(800) LV NEW ME
Find Your New Me Through Our Hand Picked TOP Cosmetic Surgeons!!!
"Thanks to (800) LV NEW ME, I now LOVE my NEW ME!!"
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Guaranteed Lowest Prices & Most Qualified Surgeons!*
25% OFF of ALL Procedures UNTIL 12/25/2012


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Breast Implants From $2950.00 To $4950.00**
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"Helping You Find Your New Me!!"



Find one of the greatest Cosmetic Surgeons or Aesthetic Physicians in your area fast! Being sent from one Cosmetic Surgeon or Aesthetic Physician to the next in search of the best treatment can be a waste of time and money, not to mention all the risks!

Nothing is more important than your health, and nobody should have to find a Cosmetic Surgeon or Aesthetic Physician through trial and error. That's why New Me® hand-picks and brings some of the best, most talented  Cosmetic Surgeons and Aesthetic Physicians to you and even the telephone call & consultations are FREE! You have absolutely nothing to lose and everything to gain! Just a NEW YOU for the absolute lowest possible prices...A PERFECT VALUE!

We are absolutely confident that our affiliated  Cosmetic Surgeons and Aesthetic Physicians are among the best and they will  offer those referred to them by New Me® some of the best prices. We should know, because over the last two decades we have been able to identify what makes physicians and surgeons the best at what they do. Our founder has been a renowned cosmetic plastic surgeon mostly in Beverly Hills, California for almost two decades. Through  (800) LV NEW ME® , which is a surgical talent and quality identification and marketing firm, he has now focused his attention towards identifying, locating and bringing some of the greatest talents in the medical and surgical cosmetic aesthetic fields to you. Have a consultation for yourself and you ultimately can be the judge.



So, if you are considering any cosmetic surgery procedures, including but not limited to Hair Transplantation, Facial Cosmetic Plastic Surgery, Nose Refinement Surgery (Rhinoplasty), Breast Cosmetic Surgery (including but limited to Breast Augmentation, Breast Lift (Mastopexy), Tummy Tuck (Abdominoplasty), Liposuction, Skin Cosmetic Procedures, BOTOX, fillers, laser treatments, or any other Cosmetic Surgery, or to set up a consultation call to schedule your complementary consultation and to receive the most competitive quotes for your desired surgeries at a New Me affiliated office near you. Your information will remain strictly confidential.

Whether you live in Los Angeles, Pasadena, Beverly Hills, Santa Monica, Glendale or any area within Southern California, we have some of the best cosmetic surgeons for you to call on. By simply calling  1-800-LV New Me  (( 1-800-586-3963 )) you can be directed to the surgeon of your choice in your area...Call Now!


                     1-800-LV-NEW ME

To find the New Me Cosmetic Surgeon or Aesthetic Physician near you, just call toll FREE (800) LV NEW ME (800) 586-3963 or email us at:


                                          info@800LVNEWME.com


 


Contact Information

IIf you are interested in having one of our professional consultants contact you in order to discuss your particular needs and to schedule an absolutely FREE confidential consultation with one of our exceptionally talented surgeons, please complete the form below and press the SUBMIT button now!

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The Premiere Cosmetic Surgeon & Aesthetic Physician Referral Network for a New YOU!





"Thanks to (800) LV NEW ME, I now Love my NEW ME!"
                                                                __ Jennifer S.


                         NEW ME








model
To find the New Me cosmetic surgeon near you, just call (800) LV NEW ME now!


               (800) 586-3963





Email:  

   info@800LVNEWME.com
Contact Information

If you are interested in having one of our professional consultants contact you in order to discuss your particular needs and to schedule an absolutely FREE confidentail consultation with one of our exceptionally talented surgeons, please complete the form below and press the SUBMIT button now!

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NEW ME on the Media

You can have confidence in New Me as over the last sixteen years, New Me has been referenced on: 

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CAN YOU KEEP YOUR INCOME?

 

 

 

Most likely NOT unless you do something more than what you are already doing! I promise you that your future is at risk! Your money ultimately depends on it! The days that appearances did not matter and natural was perfect enough are long gone. Today, good looking women and men are without a question more likely to succeed in life than the rest. Especially those who exude vigor, youth, confidence and energy! We compete with them all the time! To compete and win we’ve got to be one of them or even more so! Deny this reality and you will come to blame yourself later! I promise you that your future depends on your looks! You don’t agree with me? Then read on!!




                                                  


 








Isn’t our life just a series of meetings and events, one after another? Whether we are interviewing for a job, making a presentation or meeting others for the first time, we are judged by our looks. It is our appearance that is the determinant of our first impression on the others.

Our appearance leads to the first impression we leave others with and that is the beginning of our success or failure in any aspect of our life; professionally, financially and even in our personal life. Our look makes a whole lot of difference in the type of impression we create in the other person. Before they know who we really are inside, they see our looks! Just as in a book, today, people judge us by our covers first! Our looks and our overall appearance is who we are! That makes the difference between being given a second chance to show our true self to others and being accepted by them or being passed over and rejected by the world! Life is hard enough as it is, why make it any harder for ourselves?




This is the way life is now, in the professional environment of work, and in personal, social scene. We all do this in our own life!  We assess others we meet for the first time, first through their appearance and then we make a judgment about them. That becomes our first impression of them and that will determine how and if we proceed with a relationship with them or not, personal or otherwise! That is true even if we try our best not to fall in that trap, at least to some degree we all have been guilty of this, haven’t we? Let’s be honest, isn’t this true?

From our hair on our scalp, to our brows, our lashes all the way to the shape of our nose, our facial appearance, the health condition and appearance of our skin to the shape of our body and our figures, each and every aspect of our appearance matters these days more than ever before!

We most likely are not where we need to be in our appearance! Not all of us were born perfect! We all need something improved and we do have some good features. And then again, we still have to maintain what we do have that’s good! We all have areas of imperfection that could use a bit of help, even if we are doing our best with diet and exercise. That is where 1-800-LV-NEW ME comes in.





To find the New Me cosmetic surgeon near you, just call (800) LV NEW ME now!


               (800) 586-3963

 Email:   info@800LVNEWME.com










Contact Information

If you are interested in having one of our professional consultants contact you in order to discuss your particular and to schedule an absolutely FREE confidential consultation with one of our exceptionally talented surgeons, please complete the form below and press the SUBMIT button now!

First Name:
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1-800-LV-NEW ME with 20 years of experience has located and recruited some of the best and most talented cosmetic surgery & aesthetic medicine professionals in the world for you and has also negotiated steep discounts. The Call is FREE and so is the CONSULTATION FREE.

 

Once you are considering any cosmetic surgery procedures, including but not limited to Hair Transplantation, Facial Cosmetic Plastic Surgery, Nose Refinement Surgery (Rhinoplasty), Breast Cosmetic Surgery (including but limited to Breast Augmentation, Breast Lift (Mastopexy), Tummy Tuck (Abdominoplasty), Liposuction, Skin Cosmetic Procedures, BOTOX, fillers, laser treatments, or any other Cosmetic Surgery, or to set up a consultation call to schedule your complementary consultation and to receive the most competitive quotes for your desired surgeries at a New Me affiliated office near you. Your information will remain strictly confidential.

Find a doctor in your area fast! Being sent from one doctor to the next in search of the best treatment can be a waste of time and money.

Nothing is more important than your health, and nobody should have to find a doctor through trial and error. That's why New Me® brings these great doctors to you!



(800) LV NEW ME

 



NEW ME

"Thanks to  (800) LV NEW ME , I now Love my NEW ME!” __ Jennifer S.

The Premiere Cosmetic Surgeon & Aesthetic Physician Referral Network for a New YOU!

* 1800LVNEWME assumes no responsibility towards the final outcome of any procedures performed or the price of any procedure quoted or performed. Obviously there are risks in any procedure performed and you must discuss these risks with your chosen professional. Guarantee is limited to the price of parking expense for the consultation at the most. You are entitled to a FREE CONSULTATION in order to personally determine the qualification and competitiveness of the price quote you receive for your particular surgery. 1-800-LV NEW ME assumes absolutely no liability nor responsibility for the results or price of the procedures you desire.

** The ultimate price of a procedure will differ from patient to patient depending on the needs of each patient. The Surgeons are the only ones who will ultimately determine what the particular patient's needs are and what the cost of the particular procedure would be. There are no fixed set prices for any procedures. $2950-$4850 are only general ranges and it would be varied based on the number of implant surgeries the individual may have had, if the existing implants are still under warranty by the manufacturer or not as well as many other factors. other fees including but not limited to Anesthesia fee, garments, other particular needs of each patient. Consultations for cosmetic surgery of the NEW ME affiliates are FREE of charge in order for you to be able to determine the actual cost of your procedure and decide if it is right for your budget.

***All images on this website are of models, except the before and after photographs that are of actual patients of various physicians affiliated with 1-800-LV NEW ME network. results may vary and cannot be guaranteed.

****

Shain A. Cuber, MD

•New York, New York
•Allure Plastic Surgery Center
 
Cosmetic Surgery, Ear, Nose and Throat, Facial Plastic Surgery, Minimally Invasive Surgery (BOTOX®), Ophthalmology: Oculoplastics, Plastic Surgery
Dr. Cuber is board certified by both the American Board of Plastic Surgery and is licensed in both New Jersey and New York.
 • Shain A. Cuber, MD
Allure Plastic Surgery Center
•Location: 345 E 37th St Ste 209 New York, NY 10016


Anthony P. DiBiase, M.D

•New York, New York
•Bosley Medical - Hair Transplants for Hair Loss

P: 888-656-4247 3Hair Restoration (Replacement)

Dr. Matt Levitt at Bosley Medical - Orlando has the credentials that will put you at ease in choosing a highly trained and experienced medical doctor for your hair restoration procedure.

 

Most Popular Procedures: Female-Pattern Baldness, Follicular Unit Extraction, Hair Transplant (Restoration), Hair Transplants (Eyebrow), Hair Transplants (Scalp), Micro Follicular Unit Transplantation

 

••Anthony P. DiBiase, M.D
Bosley Medical - Hair Transplants for Hair Loss
•Location: 99 Park Avenue 20th Floor New York, NY 10016
•Phone:  888-656-4247

•Top Procedures:◦Female-Pattern Baldness
◦Follicular Unit Extraction
◦Hair Transplant (Restoration)
◦Hair Transplants (Eyebrow)
◦Hair Transplants (Scalp)
◦Micro Follicular Unit Transplantation

 


Bosley Medical Doctors

•New York, New York
•Bosley Medical - Hair Transplants for Hair Loss

P: 888-656-4247  Hair Restoration (Replacement)

Discover the Bosley Difference Today! Contact us at  888-656-4247  to request a Free Information Kit or No-Obligation Consultation.

Most Popular Procedures: Follicular Unit Extraction, Hair Transplant (Restoration), Hair Transplants (Eyebrow), Propecia

••Bosley Medical Doctors
Bosley Medical - Hair Transplants for Hair Loss
•Location: 99 Park AVENUE 20th Floor New York, NY 10016
•Phone:  888-656-4247

•Top Procedures:◦Follicular Unit Extraction
◦Hair Transplant (Restoration)
◦Hair Transplants (Eyebrow)
◦Propecia

•Languages Spoken:◦Chinese
◦English
◦Japanese
◦Malay
◦Mandarin
◦Spanish
◦Tamil

 


Kenneth R. Francis, M.D.

