Preparing For Plastic Surgery and Emotional Recovery

Set Realistic Expectations

No matter where you are on your journey, it’s never too soon to start preparing for plastic surgery and both the physical and emotional recovery to follow. It’s normal to feel like you’re on an emotional rollercoaster from the initial consultation to the final result, which in some cases can take up to six  months or longer to fully appear. Keep in mind that as you recover, your emotional health should be just as much of a priority as your physical health. Feelings of nervousness, anxiety, excitement, depression, and stress are all a normal part of the process but they can also affect your recovery. The more time you spend preparing for plastic surgery, the less stressed you’ll be, and the more quickly you’ll recover physically and emotionally. You’ll also be able to enjoy the overall process more because you’ve done the hard work ahead of time. Prepare yourself for your recovery by learning what common emotions to expect after surgery. We’ll explain how to deal with those emotions in a healthy way through the tips below.

The vast majority of patients are delighted with their results once they’ve recovered, but do experience doubts and worries before they get there. Talk to your surgeon about what to expect and make sure that you’re on the same page about realistic results. Make sure that you are getting this procedure for yourself and not for anyone else. Knowing the scientific data surrounding your desired procedure and what possible risks are involved are also an important aspect of preparing for plastic surgery. Ask your surgeon about any questions and concerns you may have so that there are no surprises. Take notes about the expectations you are setting so you can remind yourself of them in the future. Please don’t hesitate to contact your surgeon’s office, as more questions come up in the days leading up to your procedure and try to mentally relax. 

Get Ready for the Physical Recovery

If the physical recovery aspect of plastic surgery is taken care of, it will be that much easier to recover emotionally as well. Doing the following will clear your mind of any unnecessary distractions or worries before, during, and after your procedure. 

  • Double Check Medications: The top plastic surgeons in your area will tell you that checking and double checking your medications is crucial before your procedure. In order for you to recover properly, make sure that you avoid common medications like Vitamin E supplements, blood thinners, Ibuprofen, and any medication containing aspirin. 
  • Prepare Your Body for Recovery: Get enough sleep and stick to a healthy diet and exercise regimen before your surgery so your body is ready to heal. Fruits, vegetables, whole grains, and lean protein are all nutritious foods that you’ll want to fuel your body with so that it feels better and heals quickly. Continue to get lots of sleep and eat healthy during recovery. 
  • Recovery Space: Creating a place you want to come home to is one of the most important parts of preparing for plastic surgery. Setting up comfortable pillows and blankets in a way that will support any special sleeping positions that may be necessary is something you can do in the day or two before your surgery.
  • Tie Up Loose Ends: Take care of business at home and at the office so that you’ll have peace of mind before, during and after your procedure. Fill prescriptions, get groceries, pay bills, and attend to whatever you need to so that you don’t have to worry about it later. Make sure that you have all your bases covered and won’t be expected to answer emails. 
  • Stop Smoking: It’s critical to quit smoking before your surgery, even if temporarily. Nicotine can greatly slow down the natural healing process of your body and if not stopped, can even become life threatening. 

Common Emotions After Plastic Surgery

Even a top plastic surgeon in your area will tell you that there’s no guarantee of what you will or will not feel once your procedure is complete. In the days immediately after your procedure, you’ll be in the most physical pain and have to rely on others for help while recovering from plastic surgery. The combination of being on anesthesia, taking pain pills, and lying down for long periods of time can lead to feelings of depression. On top of that, you’ll have bandages and bruising that may make you worried about how your final results will look. Every person and procedure is unique, but there is an inevitable adjustment period. Some common feelings after cosmetic surgery to prepare for during the timeline of recovering from plastic surgery are: 

  • 3-5 Days After Surgery: It’s important to rest as much as possible, which means ample time to think, doubt, and wonder if your procedure was a good idea.
  • 1-3 Weeks After Surgery: Results will start to show and you may get anxious thinking that you don’t recognize yourself.
  • 3 Weeks-3 Months After Surgery: Your body is still adjusting to the changes and you may think you’ve made a huge mistake, wondering if you’ll ever be satisfied. 
  • 3-6 Months After Surgery: You’ll be adjusted, your results will look more natural than ever, and you’ll have a newfound confidence. You’ll be so happy you made a change.

To deal with feelings of doubt and discomfort, try to distract yourself with a good book or favorite TV show. Spend time thinking about what you’ll be able to wear and do once you’re healed and how good you’ll feel then. Be patient and gentle with yourself, keeping expectations low for what you can accomplish while you’re recovering and avoiding any negative self talk. It’s also helpful to have a strong support system around you and a caring top plastic surgeon in your area to validate your feelings, help remind you of why you decided to get plastic surgery in the first place, and redirect your focus to the positive. 

Support Group

Call on friends and family members that you trust to be there for you while you are recovering. Arranging school pickups ahead of time or just inviting friends to come visit while you’re stuck at home are a few ways that you can ask for help. Don’t forget that you’ll need someone to drive you home from your surgery as well. Family and friends are an essential part of preparing for plastic surgery. You may get lonely resting at home and start to feel depressed. Make sure you invite people to come by and visit. Little tasks you didn’t think of may pop up during your recovery and having a group of people you can rely on will help you to not overwork yourself. 

Find a Surgeon You Trust

Only the top plastic surgeons in your area will be board certified, meaning they have gone through extra, rigorous training to become experts in their chosen field and have more experience than other surgeons. This certification is extremely important and can give you greater peace of mind. Create a list of questions to bring to the initial consultation and see for yourself how the surgeon responds and how they make you feel. The first impression could be a good indication of if they are right for you. A great surgeon will understand the emotional aspect of recovering from plastic surgery and help you prepare in the best way so that you have as smooth of an experience as possible. 

Remember that no matter how good of a surgeon you have and how much they tell you about what to expect, your emotional and physical health after surgery is your responsibility. You may have a harder time recovering and getting back to your normal routine than you expected, and that’s ok. It’s up to you to commit to a successful recovery by committing to preparing for plastic surgery now. 

Prepare Yourself

The best thing you can do to get ready for your procedure is to be aware of the ups and downs you will feel while recovering from plastic surgery. Talk to your surgeon about what your procedure will entail so you know how patient to be while waiting for true results to appear. Studies show that factors influencing patient satisfaction are influenced greatly by the quality of the plastic surgeon. Top plastic surgeons in your area will provide you with answers, a positive experience, and fantastic results. Set up a one-on-one consultation with a top plastic surgeon in your area to learn about the details of your desired procedure and the associated physical and emotional recovery experience. 

Keep the Blues at Bay While Recovering From Plastic Surgery

Are you counting down the weeks and days until your cosmetic procedure with the top plastic surgeon in your city? Most people look forward to having plastic surgery, because it represents a positive change in their lives. Even though there can be nerves going into surgery day, patients see it as an event that marks the beginning of the newfound beauty or confidence they have been hoping to achieve. The pre-surgery anticipation and excitement is often talked about among friends or in online forums like RealSelf. However, the recovery period may not be quite as fun to discuss, and it often gets overlooked by patients. If you are getting ready for your upcoming procedure, you probably understand the physical symptoms you may encounter, but what about the emotional side effects? Here we explain some of the feelings patients experience while recovering from plastic surgery, and what you can do to prepare yourself. 

What are the Plastic Surgery Blues?

The wide range of feelings you can experience during your plastic surgery journey can feel almost like an emotional rollercoaster. After you undergo a procedure like breast augmentation, you may be surprised to find yourself facing some unexpected emotions. For example, physical discomfort, lack of activity, and surgical results that aren’t fully visible yet can cause you to feel depressed during your initial recovery period. All of these factors combined are a lot for anyone to handle; in fact, surgeons quoted in a Harvard Magazine article deem the emotional stress after surgery to be an “understandable complication.” In other words, you’re not alone. It is perfectly normal to worry that your results might not be what you hoped or to even wonder whether you should have had the procedure in the first place. But, that doesn’t mean your post-surgical blues should be dismissed or ignored. A little planning and preparation can go a long way toward preserving your emotional health. 

How You Can Avoid Post-Surgical Depression

Even if you are a generally happy and upbeat person, you can still succumb to feelings of depression while recovering from plastic surgery. The good news is that there are things you can do to lift your spirits while you wait for your body to heal and your results to be fully revealed. The best way to mitigate your risk for the post-surgical blues is to take these important steps to ensure you are mentally and emotionally prepared for this such a life changing event:

  • Before your operation, form realistic goals and expectations for your procedure’s outcome. Don’t set yourself up for disappointment by expecting plastic surgery to make you look perfect. Even with the top plastic surgeon in your city, plastic surgery is meant to enhance the area you are having treated, not to erase every flaw you find on your body. Write your goals down in a journal so you can look back on them if and when you start to feel down during your recovery.  
  • Make sure you are having plastic surgery for the right reasons. If you are doing it to please anyone but yourself, you may want to rethink the decision. It’s your body and you are the one who will have to live with these permanent changes, so be honest with yourself when evaluating your motivations for undergoing the procedure. 
  • Gather a support system of trusted friends and family to help get you through your physical and emotional recovery. Most patients understand the need to have someone drive them home and take care of them during the first few days of recovery, but it is equally as important to have emotional support at this time.  
  • Practice good nutrition and get plenty of sleep to boost your mood while recovering from plastic surgery. You may not feel like eating much during the first 24 hours, but as your appetite increases you should fuel your body’s healing with whole grains, fruits, vegetables, and lean protein. In addition to helping you avoid constipation, eating right can reduce inflammation and fight off infection.  
  • Have patience with your body as it heals. You cannot rush surgical recovery; if you try to do too much too soon, you could experience setbacks which will prolong your healing period. Be gentle with yourself and take things one day at a time.

Emotional Well-Being With Breast Implants

A 2007 study concluded that most plastic surgery patients are happy with the results of their procedure. The researchers found improvements in several areas of the patients’ lives after having plastic surgery, including “self worth,” “self esteem,” “distress and shyness,” and “quality of life”. The steps mentioned above can greatly improve your emotional well-being after surgery. If you are a breast augmentation patient, you can also gain peace of mind by choosing the right implant.    

IDEAL IMPLANT® Structured Breast Implants represent the latest advancements in breast implant technology. They are filled with saline, so they come with none of the concerns associated with silicone gel implants. IDEAL IMPLANTS are made with a unique interior structure that gives them a natural shape and feel that unstructured saline implants lack. In fact, testing has shown that IDEAL IMPLANTS even have similar shape stability to silicone gel implants, and are still soft to the touch. 

With the IDEAL IMPLANT you will immediately know if there is ever a rupture of your implant, so you never have to worry about silent rupture. By removing the risk of silent rupture and providing a beautiful aesthetic result, the IDEAL IMPLANT offers women a way to feel beautiful and secure with their breast implant choice. Breast augmentation makes up a significant percentage of plastic surgeries, therefore it is important for patients to be informed about options like the IDEAL IMPLANT that can ease post-procedural stress.

The Plastic Surgeon’s Role

No matter what type of procedure you choose, the top plastic surgeon in your city will help you navigate the process so you don’t have to do it alone. Your consultation appointments present the perfect opportunities to discuss all of your concerns. Be sure to ask your doctor questions about things to watch out for as you go through the healing process.  

The more you know about what to expect from your procedure and recovery outlook, the better equipped you will be to handle the ups and downs. Your plastic surgeon will be there for you throughout your plastic surgery journey. Don’t be afraid to call them with questions or concerns you may have. From creating a realistic plan before your surgery to seeing you through recovery, your surgeon and their staff want the very best for you.   

Knowledge is Power

The more you know about what to expect during your plastic surgery recovery, the calmer and more confident you will feel as you go through the healing process. Planning and preparation are critical for both your physical and your long-term emotional health. While you are recovering from plastic surgery, remember that feelings of depression are usually short-lived because most people are highly satisfied with their results. In the end, the investment you have made in your appearance will pay off, and you will feel more confident not only in the way you look, but in your ability to handle the ups and downs of life.   

Before Choosing Between Saline, Structured, and Silicone Implants Determine if Cosmetic Surgery is the Right Path

Breast augmentation is one of the most popular cosmetic surgeries in the United States. It offers women increased self-esteem and satisfaction with their bodies. But before you start researching topics like structured implants versus silicone gel implants (sometimes referred to simply as silicone breast implants), you need to determine if you are a good candidate for surgery. Read our guide below before you make an appointment with your board-certified plastic surgeon.

