At Vinings Surgery Center in Atlanta, Georgia, you can be positive that you’ll receive the best care by Dr. Robert Colgrove. He understands what women look for when it comes to treatments for their face, breasts, and body. We recently interviewed Dr. Colgrove to learn more about a typical consultation and his thoughts on the new IDEAL IMPLANT® Structured Breast Implants.
Tell us a little bit about you and your practice.
“I’ve been in private practice here in Atlanta since 1986. I’m board certified by the American Board of Plastic Surgery. We are located near the new stadium at interstate 285 and interstate 75.”
Why do you think women choose you?
“Women mainly choose our practice because of my extensive experience. I’ve done several thousand breast augmentations and breast lifts. Many patients that come in don’t realize they need a breast lift to get the correct result.
“We also offer the latest Vectra 3D simulation, which helps a patient visualize and understand what the various implants are going to look like. I also have an excellent staff, who’ve been with me for many years. Many of my staff have had plastic surgery, including breast implants. They’re very understanding and helpful as far as answering questions and getting you to feel comfortable with the process.”
Can you walk us through a typical consultation?
“When a woman comes in for a breast consultation, we begin with the Vectra 3D simulation. Vectra pictures will be taken, they’ll come back to the consultation room, then the nurse and I will go over the measurements and what we feel is going to be the definitive plan for this particular patient. We show them the various types of implants, along with the breast lift if necessary. Then my office manager will go over pricing, scheduling, the required blood work, and a preop visit can be scheduled if they so desire.”
Why is a breast lift only necessary in some cases?
“On the breast lift, we have measurements on the Vectra equipment that gives us a guideline. It’s just a guideline, we still have to look at the patient and see where they’re at. But typically if there’s a measurement of eight centimeters between the breast crease and the nipple, that’s typically too much for the implant to provide the necessary lift. Occasionally you can get away with it. Of course, I still have to see the patient in person and make a decision on that. But there’s the measurement, and then there’s also the elasticity of the patient’s skin. Obviously you have to examine the patient in person to determine that.”
How do you know which insertion approach to take?
“When a patient comes in we go over the various options for the insertion of the implant, you do have the axillary approach through the armpit, the areola approach, and the approach through the crease at the bottom of the breast. For most patients the crease incision is the favorable one. It heals the quickest, has the least amount of complications, and the quickest recovery. If you go through the areola area, obviously you have to go through some milk ducts, which could increase your risk of infection.
“Same with the axillary or armpit incision; there is a higher chance of infection. More pain, because you have to tunnel across from the armpit over to the breast. It’s a little harder on the patient because it takes more time for the patient to heal. Also, if they have an undesirable scar in the armpit, it’s impossible to conceal if they’re wearing a tank top or swimsuit.
“We’re certainly open to patients if they have a strong desire for one incision over the other. Some of our patients don’t scar well. Many of our Asian patient like the areola incision, because the scar is less detectable than the other areas.”
What are the long-term factors breast implant patients should consider?
“We tell the patient that they may need another procedure some point in the future, depending on several factors. Such as if they have a pregnancy after the procedure, that’s going to affect their breast. It may necessitate a breast lift at a later time. Also, the pocket of where the implants sit may change and have to be corrected.
“There’s a difference, we feel, between saline implants and silicone gel implants as far as the longevity and then need for further surgery. I tell my patients if they choose a saline filled implant and it doesn’t deflate, that they won’t have to change it. That’s assuming they don’t have a pregnancy, or rapid weight gain, or weight loss that would cause another problem.”
Why did you choose to offer the IDEAL IMPLANT as part of your practice?
“I’ve been doing this for 32 years and I’ve seen the pros and cons of the various implants. I think the IDEAL IMPLANT is going to cut down the need for future surgeries.”
How do saline and silicone gel implants compare with the structured IDEAL IMPLANT?
“The typical saline implant is basically water inside a bag and it tends to be causing more ripples and wrinkles for the patient. The silicone gel implants are softer and more natural, but then you have to deal with the silent rupture issue.
“That means that the patient and I don’t know if they have a rupture or not, unless we do an MRI or actually open the patient and look at the implant. We prefer not to do that if we don’t have to. The FDA has recommended that patients with silicone gel implants have an MRI after three years and every other year after that. It’s very expensive. I don’t think most insurance companies pay for it, therefore a lot of patients are more likely to go with a saline implant.