•New York, New York
•Francis New York Plastic Surgery, PC

Cosmetic Surgery, Facial Plastic Surgery, Minimally Invasive Surgery (BOTOX®), Plastic Surgery

You will first experience Dr. Francis's warmth and expertise as you enter the office, a beautiful location just off Park Avenue. The location and design offer a serene and very private experience. Our outpatient operating suite is a state of the art surgery center.

 

Most Popular Procedures: Brazilian Butt Lift, Breast Augmentation (Breast Implants), Breast Augmentation (Silicone Gel Implants), Buttocks Augmentation (Fat Injections), Tummy Tuck (Abdominoplasty)

••Kenneth R. Francis, M.D.
Francis New York Plastic Surgery, PC
•Location: 114 E 71st St Ste 1W New York, NY 10021


•Top Procedures:◦Brazilian Butt Lift
◦Breast Augmentation (Breast Implants)
◦Breast Augmentation (Silicone Gel Implants)
◦Buttocks Augmentation (Fat Injections)
◦Tummy Tuck (Abdominoplasty)

•Languages Spoken:◦English
◦Spanish
◦Tagalog
◦Yugoslavian

•Experience: 14 years

 


John D. Gartner, Ph.D.

•New York, New York
•John D. Gartner, Ph.D.

Psychology

 

Dr. John D. Gartner has been practicing psychotherapy and teaching psychiatrists at Johns Hopkins University Medical School for over 20 years. His two areas of specialization are Borderline Personality Disorder (BPD) and Bipolar Disorder, though he treats more common ailments such as depression and anxiety as well in a general psychotherapy.

Most Popular Procedures: Bipolar Disorder, Borderline Personality Disorder (BPD), Depression, Psychological Assessment

••John D. Gartner, Ph.D.
John D. Gartner, Ph.D.
•Location: 31 W 10th St New York, NY 10011


•Top Procedures:◦Bipolar Disorder
◦Borderline Personality Disorder (BPD)
◦Depression
◦Psychological Assessment

•Languages Spoken:◦English

 

 

 

 


Elliot M. Heller, MD

•New York, New York
•Allure Plastic Surgery Center

 Cosmetic Surgery, Ear, Nose and Throat, Facial Plastic Surgery, Minimally Invasive Surgery (BOTOX®), Ophthalmology: Oculoplastics, Plastic Surgery, Vein Treatment

Dr. Elliot Heller is certified by the American Academy of Aesthetic and Restorative Surgery , the American Society for Liposuction Surgery, and the American College of Surgeons

Most Popular Procedures: Breast Augmentation (Breast Implants), Buttocks Augmentation (Butt Implants), Liposuction Surgery (Lipoplasty), Nose Job (Rhinoplasty), Tummy Tuck (Abdominoplasty)

 

 

 


Beth Aviva Preminger, MD

•New York, New York
•Laser & Cosmetic Surgery Specialists, PC

Cosmetic Surgery, Plastic Surgery

Dr. Preminger is a Board Certified, Ivy League educated plastic surgeon with an expertise in a wide range of cosmetic and reconstructive procedures. She focuses on the individual patient and cares to tailor the patient encounter to each patient’s unique needs.

Most Popular Procedures: Breast Augmentation (Breast Implants), Liposuction Surgery (Lipoplasty), Lower Body Lift, Mommy Makeover, Tummy Tuck (Abdominoplasty)
••Beth Aviva Preminger, MD
Laser & Cosmetic Surgery Specialists, PC
•Location: 325 E 79th St New York, NY 10075
•Click here for phone number

•Top Procedures:◦Breast Augmentation (Breast Implants)
◦Liposuction Surgery (Lipoplasty)
◦Lower Body Lift
◦Mommy Makeover
◦Tummy Tuck (Abdominoplasty)

 

 

 

 


Robert Rho, M.D., F.A.A.C.S.

•New York, New York
•Aesthetix Laser Medical Spa and the Labiaplasty Master Surgery Center of New York

 Cosmetic Dermatology, Cosmetic Surgery, Facial Plastic Surgery, Medical Spas & Medspas, Minimally Invasive Surgery (BOTOX®), Vein Treatment

Dr. Robert Rho is a board-certified physician and a cosmetic surgeon who has been expertly performing cosmetic surgery for over 18 years. Dr. Rho treats both women and men for cosmetic medical and surgical services.

 

 

 

 

 

 

Most Popular Procedures: Breast Augmentation (Breast Implants), Labiaplasty, Laser Lipo, Tummy Tuck (Abdominoplasty), Vaginoplasty

••Robert Rho, M.D., F.A.A.C.S.
Aesthetix Laser Medical Spa and the Labiaplasty Master Surgery Center of New York
•Location: 37-01 Main St Ste 502 New York, NY 11354


•Top Procedures:◦Breast Augmentation (Breast Implants)
◦Labiaplasty
◦Laser Lipo
◦Tummy Tuck (Abdominoplasty)
◦Vaginoplasty

•Languages Spoken:◦Bosnian
◦Chinese
◦English
◦Hindi
◦Korean
◦Spanish

•Experience: 16 years

 

 

 

 


William Rosenblatt, MD

•New York, New York
•Lenox Hill Plastic Surgery Center

P: 888-499-3243  Anti-Aging, Cosmetic Surgery, Facial Plastic Surgery, Minimally Invasive Surgery (BOTOX®), Ophthalmology: Oculoplastics, Plastic Surgery, Vein Treatment

William Rosenblatt M.D. is a board certified plastic surgeon who specializes in cosmetic surgery. He is also double-board certified in otolaryngology. He practices in New York City and operates out of his own fully-equipped AAAASF certified surgicenter, as well as Lenox Hill Hospital in Manhattan.

 

 

 

 

 

Most Popular Procedures: Face Lift Surgery (Rhytidectomy), Neck Lift, Nose Job (Rhinoplasty), Tummy Tuck (Abdominoplasty)

••William Rosenblatt, MD
Lenox Hill Plastic Surgery Center
•Location: 308 E 79th St New York, NY 10075
•Phone:  888-499-3243

•Top Procedures:◦Face Lift Surgery (Rhytidectomy)
◦Neck Lift
◦Nose Job (Rhinoplasty)
◦Tummy Tuck (Abdominoplasty)


•Experience: 27 years

 

 

 

 


Ayman Shahine, MD, FACS, FACOG, FICS, MACS, FISCG

•New York, New York
•Ayman Shahine, MD, FACS, FACOG, FICS

5Cosmetic Surgery, Facial Plastic Surgery, Minimally Invasive Surgery (BOTOX®), Ophthalmology: Oculoplastics

Dr. Ayman A. Shahine has developed a reputation as a leader in plastic surgery, and we pride ourselves on a strong record of customer satisfaction. From laser hair removal to liposuction, we offer a wide array of surgical options, and we use only the most modern methods and technology in our procedures. During an initial consultation, we will go over all your options and explain every phase of the process to help you decide on the best option and establish a set of realistic expectations.

 

 

 

 

Most Popular Procedures: Breast Augmentation (Breast Implants), Liposuction Surgery (Lipoplasty), Nose Job (Rhinoplasty), Tummy Tuck (Abdominoplasty)

••Ayman Shahine, MD, FACS, FACOG, FICS, MACS, FISCG
Ayman Shahine, MD, FACS, FACOG, FICS
•Location: 1 W 34 St Ste. 402 New York, NY 10001


•Top Procedures:◦Breast Augmentation (Breast Implants)
◦Liposuction Surgery (Lipoplasty)
◦Nose Job (Rhinoplasty)
◦Tummy Tuck (Abdominoplasty)

•Languages Spoken:◦Arabic
◦English
◦Filippino
◦Spanish


 

 

 

 


Ken Washenik, M.D., Ph.D., Med. Dir - Beverly Hills & New York

•New York, New York
•Bosley Medical - Hair Transplants for Hair Loss

P: 888-656-4247 Hair Restoration (Replacement)

Bosley physicians are recognized for their ability to create extremely natural looking results for our patients. In fact, it is this attention to artistry that we consider to be a hallmark of the Bosley name. To achieve the most realistic results, Bosley physicians evaluate several factors during your consultation to design a specific hair restoration plan for you, including: age, facial structure, existing hairline, angles and directions or hair growth, quality of hair (texture, and color), size & shape of grafts and long term goals.

••Ken Washenik, M.D., Ph.D., Med. Dir - Beverly Hills & New York
Bosley Medical - Hair Transplants for Hair Loss
•Location: 99 Park Avenue 20th Floor New York, NY 10016
•Phone:  888-656-4247


Podiatry



Adler Footcare of Greater New York: Dr. Jeffrey Adler, DPM

•New York, New York

•P:  212-256-9803

••Adler Footcare of Greater New York: Dr. Jeffrey Adler, DPM
•Location: 25 W 45th St New York, NY 10036
•Phone:  212-256-9803

 

 

 


Javier Davila, MD

•New Haven, Connecticut
•Esana Plastic Surgery Center and Medspa - Javier Davila, MD

Cosmetic Surgery, Facial Plastic Surgery, Medical Spas & Medspas, Minimally Invasive Surgery (BOTOX®), Plastic Surgery

Dr. Javier Davila is a Yale trained plastic surgeon with a colorful background that allows him to bring a world view of aesthetic surgery into his practice. In addition to skilled hands and refined technique, his patients benefit from his keen eye for cosmetic balance.

Schedule a consultation today!

Most Popular Procedures: Arm Lifts (Brachioplasty), Breast Augmentation (Breast Implants), Buttocks Augmentation (Butt Implants), Liposculpture (Liposuction Surgery), Tummy Tuck (Abdominoplasty)

••Javier Davila, MD
Esana Plastic Surgery Center and Medspa - Javier Davila, MD
•Location: 1 Audubon St Ste 201 New Haven, CT 06511


•Top Procedures:◦Arm Lifts (Brachioplasty)
◦Breast Augmentation (Breast Implants)
◦Buttocks Augmentation (Butt Implants)
◦Liposculpture (Liposuction Surgery)
◦Tummy Tuck (Abdominoplasty)

•Languages Spoken:◦English
◦Spanish

 


Lighthouse Dental Care

•Stratford, Connecticut
•Lighthouse Dental Care

P: 888-861-1241 Cosmetic Dentistry, Dentistry, Implant Dentistry, Orthodontics (Dentistry)

"Lighthouse Dental Care - State-of-the-art, lifetime dental excellence!"

Dr. Mark Samuels is part of a 51-year Stratford tradition of dental comfort and care that began in 1954 with his father, Norman Samuels, DDS. Dr. Mark Samuels is a 1985 graducate of the University of Pennsylvania School of Dental Medicine and has dedicated his professional career to providing you with the best that dentistry has to offer.

Most Popular Procedures: Cosmetic and Restorative Dentistry, Dental Veneers, Sedation Dentistry, Tooth Whitening, Zoom!™ Whitening

••Lighthouse Dental Care
Lighthouse Dental Care
•Location: 88 Ryders Ln Stratford, CT 06614
•Phone:  888-861-1241

•Top Procedures:◦Cosmetic and Restorative Dentistry
◦Dental Veneers
◦Sedation Dentistry
◦Tooth Whitening
◦Zoom!™ Whitening

 

 

 

 


Mark DiStefano, M.D.

•Rocky Hill, Connecticut
•DiStefano Hair Restoration Center

Hair Restoration (Replacement)

At The DiStefano Hair Restoration Center, Experience Counts For Everything. The DiStefano Hair Restoration Center was founded in 1994 by Dr. Mark DiStefano and is considered to be among the most advanced and experienced hair transplant providers in New England.

Most Popular Procedures: Follicular Unit Extraction, Hair Transplant (Restoration), Hair Transplants (Eyebrow), Hair Transplants (Scalp), Micro Follicular Unit Transplantation

 

 


Jeffrey D. Gold, M.D.