Evaluating Your “Why”

Why are you seeking out a breast augmentation? There are many reasons women want to enhance their breasts. For some, pregnancy or weight loss has left them with less volume. Others have always had naturally small breasts and want a more feminine look. Most women experience some amount of asymmetry, but for some this asymmetry is very noticable and they want to even out their breasts. Sit down and think about your “why.” There is no wrong answer, as long as you are doing it for yourself. A breast augmentation will not improve personal relationships, job status, or social standing. If you feel pressured by a friend, relative, boss, or significant other to get a breast augmentation, your surgery will leave you feeling unsatisfied.

Set Realistic Expectations to Help You Choose Saline, Structured, or Silicone Implants

Setting realistic expectations is one of the keys to a successful cosmetic procedure. Every woman is different in needs, wants, and results. Rather than expecting to become a “perfect” version of yourself, strive to enhance your natural beauty though cosmetic surgery. Know that what worked for one person won’t necessarily work for you.

To get an idea of how choosing implants works, we talked to Dr. Eric Desman, a board-certified plastic surgeon in Alexandria, Virginia. He tells us

“A 300cc implant is going to look vastly different in a woman who is 5’ 1”, 105 pounds, who’s never had any children compared to a 5’ 7”, 147 pound woman who’s had two or three kids. Those women are very different in body physique and tissue type. So, during the course of a consultation, we’ll take some measurements of your breast tissues. This helps me see if what you wish to get out of breast augmentation is an achievable result. If you come in for your consultation and want to have exactly the same procedure as your best friend, that may just not be right for you. I try not to focus so much on cup size, and really hone in on the final look my patient wants.”

Looking at breast augmentation before and after pictures will give you an idea of the results you can expect. Make a note of the breast implant type (structured, saline, or silicone), breast implant size, and placement that you like. Bring these factors up with your plastic surgeon to help you decide the right path for you. Dr. Scott Greenberg, a board-certified plastic surgeon in Winter Park, Florida, explains the process his patients go through when choosing an implant. He says

“we recommend that they go to our website where they can look at photos of patients who have had breast augmentation. We have pictures taken from the front and the sides. I ask my patients to especially look at the side views. It’s been my experience that if we can get the upper pole of the breasts the way a patient wants in terms of the amount of fullness, then they will be happy. I tell my patients not to get caught up in letters or numbers when it comes to the cup size they want.”

Preparing for Surgery and Beyond

Breast augmentation is an investment in your happiness and in your future. But before you take the plunge you need to know what is involved. Make sure you consider the risks associated with surgery so you can weigh them against the benefits a breast augmentation will bring you. Your board-certified plastic surgeon should be upfront with you about these risks so you can choose the best path for yourself.

It is important to know that costs associated with a breast augmentation don’t stop after your primary augmentation. Women with silicone implants incur extra costs when they adhere to FDA MRI guidelines. Some women seek out revision surgery to increase their implant size. Others require additional surgery to address complications.

Dr. Paul Zwiebel, a board-certified plastic surgeon in Highlands Ranch, Colorado, explains how and why women should prepare themselves for future surgery

“Many women ask about the durability of the implant or whether or not they’re going to have repeat operations in the future. For years, there’s been kind of an urban myth out there that implants have to be replaced at 10 years. That’s not the case. Implants don’t really have an expiration date. However, even the latest data does show that there’s a high likelihood that anybody who chooses to have breast augmentation will probably have another operation sometime during their lifetime. I think the most important thing women can do is to go into surgery emotionally and financially prepared for the likelihood of another operation at some point in the future. While we always hope that the implants will last forever, realistically, doctors and patients have to be prepared for the eventuality of some additional surgery in the years to come.”

The breast implant you choose will have a statistically higher or lower rate of complications. For example, silicone breast implants have rupture rates for primary augmentation as high as 13% at eight years, while the IDEAL IMPLANT® Structured Breast Implant rate is only 2.1% at eight years. Knowing these statistics will help you choose the best breast implant, and help you prepare for your future. To learn more about breast implant complication statistics visit our comparison page.

Breast Augmentation Recovery

While you will see immediate results after a breast augmentation, you shouldn’t expect to return to your normal routine as quickly. Dr. Larry Weinstein, a board-certified plastic surgeon in Chester, New Jersey, tells us, “We explain to our patients that they won’t be able to exercise for several weeks afterwards. I usually recommend waiting three weeks to exercise again. I do encourage and appreciate patients who exercise regularly, but you have to give your body some time to rest and heal from a procedure like this. You can’t expect to go out and conquer the world in the first three weeks. Most patients can go back to work in four or five days, but you shouldn’t try to do every activity that you would normally do.” Recovery is generally the same if you choose saline, structured, or silicone implants. In every case it is important to adhere to your surgeon’s instructions for the best results.

Schedule Your Consultation with a Board-Certified Plastic Surgeon Today

When you’re ready to start your journey, make an appointment with an IDEAL IMPLANT surgeon. IDEAL IMPLANT surgeons are board-certified, and have shown a commitment to high quality patient care. They offer IDEAL IMPLANT Structured Breast Implants so their patients can experience a natural looking result with the peace of mind of only saline inside.

At your first consultation, your plastic surgeon will help you determine whether or not you are a good candidate for surgery. Your surgeon should always be honest with you while you compare enhancement options including silicone breast implants and the IDEAL IMPLANT Structured Breast Implant. Find the right surgeon near you with our easy Surgeon Finder.

Understanding Your Breast Implant Options With Dr. Galumbeck

https://idealimplant.com

Breast augmentation is the most popular plastic surgery procedure in the United States, with over 300,000 surgeries performed last year. Dr. Matthew Galumbecka board-certified plastic surgeon in Virginia Beach, Virginia, has performed hundreds of breast augmentations in his 25 year career. Dr. Galumbeck explains why he thinks breast augmentation is so popular, saying,

“I think women who come in and get breast augmentation do it for themselves so that they feel better about themselves. It gives them better shape, better proportion, more confidence. I think most women who come in say, ‘I want to be able to get in a bathing suit and fill it up when I walk down the beach,’ but not have people point and say, ‘oh, you look fake.’”

There are many reasons to seek out a breast augmentation, some of the most popular being:

    • Small breasts
    • Loss of breast volume following pregnancy and breastfeeding
    • Change in breast size after losing weight
    • Asymmetrical breasts

Women in all of these situations are good candidates for a breast augmentation. In addition, breast augmentation can be combined with other procedures such as a tummy tuck or liposuction to further enhance your natural beauty.

Dr. Galumbeck is an expert in breast augmentation, and provides women with the the newest surgical technologies in a safe and relaxing environment. His desire is that every patient would feel beautiful, empowered, and confident after her procedure. Great plastic surgery results start with access to choices, which Dr. Galumbeck provides for his patients. Dr. Galumbeck was recently named an Ideal Implant Premier Surgeon because he is one of the top surgeons in the nation to provide the newest breast implant, the IDEAL IMPLANT® Structured Breast Implant.

Breast Implant Options: What to Expect

If you’re meeting with your plastic surgeon to discuss breast augmentation, what should you expect? Dr. Galumbeck tells us, “One of the biggest options that women have now is the type of implant for breast augmentation that they can use.” Many women don’t realize there are options when it comes to breast implants. In fact, your choice of breast implant can have a lasting impact on your lifestyle so it is important to choose carefully.

Saline Breast Implants

Saline breast implants are made from silicone shells filled with saline (sterile salt water). As Dr. Galumbeck explains, they were the only implant choice for many years. “So, originally all we had was the saline implant. The advantage of the saline implant is that if it leaks, it is all absorbed by the body. The problem with this is it has no structure, so it can ripple. It’s not a very natural feel or very natural look.” Women still love the peace of mind they get with saline breast implants. Because the saline is absorbed, there is no need to worry about complicated surgery to remove it if the implant ruptures. However, women began moving away from this choice when silicone gel breast implants became available because of the aesthetic concerns.

Silicone Gel Breast Implants

Dr. Galumbeck explains why women liked the silicone gel breast implant when it was first introduced, “In 2007, the silicone gel implants came out and the advantage is that because it’s more cohesive, it has a more natural look, more natural feel.” Silicone gel is a thick, sticky substance that provides more stability to a breast implant than saline. The result is an implant that does not ripple or wrinkle and looks natural. Since the FDA approved silicone gel breast implants they have grown in popularity. However, these implants have a downside which Dr. Galumbeck explains, “The disadvantage is that if it leaks, the silicone gel stays in the breast tissue and so you can’t tell that its leaked with a ‘silent rupture.’ The FDA actually recommends that women get MRIs every three years to look for leakage.” Women do not like the hassle and expense of repeated MRIs, which cost on average between $444-$1468. In addition, the anxiety caused by not knowing the status of their breast implants can be a daily stress for some women.

IDEAL IMPLANT Structured Breast Implant

The IDEAL IMPLANT Structured Breast Implant was created to give women an option for beautiful, natural looking breast implants without the worry about silent rupture. Since it became available it has grown in popularity, quickly becoming the next generation of breast implant. Dr. Galumbeck explains more about it saying,

“The third implant that’s been out since 2014 is the IDEAL IMPLANT. The nice thing about this is it’s an all saline implant, but its structured so that it’s an implant surrounding an implant. And because of the structure it looks and feels like the silicone gel implant. It has a very natural look, very natural feel, doesn’t ripple, but it also has the advantage that if it leaks, because it’s saline, the salt water is absorbed by the body.”

Breast Augmentation Complications: How Implant Types Compare

Breast augmentation is not without potential complications. Additional surgeries may be required to address complications such as rupture, capsular contracture, or cyst removal. According to the FDA, rupture and capsular contracture are two of the top reasons for breast implant revision surgery. The breast implant you choose can give you a statistically higher or lower risk of needing a revision. Knowing statistics on rupture rates and capsular contracture rates can help you plan financially and prepare mentally for the possibility of additional breast surgery.

Unfortunately, many women are not aware of the high rates of complications with silicone gel breast implants. For primary augmentations, silicone gel breast implants have a capsular contracture rate of 10.9-16.2%, and a rupture rate of 7.2-13.6% in 7-8 year trials. Ruptured silicone gel breast implants can also lead to other complications. The FDA lists these possible complications as, “a decrease in breast size, change in breast implant shape, hard lumps over the implant or chest area, an uneven appearance of the breasts, pain or tenderness, tingling, swelling, numbness, burning, or changes in sensation.” It is important to get the recommended MRIs every three years to check for a silent rupture before it turns into a larger issue.

The IDEAL IMPLANT Structured Breast Implant, for primary augmentations, has a capsular contracture rate of 6.6% and a rupture rate of 2.1% at 8 years. The lower rates of these major complications mean you are at a lower risk of lifetime surgeries. Additionally, because the implant is filled with saline there is no need for repeated MRIs to check the status of your breast implant. As Dr. Galumbeck explains with the IDEAL IMPLANT Structured Breast Implant, “women have not only the look and feel, but also the confidence that she doesn’t have to worry about a silicone gel rupture or getting MRIs.”

When you’re considering your breast implant options make sure you get all the facts. Talk with your surgeon, look at before and after pictures, and feel the difference for yourself in your surgeon’s office. Educating yourself, especially when it comes to common complications such as rupture and capsular contracture, will help you make an informed decision. Choose an option that makes you feel beautiful, and leaves you without anxiety for the future.

Breast Augmentation Surgery and Recovery

Many women worry what surgery and recovery will be like after a breast augmentation. Is surgery safe? Will you be out of work for weeks? Dr. Galumbeck answers these common concerns for us:

“The procedure is very safe. It has been done for many, many years. The recovery is quick. During the operation that we perform here at our fully accredited facility, I use an endoscope, which is a specialized TV camera, to look inside. So I keep the incisions smaller, and don’t have to use drains afterwards. We have a hyperbaric oxygen unit that we have patients get in after surgery to help speed the recovery process.”

The surgical process typically includes the following steps:

    • Preoperative Markings: These markings ensure your breast implant is placed properly.
    • IV Anesthesia: A physician anesthesiologist gives intravenous anesthesia.
    • Incision: An incision is used to gain access to breast tissue. There are four choices for incisions—axillary, periareolar, inframammary, and transumbilical.
    • Creation of the Breast Pocket: A pocket is created to place the implant into. Dr. Galumbeck uses an endoscope to allow for precise dissection.
    • Inserting the Breast Implant: The breast implant is inserted into the pocket.
      • Final Check: Surgeon checks to make sure breasts are symmetrical.
    • Incision Closure: The final step, closing the incision with methods to minimize scarring.