“The IDEAL IMPLANT offers the advantages of feeling more natural than the typical saline implant and feels a little bit more like the silicone gel implants without the drawbacks of silent rupture and the frequent MRI’s.”
Do you do any saline implants anymore, or do you mainly use the IDEAL IMPLANT?
“Well, patients will still sometimes use the regular saline implant just because of the cost situation. The IDEAL IMPLANT is going to cost more, but you’re going to get a better product.
“I think if they cost the same they’d probably go with the Ideal Implant every time, but we can’t really do that just because it is a more expensive implant. It’s a more complicated implant and it deserves to cost more.”
What has been your experience with silicone gel implant rupture?
“When silicone gel implants rupture, it becomes a very complicated procedure. Particularly, if they’ve been ruptured for a long period of time. I have seen patients that have had silicone gel implants for 30 to 35 years and probably been ruptured for many years. That takes several hours to take out the capsule and the silicone gel, which is basically free floating in the pocket.
“The capsule becomes very calcified and very painful for the patient. So, it’s a bigger surgery for the patient. You have to take out the capsule along with the implant, which means that there’s a need to put drains in for the patient and a longer recovery time. That’s the issue with a silicone gel implant that has been ruptured for a long period of time.
“Say you were getting the MRI for some other reason and you identified a rupture early. Then, you would still do a capsulectomy, but you probably wouldn’t have the calcification and the painful contractures.”
How does that compare to a leak with the IDEAL IMPLANT?
“With the IDEAL IMPLANT, if you need to change that out, you typically just remove the implant and put a new one in if the patient so desires. You don’t have to go through the process of cleaning up silicone gel because it’s filled with saline which is harmlessly absorbed by the body.”
How does this compare with handling a saline or IDEAL IMPLANT rupture?
“It’s a sterile saline that’s there and is easily absorbed by the patient. Most of the time there will be nothing there but the implant, which is easily removed. If you are changing the pocket, you may have to put a drain in.
“If there’s a deflation, patients usually call us on the phone and say, ‘Well, I was changing my clothes or putting my swimsuit on and noticed that my left breast or my right breast is smaller today. I need to come in and have it replaced.’
“They don’t have to spend money on an MRI, which is nice. It’s an easy diagnosis for them and for me. Again, it’s picked up early, not late.”
What would you tell other surgeons about the IDEAL IMPLANT?
“A plastic surgeon in Ohio who was my mentor called me up and said, “I see you’re using these IDEAL IMPLANTS. How do you like them? What kind of problems have you had with them and so forth?
“I told him the experience has been very good, it has been very positive for both the patient and me. I feel good about putting the implant in, because I know I’m helping these patients in the long run avoid issues down the road. They’re not perfect. Nothing is perfect, but I would say that when you look at them long-term and the patient is not having to worry about the silent rupture, I think it’s worth it to both them and me.”
How do you help women make their implant choice?
“When we’re doing the consultation, some patients come in and they think that they want silicone gel, but then we show them the IDEAL IMPLANT and explain to them the problems with silicone gel’s silent rupture and MRI’s. Most patients go with the IDEAL IMPLANT after they hear that. They like the safety aspect of it and they like the fact that they don’t have to come in every so many years to have the implant replaced.”
What has been your experience with the IDEAL IMPLANT as far as patient satisfaction?
“The patient satisfaction has been very good across the board. We haven’t had to go back in and remove them because they didn’t like them. I would say at this point it’s been very positive for the patient and the surgeon and continues to grow. It has basically overtaken my practice as the number one choice for breast implants.”
Anything else you want to mention about your practice?
“In summary I would like to say, here at Vinings Surgery Center, we have an accredited office surgery center where procedures can be done onsite. This makes it more private and confidential for you than going to the hospital. It’s going to be easier for you psychologically to have caregivers that understand why you’re here. A lot of my staff have breast implants so they won’t be judgmental. They will be supportive, which is helpful as far as giving you a positive experience.”