•Hamden, Connecticut
•Liberty Vision / Laser Body Solutions

 Anti-Aging, Cosmetic Surgery, Minimally Invasive Surgery (BOTOX®)

LIBERTY VISION, founded by Jeffrey D. Gold, MD in 2003 and located in Hamden, Connecticut, where we offer safe and effective CustomVue Epi-LASIK (the only true non-cutting Laser Vision Correction procedure) using the VISX Star S4 Excimer Laser with Iris Registration, and Custom MonoVision. Dr. Gold has done over 10,000 Laser Vision procedures with very few minor complications.

Most Popular Procedures: BOTOX® Injections Treatment, PhotoFacials, Skin Management, Wrinkle Relief, Zerona™

••Jeffrey D. Gold, M.D.
Liberty Vision / Laser Body Solutions
•Location: 2440 Whitney Ave Hamden, CT 06518

•Top Procedures:◦BOTOX® Injections Treatment
◦PhotoFacials
◦Skin Management
◦Wrinkle Relief
◦Zerona™


•Experience: 30 years

 


Leon Goldstein, MD

•Madison, Connecticut
•Coastal Plastic Surgery

 Cosmetic Surgery, Facial Plastic Surgery, Minimally Invasive Surgery (BOTOX®), Plastic Surgery

Dr. Leon Goldstein is certified by the American Board of Plastic Surgery since 1987. He is a member of the American Society of Plastic Surgery and a Yale Graduate. He has two locations: Providence RI and Madison CT.

 

Most Popular Procedures: Breast Augmentation (Saline Implants), Breast Augmentation (Silicone Gel Implants), Breast Lift Surgery, Liposculpture (Liposuction Surgery), Tummy Tuck (Abdominoplasty)

 


Finger & Associates Plastic Surgery Center

◦Statesboro, Georgia
◦Finger & Associates Plastic Surgery Center

 Cosmetic Surgery, Facial Plastic Surgery, Minimally Invasive Surgery (BOTOX®), Plastic Surgery

Conveniently located in Savannah, Georgia, Finger & Associates Plastic Surgery Center was founded by plastic surgeon E. Ronald Finger, MD, in 1973 and has become a premier destination for plastic surgery in the Savannah area.

Most Popular Procedures: Breast Augmentation (Breast Implants), Breast Lift Surgery, Breast Reconstruction Surgery, Breast Reduction Surgery, Leg Lift

•◦Finger & Associates Plastic Surgery Center
Finger & Associates Plastic Surgery Center
◦Location: 221 South Zetterower Avenue Statesboro, GA 30458
◦Top Procedures:
■Breast Augmentation (Breast Implants)
■Breast Lift Surgery
■Breast Reconstruction Surgery
■Breast Reduction Surgery
■Leg Lift

 

 


Michael R. Huntly, MD

◦Statesboro, Georgia
◦Finger & Associates Plastic Surgery Center

Cosmetic Surgery, Facial Plastic Surgery, Minimally Invasive Surgery (BOTOX®), Plastic Surgery

Dr. Michael Huntly joined Finger & Associates in 1998 in Savannah, Georgia. He continues with a diverse cosmetic and reconstructive plastic surgery practice with particular interest in the latest techniques in facial cosmetic surgery, breast and body contouring surgery, including reconstruction surgery following major weight loss and bariatric surgery. He also maintains an interest in hand surgery and cancer reconstruction.

Most Popular Procedures: Breast Augmentation (Breast Implants), Breast Lift Surgery, Breast Reconstruction Surgery, Breast Reduction Surgery, Leg Lift

•◦Michael R. Huntly, MD
Finger & Associates Plastic Surgery Center
◦Location: 221 S Zetterower Ave Statesboro, GA 30458
◦Top Procedures:

■Breast Augmentation (Breast Implants)
■Breast Lift Surgery
■Breast Reconstruction Surgery
■Breast Reduction Surgery
■Leg Lift



Cosmetic Surgery, Facial Plastic Surgery, Minimally Invasive Surgery (BOTOX®), Plastic Surgery



Joel L Shanklin

◦Statesboro, Georgia

◦Coastal Empire Plastic Surgery

 

 

Most Popular Procedures: Breast Augmentation (Breast Implants)
Leon Goldstein, MD
Coastal Plastic Surgery
•Location: 141 Durham Rd Ste 23 Madison, CT 06443


•Top Procedures:◦Breast Augmentation (Saline Implants)
◦Breast Augmentation (Silicone Gel Implants)
◦Breast Lift Surgery
◦Liposculpture (Liposuction Surgery)
◦Tummy Tuck (Abdominoplasty)

•Languages Spoken:◦English
◦Polish


•Financing:◦SurgeryFinancing

 


Robert Colin Langdon, M.D.

•Guilford, Connecticut
•The Langdon Center for Laser & Cosmetic Surgery

P: 877-915-3286  Cosmetic Dermatology, Cosmetic Surgery, Dermatology, Minimally Invasive Surgery (BOTOX®), Vein Treatment

Robert Langdon, MD is a dermatologic surgeon who is at the forefront of cosmetic surgery. He is an innovator of improved cosmetic surgical methods and frequently shares his techniques with fellow surgeons at national and international medical meetings. Dr. Langdon has trained under several prominent plastic surgeons over the past 10 years, including Dr. Steven Hopping (Washington, DC), Dr. Ziya Saylan (Germany), and Dr. Nicanor Isse (Burbank, CA).

Most Popular Procedures: Brow Lift (Forehead Lift), Chin Augmentation (Implants), Eyelid Lift Surgery (Blepharoplasty), Face Lift Surgery (Rhytidectomy), Laser Skin Resurfacing

••Robert Colin Langdon, M.D.
The Langdon Center for Laser & Cosmetic Surgery
•Location: 5 Durham Rd Guilford, CT 06437
•Phone:  877-915-3286

•Top Procedures:◦Brow Lift (Forehead Lift)
◦Chin Augmentation (Implants)
◦Eyelid Lift Surgery (Blepharoplasty)
◦Face Lift Surgery (Rhytidectomy)
◦Laser Skin Resurfacing

 


Deborah Pan, MD, LLC.

•New Haven, Connecticut
•Esana Plastic Surgery Center and Medspa - Deborah Pan, MD

1Cosmetic Surgery, Facial Plastic Surgery, Medical Spas & Medspas, Minimally Invasive Surgery (BOTOX®), Plastic Surgery, Vein Treatment

ESANA Plastic Surgery Center and MedSpa was founded in 2006 by Dr. Deborah Pan. After building a successful Plastic and Reconstructive Surgery practice in New Haven, CT since 2003, she responded to the requests of her clientele by expanding her services to encompass the latest in aesthetic medicine.

 

 

Most Popular Procedures: BOTOX® Injections Treatment, Breast Augmentation (Breast Implants), Laser Hair Removal, Liposuction Surgery (Lipoplasty), Tummy Tuck (Abdominoplasty)

••Deborah Pan, MD, LLC.
Esana Plastic Surgery Center and Medspa - Deborah Pan, MD
•Location: 1 Audubon St Ste 201 New Haven, CT 06511

•Top Procedures:◦BOTOX® Injections Treatment
◦Breast Augmentation (Breast Implants)
◦Laser Hair Removal
◦Liposuction Surgery (Lipoplasty)
◦Tummy Tuck (Abdominoplasty)

•Languages Spoken:◦English


•Financing:◦CareCredit
◦SurgeryFinancing

 


Richard J. Restifo, MD

•New Haven, Connecticut
•Richard J. Restifo, MD - Board Certified Plastic Surgeon

P: 877-319-5738  Cosmetic Surgery, Plastic Surgery

Dr. Richard J. Restifo is a Board-Certified Plastic Surgeon specializing in aesthetic and reconstructive surgery of the breast and body. Breast Augmentation, Breast Lift , Breast Reduction, Liposuction, Abdominoplasty and Body Contouring are his most commonly performed procedures. Call  877-319-5738  to schedule an appointment.

Dr. Restifo 's education, experience and recognition make him one of the most sought after aesthetic plastic and reconstructive surgeons in Connecticut.

Most Popular Procedures: Breast Augmentation (Saline Implants), Breast Augmentation (Silicone Gel Implants), Breast Lift Surgery, Breast Reduction Surgery, Tummy Tuck (Abdominoplasty)

••Richard J. Restifo, MD
Richard J. Restifo, MD - Board Certified Plastic Surgeon
•Location: 59 Elm St Ste 560 New Haven, CT 06510
•Phone:  877-319-5738

•Top Procedures:◦Breast Augmentation (Saline Implants)
◦Breast Augmentation (Silicone Gel Implants)
◦Breast Lift Surgery
◦Breast Reduction Surgery
◦Tummy Tuck (Abdominoplasty)

•Languages Spoken:◦English


•Financing:◦CareCredit

 


Richard J. Restifo, MD

•Wilton, Connecticut
•Richard J. Restifo, MD - Board Certified Plastic Surgeon

P: 877-319-5738  Cosmetic Surgery, Plastic Surgery

Dr. Richard J. Restifo is a Board-Certified Plastic Surgeon specializing in aesthetic and reconstructive surgery of the breast and body. Breast Augmentation, Breast Lift , Breast Reduction, Liposuction, Abdominoplasty and Body Contouring are his most commonly performed procedures. Call  877-319-5738  to schedule an appointment.

Dr. Restifo 's education, experience and recognition make him one of the most sought after aesthetic plastic and reconstructive surgeons in Connecticut.

Most Popular Procedures: Breast Augmentation (Saline Implants), Breast Augmentation (Silicone Gel Implants), Breast Lift Surgery, Breast Reduction Surgery, Tummy Tuck (Abdominoplasty)

••Richard J. Restifo, MD
Richard J. Restifo, MD - Board Certified Plastic Surgeon
•Location: 539 Danbury Rd Wilton, CT 06897
•Phone:  877-319-5738

•Top Procedures:◦Breast Augmentation (Saline Implants)
◦Breast Augmentation (Silicone Gel Implants)
◦Breast Lift Surgery
◦Breast Reduction Surgery
◦Tummy Tuck (Abdominoplasty)

•Languages Spoken:◦English

 


Alfred Sofer, MD

•Fairfield, Connecticut
•Plastic Surgery Center of Fairfield

P: 800-401-9793 Cosmetic Surgery, Facial Plastic Surgery, Medical Spas & Medspas, Minimally Invasive Surgery (BOTOX®), Plastic Surgery

Welcome to the Plastic Surgery Center of Fairfield.
Dr. Alfred Sofer, certified by the American Board of Plastic Surgeons, and his expert supporting staff are proud to provide you with exceptional care, uncompromised safety and courteous

Most Popular Procedures: Breast Augmentation (Breast Implants), Breast Reconstruction Surgery, Breast Reduction Surgery, Liposuction for Women, Tummy Tuck (Abdominoplasty)

 


Jennifer M Hein, MD, FACS

•Sycamore, Illinois
•Women's Institute of Cosmetic & Laser Surgery, LLC

P: 877-807-4004 Cosmetic Surgery, Facial Plastic Surgery, Minimally Invasive Surgery (BOTOX®), Plastic Surgery, Vein Treatment

As a Board Certified Plastic Surgeon, you can feel confident in your decision to visit the Women's INstitute of Cosmetic & Laser Surgery!