The whole procedure is finished in about an hour, after which you will be taken to a recovery room. After some observation patients are usually sent home the same day. Dr. Galumbeck tells us, “most women are back to work and social activities in a day or two after breast augmentation.”

Dr. Galumbeck uses the newest surgical technology to provide safe and efficient breast augmentations for his patients. His training and experience provide him with the knowledge needed to minimize risks and complications. The result is a natural and beautiful looking breast augmentation.

How to Select a Plastic Surgeon

Finding the right plastic surgeon for your procedure is very important. Dr. Galumbeck shared the following tips and questions to ask when searching for a plastic surgeon:

    • Is the plastic surgeon board-certified in plastic surgery?  
    • How many procedures have they done?  
      • See before and after pictures of that physician’s patients.
    • Feel comfortable with the plastic surgeon.

Board-certification by the American Board of Plastic Surgery is especially important to ensure great results. Surgeons who maintain their board-certification are committed to providing a high standard of care and staying up to date with medical research.  

Before scheduling a consultation you should check out online reviews to see what past patients have to say about the surgeon. Websites like RealSelf, Facebook, or Google have real patient reviews.

Read reviews like the ones below for Dr. Galumbeck and his staff:

“Wonderful Experience!! After having 3 kids, my mommy makeover by Dr. Galumbeck has really helped me feel beautiful again! His staff is AMAZING! Everyone was super friendly, caring, and easy to talk to. I would recommend Dr. Galumbeck to everyone!!” – Google reviewer Charlotte Reed

“Absolutely amazing. My results are phenomenal!!! I couldn’t be happier with my decision. You don’t realize how much of a positive change you can make until you take a leap of faith. Dr. Galumbeck and his staff were professional, made me feel at home and 6 months post surgery they still make me feel like a part of their family. 100% recommend and would do it all over again!! Thank you guys.” – Facebook reviewer Stefani Skiest

“Dr. Galumbeck and his staff were outstanding. I never ever felt rushed or pushed to make a decision. He offers the Ideal implant which after researching for years on implants, I felt this was the best for me. He was personable and easy to talk to. He didn’t even mind the kiddos (sitter bailed) on procedure day! He let my husband watch the kiddos in a side room just so it was more convenient for us all. I would do this over in a heartbeat! His procedure is fantastic! No muscles cut or torn and no need for drainage tubes! He changed my life!!!!” – Realself reviewer Stski

Finding a skilled and experienced board-certified plastic surgeon is the first step toward a new you. If you’re in Virginia Beach call Dr. Galumbeck to set up your complimentary breast augmentation consultation. Dr. Galumbeck was trained at Case Western Reserve University and Eastern Virginia Medical School. He also received advanced body contour training in Paris. In addition to his plastic surgery practice, Dr. Galumbeck founded and serves as the medical director of Spa Phoenix, the area’s first doctor directed medispa. Dr. Galumbeck prides himself on providing safe and efficient cosmetic procedures that get his patients the results they want.

Considering breast implants in Virginia Beach? Contact Dr. Matthew Galumbeck today to discuss your options. Simply call (757) 491-3204, or visit www.galumbeckplasticsurgery.com. Dr. Galumbeck’s office is located at 1817 Republic Road, Virginia Beach, Virginia 23454 US. Call today for more information on IDEAL IMPLANT® Structured Breast Implants.

A Conversation About Breast Augmentation, Implants, and More With Dr. Paul Loewenstein

Doctor Paul Loewenstein practices in Brookfield, a suburb of Milwaukee, Wisconsin. With over 34 years of experience in the plastic surgery industry, Dr. Loewenstein’s current practice is devoted mostly to aesthetic surgery, including but not limited to face lifts, nose jobs, eye lifts, breast augmentation, breast lifts, breast reduction, tummy tucks and liposuction. Here, we discuss his practice, breast augmentation, and all the breast implant options available.

What are the advantages of your practice over the other options women might have in your area?

“I have a broad training in plastic surgery. I had six years of training in general surgery and plastic surgery combined. At our office, we don’t specialize in one part of the body, so if a woman comes in and she wants to have a breast augmentation and a nose job, we can do both. We have the flexibility of being able to approach different parts of the body all at once, which is something that my patients find convenient.”

Over your 34 years of practice, what trends or changes have you seen in breast enhancement and with silicone gel-filled implants in particular?

“Breast implants over the years have undergone a lot of changes. Silicone gel-filled implants have undergone three or maybe even four or five generations of shell and filler material. In the early 1990s the FDA put a moratorium on the use of silicone gel implants for breast enhancement. This was based on some claims patients made (mostly in the state of Texas) that the silicone gel implants were causing them to have diseases such a rheumatoid arthritis, scleroderma, lupus, or what we call connective tissue diseases.

“After thorough research was completed using large populations of women and extensive analysis, those studies showed there was no statistical association between silicone gel-filled implants and those diseases. So the silicone gel implant came back on the market and the companies have improved those implants over the years. The current generation has a little bit thicker shell, a more cohesive gel, but they still haven’t been able to get around the fact that the body builds a shell around the implant. If there’s a break in the silicone shell it’s going to be contained by the bodies’ scar tissue layer, so women don’t know if they have a leaking silicone implant. They have to get an MRI to detect a leak.”

How have saline implants changed over the years?

“Traditional saline implants haven’t really changed much at all in 30 plus years, with the exception of the IDEAL IMPLANT. The old saline implants were basically a bag of salt water, and they sloshed around like a bag of salt water. Now, once it was in the body, there wasn’t as much of a problem with that, but you could still tell the difference in most patients. The IDEAL IMPLANT is made up of baffled shells nested inside of each other so that the saline doesn’t slosh, it sort of flows more gradually, similar to what a silicone gel-filled implant does. So the one big change with saline has been the advance of the IDEAL IMPLANT.”

Do women come in to see you already aware of the different types of implants?

“Women are a little bit more health conscious overall than maybe they were 30 years ago when I started. They’re certainly more educated, they spend time on the internet doing their research. They know a lot more about what is available, what is out there, and the pros and cons of each type of implant. So they come in much better educated, but yet they know enough to know that sometimes the Internet isn’t 100% accurate, and almost all the time they’ll say, ‘well, what’s your opinion, Doctor?’  They may have a preconceived notion of what they want when they come in, but they’re willing to listen in spite of the fact that they’re much better educated than they were 20, 30 years ago. They’re still willing to get a professional opinion.”

Have women’s preferences shifted when it comes to breast size?

“When a patient comes in for a breast augmentation consultation, we take measurements of the patients’ chest width, the base diameter of the breast, the amount of skin elasticity, and we determine how much the skin will stretch. We look at the overall shape of the breast. Is it a little bit droopy? Is it perky to begin with, but small? All these different measurements and parameters are put into our computer and help us make the decision as to what size implant would work best. I think in the last 5 to 10 years I’ve seen a shift from women coming in saying, ‘I want 500 or 600cc implants’ to, ‘What do you think would work for me, Doctor?’

“There are anatomic limitations as to how big you can go, and I think again women appreciate a professional who has experience and knowledge and can give them advice. I think size preferences are also somewhat regional in terms of the United States. Maybe even worldwide, where it’s said in South America men prefer small breasts, and large rear ends. Different parts of the country where women are going to be wearing swimsuits more during the year may put an emphasis on a larger size. In some of the conservative North Eastern states, the overall implant size tends to be less from what I’ve heard, while the Midwest tends to be somewhat conservative. In California, Texas, or Florida the sizes may average a little bit higher.”

How can a woman know if she is or is not a good candidate for breast implants?

“The people who are not good candidates are generally the ones that have unrealistic expectations. If a patient comes in and they want to have a 600cc implant and they’re five feet, 100 pounds, that is probably not a good option for them. If they’re insistent on that, I will tell them, ‘I can’t give you that kind of a result just because of the limitations of your anatomy.’ Someone who has an active infection is also not a good candidate.”

Should a woman be finished with her childbearing and nursing years before she has a breast augmentation?

“Not necessarily. I see women who are single, young, and flat-chested, and want to enhance what they have. I think they’re perfectly good candidates for breast augmentation, and there’s no reason to tell them to wait 15 years before doing it. Then there are the women I see who are done having children. Some of them have nursed and what they used to have in the chest area has been deflated. So they’re another group of people who are very good candidates for breast augmentation.”

What would you tell a woman who is worried about scars from her breast enhancement surgery?

“Certainly it’s a cosmetic operation and both the patient and I myself are concerned about the scars. There are three different areas of the body where breast implants are usually inserted. There’s the inframammary crease under the breast, there is the areola or nipple approach, and then there’s the armpit, the axillary approach. Of those three options, I do about 80% of my incisions in the crease, 15% in the armpit and about 5% around the areola.

“If the patient is really concerned about having a visible scar, or a scar on the breast I will recommend the axillary approach. That is done endoscopically. The axillary approach got a bad reputation before the advent of the endoscope because it was a blind operation and it was generally done under the muscle. With endoscopy, you can look to see the extent of your dissection and make sure that you have done an adequate job so that the implant rests low enough and it doesn’t look too high. Having said that, there is a noticeable scar for a period of time while it’s red, and if you’re wearing a sleeveless top or a tank top, and you raise your arm up that’s going to be noticeable. On the other hand when it’s all said and done, that scar is very imperceptible, it looks just like a wrinkle in the armpit.

“The one around the areola seems to be popular in some parts of the country. I certainly will do that if that’s what the patient wants. Sometimes those scars depending on the pigmentation of the areola can be even more noticeable. They are on the front part of the breast. I have never had to do a revision of an inframammary crease incision in all my 34 years. They tend to heal with a very fine line. So the inframammary crease under the breast gives you the most flexibility if you have to go back down the road 10, 15, 20 years later and do something else.”

Should implants go in over or under the muscle? Do you have a personal preference?

“I find it’s very difficult to do on top of the muscle unless you make a large incision, which then sort of defeats the purpose of going through the axilla and having a very small, inch long scar. So when I go through the armpit, I virtually always go under the muscle. However, there are a lot of factors that come into play when you’re trying to decide to go over versus under the muscle. If a person has a really physical job, or if they’re really into weight lifting and bodybuilding, going under the muscle may not be the best approach. I’ve done some placements on top of the muscle in those situations. For a person who’s really thin, the edges of the implant may be more visible going over the muscle, so it may be better to go under the muscle in those situations.

“If I’m seeing a patient with a family history of breast cancer, I’d prefer to go under the muscle because it should be easier to perform a good mammogram with the implant under the muscle. The majority of the implants I put in are done under the muscle.”

What is your advice to help women ensure that they have the results that they want?

“In order to ensure a successful operation, patients should have in mind what their goals are. I don’t mind having a patient bring in pictures of other people, of what they think looks good. It may be unrealistic, but at least I can have a visual sense what they’re looking to accomplish. I’m in the Midwest and some women say, ‘I don’t want to look like Dolly Parton. I don’t want to look like a Barbie doll. I just want to restore what was there before I got pregnant and had children.’ while other women have different goals in mind.”

What should a woman do to ensure she’s getting a great plastic surgeon?

“I think communication is all important. If you don’t feel comfortable with your plastic surgeon, no matter what their credentials, see someone else! If you don’t feel like you’re communicating on the same page, see someone else! Of course a woman should seek out a board-certified plastic surgeon, preferably one who does a fair number of breast augmentations in their practice. He or she should have an open approach to different types of implants. I know some of my colleagues tend to steer their patient in one direction or the other because of deals they may have with certain companies.

“Doctors need to be forthright about what each implant can and can’t do for the patient. They should present it in an honest and open fashion. In some cases, if the patient feels like they’re being steered one way they should say, ‘Is there a reason you’re trying to talk me into this? I came in asking for one implant and you’re trying to talk me into a different implant.’ If you don’t feel comfortable with that situation, get another opinion from another plastic surgeon.”

What kind of complications should women be aware of when it comes to breast enhancement surgery?