Considering breast implants in Atlanta? Contact Dr. Colgrove today to discuss your options. Simply call 770-955-9000 or visit www.colgrove.com. Dr. Colgrove’s office is located at 1900 The Exchange SE, Bldg. 300, Ste 300, Atlanta, GA 30339. Call today for more information on IDEAL IMPLANT® Structured Breast Implants.
https://idealimplant.com/wp-content/uploads/2018/11/20181017_Colgrove_Atlanta-Plastic-Surgery_HERO.jpg6281200Valerie Christensenhttps://idealimplant.com/wp-content/uploads/2019/01/Copy-of-II_Logo_Straight-Tag-Icon_4C-300x75.pngValerie Christensen2018-10-25 05:00:062020-02-12 23:33:47Get to Know Atlanta Plastic Surgery Expert, Dr. Colgrove, and His Thoughts on the New IDEAL IMPLANT®
Before your breast augmentation, it can be helpful to hear about other people’s experiences. Monica is a former breast augmentation patient of Dr. Ben Moosavi. Dr. Moosavi operates his private practice, Ultimate Plastic and Reconstructive Surgery in Huntington, West Virginia. Monica chose IDEAL IMPLANT® Structured Breast Implants for her procedure after learning about them from Dr. Moosavi. Monica is thrilled with the IDEAL IMPLANT and loves her results! She was interviewed and gave us permission to share her story with others.
“This was my third breast augmentation, and with the previous surgeries I’d chosen saline implants, so when it came to what type of implant I was going to use, I decided I still wanted a saline-filled implant, but I was interested in what was new.
“It had been eleven years since I had the previous surgery, so I had a lot of rippling, and I had three babies, so my body had changed a lot, and I was really looking for a new option that was closer to silicone but without having scary side-effects you hear of and read about online. So that’s when Dr. Moosavi recommended the IDEAL IMPLANT. I honestly researched it for a long time and couldn’t find anything negative on it, and it sounded to me like a great option.”
Monica says she didn’t have very much anxiety prior to her procedure because she was so confident in the advantages IDEAL IMPLANT had to offer.
“I wasn’t nervous about breast augmentation surgery at all, since I’d already gone through two surgeries. Honestly I was more excited! Everything I read online about IDEAL IMPLANT and everything I read in other people’s reviews was positive.”
“I’ve had breast implants for a long time, and I was really excited to get the IDEAL IMPLANT because it felt different. I’ve had them since June, and I’m a runner. I work out, and they feel amazing. Obviously I had to wait for the recovery a little bit, but I’ve been feeling great since I’ve had them. It just seems like a wonderful switch out so far.”
With her first set of saline breast implants, Monica’s former plastic surgeon diagnosed her with capsular contracture. They tried multiple treatments to fix the problem, but nothing seemed to help.
“It was just a tightness, and my right implant sat much higher, so you could almost see that it was being pushed up a little bit more than it should have been. The left one settled, and the right one never did, so that was something I lived with for five years. They tried ultrasound treatment, and other things to get it to release a little bit, but at the end of the day I lived five years with it as long as I could, and then I had them switched out. And I had no problems with my second surgery. I was 20 when I got my first set, I was between 25 and 26 when I got my second set, and then I just turned 36 and got the IDEAL IMPLANT. I can tell a big difference. I know a good implant and a bad one, and the IDEAL IMPLANT just feels great.”
“I spent a lot of time researching, and I read about women having symptoms after silicone implants, and actually having their implants ex-planted because they were concerned about the side-effects that aren’t that well known. Most of the stories I read were tied to silicone gel breast implants. The articles on the internet listing side effects, and the comments from other women out there kind of scared me. I’m really active and and I have children, and I don’t want to have an implant rupture. People say it happens more commonly with silicone gel, so I was nervous about that too. Honestly, I never was displeased by the look of saline, I just wanted to stick with what I knew and what I felt safe with.”
Some women who are considering breast augmentation surgery have a hard time choosing their implant size. Often augmentation patients will say they wish they had gone bigger or smaller. Monica has advice for those women struggling to pick what’s right for them.
“The first time my implants were at 330 ccs, and now I’m almost double that size. Each time you have surgery, you don’t realize your swelling goes up and then goes down, so you’re very happy with your results for the first six months, and then suddenly you’re like, “Hey. I went through all that, and they’re not that big.” So the second time I went up to 525 ccs. This third time with the IDEAL IMPLANT I went with around 625 ccs. I definitely went up each time, because I remembered how it felt after the swelling went away.”
With all of her experience, Monica also suggests that breast augmentation patients keep in mind their long-term plans and goals.
“Remember that breast implants are temporary. At some point you do have to change them out. You have to think about that in the future. Is that something you want to do or not? If you don’t want to be in it for the long haul, don’t do it because here I am three surgeries in. It happens. That’s the negative end. The positive end is it’s life changing. Breast implants can make you feel great about yourself, really. This far into it I feel like you owe it to yourself to be the best you. I don’t really have any regrets.”