 

Most Popular Procedures: Abdominal Liposuction (Liposculpture), Breast Augmentation (Breast Implants), Breast Lift Surgery, Labiaplasty, Tummy Tuck (Abdominoplasty)

••Jennifer M Hein, MD, FACS
Women's Institute of Cosmetic & Laser Surgery, LLC
•Location: 610 Plaza Dr Ste 1 Sycamore, IL 60178
•Phone:  877-807-4004

•Top Procedures:◦Abdominal Liposuction (Liposculpture)
◦Breast Augmentation (Breast Implants)
◦Breast Lift Surgery
◦Labiaplasty
◦Tummy Tuck (Abdominoplasty)

 

 


Robert Kagan, MD

•Elk Grove Village, Illinois
•Anew Allure

P: 888-415-7984 Cosmetic Surgery, Facial Plastic Surgery, Minimally Invasive Surgery (BOTOX®), Plastic Surgery

Anew Allure performs Allurelipo & NaturalFill procedures - the next generation of liposuction and body enhancement. Anew Allure employs Board Certified Plastic Surgeons with hospital affiliations. Anew Allure’s office staff is well-trained and welcoming making for a fully satisfying, end to end patient experience.

Most Popular Procedures: Body Jet Liposuction, Brazilian Butt Lift, Breast Augmentation (Breast Implants), Fat Transfer, Liposculpture (Liposuction Surgery)

••Robert Kagan, MD
Anew Allure
•Location: 800 Biesterfield Rd Ste 302 Elk Grove Village, IL 60007
•Phone:  888-415-7984

•Top Procedures:◦Body Jet Liposuction
◦Brazilian Butt Lift
◦Breast Augmentation (Breast Implants)
◦Fat Transfer
◦Liposculpture (Liposuction Surgery)

•Languages Spoken:◦English

 


John P. Kalamaris, DO, FAACS

•Orland Park, Illinois
•Orland Cosmetic Surgery

P: 866-325-7331  Cosmetic Surgery, Facial Plastic Surgery, Minimally Invasive Surgery (BOTOX®)

When you come to Orland Cosmetic Surgery for a consultation, whether you are interested in breast augmentation, body contouring, facial rejuvenation, or scalp reduction, we take the time to get to know you so that we can thoroughly understand your desires and expectations. Our patients say they experience an environment that is simply unmatched anywhere else. We take great pride in the level of care and concern we show to every patient.

Most Popular Procedures: Breast Augmentation (Breast Implants), Breast Lift Surgery, Breast Reduction Surgery, Gynecomastia (Male Breast Reduction), Liposculpture (Liposuction Surgery)

  

Thomas Su, MD

 

Artistic Liposuction Center/ ...

Cosmetic Surgery

Tampa, FL

  877-848-1750

                                     


Ann P Marx, MD

•Sycamore, Illinois
•Women's Institute of Cosmetic & Laser Surgery, LLC

P: 877-807-4004 Cosmetic Surgery, Facial Plastic Surgery, Minimally Invasive Surgery (BOTOX®), Plastic Surgery, Vein Treatment

As a Board Certified Plastic Surgeon, you can feel confident in your decision to visit the Women's Institute of Cosmetic & Laser Surgery!

Most Popular Procedures: Abdominal Liposuction (Liposculpture), Breast Augmentation (Breast Implants), Breast Lift Surgery, Labiaplasty, Tummy Tuck (Abdominoplasty)
••Ann P Marx, MD
Women's Institute of Cosmetic & Laser Surgery, LLC
•Location: 610 Plaza Dr Ste 1 Sycamore, IL 60178
•Phone:  877-807-4004

•Top Procedures:◦Abdominal Liposuction (Liposculpture)
◦Breast Augmentation (Breast Implants)
◦Breast Lift Surgery
◦Labiaplasty
◦Tummy Tuck (Abdominoplasty)

•Languages Spoken:◦English

 


Otto Placik, MD

•Chicago, Illinois
•Associated Plastic Surgeons, S.C; Otto J Placik MD

 Cosmetic Surgery, Facial Plastic Surgery

Dr. Placik has an extensive background in breast augmentation as well as liposuction, laser and endoscopic-assisted lift, tuck and implants of the face, ears, eyes, cheeks, chin, nose, neck, body, breast, abdomen (tummy), thighs and legs.

 

 

Most Popular Procedures: Breast Augmentation (Breast Implants), Labiaplasty, Liposuction Surgery (Lipoplasty), Tummy Tuck (Abdominoplasty), Vaginal Rejuvenation

••Otto Placik, MD
Associated Plastic Surgeons, S.C; Otto J Placik MD
•Location: 845 N. Michigan Ave Ste 923E Chicago, IL 60611


•Top Procedures:◦Breast Augmentation (Breast Implants)
◦Labiaplasty
◦Liposuction Surgery (Lipoplasty)
◦Tummy Tuck (Abdominoplasty)
◦Vaginal Rejuvenation

•Languages Spoken:◦English
◦Spanish

 


Otto Placik, MD

•Arlington Heights, Illinois
•Associated Plastic Surgeons, S.C; Otto J Placik MD

 Cosmetic Surgery, Facial Plastic Surgery

Dr. Placik has an extensive background in breast augmentation as well as liposuction, laser and endoscopic-assisted lift, tuck and implants of the face, ears, eyes, cheeks, chin, nose, neck, body, breast, abdomen (tummy), thighs and legs.

 

Most Popular Procedures: Breast Augmentation (Breast Implants), Labiaplasty, Liposuction Surgery (Lipoplasty), Tummy Tuck (Abdominoplasty), Vaginal Rejuvenation

••Otto Placik, MD
Associated Plastic Surgeons, S.C; Otto J Placik MD
•Location: 880 W Central Rd Ste 3100 Arlington Heights, IL 60005

•Top Procedures:◦Breast Augmentation (Breast Implants)
◦Labiaplasty
◦Liposuction Surgery (Lipoplasty)
◦Tummy Tuck (Abdominoplasty)
◦Vaginal Rejuvenation

•Languages Spoken:◦English
◦Spanish

 

•Harrison C. Putman, M.D., F.A.C.S.

•Peoria, Illinois
•Harrison C. Putman, III, M.D., F.A.C.S.

P: 866-744-3713  Cosmetic Surgery, Ear, Nose and Throat, Facial Plastic Surgery, Medical Spas & Medspas, Minimally Invasive Surgery (BOTOX®), Vein Treatment

Dr. Putman employs a select group of office staff specializing in consultation, aesthetic skincare services, perioperative counseling and care, and other important facets of the surgical experience. They will help to ensure that you receive the optimum level of services and care that you deserve.

Most Popular Procedures: Brow Lift (Forehead Lift), Eyelid Lift Surgery (Blepharoplasty), Face Lift Surgery (Rhytidectomy), Hair Transplant (Restoration), Nose Job (Rhinoplasty)

••Harrison C. Putman, M.D., F.A.C.S.
Harrison C. Putman, III, M.D., F.A.C.S.
•Location: 7301 N Knoxville Ave Peoria, IL 61614
•Phone:  866-744-3713

•Top Procedures:◦Brow Lift (Forehead Lift)
◦Eyelid Lift Surgery (Blepharoplasty)
◦Face Lift Surgery (Rhytidectomy)
◦Hair Transplant (Restoration)
◦Nose Job (Rhinoplasty)
 
•Experience: 30 years


Laura C Randolph, MD

•Bloomington, Illinois
•Laura C. Randolph, M.D.
Cosmetic Surgery, Facial Plastic Surgery, Minimally Invasive Surgery (BOTOX®), Plastic Surgery, Vein Treatment

Dr. Randolph's staff and the surgicenter staff will help you through the process to ensure your time with us is as supportive, private, and stress-free as possible. An attached and fully accredited surgicenter helps Dr. Randolph's patients feel confidential, comfortable, and safe throughout the entire process. Come see today the new techniques Dr. Randolph is bringing to her hometown community.

Most Popular Procedures: Arm Lifts (Brachioplasty), Breast Augmentation (Breast Implants), Gynecomastia (Male Breast Reduction), Liposuction Surgery (Lipoplasty), Tummy Tuck (Abdominoplasty)

••Laura C Randolph, MD
Laura C. Randolph, M.D.
•Location: 2502 E Empire St Ste C Bloomington, IL 61704

•Top Procedures:◦Arm Lifts (Brachioplasty)
◦Breast Augmentation (Breast Implants)
◦Gynecomastia (Male Breast Reduction)
◦Liposuction Surgery (Lipoplasty)
◦Tummy Tuck (Abdominoplasty)


Richard Shatz, MD

•Glen Carbon, Illinois
•Metro East Plastic Surgery

P: 877-291-1834 Cosmetic Surgery, Facial Plastic Surgery, Minimally Invasive Surgery (BOTOX®), Plastic Surgery

Dr. Shatz prides himself on offering the newest and most advanced techniques balanced by his decades of experience with proven, time-tested methods. These two approaches of innovation and established techniques combine to offer you the most choices to achieve your cosmetic surgery goals.

Most Popular Procedures: Breast Augmentation (Breast Implants), Breast Lift Surgery, Breast Reduction Surgery, Liposuction Surgery (Lipoplasty), Tummy Tuck (Abdominoplasty)

••Richard Shatz, MD
Metro East Plastic Surgery
•Location: 2246 S State Route 157 Ste 200 Glen Carbon, IL 62034
•Phone:  877-291-1834

•Top Procedures:◦Breast Augmentation (Breast Implants)
◦Breast Lift Surgery
◦Breast Reduction Surgery
◦Liposuction Surgery (Lipoplasty)
◦Tummy Tuck (Abdominoplasty)

•Languages Spoken:◦English

 

 

•Chad Tattini, MD

•Bloomington, Illinois
•Chad Tattini

 Cosmetic Surgery, Facial Plastic Surgery, Plastic Surgery, Vein Treatment

Helping you fulfill your dream of restoring your youth is a detailed process from the moment you enter the office. Dr. Tattini's commitment to personal, attentive, and private patient care is evident throughout the entire process.

 

 

 

Most Popular Procedures: Abdominal Liposuction (Liposculpture), BOTOX® Injections Treatment, Breast Augmentation (Breast Implants), Juvederm ™, Tummy Tuck (Abdominoplasty)

 

 

 

 

 





Interested in Plastic Surgery?


If you care about your appearance, and you want to find a top quality surgeon at an affordable price, then Click here to contact us right now.


We have several locations in Southern California so we're nearby wherever you are. We use the most advanced technology, the latest techniques, and our award-winning, expert surgeons are among the best in the business, yet we also have the most competitive prices in the US.


We have financing plans available, and we're currently offering free, private consultations with our expert doctors.


So, if you are considering breast implants, liposuction, tummy tuck, breast augmentation, nose refinement, or any other Cosmetic surgery, please click here to contact 123 New Me to set up a consultation. Your information will remain strictly confidential.






Cosmetic Surgery and Laser Surgery


The plastic surgery specialty encompasses both reconstructive surgery and aesthetic surgery, popularly referred to as Cosmetic Surgery. Reconstructive surgery restores or improves physical function and minimizes disfigurement from accidents, disease or birth defects. While not essential to physical health, aesthetic surgery can make a significant contribution to the quality of life by improving the appearance of normal body features and enhancing self-image.


An increasing number of Americans elect aesthetic surgery to change the way they look. Some have noticeable changes made, others subtle refinements. The decision to have aesthetic surgery is usually based on personal factors, as well as the accepted values of our society.