“Capsular contracture (or the buildup of scar tissue around an implant) has bothered us plastic surgeons over the years, because no one has been able to figure out a true solution to it. There are a lot of theories as to why it happens. Those theories change about every five or ten years. The current theory is that there is a biofilm formation of bacterial slime around the implant. So some doctors irrigate the pocket with antibiotic solutions and put the patient on antibiotics for a period of time. Most surgeons try a “no-touch” technique where there’s only one person that contacts the implant and that’s the surgeon.

“I use, for example, a barrier film over the skin called IOBAN, which is impregnated with iodine that prevents bacteria from being dragged in the pocket. Having said that, capsular contraction still exists. It’s graded one, two, three, and four. One and two are mild, and probably aren’t going to require additional surgery, but the three and four capsular contractures may cause visible distortion of the breasts to the point where additional surgery is necessary.

“There’s another problem called BIA ALCL, which is Breast Implant Associated Anaplastic Large-Cell Lymphoma, because it is associated with and occurs around a breast implant. It’s a type of lymphoma or blood cancer that can occur around breast implants. To my knowledge, that has been described and confirmed only with textured implants. With so-called “fuzzy” implants, or implants that don’t have a smooth surface. IDEAL IMPLANT, for example, has a smooth surface. With most silicone gel-filled implants you can choose between a smooth or textured surface depending on the shape. The tear drop shapes are pretty much all textured, and the round tend to be smooth. The incidence is extremely low, maybe as low as one in a million, but it is a real entity, something to be aware of.

“Probably the most common complication would be a hematoma, or a bleeding issue that occurs after the surgery is over. I find that my incidence is extremely low, especially since we’ve been emphasizing avoiding medications that can contribute to bleeding. For example, I tell all my patients, no aspirin for two weeks, no ibuprofen, Aleve, etc., for at least a week. Also things like fish oil and vitamin E and many of the herbal supplements can cause prolonged bleeding. A lot of people don’t consider those drugs I listed as medications, but they are. They have side effects, known side effects that can cause problems with bleeding or even prolong the effects of anesthesia.

“It’s important to communicate to your plastic surgeon what medications you’re taking in all regards, not just prescriptions. I would say my hematomas have gone down significantly since emphasizing the importance of avoiding certain medications. If an infection occurs around the breast implant, the body’s immune system can’t function properly without having to remove the implant. I, for one, have never had to do that in my 34 years of practice, but infections do happen and they have been reported.

What should women do to avoid any complications post-surgery?

“Your plastic surgeon should give you a definite set of printed instructions on what to do after the surgery. Pay attention to that. Don’t ask your girlfriend, ‘What do you think I should do in this situation?’ Your girlfriend hasn’t done hundreds and hundreds of breast augmentations, she’s maybe had one herself, but every person’s experience is different. I just can’t emphasize enough that women should listen to the advice of their plastic surgeon. They are the best person to tell you what you should and shouldn’t be doing.

“Activity does have to be restricted afterwards, particularly if you go under the muscle. There are certain exercises like push ups and bench presses that I don’t want my patients doing for at least three months after the surgery. If your surgeon has a longer period of time where they restrict your activities, there’s probably a reason for that. So listen to your doctor, they’ve got the experience, they’ve got the knowledge.”

How long have you been using the IDEAL IMPLANT?

“I was first introduced to the IDEAL IMPLANT at one of our national meetings by the inventor, Dr. Hamas, and I had no knowledge of it prior to that time. He lined up an IDEAL IMPLANT next to a traditional saline implant and a silicone gel-filled implant and covered them with a cloth, and had me feel each implant through a cloth. I could tell an obvious difference between the traditional saline and silicone-gel implants. Then when I felt the third implant, which was the IDEAL IMPLANT, I thought it felt very similar to silicone gel. I could tell a little bit of a difference but it felt very, very close. So I started using IDEAL IMPLANT as soon as it became available to the general plastic surgery community around 2014.”

Have you noticed more women asking specifically for the IDEAL IMPLANT?

“As time has gone on and women have heard about it, more and more people come in requesting it. In the beginning I would present all the different types of implants to my patients and sort of let them decide. When patients would ask my opinion I tried not to say, ‘Go with this one for sure,’ but I would try to present the pluses and minuses and ask them what their concern was. If their concern was silent rupture and having to get MRIs to determine if they had a rupture, I would steer them more toward the IDEAL IMPLANT or the traditional saline implant. But after showing them the difference physically by having them examine each with their own hands, 100% choose IDEAL IMPLANT over traditional saline implants. Some patients and some husbands actually thought IDEAL IMPLANT felt more natural than a silicone implant. Not everybody chooses it, but a larger and larger percentage of my practice has been devoted to inserting IDEAL IMPLANT as time goes on.

What can you tell us about IDEAL IMPLANT and silent ruptures?

I’ve used IDEAL IMPLANT in my practice for at least three and a half years. I see people coming in with silicone gel-filled implants and something may have happened. Maybe they got into a car accident. They’re worried if they have a leak or not. If they have silicone gel, you may have to tell them, ‘The only way to know for sure is to have an MRI.’ But with my IDEAL IMPLANT patients, you can tell whether you have a leak or not by just looking in the mirror. I don’t have to send them for additional x-rays or studies. I can tell when they walk in the office if they have a leak or not. Women who want to have peace of mind about knowing whether they have a silent rupture are not stressed after surgery when they choose the IDEAL IMPLANT.”

What else do you like about the IDEAL IMPLANT?

“It has a very natural look and feel. The rippling that you sometimes see with the traditional saline implants just hasn’t been an issue. There are a lot of advantages. So far I haven’t seen capsular contracture as a major problem. Now that may change 15 years from now, but for now, the incidents of capsular contracture are extremely low. It’s lowest among all the different types of implants available. I just find that there’s a lot of reasons to have peace of mind when using the IDEAL IMPLANT.”

Do you feel like your IDEAL IMPLANT patients are satisfied with their results?

“Yes, our IDEAL IMPLANT patients are very happy, very satisfied. It really is, I think, the ideal implant.”

Considering breast implants in Brookfield, WI? Contact Dr. Paul Loewenstein today to discuss your options. Simply call 262-717-4000 or visit www.drloewenstein.com. Dr. Loewenstein’s office is located at 13800 West North Avenue, Suite 110, Brookfield, WI 53005. Call today for more information on IDEAL IMPLANT® Structured Breast Implants.

A Plastic Surgeon’s Perspective On Breast Augmentation

Dr. David Creech has been a board-certified plastic surgeon for 30 years. In his Chandler, Arizona, practice he has performed hundreds of breast augmentations. We sat down to ask him about his experiences and why he is excited to offer the latest breast implant technology, the IDEAL IMPLANT® Structured Breast Implant.

The IDEAL IMPLANT® Structured Breast Implant From a Surgeon’s Perspective

We asked Dr. Creech how he feels about the IDEAL IMPLANT® Structured Breast Implant, how it compares to saline implants and silicone gel implants. With 30 years of experience Dr. Creech has seen the good and bad of what breast implants have to offer. This gives him a unique perspective on the benefits and compromises of breast implant types.

“What I’ve found through the years is my lack of content with the implants available prior to IDEAL IMPLANT® Structured Breast Implant. Silicone gel implants are soft, but the IDEAL IMPLANT is also soft and has turned out to be a really good alternative to silicone gel. This is because you don’t need an MRI or a surgery to determine if the implant is leaking. With the IDEAL IMPLANT, if it leaks you’ll lose volume in the upper part of your breast, so when you look in your mirror you can tell that there is probably something going on. Through clinical exam I can determine whether there’s a leak or not.

“The other advantage of the IDEAL IMPLANT® Structured Breast Implant compared to saline implants is, it has very minimal wrinkling and very natural feel. That is in direct contrast to the older saline.

“I can also adjust the volume on the IDEAL IMPLANT to get more symmetry between the two breasts. With silicone gel, it comes pre-filled, so whatever size you choose is what you get. There’s no adjustments with that.

“Complications are low with the IDEAL IMPLANT® Structured Breast Implant. So far I’ve only had one capsular contracture with the IDEAL IMPLANT® Structured Breast Implant. I’ve had many more with the other implant types.”

The IDEAL IMPLANT® Structured Breast Implant vs. Silicone Gel Implants

One goal of breast augmentations is to make your breasts look as natural as possible. This is one reason women choose silicone gel implants and the IDEAL IMPLANT® Structured Breast Implant over saline implants. But how does silicone gel compare to the IDEAL IMPLANT in terms of softness and similarity to natural breast tissue?

“I have two implants here. One is the silicone gel, this is the softest implant on the market. The other is the IDEAL IMPLANT® Structured Breast Implant. The beauty of this implant is with the way it was designed, the IDEAL IMPLANT® Structured Breast Implant has two primary chambers. In between the inner chamber and the other chamber are multiple sub-chambers which have baffling between, so it allows the saline to go in and out between that outer chamber. That creates softness and diminishes wrinkling. I think with diminished wrinkling you also diminish the risk of rupture.

“When you squeeze an IDEAL IMPLANT it is very similar to silicone gel without the disadvantages that I think silicone gel has. The IDEAL IMPLANT company has shown statistically, for the first six-to-seven years, it has a much better track record versus the silicone gel and the saline implants. That’s a huge advantage.

“In terms of scarring, the two primary incisions that I use are the areola approach and through the inframammary crease approach. The scar for the silicone gel has to be a certain size to get it into the space. With the IDEAL IMPLANT® Structured Breast Implant, I can typically get the implant in safely, deflated, through a four centimeter incision. With the silicone gel implant, it could be as much as five or six centimeters, depending on the size and the projection of the implant. silicone gel implants go in already pre-filled, so you have to adjust the incision to allow for that to go through the incision.”

Breast Implant Surgery Tips

With so much information available on the Internet it is important that women follow the instructions given by their board-certified plastic surgeon. You may hear an anecdote about a woman who started exercising 3 weeks post-op and did fine! But is that woman putting herself at risk? Here, Dr. Creech discusses what recovery will be like and how women can ensure they get the best results from their breast implant surgery so they don’t find themselves back on the operating table.

“When I prep the patient, I want her to know that there are certain things I don’t want her to do prior to the surgery. One is taking non-steroidal pills, which can increase the risk of bleeding. In my career, I’ve had maybe three or four over the last 20 years. Every time a patient has been on Ibuprofen or a non-steroidals. That also increases bruising, which is not a problem as long as there’s no blood around the implant. Anti-inflammatories that are touted for good health can also cause a problem. In lay terms, they thin the blood, I want them to avoid that.

“Post-operatively is another thing. When you go below the muscle, the edge of the muscle is very fragile. I want the patient to take it easy. Don’t pull down a hatchback on a truck or a car, don’t do heavy lifting, don’t reach up high, don’t pull yourself up on a ledge, no working out. The working out part, depending on the type of workout, is going to be limited until four-to-six weeks. After that I don’t mind them doing a treadmill or something that does not use the chest muscles. The chest muscle can get back to a full workout at eight weeks. The reason for that is that muscle that has been divided at the bottom part isn’t strong enough to tolerate exercise for about eight weeks.

“Once the skin is healed, it’s like armor, it protects your implant from getting an infection. If you have an infection around the implant, the implant has to be removed for up to three months before a new one can be put in. I don’t want my patients to go through that, and I don’t want to have to replace an implant. I want a perfect result every time we do these operations.”

Considering breast implants in Chandler, Arizona? Contact Dr. David Creech today to discuss your options. Simply call (480) 899-3737 or visit www.davidcreechmd.com. Dr. Creech’s office is located at 485 S Dobson Road, #217, Chandler, AZ 85224. Call today for more information on IDEAL IMPLANT® Structured Breast Implants.

An Interview with New Jersey Plastic Surgeon Dr. Larry Weinstein

Board-certified New Jersey plastic surgeon Dr. Larry Weinstein has over 30 years of experience in cosmetic surgery. He has conducted extensive research on breast implants and breast tissue expanders. Dr. Weinstein helps his patients achieve their optimal results in breast augmentation and breast enhancement. His patients appreciate his professionalism, his thoughtfulness, and his kindness. We recently sat down with Dr. Weinstein to discuss breast augmentation and what to expect from a consultation, different breast lift options, and IDEAL IMPLANT® Structured Breast Implants.

Why should patients choose your practice over others in the New Jersey area?