Monica believes it’s important to pick a plastic surgeon you feel confident in and who doesn’t try to sway you in one direction or another when choosing your implants.
“We’re a military family, so we move about every four years. I’m originally from south Florida. My first two surgeries were done in south Florida before I was a part of the military. When we landed in West Virginia I found Dr. Moosavi. Dr. Moosavi is a mutual friend of a friend here in West Virginia. A few other military wives I know had gone to him and I heard his name a lot. I started asking other women who had gone to him, ‘What was your experience like?’ And I also did some of my own research online, and that’s how I narrowed that down. You have to be knowledgeable about researching surgeons. I never had a surgeon try to push silicone gel on me, but that is not always the case.”
Now that she has the IDEAL IMPLANT, Monica is extremely satisfied with how her breast implants look and feel.
“Now that I’ve switched to the IDEAL IMPLANT, they feel really natural so far. Running feels great. I don’t have that sloshy weird feeling. That’s gone. They just feel comfortable and natural. It doesn’t feel like there’s anything in there! They feel great.”
About Dr. Ben Moosavi
Dr. Moosavi established his practice Ultimate Plastic and Reconstructive Surgery in 2013. He completed one of the most prestigious plastic surgery fellowships in the world at Emory University, after undergoing a rigorous education in general surgery. Dr. Moosavi has a reputation for providing safe, exceptional, quality care and treats each and every patient with respect and compassion. His breadth of training in the reconstructive and aesthetic realm has allowed him to perfect his surgical skills and technique. Dr. Moosavi is one of a limited number of board-certified plastic surgeons who offers his patients the latest in breast implant technology with the IDEAL IMPLANT.
Considering breast implants in West Virginia? Contact Dr. Moosavi today to discuss your options. Simply call 304-399-4220, or visit www.ultimateprs.com. Dr. Moosavi’s office is located at 5170 U.S. 60, Huntington, WV 25705. Call today for more information on IDEAL IMPLANT® Structured Breast Implants.
https://idealimplant.com/wp-content/uploads/2018/11/20181101_Moosavi_breast_implant_sizes_HERO.jpg6281200Valerie Christensenhttps://idealimplant.com/wp-content/uploads/2019/01/Copy-of-II_Logo_Straight-Tag-Icon_4C-300x75.pngValerie Christensen2018-10-24 05:00:172019-01-09 02:57:34Breast Implant Sizes and Options: An Experienced Patient’s Advice
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The IDEAL IMPLANT is a new, innovative breast implant option that offers the benefits, without the drawbacks, of both traditional saline and silicone gel implants. Dr. Benjamin Gelfant is a board-certified plastic surgeon in Vancouver, BC,who is part of an exclusive group of surgeons eligible to offer the IDEAL IMPLANT® Structured Breast Implant to their patients. During a recent interview, Dr. Gelfant discussed how he helps women decide between these three breast implant options.
Describe your work experience as a plastic surgeon.
“I started in practice in 1989, shortly before the moratorium silicone gel implants came into place in April of 1992, although I had a brief experience with polyurethane foam covered textured implants in 1990-91. So, from ‘92 until 2006, with very limited exceptions, my practice was exclusively saline filled breast implants and I was one of the first, and certainly the most prominent person, to use transaxillary endoscopic approach to breast augmentation, which became a very big part of my practice success. When silicone gel implants came back onto the market, it was clear that, except with using small implants, transaxillary augmentation was not going to be a viable approach, so I went back to using inframammary incisions for the next few years until the advent of the Keller Funnel.
“I had probably in the range of 1,500-2,000 patients with saline filled implants from the era of 1992 forward. My experience was that women were coming back occasionally for check ups, 5, 10, 12, 13 years after augmentation, with actually excellent results long-term and extremely low rates of capsular contractures, well under 1% and the high rates of complete non-concern.”
How do you help your patients choose between the different types of breast implants?
“My responsibility, as a doctor, is to give patients treatment options, including no treatments, and that’s what I’ve done. I’ve always said to patients, ‘Here’s what you’ve got available to you. Here are the pros and cons of each of them. It’s your choice.’ My role has been to be a learned intermediary, in other words, to learn and to nurture, to have my own experience and to present the patients with the information that they need in order to make an intelligent decision. That seems to work for the kind of patients that I want to have. There’s a large standard practice of, ‘Leave it to me, I’m the doctor; trust me, I’m the doctor.’ That just doesn’t fly with a lot of women. It doesn’t fly in society in general. As we know in many sectors of society, a lot of people have a lot of catching up to do.”
