds for three weeks.
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.
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.
A breast reduction, or a reduction mammoplasty, can reduce a significant amount of volume and alleviate excess weight in the breast area. It does this by removing excess skin, fat and tissue to reduce the size of the breasts. This procedure is beneficial for women who are seeking to reduce the size of their breasts because of health issues or personal preference. Often when the breast reduction procedure is performed, women experience a much more lifted appearance. Some patients opt to have their areolas reduced or in some cases have their excess tissue sent off to be screened for breast cancer.

“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 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]
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