Breast Augmentation ( Implants and Fillers )


Breast augmentation, technically known as augmentation mammoplasty, is a surgical procedure to enhance the size and shape of a woman's breast for a number of reasons. Breast augmentation is usually done to balance a difference in breast size, to improve body contour, or as a reconstructive technique following surgery. To assist you in obtaining a better body, 123 New Me can offer Surgeons with accumulated surgical experience of more than 30 years. Read

Body Contouring ( Liposuction and "Tummy Tuck" )


Body Contouring, Liposuction and Abdominoplasty, are procedures to improve the appearance of your body contours. Liposuction is a procedure that can help sculpt the body by removing unwanted fat from specific areas, including the abdomen, hips, buttocks, thighs, knees, upper arms, chin, cheeks and neck. Although no type of liposuction is a substitute for dieting and exercise, liposuction can remove stubborn areas of fat that do not respond to traditional weight-loss methods. 


Face Lift


A Facelift (technically known as Rhytidectomy) cannot stop the aging process, but it will be able to "set back the clock," improving the most visible signs of aging by removing excess fat, tightening underlying muscles, and redraping the skin of your face and neck. 


Rhinoplasty


Rhinoplasty (or Nose Refinement Surgery) is the most intricate Cosmetic surgery performed today. Rhinoplasty can reduce or increase the size of your nose, change the shape of the tip or the bridge, narrow the span of the nostrils, or change the angle between your nose and your upper lip. It may also correct a birth defect or injury, or help relieve some breathing problems.

Skin Rejuviation ( Botox and Injectable Fillers )


Fat Transfer, Collagen and BOTOX injections are procedures used i n improvement of the facial features and relaxation of the fine f


Hair & Tattoo Removal ( Laser Treatment )


Laser Treatment Procedure performed by 123 New Me include Laser Hair Removal, Laser Tattoo Removal, Laser Facial Resur facing and other General Laser Surgery Procedures. Endermology, Micro-dermabrasi on and other Cosmetic procedures are also available at our practice. Read More >


Anti-Aging


While Cosmetic Surgery emphasizes external improvement, Anti-Aging Me dicine addresses the internal improvement. Anti-Aging is the most advanced field of medicine committed to the reversal of the cellular damage and aging process through maximal hormonal and nutritional balance. Read More >








FAQ's


PRICING AND FINANCING QUESTIONS


How much do the consultations cost?


Absolutely nothing, the consultations are free! You will meet your surgeon for an initial consultation, a pre-op consultation and several post-op consultations, all which are free of charge.


Are there any extra costs I should know about?


The price for the procedure will include everything except anesthesia (approximately $400 - $600 depending on the procedure), blood test, laboratory and handling ($150 ) and your surgical garment ($60 - $150). Click here to visit our pricing page.


Is there an extra discount for having more than one procedure?


Yes, if you are having more than one procedure done, you can expect a substantial discount on the standard rates.


I do not have enough cash to pay for my procedure, can you help?


Yes, we offer assistance in obtaining financing from accredited patient financing institutions. For more information, please reference our finance page by clicking here.


Does my medical insurance cover Cosmetic surgery?


Most medial insurance plans do not cover elective surgery, but in those cases they do - 123 New Me is more than happy to accept medical coverage. You should ask your medical insurance provider and schedule an appointment with our surgeons to find out the options for your particular case.


GENERAL QUESTIONS


Who do I contact if I want more information about your procedures, the practice and the surgeons?


Please contact the 123 New Me to get in touch with one of our Cosmetic consultants.


Where can I see before- and after photos of procedures performed by your surgeons?


Before and after photos are available on our website by clicking here. You are also welcome to view the pictures during your initial complementary consultation with our experienced surgeons.


Are your surgeons Board Certified?


Our surgeons are highly skilled and experienced surgeons with immaculate training. They are diplomates of either American Board of Plastic Surgery or the American Board of Cosmetic Surgery.


Is there any age restriction for people to come in and get a consultation?


No, patients of all ages approach our clinic, and the surgeons that work here also perform reconstructive surgery, which sometimes is needed by young people.


What are your office hours?


1800 New Me has a 24/7 phone line open to our patients and customers. Our hours for consultation and surgery vary depending on your preferences. The easiest way to schedule an appointment is to contact the 123 New Me and we'll set up a consultation for you. Late evening consultations can be scheduled to accommodate each patient individually.


ABOUT THE PROCEDURE


What is the difference between Cosmetic and reconstructive surgery?


Cosmetic surgery is performed to reshape normal structures of the body in order to improve the patient's appearance and self-esteem. Cosmetic surgery is usually not covered by health insurance because it is elective.


Reconstructive surgery is performed on abnormal structures of the body, caused by congenital defects, developmental abnormalities, trauma, infection, tumors or disease. It is generally performed to improve function, but may also be done to approximate a normal appearance. Reconstructive surgery is generally covered by most health insurance policies although coverage for specific procedures and levels of coverage may vary greatly. There are a number of "gray areas" in coverage for plastic surgery that sometimes require special consideration by an insurance carrier. These areas usually involved surgical operations which may be reconstructive or Cosmetic, depending on each patient's situation. For example, eyelid surgery (blepharoplasty) - a procedure normally performed to achieve Cosmetic improvement may be covered if the eyelids are drooping severely and obscuring a patient's vision.


Will It Hurt?


During a procedure anesthesia ensures that you're comfortable and feel no pain. If general anesthesia is used, you'll even sleep through the entire operation After surgery any pain of discomfort you may experience can usually be controlled through medication and will usually subside in a matter of days.


Will there be scars?


To most surgical Cosmetic procedures the answer is yes. Will they be noticeable- Probably not. Your surgeon will make every effort to keep scars as minimal as possible and try to hide them in the natural lines and creases of your skin. For the majority of procedures, your scars will fade over time and become barely visible.


Is it safe?


Millions of Cosmetic procedures are performed successfully every year and complications are usually rare and uncommon. But no matter how easy, simple or safe today's Cosmetic surgery may seem to be, you must remember that it is still surgery and with any surgery there are certain risks involved.


How long will it last?


The duration of the results is very specific to the procedure performed. In general, procedures that are performed to correct or reshape nature's small defects such as surgery of the nose, breast augmentation/reduction and chin augmentation, the benefits may last a lifetime. For those that focus on rejuvenation such as a face lift, forehead lift chemical peel or eyelid surgery, the results can last 5 - 10 years


Will people be able to tell?


In general, most Cosmetic procedures enhance your looks or minimize perceived flaws naturally, and often go unnoticed. You may be asked if you've been exercising, lost weight or have begun a rejuvenating routine. Typically, no one will know unless you tell.


How soon can I return to work?


Again, this differs widely on the procedure that has been performed, but on average, most Cosmetic surgery patients are back to work within 3 to 10 days


How many people undergo Cosmetic surgery each year?


Nearly 3.5 million Cosmetic surgery procedures are performed each year.


At what age do most people have Cosmetic surgery?


About one-third of Cosmetic surgery patients are between 35 and 50. About 22 percent are 26 to 34, 18 percent are 25 and under and 27 percent are over 51.


How many men have Cosmetic surgery?


Almost 700,000 Cosmetic procedures are performed on men each year. And the number gets larger each year as men grow increasingly comfortable with the concept of Cosmetic surgery for themselves.


What are the most popular procedures for men?


- hair transplantation/restoration

- chemical peel
- liposuction
- sclerotherapy (vein treatment)
- eyelid surgery

LIPOSUCTION QUESTIONS


What is Liposuction?


Liposuction is the surgical vacuuming of fat from beneath the surface of the skin. It is used to reduce fullness in any area of the body. It is an excellent method of spot reduction but is not an effective method of weight loss.


What is the tumescent technique?


The tumescent technique involves injection beneath the skin of large volumes of salt water containing lidocaine, a local anesthetic and small amounts of adrenaline, a naturally occurring hormone which shrinks blood vessels. By injecting this solution to the fat prior to performing liposuction the plastic surgeon numbs the tissues and shrinks the blood vessels thereby eliminating pain and reducing and minimizing bleeding, bruising, and swelling. The tumescent technique permits some patients who were previously treated under general anesthesia to be treated under local anesthesia with sedation.


Who is a candidate for liposuction?


Generally people who have localized areas of protruding fat achieve the most dramatic results. Patients who are slightly overweight can benefit from liposuction. It is best to be at or near your normal weight. Good skin elasticity permits the skin to shrink easily to the reduced contour. There are no absolute age limits for liposuction.


What areas are most frequently treated?


In women, the single most frequently treated areas are the outer thighs, followed by the stomach. In men, the flank area or "love handles" are treated most frequently.


Can liposuction tighten up a loose neck?


If there is excess fat in the area under the chin and the skin is taut, liposuction alone can produce a more sculpted, angular, and youthful jaw line. If, however, the skin of the neck is loose or hanging, even if there is excess fat, liposuction alone will not produce the desired result. Patients with loose skin usually require a face and neck lift in addition to or instead of liposuction. In general, most patients who benefit from liposuction of the neck are under 40. Most patients over 40 will require some surgical skin tightening.


Liposuction seems very simple and safe. Are there any dangers?


Although liposuction is very safe and effective, it is a surgical procedure and can cause complications such as infection, bleeding, and nerve damage. In addition, aesthetic complications such as skin irregularity or waviness can occur if too much fat has been removed. Fortunately, complications are uncommon and most patients are satisfied with their results.


Do you do liposuction of the abdomen?


Yes, sometimes it is recommended to perform a liposuction of the abdomen instead of a tummy tuck.


BREAST AUGMENTATION QUESTIONS




Breast Implants

Women can get breast implants to make their breasts bigger and fuller. That can be done for reconstructive purposes, such as after mastectomy for breast cancer, or for cosmetic reasons.


This article covers cosmetic breast augmentation only. It discusses the types of breast implants available, the procedures used, and the complications that can occur.


 
Saline and Silicone Breast Implants

There are two types of breast implants: saline and silicone.


Saline-filled implants are silicone shells filled with sterile salt water (saline). Silicone-filled implants are silicone shells filled with a plastic gel (silicone). Although many women say that silicone implants feel more like real breasts than saline, they pose more of a risk if they leak.


In 1992, the FDA halted the sale of silicone implants because of safety concerns. In 2006, after reviewing more research, the FDA allowed two companies, Mentor and Allergan, to sell silicone implants. A third company, Sientra, now also has FDA approval to make silicone gel implants.


 
Costs

How much breast implants cost depends on the location, doctor, and type of implant used. Typically, the surgery ranges from $5,000 to $10,000. Because it is considered a cosmetic procedure, breast augmentation is usually not covered by medical insurance.

How the Breast Implant Procedure Is Done

Because the breasts can continue to develop until a woman reaches her late teens or early 20s, the FDA requires that women be at least 18 years old to get breast augmentation with saline-filled implants and at least 22 years old to receive silicone implants.


When picking your surgeon, look for one who has a lot of experience. You may be less likely to have complications later on if you choose a surgeon who has had at least five years of surgical training and at least two years' experience in plastic surgery.


Before your breast implant procedure, you will meet with your surgeon for a medical evaluation. You can talk about what you want and get feedback from the doctor. Your surgeon may ask you to stop taking certain medications a few days or weeks before your surgery.


You can get breast augmentation done as an outpatient procedure, or you may stay overnight in the hospital.


The procedure takes one to two hours. You will likely be given general anesthesia, during which you will be "asleep" and pain-free.


The surgeon will make a cut under your breasts, under your arms, or around your nipples, depending on your body, the type of implant, and how much enlargement is being done.


The surgeon will put the breast implant into a pocket above or below your chest muscle. After the implant is in place, the surgeon will close the cuts with sutures or surgical tape.


Is your price quote for the breast augmentation including both breasts?


Most definitely yes, the prices for procedures like breast augmentation, eyelid surgery etc. are always quoted in pairs.


Why are you not offering silicon breast implants?