How have your patients responded to the IDEAL IMPLANT?
“When the IDEAL IMPLANT came out in 2014, we figured we would capture almost all of the saline market and maybe a nibble of the last part of the silicone gel market, and that’s really happened. I get a lot of patients who come in here and they look at all the different options and say, ‘I like that one, I like the new one.’ It’s been very favorably received.”
For your patients that choose silicone gel breast implants, what are their main reasons?
“Patients are subject to peer influence and say, ‘My girlfriend got these.’ So there are a significant number of patients that want what their girlfriends have. They come in asking for ‘gummy bear’ implants and they’re confused about that. They think that silicone gel is ‘gummy bear’ and the Gans Marketing term of cohesive gel. Well, they’re all gels. It all comes from the same company in California and is sold to different implant companies. If I see a patient who’s got a generous amount of breast tissue to begin with, yet she’s got a drooping breast, then she has got to have a breast lift. It doesn’t matter what implants she has put in. They’re going to feel fine, as long as they don’t get a contracture. So, I don’t try to convince those patients that saline implants are better. It’s up to them to make a decision. But I make a strong point to them that maybe you don’t want to monitor your implants long-term with either MRI’s or ultrasounds. From there on, it’s up to them.”
How do you help reduce the rate of capsular contracture among your patients?
“I do all my implants under the muscle. I have since 1997. It’s the only effective means that we have of reducing capsular contracture. From the time I went to strictly submuscular, my contracture rate has plunged to less than 1%. I had a bit of a run of contractures in 2017, certainly nothing like what they were subglandular. I changed a little bit in my protocol, and it’s dropped back off again. I think so much goes into the way we go until we get something that doesn’t develop contractures.”
Considering breast implants in Vancouver? Contact Dr. Benjamin Gelfant today to discuss your options. Simply call 604-874-2078 or visit www.drgelfant.com. Dr. Gelfant’s office is located at 1333 West Broadway #100, Vancouver, BC, V6H 4C1 Canada. Call today for more information on IDEAL IMPLANT® Structured Breast Implants.
https://idealimplant.com/wp-content/uploads/2018/10/20180524_Gelfant_HERO.jpg4231200Valerie Christensenhttps://idealimplant.com/wp-content/uploads/2019/01/Copy-of-II_Logo_Straight-Tag-Icon_4C-300x75.pngValerie Christensen2018-10-17 05:00:232020-02-12 23:33:48Is the IDEAL IMPLANT Right For You? Dr. Benjamin Gelfant Helps You Decide
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.
https://idealimplant.com/wp-content/uploads/2018/10/20180612_Creech_HERO.jpg4231200Valerie Christensenhttps://idealimplant.com/wp-content/uploads/2019/01/Copy-of-II_Logo_Straight-Tag-Icon_4C-300x75.pngValerie Christensen2018-10-16 05:00:312020-02-12 23:33:48A Plastic Surgeon’s Perspective On Breast Augmentation
IMPORTANT NOTE: Below you may find untouched before and after photos of patients who have granted permission to their surgeon to show them anonymously. While we protect the identities of our patients, please be advised that by their nature, these photos contain sensitive content.Read more
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At Plastic Surgery Center of Hampton Roads, you’ll find board-certified plastic surgeon Dr. Michael Lofgren to be professional, experienced, and compassionate. A New York native, Dr. Lofgren has been in the Virginia area for over 20 years. He specializes in cosmetic surgery, focusing primarily on breast and bodywork. In a recent interview, he spoke with us about his breast augmentation process, silent rupture, and the new IDEAL IMPLANT® Structured Breast Implants.
Why should patients choose your practice over others in the area?
“When a person is looking for a practice to go to and they’re considering having any type of breast surgery done, I think it’s important to make sure that they go to an accredited facility. They should look for plastic surgeons that are board certified. They should also be sure that the practice they’re looking into has a wide variety of experiences in dealing with the specific type of surgery they’re seeking. We’re fortunate in our practice that we have a quad-ASF certified facility. All of our surgeons are board certified and we do extensive breast and bodywork here.”