“When it comes to performing breast augmentations, I have 32 years of experience. Not every surgeon can say that. My goal is to help my patients achieve a natural, proportional look to their bodies. I strive to never rush my patients, so I’ll spend quite a bit of time discussing the procedure and answering any questions they might have. I do everything I can to make my patients’ expectations a reality.”

What is a breast augmentation consultation like in your office?

“The first thing I do is ask my patient what their goals are. I talk to them in terms of cup size and  volume. Then I’ll examine the patient to check and make sure that they don’t have any breast abnormalities. My examination also helps me determine if they would also benefit from a breast lift. The patient can then try on different sizes of breast implants in a tight fitting sports bra so they can get an idea of what they will look like when everything is said and done. Once the patient and I are on the same terms as far as volume is concerned, my Vectra 3D imaging machine can also project a 3D image of that breast size. I try to help my patients achieve a natural and balanced look. I check the breast diameter, the tummy diameter, and the hip diameter so their body can be as close to proportional as possible.

“After we’ve established what the patient wants, my computer can also show them what a breast lift might look like if they need it. We’ll also look at their photographs and compare those to previous patients I’ve operated on. I show them patients who are 18 years old and I show them patients as old as 69. These before and after pictures help the patient determine to what extent they want to be enhanced.”

Do a lot of your patients get a breast lift in addition to a breast augmentation? Can you talk about the different breast lift options?

“Many people think that breast implants will correct saggy breasts. Certainly an implant can help with that, but if a patient’s entire breast is below the inframammary fold, they are going to need some type of lift in addition to an augmentation. With a lift, excess breast skin is removed and then the nipple and areola are lifted to a higher position. The skin that surrounded the areola is then brought down and met together to reshape the breast.

“I perform four different types of breast lifts. It depends on the volumetric difference. The simplest lift I do is called a Crescent lift. The Crescent lift is where I take a little ellipse of skin above the areola and I bring the areola up and that brings the breast up a good half of an inch or 3 centimeters. That allows us to bring the areola into a better position rather than it hanging too low.

“The other technique is a periareolar approach which I do with patients who have laxity in the breast and sagginess. With the periareolar approach, I make an incision that goes all the way around the areola to lift the location of the nipple. I use a permanent suture in order to maintain the areola diameter. A dissolvable stitch in that area tends to cause an increase in diameter over time because of the implant play on it.

“I also do what’s called the lollipop lift. This is where I make an incision that goes around the areola and straight down to the fold underneath the breasts. Many patients benefit from that. I have done that a number of times when doing a full mommy makeover. We’ll do a tummy tuck, breast augmentation, and a little lollipop lift.

“Another common technique for a breast lift is the anchor-shaped incision. This is where I make a small incision underneath the inframammary fold or an inverted T that follows the natural contour of the breast. I’m very careful in terms of suturing. That’s really the key whenever you do any procedure. It’s not about how fast you do it, but how well you do it. Each procedure has to be individualized and each wound has to be treated appropriately and carefully. By having that careful and gentle approach, you tend to get a very nice result.”

What can you tell us about the difference between silicone gel implants, saline implants, and the IDEAL IMPLANT?

“When my patients are trying to decide which breast implant they want, I have them look at and feel silicone implants, regular saline implants, and the IDEAL IMPLANT. Most of my patients describe the IDEAL IMPLANT as very soft and pliable, with a similar feel to the silicone gel implant. Because the IDEAL IMPLANT has a double chamber, we can also give it more projection, which can sometimes avoid the need for any breast lift procedures. The other nice thing about the IDEAL IMPLANT is that it allows me to make smaller incisions in surgery, which I prefer to do. Of course each patient is an individual and can decide which breast implants are right for them. We tailor each procedure to that individual and if they want to use the IDEAL IMPLANT, then I am happy to do that.”

How can women ensure they have a successful recovery after surgery?

“In preparation for surgery I always make sure that my patients understand that they should stop taking any sort of NSAIDs [nonsteroidal anti-inflammatory drugs], such as aspirin, Motrin, Advil, Clinoril. These medicines can affect the plated adhesiveness and you run an increased risk of having a clot or hematoma. We also explain to our patients that they won’t be able to exercise for several weeks afterwards. I usually recommend waiting three weeks to exercise again. I do encourage and appreciate patients who exercise regularly, but you have to give your body some time to rest and heal from a procedure like this. You can’t expect to go out and conquer the world in the first three weeks. Most patients can go back to work in four or five days, but you shouldn’t try to do every activity that you would normally do.

“I also tell my patients to take a multivitamin everyday, to eat healthy, and to not smoke. It’s very important they don’t smoke for at least two weeks before surgery because it affects their ability to recover from surgery. Also, the problems with anesthesia are greater with smokers than non-smokers and the healing process is different with smokers versus non-smokers. I’ve done research on the effects of smoking on wound healing and smoking does not contribute toward the healing process. We want the wounds to heal perfectly, as beautiful as possible, and we want our patients to have the easiest recovery. So I think if you avoid alcohol, avoid smoking, avoid the sun after surgery, and avoid exercise for about three weeks after surgery, you’re going to have a very smooth recovery.

“Before surgery, we also have our patients wash with special soap. We use the Hibiclens soap, which keeps bacteria from growing for about 48 hours on the skin. When using the Hibiclens shower, our incidents of infection are zero. We want to keep our infection rate for breast augmentation at zero so we always ask our patients to wash with a microbial soap, to shower the night before surgery, and the morning of surgery. I ask my patients to keep certain areas dry immediately after surgery, and to only shower after an appropriate amount of time.”

Can you share any stories of successful past procedures?

At one time, three sisters came in and they all wanted a breast augmentation. One sister was married with children and had slightly saggy breasts. She wanted to be a B-cup, but she had almost no breast tissue. She had what’s known as postpartum involution when the breasts sort of go away after you’ve had children. So in her particular case, I was able to use a slightly wider implant with low projection. She did extremely well, she got her B+ cup and she was really excited to go to the beach after that.

Her other sister was younger but she was very thin and delicate and had almost no breast tissue whatsoever. So I used a moderate plus profile and an IDEAL IMPLANT, which gave her nice cleavage and some volume and a little more projection. Then the third sister came in and she was a little bit heavier, slightly more stocky than the other two. So I selected an implant that was perfect for her and we were able to achieve a result that was very proportional for her body. She had nice cleavage and superior fill.

Though these sisters had some genetic similarities, I customized all their breast augmentations to meet their different goals. I used three different types of implants of varying sizes and volume with distinctive projections in order to achieve ideal results. My goal in every breast augmentation I perform is to make sure I gave my patient what they wanted, and that they are thrilled with the outcome.

Considering breast implants in New Jersey? Contact Dr. Weinstein today to discuss your options. Simply call 908-879-2222 or visit docweinstein.com. Dr. Weinstein’s office is located at 385 State Route 24, Chester Township, NJ 07930. Call today for more information on IDEAL IMPLANT® Structured Breast Implants.

Your Breast Surgery Questions Answered by Dr. Jed Horowitz

Dr. Jed Horowitz is a board-certified plastic surgeon at Pacific Center for Plastic Surgery in Newport Beach California. Dr. Horowitz has been practicing since 1985 and has expertise in many different areas of plastic surgery. We recently asked him about his experience in plastic surgery, what he thinks about the IDEAL IMPLANT® Structured Breast Implant, his breast enhancement recommendations, and more. Read below for his expert answers then visit his website to schedule a consultation.

How many breast enhancements do you perform and what is the breakdown of breast implant types?

“Breast enhancement has always been a big part of plastic and cosmetic surgery in general and, in our practice, it’s always been a large part. Along with breast enhancement, which is basically breast enlargement and breast augmentation, we also do breast lifts and breast reductions.

“Our practice probably 50% revision or secondary breast surgery because we have patients who have breast implants for 10, 15, 20, 30 years. Their bodies have gone through changes, their breasts have responded through their lives to all of these changes. Now maybe their breasts are sagging a little bit. Maybe they’re emptying in their upper part. Maybe the implants are too large, maybe they’ve gained weight and their breasts are just too large. Or they’ve had their breast implants for 20 years and it’s time for a change. Implants still play a large part in those changes.

“When I started doing the surgery a long time ago, the only implants that are available were silicone gel implants and traditional saline implants. We have silicone gel that’s more cohesive, more gummy bear or like jello, and some that are more liquidy. Then we have the IDEAL IMPLANT® Structured Breast Implant. The IDEAL IMPLANT is a structured implant filled with saline as opposed to silicone gel. It feels more like a traditional silicone gel implant because of the way it’s structured.

“The company spent more than ten years in developing and testing this implant. The idea was that if you put in inner layers into this outer silicone shell, it would slow down the flow of saline when you would touch the implant. It’s the way the saline flows through the implant that makes it feel more like a silicone gel implant. The saline doesn’t just slosh through the implant as in a more typical saline implant. It has a much more natural feel. It feels more like breast tissue. It feels more like silicone gel. It’s a great option for the women who has concerns about a silicone gel implant that still wants to have a breast implant. It’s just a great alternative for those reasons and several other reasons.”

How does IDEAL IMPLANT® Structured Breast Implant compare to traditional saline implants? Do incisions play a role in determining which implant you recommend?

“In my practice, I’ve been doing this long enough that I’ve used pretty much every implant that’s available and has been developed. We’ve used all the different incisions that are available. That includes incisions under the breast (inframammary), incisions around the nipple (periareolar incision), and incisions in the armpit (transaxillary). For many patients, we used to do a TUBA or transumbilical breast augmentation. The only scar is in the belly button. That’s the only time that we’ll use a standard traditional saline implant. The saline implants roll up very thin so can roll them up like a cigar when you insert them. You can make a small incision in the belly button, roll this up, make a small tunnel from the belly button to the bottom of the breast and then insert the implant in that matter. Currently the most commonly requested incision is actually under the breast. If I’m making an incision under the breast, there’s no benefit of using a traditional saline implant. It doesn’t feel as natural as breast tissue.

“The IDEAL IMPLANT® Structured Breast Implant is just a much better implant. We have now more than ten years of follow up. The complication rate for IDEAL IMPLANT® Structured Breast Implants is very, very low. When I say complication, in particular we’re talking about deflation of the implant where the saline just leaks out, and capsular contracture where you develop firmness around the implant. IDEAL IMPLANT has better statistics right now in their six year follow up then traditional saline implants and even traditional silicone gel implants. Those are other reasons why the IDEAL IMPLANT is just a better choice for many patients.”

How does the IDEAL IMPLANT® Structured Breast Implant compare to silicone gel options available?

“Even with a silicone gel implant, it’s still possible to see some of these same problems of rippling, wrinkling, waviness of the implant. And there are some women that still have concerns about silicone gel. Some women have had silicone gel implants for many years and have had what’s called “silent rupture” where the implant can actually leak and break and you don’t know it until you have a mammogram or an MRI. The recommendations are to remove all of the silicone gel, remove the capsule, and start fresh. A woman who has experienced that and now needs to have a new implant frequently will be concerned about having another silicone gel implant. That’s one group of women that frequently will switch to the IDEAL IMPLANT® Structured Breast Implant. Another group of women are women who know women who’ve had that problem and are concerned because their best friend had to have repeated breast implant surgeries because of problems with their silicone gel implant. They feel more comfortable having saline. When an IDEAL IMPLANT® Structured Breast Implant leaks, it doesn’t happen frequently and it happens less than silicone gel. But when it does, our bodies just absorb the saline, which is a natural part of our body. There’s nothing that’s fearful about that.”

How do you help patients who are trying to determine the best implant size for them?

“I think I’ve done pretty well on sizing over the years because I haven’t had anybody request a change in size for a long time. The number one cause for a secondary breast operation is for a women to change the size of her implant.

“The conversation starts off with education. I have to explain the difference between cup size and bra size and patient size. Their height and their weight and their size. A zero size versus a six or eight and what that all means relative to cc’s of volume of the implant. For some reason, this is just not intuitive to many patients when they come in. That’s a long discussion as part of the consult.

“Another part of the consult may involve a patient bringing in photos taken usually from a website of what she would like to look like. Then we have to look at the photos and see if her before photo looks anything like the patient. You need to look at the patient’s height and weight and see if they’re similar. If the patient brings in an image of a patient who is 5 foot ten and 145 pounds and she’s 105 pounds, the implant is going to be very different. We have to digest all of that information, then have a long discussion with a patient so she understands why we’re choosing a certain size. It’s confusing for the patients because the patients will go to three different doctors and they’ll come and see me. They’ll say, ‘I just saw doctor so-and-so down the street and they say I need 450cc.’ I say, “That’s great. That’s gonna make you a 32F cup. If that’s what you would like to be, that’s fine. That’s not what I think you want.’ It’s difficult for the patients sometimes. They get a lot of different information and it’s not always correct.”