Despite the popularity and great results with silicon breast implants, the use of silicon is currently under federal investigation, disabling us from using them in our procedures.


Is it possible to perform the breast implant procedure via the armpit or bellybutton?


Yes, our armpit and bellybutton procedures are becoming increasingly popular, since they leave no visible scars.


Can you breast feed after having a breast enlargement?


Yes, the functions of your breast are in no way limited by the implants.


Is it true you have to replace breast implants every 10-15 years?


Some patients need to replace their implants if their breast starts sagging, or if the implant should be leaking. The implants we use have a lifetime guarantee, however, so the implants will be replaced at no cost to the patient.


Can breast augmentation be done without taking any pain medication whatsoever?


Yes, there is no requirement to take pain killers after any procedure, but most patients find it comforting to ease the pain - especially since the muscles after a breast augmentation can be rather sore.


Recovery After Breast Implantation

Your breasts will be covered with gauze after the surgery. You may have drainage tubes, which will be removed in a few days. You may need to wear a surgical bra as you heal.


You'll need to take it easy for a few days after your breast augmentation surgery. For instance, you shouldn't do any heavy lifting for up to six weeks after getting your implants.


Over-the-counter pain relievers such as acetaminophen may help relieve discomfort. Your doctor may also prescribe pain medication for you.


You will probably have some swelling in the area where the surgery was done. Over time, the swelling should ease and the scars will fade.


 
Possible Complications

Although it is a cosmetic procedure, breast implant surgery can have risks, such as:


    Breast pain
    Changes in sensation in the nipple and breast
    Scar tissue forming and hardening in the area around the implant
    Scarring
    Bleeding
    Infection
    Problems with the size or shape of the implants (for example, the breasts may not be symmetrical)

It is also possible for implants to rupture and leak. If saline implants rupture, the saline will be safely absorbed by the body. A silicone leak may stay inside the implant shell or leak outside of the shell. When a saline implant ruptures, it will deflate. But silicone breast implants may cause no obvious symptoms when they rupture. This is called silent rupture.


 
Maintenance

Breast implants are not designed to last a lifetime. You may need to have the implants replaced if you have complications or if the size and shape of your breasts change over time.


Women who have silicone gel-filled implants will need to get an MRI scan three years after the implant surgery and then MRI scans about every two years to check for silent rupture. If your implants rupture, you will need to have them removed or replaced.


Having breast implants can make it more difficult to get a mammogram, but special X-ray views can be done. There is a chance breast implants may make you more likely to get breast cancer. Breast implants also may make it harder for you to breastfeed.




Breast augmentation plastic surgery is one of the most common procedures performed annually by members of the American Society for Aesthetic Plastic Surgery. Women may choose to under go breast enlargement surgery for various reasons. These personal reasons may center around breasts that are perceived to be under developed, or because of differences in the sizes of the breasts or from changes after pregnancy or breast feeding. Some women may be happy with their breasts but just want them made fuller. Often after weight loss, aging or childbirth a woman's breast volume and shape may change. This too can lead to a woman to seek a breast augmentation. Breast implant surgery performed by cosmetic plastic surgeons is the most popular way to improve breast shape and size. Breast enhancement using breast implants can give a woman more proportional shape and may improve self esteem.

Am I a good candidate for breast augmentation?

One or more of the following feelings or conditions may indicate that you are a good candidate for breast augmentation:


    you are bothered by the feeling that your breasts are too small
    clothes that fit well around your hips are often too large at the bustline
    you feel self-conscious wearing a swimsuit or form-fitting top
    your breasts have become smaller and lost their firmness after having children
    weight loss has changed the size and shape of your breasts
    one of your breasts is noticeably smaller than the other

Your Personal Consultation


During the consultation, you will be asked about your desired breast size and anything else related to the appearance of your breasts that you feel is important. This will help your surgeon to understand your expectations and determine whether they realistically can be achieved.

How will my ASAPS plastic surgeon evaluate me for breast augmentation surgery?

Your plastic surgeon will examine your breasts and perhaps take photographs for your medical record. He or she will consider such factors as the size and shape of your breasts, the quality of your skin and the placement of your nipples and areolas (the pigmented skin surrounding the nipples). If your breasts are sagging, a breast lift may be recommended in conjunction with augmentation.


You should come to the consultation prepared to discuss your medical history. This will include information about any medical conditions, drug allergies, medical treatments you have received, previous surgeries including breast biopsies, and medications that you currently take. You will be asked whether you have a family history of breast cancer and about results of any mammograms. It is important for you to provide complete information.


There is no scientific evidence that breast augmentation increases the risk of breast cancer. The presence of breast implants, however, makes it more technically difficult to take and read mammograms. This may be a special consideration for women who perhaps are at higher risk for breast cancer because of their family history or other reasons. Placement of the implant underneath the pectoral muscle may interfere less with mammographic examination, but other factors may also need to be considered with regard to implant placement. Your plastic surgeon will discuss this with you.


If you are planning to lose a significant amount of weight, be sure to tell your plastic surgeon. He or she may recommend that you stabilize your weight prior to undergoing surgery.


If you think that you may want to become pregnant in the future, you should mention this to your surgeon. Pregnancy can alter breast size in an unpredictable way and could affect the long-term results of your breast augmentation. There is no evidence that breast implants will affect pregnancy or your ability to breast-feed, but if you have questions about these matters, you should ask your plastic surgeon.

Your Surgical Experience

The goal of your plastic surgeon and the entire staff is to make your surgical experience as easy and comfortable for you as possible.

How should I prepare for breast augmentation plastic surgery?

In some instances, your plastic surgeon may recommend a baseline mammogram before surgery and another mammographic examination some months after surgery. This will help to detect any future changes in your breast tissue. Following breast augmentation, you will still be able to perform breast self-examination.


If you are a smoker, you will be asked to stop smoking well in advance of surgery. Aspirin and certain anti-inflammatory drugs can cause increased bleeding, so you should avoid taking these medications for a period of time before surgery. Your surgeon will provide you with additional preoperative instructions.


Breast augmentation is usually performed on an outpatient basis. If this is the case, be sure to arrange for someone to drive you home after surgery and to stay with you at least the first night following surgery.

What will the day of breast implant surgery be like?

Your breast augmentation surgery may be performed in a hospital, free-standing ambulatory facility or office-based surgical suite.


Medications are administered for your comfort during the surgical procedure. Frequently, local anesthesia and intravenous sedation are used for patients undergoing breast augmentation, although general anesthesia may be desirable in some instances.


When surgery is completed, you will be taken into a recovery area where you will continue to be closely monitored. Your breasts will be wrapped in gauze dressings or a surgical bra.


You may be permitted to go home after a few hours, unless you and your plastic surgeon have determined that you will stay in the hospital or surgical facility overnight.

How will my breasts look and feel after the breast implants have been placed?

A day or two after surgery, you should be up and about. Any dressings will be removed within several days, and you may be instructed to wear a support bra. Your plastic surgeon will probably permit you to shower between three and seven days following surgery. Stitches will be removed in about a week.


Some discoloration and swelling will occur initially, but this will disappear quickly. Most residual swelling will resolve within a month.

What should I expect during the recovery process?

Recovery

At the conclusion of your breast augmentation procedure, you may be placed in a surgical dressing that may include a support bra or garment. You should follow your plastic surgeon’s directions as prescribed. Prior to your discharge, you and your caregiver will be given detailed instructions about your post-surgical care including drains if they have been placed, the normal symptoms you will experience, and any potential signs of complication.

Options for your recovery after undergoing breast augmentation include:


    Home: When discharged, you will be released to the care of a responsible adult with safe, licensed transportation home. The adult may be a family member, friend or hired caregiver and must be competent to understand your recovery instructions and to monitor your health. Your caregiver must commit to stay with you at all times for a minimum of 24 hours after surgery.
    Licensed Recovery Facility: You will be released to the care of a licensed post-surgical recovery facility where nurses or specially trained medical professionals will monitor your health and comfort until you are able to return home and capably care for yourself.
    Hotel or spa: You may wish to recover at a hotel or spa location, where licensed healthcare professionals will monitor your recovery around the clock as recommended by your plastic surgeon.
    Overnight Hospital Stay: An overnight hospital stay may be offered to you or may be recommended. In this case your surgery will be performed at the hospital where you will stay overnight. You will be released from the hospital to a capable caregiver to continue your recovery at home, or to a licensed recovery facility.

You should be walking under your own strength immediately after your breast augmentation surgery.  It is very important that you walk a few minutes every few hours to reduce the risk of blood clot formation in your legs.


The first 2-5 days following your breast augmentation surgery you may feel stiff and sore in the chest region. Any dressings will be removed within several days, and you may be instructed to wear a support bra. Your breasts may feel tight and sensitive to the touch, and your skin may feel warm or itchy. You may experience difficulty raising your arms. You should not lift, push or pull anything, or engage in any strenuous activity or twisting of the upper body. Some discoloration and swelling will occur initially, but this will disappear quickly. Most residual swelling will resolve within a month.


It is important to follow all patient care instructions as directed.

When can I expect to resume my normal activities after my breast augmentation?

While it will take several days to return to more normal activities after your breast augmentation, it is important to your recovery that you get up and move around. After breast augmentation, it is often possible to return to work within just a few days or a week, depending on the type of activities that are required at your job.


Physical activity should be avoided for at least the first couple of weeks following surgery. After that, care must be taken to be extremely gentle with your breasts for at least the next month.

How Breast Augmentation is Performed

Individual factors and personal preferences will help you and your plastic surgeon to determine your appropriate breast size, the location of incisions, and whether the implants will be placed on top of or underneath the chest muscle.

Breast Implant Options for the 21st Century

Breast augmentation is designed to increase the size of small or underdeveloped breasts. Breast surgery can also restore and enhance your breast volume if it has decreased as a result of pregnancy and breast feeding. In addition, breast implants can serve one or more of a number of purposes; breast cancer victims can use breast implants for reconstructive purposes after mastectomy, or women with asymmetrical breasts may use a single breast implant to balance the difference in size.


The availability of FDA-approved silicone gel implants will create new options for women considering breast surgery for the first time and for those who have had previous surgeries but are seeking new replacements or revision. Now, all women over 22 years old seeking cosmetic breast augmentation and women seeking breast reconstruction surgery will be able to select silicone breast implants.

What type of breast implants can be used for breast augmentation?
The implant is placed in a pocket either directly behind the breast tissue (right) or underneath the pectoral muscle which is located between the breast tissue and chest wall.

The size and type of breast implant recommended for you will be determined by your goals for breast enhancement, your existing body frame, and mass, your existing breast tissue, and the preferences you and your plastic surgeon discuss.  All breast implants include a solid silicone rubber outer shell, called a lumen.


Breast implant options include:


    Saline breast implants: Filled with sterile salt water.  Saline implants may be pre-filled to a predetermined size. Saline may also be  filled at the time of surgery to allow for minor modifications in implant size.
    Silicone filled breast implants: Filled with soft, elastic gel. All silicone breast implants are pre-filled and may require a longer incision for implant placement.

New scientific data on the safety of breast implants is rapidly being collected. In the future, it is possible that additional types of filler materials may become available as advancements take place. Surgical techniques for breast augmentation and breast implants themselves are continuously being refined, increasing the safety and reliability of the procedure. Your plastic surgeon will be able to provide you with the latest information.

Where are the incisions made for the placement of breast implants?
An incision can be made either underneath the breast, just above the crease, around the lower edge of the areola or within the armpit.