How do you guide women through the breast augmentation process?
“When we have a patient first come to us considering breast augmentation, we try to break down all the components that are important in making that decision. The first is, how are we going to place the implant? Where will the incision be? There’s a wide variety of ways to do that. We can make inframammary incisions, where we place the incisions underneath the breast, we can go with a transaxillary incision in the armpit, or we can make an incision around the areola or even through the belly button. Secondly, we look at exactly where we are going to place the implant. We decide if it’s going to be under just the breast tissue itself, or actually under the muscle, which is more common these days.
“We also look at the type of implant that’s going to be used for the breast augmentation. We used to be quite limited in that, with a traditional saline implant or a silicone gel implant as the only options, but thankfully now we have the IDEAL IMPLANT that offers a lot of tremendous advantages. Finally, we’ll talk about the overall size and type of look that the patient’s going for. That’s where we really get involved with the patient and help them determine what is going to fit their body the best and get them the results that they really desire.”
In your years of practice, have you noticed any trends over time in terms of breast implant size?
“In breast augmentation surgery, I think a lot of it is regionally dependent. I’m originally from the Northeast, where I tended to see much smaller breast augmentations, much more of a natural look. I did my training in Miami, Florida, and down there the overall size was a bit bigger than we see on a daily basis. And then here in the Mid-Atlantic, I think we fall somewhere right in the middle. Most women want an average size in the upper 300s to low 400 range, and I think that size still gives a very nice, more natural look.”
How did you hear about the IDEAL IMPLANT and when did you start using it in your practice?
“We had the opportunity to learn about the IDEAL IMPLANT very early. We started to hear rumors about the implant soon after it was developed, and we actually sought out the implant and did some research to find out more about it. Very quickly we saw the advantages of it, and we contacted the company. They had one of their sales reps come to us and spend some time with us, and so we’ve been offering the IDEAL IMPLANT as an option to our patients for a few years. It’s worked out tremendously for us.”
What are the advantages of the IDEAL IMPLANT to both the patient and the surgeon?
“The first advantage is the feel of the implant. Its overall feel is much improved compared to a traditional saline implant. I think that also translates into the appearance of the implant in the body. You see much less rippling, and you get a much more natural feel. I think the higher fill volume that’s achievable with the IDEAL IMPLANT also gives women a much nicer, fuller appearance. And then most importantly, when women select a structured saline implant over a silicone gel implant, it alleviates a lot of the fears they have about the risks of silent rupture, and having to perform routine monitoring of the implants and eventual replacement or removal.”
Are your patients satisfied with the IDEAL IMPLANT?
“When it comes to our satisfaction rates with IDEAL IMPLANT, I think it’s well above what our normal satisfaction rates are with other implants. I’ve found personally in my practice that I have much fewer women who complain about either visible or palpable rippling of the IDEAL IMPLANT. Years after women have breast augmentation surgery, they don’t have to worry about checking the implants or deal with the hassle of obtaining MRIs. That just makes for a more happy, satisfied patient in general.”
Complications are inherent to any surgery and breast surgeries have their sets. What has been your experience in complications with the IDEAL IMPLANT?
“When it comes to complication rates and the IDEAL IMPLANT specifically, in my practice I’ve seen a significant decrease in the rates of capsular contracture. As far as rupture is concerned, I think it’s also less than our traditional saline implants that we had used previously. And when compared to silicone gel implants such as the gummy bears or the anatomically shaped implants, we don’t run into the problems with malposition and shape issues that we had with those implants. Overall, I think the IDEAL IMPLANT has the least complications out of any of the implants that we currently use today.”
How do you educate your patients about the realities of silent rupture?
“When it comes to silent rupture in breast implants, I think that a lot of women are inherently concerned about it. Here at the practice we have a typical cohesive silicone gel implant that we’ve intentionally ruptured that we keep in a plastic bag to show patients what it’s going to look like in their body if their implant has a silent rupture. And honestly, even though it’s a cohesive silicone gel implant, it’s still just a gooey mess! People are absolutely amazed that that would be in their body. With the rates of silent rupture in silicone gel implants as high as they are, (and in my own practice I was quite surprised to find that there’s more silent ruptures than even I had suspected), the IDEAL IMPLANT is a great option for patients to alleviate that fear.”
What is it like to clean up a silent rupture?