What advice do you give to patients who are concerned about scarring?

“Most patients coming in for cosmetic surgery are concerned about the incisions or placement of the incisions. I always ask the patient what they’ve been thinking of because they’ve absorbed a lot of information from social media, the Internet, previous consults, what their friends have told them, so I always ask if they have ideas in mind.

“I spoke a little bit earlier about the incisions that are available. Most typically now, we’re not using the belly button incision. They’re through the armpit, around the nipple and under the breast. Some women are fearful now about the incision around the nipple or the areola because there’s some information saying there’s more bacteria and a higher risk of encapsulation. There’s some literature available to that, but I’m not sure it’s concrete. My personal experience, I think my rate of capsular contracture has been the same, regardless of the incision that we use. I personally think that there are good options for each patient.

“A patient who has a very small areola . . . they’re not a good candidate for an areola incision at all, it’s just too small. If we try to make the incision under the breast, if they’re very small and they’re very flat chested, they don’t have a good fold, and that scar will be more visible. For that patient, a transaxillary incision is a great option. Doctors who don’t do a transaxillary incision will frequently have bad things to say about it. They’ll say, ‘You can have bleeding, you can have nerve damage. You can’t place the implant correctly,’ and that’s all nonsense. Any doctor who has done that operation consistently knows you can get the same result with any of the incisions that I spoke about.

“For another woman that comes in and already has had children, maybe she has some laxity of her skin, she already has a well-defined fold under her breast, an incision under the breast is great. It’s going to be hidden no matter what, we don’t have to cut any of the breast tissue. When we do a periareolar incision, usually we’ll cut through the lower part of the breast tissue to get to the muscle or to go under the breast, so you’re disrupting a little bit more of the glands of the breast. When you make the incision under the breast in the fold, you’re immediately under everything. If a woman has more breast tissue, more gland, then going underneath the breast in the fold might be a better operation for her.”

How do you advise patients who aren’t sure which implant type to pick?

“Every woman is different, their breasts are different, their needs are different. I try to educate my patients and tell them what I think is best for them given all of the options. In my practice, silicone gel implants are still probably 85% of the implants that I use, but every year we’re putting in more of the IDEAL IMPLANT® Structured Breast Implants. Because patients now are becoming more aware of IDEAL IMPLANT and they are more readily available.

“When patients come in, before they just sit down and we start talking about silicone gel implants, I will give them a sheet of paper that discusses IDEAL IMPLANT, because they may not be familiar with it. It will outline why the IDEAL IMPLANT® Structured Breast Implant might be a better choice for them compared to the silicone gel implant, so at least it’s in their mind. They’ve had the ability to at least read about it and know that that’s an option. Then we’ll continue with the rest of the consult I’ve just discussed. At that point we’ll say, ‘What do you think about the IDEAL IMPLANT? Are you set on having a silicone gel implant? Is this of interest to you? Do you want more information?’ Then we’ll go from there. I like for my patients to make educated choices, to make their choices for good reasons.

“If they say, ‘I want this silicone gel implant,’ I ask, ‘Well, why are you choosing that?’ They’ll say, ‘I’ve been told that it’s this and this and this. I’ve felt them, I’ve read about it. I just think it’s a good choice for me.’ That’s great. Then if a patient is just reading about the IDEAL IMPLANT® Structured Breast Implant for the first time, I’ll say, ‘How do you feel about the IDEAL IMPLANT?’ They’ll say, ‘It’s the first I’ve heard about it.’ I’ll say, ‘Good. Why don’t you take home the information, here’s a website. Think about it. We’re not doing the surgery for six weeks. See if this is a good option for you and we’ll go from there.’

How long can women expect their breast implants to last?

“The longevity of an implant is something we’ll discuss at a consult. It’s an important discussion because the party line right now for most implants has been that implants will last about 10 years. That’s just all implants across the board, different companies, different styles of implants. Now there are doctors who’ve told patients, ‘You need to come in and replace your silicone gel implants at 10 years, you have to do that.’ Again, there’s no statistic, there’s no literature that supports that. I tell my patients that implants become weaker over time and at 10 years, you need to think about possibly having to replace them and it would be a good time at that point, if you haven’t already had mammograms and ultrasounds, to at least get that as a starting point, and if there’s any concern, to get an MRI, which is recommended by the FDA for a silicone gel implant.

“Now our own bodies don’t last a lifetime. We get arthritis, our knees give out, our shoulders give out, we get neck pain or back pain, so our bodies don’t last a lifetime. There’s no man-made device that lasts a lifetime. It would be great if our cars would last forever but they don’t. Man-made devices wear out. When you put a breast implant into a woman’s body, her heart is beating, she’s breathing. If she’s athletic she’s moving, her breasts are moving, there’s constant motion. If you think about taking a paperclip and bend that paperclip back and forth and back and forth and back and forth, you develop a weak spot in that paperclip, and at some point, it just breaks. Implants are no different, just like every other device, so over time, they will wear. Now some of the companies have been really good about warranting their implant, at least for 10 years, as IDEAL IMPLANT does. They will replace the implant if they become defective before that 10 year period.

“I have patients coming in that have implants that are 30 years old. I have patients coming in for their light lift facelifts and I’ll go through their medical history and they’ll say they had breast implant surgery 25 years ago. I’ll say, ‘Oh, that’s great. When did you replace them?’ They’ll say, ‘I haven’t replaced them.’ I’ll say, ‘Have you thought about it?’ They’ll say, ‘They’re fine.’ We’ll talk a little bit about that and why it might be a good idea to do a little bit of research on that and think about it, but there are a lot of patients, they just come in, they’ve had their implants for 10, 15, 20, 30 years and they’re good, they’re fine.”

Through your years in practice have you seen any trends in cosmetic surgery?

“I’ve been in practice for a while now and I’ve seen all the changes that have occurred with breast implants, breast sizing, types of surgery. Breast implants initially were pretty much mostly silicone gel. We had traditional saline implants then, but almost everybody had silicone gel placed. There were all almost always placed through an incision in the mammary fold. In the United States, they were almost always placed under the muscle. Since that time, we’ve gone through smooth implants, we’ve gone through textured implants. We’ve had textured implants with different types of texturing. Minimal texturing, coarse texturing, and all of that was focused at cutting down on scar tissue or the rate of encapsulation. We’ve gone through shaped implants, we had saline shaped implants, we’ve had silicone gel shaped implants.

“Those are trends with implants and now we have the IDEAL IMPLANT, of course, a much better structured saline implant, so it’s rare to use a traditional saline implant at all. I’ll just go to the IDEAL IMPLANT, and it’s a great name. It’s the ideal implant for that patient. The other big change, the other really big change in breast surgery has been, again, it’s called hybrid or composite breast surgery, there may be some other names that doctors use. It’s using a combination of your own tissue, your own body fat, and an implant or no implant.

“The hybrid operations are usually a combination of an implant, whether it’s an IDEAL IMPLANT® Structured Breast Implant or a silicone gel implant, and, again, the body’s own fat. You put the implant in and, if it’s just a breast augmentation, we may decide the patient needs a little bit more fullness in one part of the breast or the other, and because the implants are a fixed shape, they can’t take a customization of the contours. Most women have breasts that are unequal, they’re asymmetric, so the ability to correct small asymmetries by adding their own fat is a great advance. That’s a big change.”

Have size requests changed much over time?

“Size requests for implants go a little bit like fashion. When I started, Twiggy was really popular. Twiggy was a model back in the early ’70s and she was very young and she must have been like a size double zero, very flat chested, and that was the image of a model at that point in time. Women just wanted a little bit of breast enhancement. I mean, a typical breast implant volume in the late ’70s was probably 240cc for an average size woman. Then we got into the 1980s and 1990s, and everything got bigger, the world got bigger, breasts got bigger. We got to a point where the average size implant probably went up to about 375cc, 390cc.

“The average cup size, the average bra size sold was a 36C. If you went to clothing manufacturers, I think that’s what they would gear most of their clothing towards. Either a 34 or 36C was the average size. Along with that, that became the average size breast implant, and there were always extremes. Most women did not want smaller, larger sometimes.

“Now I think it’s going backwards. I think women now are coming in, some women are having their implants removed. A lot of those women are having a small lift, maybe they’ve had children. Maybe their bodies have changed a little bit. Maybe they’ve gained a little bit of weight. They’re now in their 40s or 50s. They’re beyond having that 375cc implant.

“Smaller implants also have less complications. Smaller implants have less problems of stretching of the skin, stretch marks, dropping into a low position below the fold. I think in general, smaller implants, they’re more modest, you’re placing less of a demand on the woman’s body. I think they heal better, longevity is probably better. Bigger breasts sag, whether you have implants or natural breasts. More weight and gravity is a bad combination, so it’s not just implants.”

As a surgeon, what do you like about the IDEAL IMPLANT® Structured Breast Implant? Why should women be aware of this option?

“First of all, I want to give my patients options, so it’s good having choices for my patients when they come in. For the patients that are concerned about silicone gel, and they’re concerned about the safety of silicone gel, I am happy to give them an alternative. And the only alternative I had before was the standard saline implant. And the standard saline implant doesn’t feel as natural as breast tissue or as natural as silicone gel, and has greater problems with rippling, wrinkling, or waviness for many patients. So for me as a surgeon, I like having the IDEAL IMPLANT as an option for all those patients, particularly the ones that have safety concerns.”

What is your advice for women who aren’t in Newport Beach to find the right plastic surgeon?

“For the few patients that just don’t want to travel and want to go to somebody local I think board-certification is always at the top of the list. At least it’s a starting point to make sure your doctor has had appropriate training and has gone through appropriate testing to make sure that they have the correct information, the ability and the skill sets to do the correct operation. The next thing of course is experience because you have young doctors. That’s great, when I was a young doctor, I felt I knew everything, and I knew a lot and I was good then. But with time and experience, most doctors get better at what they do. Also, I think the experience of the doctor who has used different types of implants, different incisions, different type of breast enhancement, I think it’s important because they’re not just choosing the one operation that they’ve learned how to do well.

“Because every patient is different. And one incision may be great in one patient, but the other incision might be better for the next patient. So to go to a doctor who has experience in doing the different techniques, the different placement of implants. Who has used the different types of implants. I think if you can get to a surgeon who has that experience, that’s a plus for that patient. It’s not always possible if you live in a geographic area where you have limited number of doctors. But that’s when it pays sometimes to travel.”

What information do women need for a successful outcome?

“We give our patients maybe too much information. There’s a lot of information that they get to prepare for surgery. And then a lot of information about what they can expect after surgery and the things they need to do. For a breast augmentation, it may be as simple as wearing a tape over the incision. All the stitching is always done underneath the skin, so there are never any stitch marks. But we want to support that initially, so we may use tapes.

“Now, full on activity, if we’re going underneath the muscle for a lift or an augmentation, we want to let that pectoralis muscle mend a little bit. So I may start to increase their activity over two to six weeks for full on activity. At six weeks we cut them free to do whatever they want. But again, things that they can do: taking care of the incisions with the products that we give them, wearing their sports bra or whichever bra that we feel is necessary for them for their particular operation, sometimes we use a support strap that goes over the top of the breast, if we need the bottom parts of the breasts to stretch a little bit. And that goes on over about two or three months. And those are most of the things we ask our patients to do.”

Why should women choose Pacific Center Plastic Surgery in Newport Beach?

“I think Newport Beach has many, many plastic surgeons. They have many well-trained plastic surgeons. I think what’s different about our practice, Dr. Nichter and I have performed surgery for many years now. We’ve done these operations every way they could be done, used every implant. And I think our experience is very important to patients coming to visit us. I think right now there are not many doctors in this area that have that level of experience with all the incisions, all the devices, different types of anesthesia, different operating room settings. Outpatient, inpatient, you know, we’ve done this surgery pretty much every way it could be done.