One of the advantages of a saline-filled implant is that, because it is filled with saltwater after being inserted, only a small incision is needed. Often, an incision of less than one inch is made underneath the breast, just above the crease, where it is usually quite inconspicuous.


Another possible location for the incision is around the lower edge of the areola. A third alternative is to make a small incision within the armpit.


Once the incision is made, the surgeon creates a pocket into which the implant will be inserted. This pocket is made either directly behind the breast tissue or underneath the pectoral muscle which is located between the breast tissue and chest wall.

Understanding Risks

Every year, many thousands of women undergo successful breast augmentation surgery; however, anyone considering surgery should be aware of both the benefits and risks.

I understand that every plastic surgical procedure has risks, but how will I learn more so that I can make an informed decision?

The subject of risks and potential complications of surgery is best discussed on a personal basis between you and your plastic surgeon, or with a staff member in your surgeon's office.


Some of the potential complications that may be discussed with you include reactions to anesthesia, blood accumulation that may need to be drained surgically and infection. Although rare, an infection that does not subside with appropriate treatment may require temporary removal of the implant. Changes in nipple or breast sensation may result from breast augmentation surgery, although they usually are temporary.


When a breast implant is inserted, a scar capsule forms around it as part of the natural healing process. The capsule may sometimes tighten and compress the implant, causing the breast to feel firmer than normal. Capsular contracture can occur to varying degrees. If it is severe, it can cause discomfort or changes in the breast's appearance. In such cases, more surgery may be needed to modify or remove the scar tissue, or perhaps remove or replace the implant.


Breast implants are not lifetime devices and cannot be expected to last forever. If a saline-filled implant breaks, its contents are harmlessly absorbed by the body within hours. A definite change in the size of the breast is clearly noticed. Rupture can occur as a result of trauma to the chest, but more commonly it occurs spontaneously with no apparent cause. Surgery will be required to replace the implant, if desired.


If you are at an age when mammographic examinations should be conducted on a periodic basis, it will be important for you to select a radiology technician who is experienced in taking x-rays of augmented breasts. Additional views of your breasts will be required. Your plastic surgeon, in some instances, may recommend other types of examinations such as ultrasound or magnetic resonance imaging. It is possible that the presence of breast implants could delay or hinder the early detection of breast cancer.


Some women with breast implants have reported problems including certain connective tissue and immune-related diseases. Women without implants also have these disorders, so the key question is whether breast implants increase the risk of developing the conditions. Several large studies have been completed that provide reassurance that women with breast implants do not have a significantly increased risk for these diseases.

Results of Breast Augmentation

Breast augmentation will make your breasts fuller and enhance their shape. You will find it easier to wear certain styles of clothing. Like many women who have had breast augmentation, you may have a boost in self-confidence.

How long will the results last after a breast augmentation?

Except in the event of implant deflation requiring surgical replacement with a new implant, the results of your breast augmentation surgery will be long-lasting. However, gravity and the effects of aging will eventually alter the size and shape of virtually every woman's breasts. If, after a period of years, you become dissatisfied with the appearance of your breasts, you may choose to undergo a breast "lifting" to restore their more youthful contour.

Maintaining a Relationship with Your Plastic Surgeon

You will return to your plastic surgeon's office for follow-up care at prescribed intervals, at which time your progress will be evaluated. Your surgeon will encourage you to schedule routine mammographic evaluations at the frequency recommended for your age group.


Please remember that the relationship with your plastic surgeon does not end when you leave the operating room. If you have questions or concerns during your recovery, or need additional information at a later time, you should contact your surgeon.




Breast Augmentation Surgery – A Complete Consumer Guide


Breast augmentation is a type of plastic surgery performed to improve the appearance of a woman's bustline. It involves the insertion of breast implants into the breast mounds to add volume and enhanced shapeliness.


Women opt for breast surgery for a variety of reasons. For example, some wish to increase the size of naturally small breasts, while others seek to correct disproportionate breasts or repair breasts following mastectomy or trauma to the chest.

Breast Augmentation Education and Consultation

If you are thinking about breast enhancement surgery, be sure to do some research and learn more about breast augmentation. Our Breast Implants Consumer Guide can provide you with valuable information as you consider your options.


Next, consult with a board-certified plastic surgeon and ask him or her, "Am I a candidate for breast implants?" During this consultation, the surgeon will perform an exam and listen carefully to your goals for surgery. It is important to be as clear as possible about what you want to achieve with the surgery and the exact look you desire.


The surgeon will then tell you what you need to know about breast augmentation, including information about breast augmentation cost and risks.

Types of Breast Implants

If you decide to go ahead with surgery, one of the first questions you will have to ask yourself is, Which breast implant is right for me? However, you will not make this decision on your own. Your surgeon will help you decide the best implant type for you based on your body type and goals.


Breast implants come in two basic types: saline and silicone. Both types are composed of a rubbery silicone shell containing a filler material. Saline implants are filled with a saltwater solution, whereas silicone implants are filled with silicone gel. There are two types of silicone gel: cohesive gel and highly cohesive, form-stable gel. The latter is found in "gummy bear" implants, so named because they have the consistency of gummy bear candies.


One of the differences between the two types of implants is cost; saline breast implants are slightly cheaper than silicone implants. The implants also differ in the way they feel to the touch. Most people agree that silicone breast implants feel more natural than saline implants.


Both types of implants are approved by the Food and Drug Administration (FDA). For information about the approval history of implants, please visit our page on breast implants and the FDA.

Breast Implant Sizes and Shapes

In addition to the type of implants you wish to receive, you will need to make decisions about the size and shape of your implants. Your surgeon may ask you to "try on" different sizes and test them out using special devices and bras. One of the most common reasons women undergo revision breast augmentation is to receive larger implants, so take your time and be sure you are making the right choice the first time through.

Learn more about breast enhancement surgery

Implants also come in different shapes. Some implants are teardrop-shaped for a more natural appearance, while others are rounded for a fuller look at the top of the breasts. Again, your surgeon will help you choose the shape that will help you attain the look you want.

Placement of Breast Implants

When performing breast augmentation surgery, your surgeon will create a pocket within each breast in which he or she will place your implants. There are several options for the placement of these pockets in relation to your breast tissue and chest muscles. The three main breast implant placement choices are:


    Subglandular, or above the pectoral muscles – With this placement, the implants are situated behind the breast tissue but in front of the chest muscles.
    Partial submuscular, or partially behind the muscles – When performing this placement, the surgeon inserts the implants behind the breast tissue and partly beneath the chest muscles.
    Complete submuscular, or completely behind the muscles – In this case, the implants are fully beneath both the breast tissues and chest muscles.

As with every other decision in the breast augmentation process, the choice of where to place your implants will be made by you and your surgeon and will be based on your particular body characteristics and treatment goals.

Incision Options

To perform breast augmentation surgery, your surgeon must make incisions in your skin. These incisions can be quite small and carefully placed, making them nearly undetectable. Breast implant incisions can be placed in one of the following four locations:


    Under the breast (inframammary incision) – These incisions are located along the natural skin folds where the bottoms of your breasts meet your chest.
    Around the nipple (periareolar incision) – Carefully placed along the edges of the areolas, these incisions are largely unnoticeable after healing.
    In the arm pit (transaxillary incision) – Using this placement option, the surgeon maneuvers the implants beneath the skin from the armpits to the breasts.
    In the navel area (transumbilical, or TUBA, incision) – Reserved for saline implants, which can be inflated following insertion, this placement allows the surgeon to place the implants with virtually no visible scarring.

The best incision location for you will depend on several factors, including the type of implants you have chosen.

Other Types of Breast Surgery

In addition to breast augmentation, women often seek other types of breast enhancement surgery, including breast lift, breast reduction and nipple surgery.


Breast lift is performed to correct drooping, sagging breasts. In performing this procedure, the surgeon removes excess skin to raise the breasts higher on the chest. Breast lift is often part of a mommy makeover, a combination procedure to help mothers regain a more youthful appearance following the rigors of pregnancy and childbirth.


Breast reduction is a procedure in which excessively large breasts are reduced in volume by means of the surgical removal of breast tissue and skin.


Nipple surgery is performed to correct nipples that are too large, too small or mismatched.


Regardless of the type of surgery you might be considering, be sure to consult with a board-certified plastic surgeon who is certified by the American Board of Plastic Surgery. Visit our directory to find a surgeon near you.








Whether your goal is a subtle change or a more dramatic difference, there is a breast implant that’s right for you.

Types of Implants Profile, Size, Texture MENTOR® MemoryGel® Breast Implants MENTOR® Saline® Breast Implants
About Mentor Silicone Safety Breast Implant Warranties Glossary

Materials, sizes, textures: it’s time to discover your breast implant options.


Once you have read Get Educated on Breast Augmentation and have a general understanding of the procedure, you are ready to take the second step of your breast augmentation journey: discovering your breast implant options. The implant type you choose directly affects your overall look. Whether your goal is a subtle change or a more dramatic difference, there is a breast implant that’s right for you.

Explore these pages for more detailed information:

    Types of Implants: Discover the many types of breast implants and view our comparison chart
    Profile, Size, Texture: Learn about different breast implant features
    MENTOR® MemoryGel® Breast Implants: Consider your safe and reliable silicone breast implant options
    Saline Breast Implants: View your standard and post-operatively adjustable saline breast implant options
    Silicone Safety: Read about the safety of new silicone implants
    Breast Implant Warranties: Explore product warranties that add value to the look you love

Remember, choosing your breast implant type is something that you will do with the help of your surgeon at the time of your consultation. Read this section now to become more familiar with breast implants, allowing for the best possible communication with your surgeon when the time is right.









Beverly Hills beauty isn't always exactly what it seems. Many of the beautiful people you see walking down the streets, in the stores, and on TV have had or will have some plastic surgery in their lives. Also, nowhere else in the world is plastic surgery more accepted than it is in Beverly Hills! If you're thinking about having cosmetic plastic surgery, there's really no better place than Beverly Hills to get work done. The doctors are discreet, the results are stunning, and you can even find plenty of financing opportunities.


  1800LVNEWME is one of the largest networks of beauty and health care providers in California. Though specialists primarily inclue plastic surgeons, the network hosts physicians, dentists, and aestheticians for all categories of beauty and wellness.


When it comes to plastic surgery in Beverly Hills or Los Angeles, the stars and everyday people all agree that is the best in the business. A visit to Beverly Hills is like being on your very own makeover reality show, we strive to provide you with the most reputable professionals within all facets of beauty: cosmetic dentistry, laser treatments, female corrective surgery, LASIK eye surgery, health and wellness services, and much more. As a patient of the Beverly Hills  beauty network, you will have access to preferred patient pricing and incomparable customer service.


As a plastic surgery specialist,  provides highly-trained cosmetic surgeons and medical staff, spa-like facilities, and unparalleled patient services.


The professionals at Beverly Hills Physicians have been featured in glamour magazines like Elle, Cosmopolitan, and Bazaar, consulted on awards shows, and provided commentary for entertainment shows like Extra, Entertainment Tonight, and Tyra.


Our highly-trained plastic surgeons will sculpt and enhance your natural beauty. With over 100 years of combined experience, our surgeons provide unsurpassed medical expertise and commitment to patient education and care. Our plastic and cosmetic surgeons will assist you in achieving the figure of your desires.


We have experienced consultants who will guide you through your surgical experience at any of the  locations (Los Angeles, Beverly Hills and other centers in Southern California). Your consultant will recommend a qualified doctor to meet your surgical needs, in addition to assisting you with financing, pre-operative and post-operative care.