“It depends on the generation of the implant. There are several different generations of silicone gel implants. Some have a more cohesive gel than others. I’ve found personally that when I have to go in and remove an early generation silicone gel implant, (or a non-cohesive gel implant), the tissue reaction can be profound. Cleaning out one of those pockets often requires complete capsulectomies. Quite extensive surgery. When it comes to the later generation silicone gel implants, even though they are a cohesive gel and the majority of the implant stays together, there is still significant leakage within the pocket that does require significant work to remove it, just not quite as much as the earlier implants.”
What is surgery like if an IDEAL IMPLANT ruptures?
“In the event of a rupture with IDEAL IMPLANT, it has several advantages over older silicone gel implants. The ability to detect the rupture is much easier. It’s just a simple change in shape or overall fullness of the breast, and you know quite readily that that implant has a problem with the shell. And as far as repairing it or managing that issue, it’s extremely easy. It’s just a simple 20 minute surgery to basically go in, remove the shell, place a new implant, refill it and close the incision. It’s much less invasive, much faster recovery, and much less of a headache compared to a traditional silicone gel implant.”
Are more women asking about IDEAL IMPLANT than just a few years ago?
“In my practice here, we’re very excited to have the IDEAL IMPLANT as an option for our patients. I think we’re truly at the cusp of seeing it absolutely explode as far as popularity is concerned. People are starting to come in asking for it by name. When women understand the inherent benefits of it and the decreased risks, the decreased rupture rates, the decreased risks of capsular contracture, and just the overall peace of mind, the implant really speaks for itself. I think we’re really at the very early stages of that. I know in my personal business, I’ve gone from doing 80% silicone gel implants now to doing about 35% silicone gel implants with almost all of that being a change into the IDEAL IMPLANT market.”
No other breast implant company besides Ideal Implant Incorporated can manufacture or sell the IDEAL IMPLANT. What has been your experience working with them?
“In looking at the company overall, they’re incredibly responsive to the individual surgeons and their patients. They’ve been very receptive to ideas as far as improving the implant and making adjustments to things. Just as an example, the enhancement of the warranty that’s now available with the implant is tremendous. We’ve actually gone so far as to package that as part of our normal breast augmentation package. It gives women an added reason to really trust in their product, something that’s going to be in their body for many years and it gives them that extra little bit of satisfaction and peace of mind.”
Any other thoughts about the IDEAL IMPLANT?
“The IDEAL IMPLANT is fantastic. Once I express to my patients the different characteristics of the implant and the natural advantages that it has over some of the other implants, women just naturally recognize it as the great choice that it is. I don’t think that there’s anything specific about the other implants that necessarily make them bad, it’s just that the advantages of the IDEAL IMPLANT are really head and shoulders above some of the other choices that are available.”
Considering Virginia breast implants? Contact Dr. Lofgren today to discuss your options. Simply call 757-873-3500 or visit www.PSCHR.com. Dr. Lofgren’s office is located at 895 City Center Boulevard Suite 300 Newport News, VA 23606. Call today for more information on IDEAL IMPLANT® Structured Breast Implants.
https://idealimplant.com/wp-content/uploads/2018/10/20181016_Lofgren_Virginia-breast-implant_FB.jpg6281200Valerie Christensenhttps://idealimplant.com/wp-content/uploads/2019/01/Copy-of-II_Logo_Straight-Tag-Icon_4C-300x75.pngValerie Christensen2018-10-11 05:00:192020-02-12 23:33:48Virginia Breast Implants: Why Dr. Michael Lofgren Says, “The IDEAL IMPLANT® is Fantastic”
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.
https://idealimplant.com/wp-content/uploads/2018/10/20180612_Weinstein_HERO.jpg4231200Valerie Christensenhttps://idealimplant.com/wp-content/uploads/2019/01/Copy-of-II_Logo_Straight-Tag-Icon_4C-300x75.pngValerie Christensen2018-10-10 05:00:102020-02-12 23:33:48An Interview with New Jersey Plastic Surgeon Dr. Larry Weinstein
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.
https://idealimplant.com/wp-content/uploads/2018/10/20180614_Horowitz_HERO.jpg6281200Valerie Christensenhttps://idealimplant.com/wp-content/uploads/2019/01/Copy-of-II_Logo_Straight-Tag-Icon_4C-300x75.pngValerie Christensen2018-10-09 05:00:292020-02-12 23:33:48Your Breast Surgery Questions Answered by Dr. Jed Horowitz