“Dr. Nichter and I also spend a lot of time researching products that are available to our patients. We were on the first group of people to start using IDEAL IMPLANT® Structured Breast Implants. We won’t do anything that is not safe, anything that we don’t believe in, anything that we feel has not been researched and studied. But as soon as we get to that point, we will get that device, that product, and make it available to our patients, if we think it’s something our patients will benefit from. Like the IDEAL IMPLANT® Structured Breast Implant. IDEAL IMPLANT and Sientra are the only two implant companies that will sell implants only to board-certified plastic surgeons. And I think that speaks volumes to the integrity of both of those companies. And it speaks volumes to our practice. Because a lot of doctors will continue to use the other implants because for whatever reason, they’re part of a buying program. If you buy Allergan products, use their Botox, get their implants, you have a better arrangement with that company. But we told that company, unless you sell only to board-certified surgeons, we will stop using your product. And now that we have two alternatives, that’s what we’ve done.”

Considering breast implants in Newport Beach? Contact Dr. Horowitz today to discuss your options. Simply call  949-720-3888 or visit www.PacificCenterPlasticSurgery.com. Dr. Horowitz’s office is located at 3991 MacArthur Boulevard, Suite 320/340, Newport Beach, CA 92660. Call today for more information on IDEAL IMPLANT® Structured Breast Implants.

Want a Breast Augmentation? Dr. Thomas Hubbard’s Patients Feel Confident about the IDEAL IMPLANT

Did you know that there is a new type of breast implant available to those seeking a breast augmentation? Now women don’t have to only choose between saline or silicone gel implants. Dr. Thomas Hubbard, a plastic surgeon located in Virginia Beach, VA, and board-certified by the American Board of Plastic Surgery, discussed in a recent interview the differences and advantages of this new, innovative structured implant: IDEAL IMPLANT® Structured Breast Implants.

Can you describe your practice and primary focus as a plastic surgeon?

“I’ve been in practice for 25 years now. Breast enhancement surgery has been a big interest of mine, and a large portion of my practice throughout my career. I’ve always had an emphasis on breast surgery. I joined a surgeon who developed possibly the most important technique in breast surgery – the ‘no-touch technique.’ I was with him almost six years. And with that technique, I’ve got my capsular contracture rate down one in many hundreds. But that’s not the only important thing with breast surgery, there are many parameters that need to be controlled, adjusted, and it’s all about pleasing the patient and getting what she wants.”

How do you help women beginning the breast augmentation process determine implant size, implant placement, and incision location?

“All of my implants are placed beneath the muscle. The advantages are numerous: lower rate of capsular contracture, quality mammograms, more natural appearance. I think with age it works out better in the long run as well. And then a recent study even showed that women with implants above the muscle, when they get breast cancer, it’s more advanced. There are so, so many advantages to going beneath the muscle.

“Regarding the choice about incision, most of mine are inframammary. I use a sleeve, whether I’m using saline or silicone gel, which helps with the capsular contracture rate being extremely low, but especially with silicone gel since it helps with the smaller incision in the inframammary area.

“For all my 25 years, I’ve been using sizing. We have several sets of sizers in the office, and a staff member spends plenty of time with each woman where she tries on different sizers in a bra with a top on, looking in the mirror, until she finds that look that she’s looking for. Now I tell her, ‘I don’t know whether that’s a Double D or a C. In fact, one company’s D is another company’s C. So, that really doesn’t matter. I want you to be comfortable with that look, you’ll find out later what the cup size is.’ We also have the Vector System 3D Imagery that we use. That’s a big advantage. It helps women preview the result. It’s nice to have the 3D imager because all of the implants, all the brands and types are programmed in. Sizing preoperatively is extremely valuable for getting those proportions that you want.”

How do you help women decide between traditional saline implants, silicone gel implants, and IDEAL IMPLANT® Structured Breast Implants?

“I have found that women choose, some with my help and some based on their friends, they choose an implant type and I really don’t see many regrets with the implant type. Maybe because they’ve made up their mind and they’re going to stick with whatever they’ve decided. Maybe because we have done a very good job of educating them about the pros and cons, and they’ve worked it through.

“There are some women who have made up their mind before they come in. I’m happy to go along with their choice. All my implants are smooth. I’ve never done the textured implants, so I don’t have to worry about the lymphoma that is related to textured implants. So if you want silicone gel, fine. If you want saline, that’s fine.

“Now, there is a sizable portion of women who have not made a decision and I’m happy to provide unbiased information. I tell them there is no implant that’s perfect and then I go on to describe the three types of implants – silicone gel, saline, and the IDEAL IMPLANT® Structured Breast Implant. I talk about the pros and cons of all.

“I had practiced many years before silicone gel implants were available, so there was quite a big change when all the silicone gel became available for women age 22 and older. My experience with saline was so good that I didn’t necessarily go to pushing silicone gel, and I still don’t go to pushing silicone gel. I still feel a woman needs to know the pros and cons of all of them, and I’m not going to tell a woman that she needs to go to silicone gel for sure or saline for sure.

“Now some women are better candidates for silicone gel and some women are better candidates for saline. For example, if there is a woman who is 5’10”, 105 pounds, you can see her ribs with very little breast tissue, she’s a Double A or Triple A, I am actually going to suggest to her silicone gel. She has very little padding, so her whole breast is the implant. But a woman who is even a B or a C, even some As, that have enough tissue, they can enjoy the benefits of saline as well. But they need to make that decision.

“If I were to summarize women who are choosing the IDEAL IMPLANT, I’m going to say I think they get it. They get it because they are looking through a lot of hype, a lot of different opinions on the Internet, and they’re seeing that saline has the same happiness rate as silicone gel. There are some long-term benefits of a saline implant: lower capsular contracture rate, less concern over time, and no need to get MRI scans.

“So, in choosing the IDEAL IMPLANT, they get it. The IDEAL IMPLANT is less likely to get visible rippling. It has a more natural feel. And it’s going to have that extremely low capsular contracture rate, which with saline, one in hundreds and hundreds and hundreds gets capsular contracture.”

What if a woman is concerned about implant rupture or wrinkling?

“If you’re really worried about rupture, if it’s something causing your anxiety, if you’re going to find yourself worrying about the silicone gel and “Should I get the MRI?” or wonder if it’s ruptured, maybe you should be considering saline. And if you’re considering saline, look at the rupture rate of the IDEAL IMPLANT. If the leak rate is a concern to you, the IDEAL IMPLANT leak rate is not even half the rate of other implants. So that is a big advantage of the IDEAL IMPLANT.

“As far as rippling goes, I think rippling rates are greatly exaggerated. If you look at the actual studies on rippling rates, the rate is pretty low unless you’re really, really thin. But if it’s a concern and you’re going the saline route, then look at the benefits of the IDEAL IMPLANT as far as rippling rates go.”

Should a woman be concerned about implant rupture?

“I don’t think women that think it’s not a problem are completely informed about the situation. Yes, you can take a ‘gummy bear’ implant, slice it on a table, and really there doesn’t appear to be anything flowing. But then there is an implant that is under the muscle getting squeezed and smashed and squeezed and smashed all day long with all our daily activities. Things don’t stay that way, so the inside silicone gel does get out.

“And in fact, since very few women actually end up getting the MRI scans, there’s a growing number of plastic surgeons who are recommending that a woman just go ahead and switch out her silicone gel implants at 10 years. At that point you probably have about 8% leak rate and with an 8% leak rate, it’s probably time to switch it out and put new implants in.

“Now with silicone gel implants, you’ve got to think about cost. I do inform women that if they’re choosing the silicone gel route, it’s safe and a good implant, but think of long-term cost with the silicone gel as well. Also, there are many of us who believe that it can lead to a capsular contracture at a later time. Women need to consider that you’re not going to know when you have a rupture. A sign that your implant has had a rupture that could have happened years before, is that your breast has turned firm and hard. That’s a capsular contracture. We do everything we can to avoid a capsular contracture.”

How soon after surgery can women return to their regular exercise routines?

“I feel strongly about some recommendations I make. No exercise for three weeks. Why? This goes back to the capsular contracture rate. We want it one in hundreds and hundreds. We don’t want to see capsular contracture more than every few years. And that’s one, and that’s in my opinion, too many. We want it at almost zero.

“How do you do that? Well, a lot is on the surgeon with the technique. I change my gloves multiple times during surgery. I use a sleeve no matter what I do, and you can go on and on with that.

“After surgery though, some woman bring up that their friend did exercise at a week. Well, but up to three weeks you can have a little bit of bleeding. You may not know about the bleeding, but a little around the implant can increase your rate of capsular contracture. This is an investment for the rest of your life. You want it to go extremely well, so we do need to go three weeks without exercise.”

How do women typically feel about the outcome of their breast augmentation?

“I actually do research on satisfaction rates with breast surgery. This is one of the highest happiness rates of any operation out there. Yes, silicone gel and saline have the same happiness rate. It’s very high. So whether you go with silicone gel or saline, you’re likely going to be quite pleased. The bottom line is you’re probably going to be happy with your choice.”

Do you conduct any other research?

“I’m doing research on controlling the settling of implants. I think there are ways to control the settling of implants. Did you know that when a surgeon puts the implants in, they sit a little high initially? They look a little funny initially, since they sit too high. Then they drop for six to seven months. It’s so out of the control of surgeons as to what happens during that six to seven months. Where they’re going to go is where they’re going to go.”

What should women look for in a plastic surgeon?

“I think she needs to make sure that breast surgery is one of the primary focuses of the surgeon that she’s going to see a consultation with. Reputation is very important as well. That makes a big difference. I would pick a surgeon who is offering saline, silicone gel, and the IDEAL IMPLANT. And why is that? Because all women are different. All women have different goals. Why would a surgeon exclude a class of implants that have the same happiness rate. A surgeon should offer all three implants, because all women are different. Their goals are different, and I think it’s important.”

Considering breast implants in Virginia Beach? Contact Dr. Thomas Hubbard today to discuss your options. Simply call 757-687-1900 or visit www.hubbardplasticsurgery.com. Dr. Hubbard’s office is located at 329 Phillip Avenue, Virginia Beach, VA 23454. Call today for more information on IDEAL IMPLANT® Structured Breast Implants.

Breast Surgery Plastic Surgeon Dr. Sophie Bartsich on Breast Implants and the IDEAL IMPLANT

Ask Dr. Sophie Bartsich why she chose to become a plastic surgeon and she’ll tell you it’s because it unites everything she likes to do: medicine, surgery, working with her hands, and art. Dr. Bartsich practices in New York City, where she aims to restore form and function for each of her patients while seeking an intuitive balance. She is recognized by her patients as a kind, caring doctor who is passionate about her work.

What is unique about your practice compared to others in the New York area?

“I really feel like aesthetic surgery should be a ‘fake out.’ You should not know that someone had work done, it should just look natural. The majority of my patients are looking for something natural, low maintenance, low worry, and very high impact. They don’t want other people knowing exactly what they did, they just want to look and feel great. I try and give that to my patients. During a consultation, I also give my patients a lot of information because I want them to be educated about their choices. I have a very information-driven and natural result-driven practice, and I don’t think that represents most other plastic surgeons.”

Why did you become interested in breast surgery in particular?

“As a resident in training, my program was in the 99th percentile for breast surgeries. I didn’t even realize that that was unique to our program, so for a very long time I thought breast surgery was 60, 70 percent of all plastic surgery. It never occurred to me that it wasn’t! I became very well trained in breast surgery, but it’s also something that I just responded to. I think every surgeon has their tissue, and every surgeon has their body area, and they just respond to some and not to others. I just instinctively responded to breast surgery.”

How is your approach to breast surgery different from other plastic surgeons?

“Whether it’s reconstruction or cosmetic, I think there are a lot of things that you can make unique within breast surgery. There are a lot of ways you can technically approach things that limit post operative pain. I think it’s really important that the nipple be shaped exactly right, instead of considering it as an afterthought. It’s the focus of the whole breast.

“I put a lot of emphasis on symmetry and balance. I think as a woman, I can understand things that maybe a male surgeon might not. For instance, if you go to buy a bikini and you have to purchase two really expensive separate pieces because you can’t just buy a set, it’s really annoying. To me, that defines you not being balanced. If you were balanced, you could buy a set. Balance and harmony are really, really important to me. My goal with each patient is to find that balance.

“The breast tissue is also a tissue I’m very familiar with and comfortable operating on. I enjoy performing breast surgery because it’s a very high reward for my patients and a very high reward for me. I believe it’s important to listen to my patients and understand what they want, and then apply some very basic principles of aesthetics and balance. When you do that, I think you get a great result.

“The other thing I really love about breast surgery is it’s ‘undercover difficult,’ and I like things that are undercover difficult. It might seem really easy to take an implant and pop it in. Any surgeon could take an implant and pop it in. But it’s actually very challenging to get just the right size, just the right shape, and put it in just the right place. It’s very deceptive, because it sounds easy. Everyone knows that a rhinoplasty is difficult, they know that doing a nose is hard and every little thing shows and everyone sort of sweats it out when they’re going to do a nose.

“When it comes to breasts, I think a lot of people are like, ‘Eh, that’s no problem,’ and they send their patients home with a bunch of sizes. They tell them to choose one and they pop it in and they just expect it to be fabulous and it’s not like that at all. You have to understand a lot of things about how tissues reacts, how much breast tissue you have, how stretched it is, babies, no babies, future plans, level of activity, etc. I think there’s so much that goes into it. It takes a certain level of intuition and experience and it’s actually really hard to get a great outcome. If you really know what you’re doing you can get a great result with the satisfaction that what you did was difficult.”

Has the selection of breast implants changed over time? What is your experience with silicone gel and traditional saline implants vs. IDEAL IMPLANT® Structured Breast Implants?

“I’ve never really liked traditional saline implants. For me, the natural look is very important and I found it very difficult to get it with those implants. The way traditional saline implants feel has also been a problem for me and my patients. It doesn’t feel natural. I always had a bit of a hesitation with silicone gel implants, because once you’ve cleaned up a few ruptures, you get a little nervous about it. But the look and feel was so great, and so disproportionately better that I felt like it tipped the balance.

“So, for a really long time I was very pro-silicone gel. I never really subscribed to the form-stable implants that much. To me they felt a little too firm. I also really didn’t like the idea of them rotating. I don’t like having the potential for an additional complication in an elective procedure on a young, healthy person. I felt that was an unnecessary added risk. The textured implants also made me a little bit uneasy. I was never that into using them. When the overfilled silicone gel implants came out, I liked them because they gave women a little more upper pole fullness.

“Most women who are getting a breast augmentation want to finally wear something that’s low-necked that shows off their cleavage. I mean, that’s the whole point. You don’t want to overdo it, but you need something there or there’s nothing to show. I always felt like the silicone gel implants sagged a little and the form-stable ones were skinnier up top, which is exactly where you want more.

“In addition to that, in the last couple years I’ve had several patients who’ve had MRIs done because there was a question about their existing silicone gel implant. I’ve found that sometimes MRIs are not actually very reliable. In some instances, a patient’s MRI said the silicone gel implant had ruptured, and then when I went in to operate on it, it actually hadn’t. I’ve had one or two patients where an MRI showed the implant wasn’t ruptured, but based on my clinical exam I really thought there was a concern, so I went in and it turned out it was ruptured.

“I became frustrated with the constant monitoring of the silicone gel implants, but they looked and felt good so I just dealt with whatever other issues came up. I wanted an option for my patients that felt psychologically and physically healthier and didn’t have these other concerns or challenges attached to them

“When I found IDEAL IMPLANT, I was very excited about it. I remember thinking, ‘If it looks and feels even half as good as silicone gel, I’m probably going to to try it because I think my patients will respond to that. Plus it will make management and monitoring easier and calm a lot of my concerns.’ So I did a few IDEAL IMPLANT cases and my patients were very happy. Then I did a few more and those patients were also very satisfied. When a patient comes in and I discuss all their implant choices, they’re excited to see that there’s something like that. People like the structure, the stability of the shape, and the feel. I’ve had no one complain it didn’t feel normal or natural. The IDEAL IMPLANT has been a very welcome addition to both my practice and my patients.”

What kind of changes have you seen in the last few years of what women want or expect out of breast surgery?

“I’ve seen changes in both the patients and the surgeons, but I’ve seen more changes in the patients. When I was in training, we were taught the most frequent complaint among patients after breast augmentation was, ‘I should’ve gone bigger.’ I think this was very much the teaching a while ago. A lot of the surgeons in practice who are maybe five or ten years ahead of me still have that sort of indoctrinated. So, there was a time when surgeons were putting in as big an implant as they could because they really didn’t want the patient to come back and say, ‘I wish I had gone bigger.’ I think those days are over. Celebrity trends and general lifestyle trends are moving more and more towards the natural look. People are getting plastic surgery earlier on but they’re doing less drastic things. I tell my patients, ‘Listen, no one will know they’re fake unless you feel like showing them,’ and they really like that.

“In my personal opinion as a woman, there’s also a fine line between wanting to be noticed, but not necessarily wanting too much attention. Most women don’t want to walk around broadcasting that they had a breast augmentation. They want to look good in a dress, they want to look good in a T-shirt and jeans. It’s not just about the bikini. They want to feel comfortable. They don’t want to wear an orthopedic device which calls itself a brassiere, because that’s sort of the point we’re at with underwear now. Women are doing this for themselves, they’re not doing this for other people. I think sometimes that also gets misunderstood.”

“Today’s patient is very educated, very sophisticated. There’s also a lot of concern about health.
In the last couple of years, my patients have become more concerned about silicone gel in particular. More and more people are coming in and saying, ‘I really don’t like the idea of silicone gel in my body.’ Patients have access to information on a scale that never existed before. Things are very different than they were ten years ago. If there’s a potential problem or complication a patient is worried about, they will look it up and find out more about it. Women in today’s world want to have peace of mind. These are women who are working and have children and have lives and marriages and households, and the last thing they need is something else to worry about and monitor all of the time.”

How do you help women determine the best size of breast implants for them?

“That’s an important question, because the way most people think about size is A, B, C, D. Those are not exact measurements. The sizing system for bras is actually not anatomic. It’s not based on anything real. Most people have no idea where these sizes even came from. In actuality, bra sizes are a leftover of the old school corset sizing system.

“All your cup size really measures is your projection, or how far from the chest wall your breast goes. If you are narrow and short breasted and perky, you might go pretty far out of the chest wall and have a tiny little breast. If you are wide and high and saggy, and things are sort of all over the place, you might go that same distance from the chest wall and measure the same letter but be five times bigger breasted. That’s why those sizes don’t really mean much.

“A patient might come in and say, ‘Well, I’m a B and I want to be a C,’ or, ‘I don’t want to be a D.’ The first thing I have to dispel is the fact that those letters are actually anything to hold onto. I know what they mean when they say that, and it’s sort of a guide and a concept, but it’s not a measurement. The most important measurement of the breast is its width. Unless the fit model has the same width breast as you, the foundation of the bra is wrong and you’re just trying to squeeze things either narrower or wider depending on how things measure out. So the most important thing is that the implant has to be the same width as the breast. It’s like a foot in a shoe. If you go into to a shoe store and you just pick whatever shoe you think looks nice but you don’t actually pay any attention to size, it’s not going to fit.

“A lot of my breast augmentation patients will show me a picture and say, ‘I really don’t like this,’ and the first thing I say is, ‘It’s not the implant’s fault.’ With implants, (in terms of size), there’s sort of a range. I tell all my patients, ‘There’s a range that will fit you. There is some wiggle room within that range, and you can go on the lower end or the higher end.’ Once you know what that range is, then the patient can give you feedback. Patients can tell you they want to be higher up or lower down within that range. Sometimes people will come in and say, you know, ‘I’m getting married in six months and I want to look classy in my wedding dress. I want to fill it out and not have to worry that I’m not wearing a bra, but I don’t want it to be weird.’

“I understand a woman’s perspective. I know what having breasts means and how the world responds to your breasts and how you feel about your breasts and how you wear them. Because, basically, you wear them. Breast implants are just like anything else you wear. If they’re sized right and proportionate and fit your lifestyle, then they’re going to work great and enhance everything and make you feel awesome. Size is important and the patient can give you guidance, but they can’t pick it because it has to be chosen with training.”

Do you have a preference on placement of breast surgery incisions? What do you say to women who are concerned about scarring?

“A lot of plastic surgeons like to use the trans-axillary technique for breast augmentation. That places the incision in the armpit (axilla). I don’t like that approach. I never really understood why anybody would think the armpit was hidden on a woman. If you go to a black tie dinner, your armpit’s open. It’s not just on the beach or in the shower. It’s shaved and it’s open and everyone can see it. The minute you reach to get your champagne glass, everyone’s going to see it. So that’s not hidden, and if it doesn’t turn out well, you’re stuck with a scar on your armpit. On top of which, technically it’s a difficult surgical approach. So I never really understood the benefit of that either. It makes the surgery much more difficult for a potential scar in a really bad place.

“I also don’t like to make incisions around the nipple, because the areola transitions to skin as a fading rather than a definite line. I’ve done a lot of research on the bacteria that live in the breast. Many people don’t know that bacteria can cause you to get infections when you’re nursing. They’re all in the ducts and they all converge on the nipple where all the ducts meet. So if you do that approach, you’re potentially contaminating the implant and you have a higher risk of contractures. You also have less area to work with, and what if the breast tissue that you just went right through doesn’t line back up again? Now you have an additional problem.

“In my professional opinion, the incision under the fold, or the inframammary approach, makes the most sense. Even if you don’t have a fold, once you have a breast augmentation you’re going to have a fold. That, to me, is the most hidden spot. When my patients come in for post op, for me to see the scar they have to be completely undressed and lift their breast for me. If they’re just standing there, I don’t see it. If my patients have an issue with the scar, that’s about as hidden as you’re going to get. It’s also an area that lends itself to revision if you ever have to cut the scar out for some reason, which is really not very common. You can do that in that spot, but you can’t do it around the nipple. I prefer to make my incisions under the fold. You have the most visibility during the surgery, you have the most control over the surgical field, and the scar is as hidden as you’re going to get.”

What specifically do you like about IDEAL IMPLANT?

“I don’t want to do anything to someone else I wouldn’t want done to myself. I think a lot of the implants I’ve used in the past gave me excellent results, patients were happy, I think that they’re still very reasonable alternatives to use, and I still offer them to my patients. But when I first started using IDEAL IMPLANT® Structured Breast Implants, I thought to myself, ‘I’m sure there’s going to be a couple of patients who just really like the idea of this,’ but I was shocked at just how many patients started requesting it once I introduced it to my practice.

Since I started using IDEAL IMPLANT, I’ve had almost no patients choose anything else. That’s not because I’m pushing one implant over the other, and it’s not because I say to them, ‘Well, this is the one that I want you to use, and also there’s this other stuff.’ I don’t think that’s fair. I think that silicone gel implants are still fine and I’ve gotten amazing results for years. I’ve had many patients in the past who have chosen silicone gel that are happy, they like the feel, they like the look. But, I think there’s something IDEAL IMPLANT offers that I’m responding to and that my patients are responding to.

“So, for me, IDEAL IMPLANT has been a very welcome addition to my practice, and for my patients it’s been wonderful. I’ll tell some of my existing patients who need a revision for whatever reason, ‘Two years ago I didn’t have this option, but just so that you know, this is a new implant I’ve been working with,’ and the majority of them say, ‘Oh, I think I want that instead, I like the idea of that.’

“Also I’ve had a lot of patients who come to me who’ve had silicone gel implants placed many, many years ago and they’re sort of at a loss of what to do. These patients will say, ‘Some people say I should take them out, and some people say leave them alone, and it’s been 15 years. What do I do?’ I’ve had some changes in my approach to that question as well. Now I’m leaning towards the opinion that after a certain amount of time maybe that patient should think about switching them out.

“A lot of those patients say to me, ‘If I’m going to do it, now that I have another option, I think I might actually do it with IDEAL IMPLANT instead. I just don’t want to have to worry about these things again, and it’s really challenging to monitor something all the time. Since we’re going back, let’s just go to something simpler.’ The results have been great and the patient satisfaction is very high. Overall, IDEAL IMPLANT® Structured Breast Implants are a wonderful addition to my practice.”

Considering breast implants in New York City? Contact Dr. Sophie Bartsich today to discuss your options. Simply call 516-773-9200 or visit www.doctorsophie.com. Dr. Bartsich’s office is located at 960 Park Avenue, New York City, NY 10028. Call today for more information on IDEAL IMPLANT® Structured Breast Implants.