Peace of mind is invaluable to our patients and to our plastic surgeons. All of our surgical facilities are fully accredited by the American Association for Ambulatory Healthcare, and each center (like Beverly Hills, Encino, Thousand Oaks, Valencia, Pasadena, Long Beach and Oxnard) is equipped with state-of-the-art instruments.



What is breast asymmetry and how can different sized breast implants help correct this?


Many women experience slight differences between their breasts. These dissimilarities, known as asymmetry, can range from slightly noticeable to very obvious. Asymmetry may affect the breast size, shape, or placement of the nipple.


Breast augmentation can help improve asymmetry by using different sized implants to create an appearance of breast equality and balance. If unequal amounts of breast tissue are responsible for the asymmetry, this corrective measure can drastically help patients achieve a more proportioned appearance.


Breast implants come in both saline and silicone. Empty saline implants are placed in the breasts and are filled in during surgery, while silicone implants are inserted pre-filled. Saline implants offer the distinct advantage of precise volume management, an important consideration when it comes to correcting pre-operative breast asymmetry. The amount of volume in saline implants can be adjusted individually, providing optimal control when it comes to creating smooth symmetry between both breasts.


During a complimentary consultation, Dr. can discuss the implant selections, as well as the choices for incision placement. Breast implants come in a variety of shapes, textures, and profiles, providing a range of options for each individual.


Please feel free to schedule an appointment at the Institute for Plastic Surgery to discuss how breast augmentation can help balance the appearance of both breasts and create greater body symmetry.


Breast Augmentation


Breast augmentation have been performed since the 1960’s, with a 40 year track record for safety. Breast augmentation results in more volume and fullness to the breast. It is one of the most common cosmetic procedures performed. Both saline (salt-water) and silicone gel breast implants are available, and Dr. will discuss both options with you during your complimentary consultation.

Types of Breast Implants

Currently, there are two types of breast implants available:


    Silicone implants are pre-filled with silicone gel, and the volume cannot be altered. The main advantage of saline implant is volume control. This is especially true in patients who have markedly asymmetrical breast pre-operatively. With saline implants, there is a higher chance of achieving better symmetry, since the volume of each implant can be adjusted individually. Silicone implants, on the other hand, do feel more natural than saline implants, and are the best choice if the patient has very thin skin.
    Saline implants are empty and the saline is added to the implant through special tubing.


Styles of Implants


There are also different styles of implant available: smooth and round, textured and round, textured anatomical (tear-drop shape). Within each category there are different types of implant: low, moderate, and high profile. As one can see, the combination of factors to consider can become very challenging. It is our responsibility to clarify and simplify the decision making so the patient can obtain the best result possible.

The Procedure

Breast augmentation can be performed through incisions made around the areola (peri-areolar), underneath the breast fold (inframmamary approach), through the arm pit (trans-axillary), or around the belly button (trans-umbilical or TUBA). The implant can also be placed above or below the pectoralis muscle (the muscle underneath the breast tissue). Each approach has its advantages and disadvantages. During the consultation, Dr. Jazayeri will recommend the best and safest approach for the patient’s desired needs.


It is important to realize breast implants are not permanent, and eventually need to be replaced. Fortunately, the risk of implant leak is low, but it does increase with the age of the implant. Mentor and Allergan are currently the only FDA approved companies providing implants in the U.S. Both companies have a life-time warranty should an implant leak. In case of saline implants, a leak will be noticeable as the saline will be absorbed by the body, resulting in a change and feel of the affected breast. With silicone implant, the gel cannot be absorbed. In some cases, therefore, the implant may have leaked without any noticeable change or feel in the breast. Silicone is not dangerous and is not harmful to the body. If you are concerned about a silicone implant leak, the best method of diagnosis is an MRI.


Our philosophy is to make cosmetic surgery results look as natural as possible. For more information on breast augmentation please contact the office near Orange County to speak with Dr. .


In addition to this aspect of your procedure, Dr.  will be glad to discuss the ideal location in which to place your implants, as well as the preferred incision site. Knowing and implementing a precise surgical plan is highly valued at Institute for Plastic Surgery.

Benefits of Breast Augmentation

    Your reason for undergoing the procedure
    The current size/shape of your breasts
    Results that you desire to achieve




Breast Lift


Breast lift is indicated for patients who have loose skin and/or sagging of the breast tissue and nipple. The procedure involves repositioning of the nipple and removal of excess skin. In most cases, best results are obtained when the lift is combined with a breast augmentation. The lift places the nipple in its correct position and tightens the loose skin, while the implant provides the needed volume which has been lost.

What Is A Breast Lift?

A breast lift (mastopexy) is a procedure designed to re-establish an attractive breast position and appearance required when the patient has droopiness of the nipples and the skin of the breast (nipple ptosis). This typically occurs after pregnancy, especially if breast feeding was prolonged. It can also occur with patients who have had cycles of major weight gain and loss. In some patients, it is genetic.


If the patient has adequate volume of breast and only requires repositioning of the nipple, then a breast lift alone is sufficient. Unfortunately, in majority of cases, breast ptosis and loss of breast volume go hand in hand. The only way to restore volume to a deflated breast is with a breast implant. A mastopexy is then required to reposition the nipple and tighten the skin envelope.

Types of Breast Lifts Available

    Donut (peri-areolar) Mastopexy: Indicated in patients who require less than one inch of lift and have minimal to no loose skin in the lower portion of the breast. A circle of skin and areola (if the size of the areola needs to be reduced) is removed, and the incision is then closed. Imagine a donut, with the hole being the nipple/areola, and the actual donut being the area where the skin was removed. As the wound is closed, the surrounding skin is tightened and the nipple is repositioned. The final incision is around the areola in a circular fashion.
    Full Mastopexy: A full (anchor) mastopexy is required when the nipple is positioned very low, near the base of the breast, and there is significant loose skin in the lower portion of the breast. This type of ptosis requires skin tightening in a three dimensional fashion. The incision is around the areola, extends down in the middle of the breast, and ends at the inframmamary fold (where the breast fold attaches to the skin). Imagine a lolli-pop with a smile at the end of the stick. This is how the incisions for a full mastopexy will look.
    Vertical Mastopexy: For patients whose breasts are between a donut and full lift, a vertical (lolli-pop) mastopexy is performed. The incision is similar to a lolli-pop, but without the extra "smile."

The determination for the type of lift will be made at the time of consultation. During the consultation, implant sizing will be performed as well (if required).


Many patients are fearful of scarring after a breast lift. However, if the surgery is performed by a well-trained board certified plastic surgeon, the risk of unsightly scars is rare to non-existent, assuming a normal post-operative healing process.


The recovery for a breast augmentation with lift is similar to breast augmentation without a lift. The patients should refrain from upper body activity for at least 4 weeks. After 4 weeks, gradual exercise is resumed as tolerated.


Breast Lift


Breast lift is indicated for patients who have loose skin and/or sagging of the breast tissue and nipple. The procedure involves repositioning of the nipple and removal of excess skin. In most cases, best results are obtained when the lift is combined with a breast augmentation. The lift places the nipple in its correct position and tightens the loose skin, while the implant provides the needed volume which has been lost.

What Is A Breast Lift?

A breast lift (mastopexy) is a procedure designed to re-establish an attractive breast position and appearance required when the patient has droopiness of the nipples and the skin of the breast (nipple ptosis). This typically occurs after pregnancy, especially if breast feeding was prolonged. It can also occur with patients who have had cycles of major weight gain and loss. In some patients, it is genetic.


If the patient has adequate volume of breast and only requires repositioning of the nipple, then a breast lift alone is sufficient. Unfortunately, in majority of cases, breast ptosis and loss of breast volume go hand in hand. The only way to restore volume to a deflated breast is with a breast implant. A mastopexy is then required to reposition the nipple and tighten the skin envelope.

Types of Breast Lifts Available

    Donut (peri-areolar) Mastopexy: Indicated in patients who require less than one inch of lift and have minimal to no loose skin in the lower portion of the breast. A circle of skin and areola (if the size of the areola needs to be reduced) is removed, and the incision is then closed. Imagine a donut, with the hole being the nipple/areola, and the actual donut being the area where the skin was removed. As the wound is closed, the surrounding skin is tightened and the nipple is repositioned. The final incision is around the areola in a circular fashion.
    Full Mastopexy: A full (anchor) mastopexy is required when the nipple is positioned very low, near the base of the breast, and there is significant loose skin in the lower portion of the breast. This type of ptosis requires skin tightening in a three dimensional fashion. The incision is around the areola, extends down in the middle of the breast, and ends at the inframmamary fold (where the breast fold attaches to the skin). Imagine a lolli-pop with a smile at the end of the stick. This is how the incisions for a full mastopexy will look.
    Vertical Mastopexy: For patients whose breasts are between a donut and full lift, a vertical (lolli-pop) mastopexy is performed. The incision is similar to a lolli-pop, but without the extra "smile."

The determination for the type of lift will be made at the time of consultation. During the consultation, implant sizing will be performed as well (if required).


Many patients are fearful of scarring after a breast lift. However, if the surgery is performed by a well-trained board certified plastic surgeon, the risk of unsightly scars is rare to non-existent, assuming a normal post-operative healing process.


The recovery for a breast augmentation with lift is similar to breast augmentation without a lift. The patients should refrain from upper body activity for at least 4 weeks. After 4 weeks, gradual exercise is resumed as tolerated.

Breast Reduction

Do you suffer from back, neck, and/or shoulder pain due to overly large breasts? Perhaps you find difficulty participating in certain activities or finding tops/dresses that fit you appropriately. If this is the case, then you may be considering undergoing a cosmetic plastic surgery procedure such as breast reduction ("reduction mammaplasty").  M.D. of Institute for Plastic Surgery performs this breast contouring procedure to help you achieve a more balanced appearance.

The Procedure

Typically, patients should be in good physical, psychological health, and have realistic expectations. During your visit with our Irvine breast reduction surgery specialist, you will be thoroughly examined, and the procedure will be discussed in detail in order to fully inform the patient of her options.


Based on the amount of excess skin, fat, and tissue in the breasts, one of the following incisions is made: in a circular method around the areola; around the areola and vertically down the breast crease; or an anchor shape in the lower part of the breast. Dr.then removes the breast tissue, fat, and skin in order to reshape the breast and provide a more proportionate contour.

Recovery

Recovery after breast reduction is easier yet longer than a standard breast augmentation. Pain after breast reduction is less than sub-muscular breast augmentation, since the chest muscle is not divided during the surgery. However, the recovery can be longer; especially with larger amount of breast tissue removed, since there may be significant swelling. It usually takes 6-12 months in a typical breast reduction for the breast to “settle in”. This is in contrast to standard breast augmentation which usually takes 3-6 months for the implants to settle in. The recovery and healing process for a breast augmentation with a breast lift is mor



Gynecomastia Correction Surgery (Male Breast Reduction)


Gynecomastia is a medical condition that is prevalent among many men; it is the enlargement of breast tissue, which is also referred to as “female-like breasts.” The condition of over-developed breasts can affect males of nearly any age.


It can be caused by hormonal changes, hereditary conditions, disease, alcohol, or certain drugs and medications. Diet and exercise is unable to correct, or reverse, the condition of gynecomastia; therefore, plastic surgery is the only effective solution to creating a more masculine appearance.


Gynecomastia may affect one or both breasts, characterized by an excessive amount of localized fat and glandular tissue development. It is typically an embarrassing condition for men, which in turn, can lower their self-confidence. As a result, these individuals tend to avoid certain physical activities and intimacy.


You may be an ideal candidate for gynecomastia correction surgery if you are:


    Physically healthy and of relatively normal weight
    Realistic in your expectations
    Your breast development has stabilized
    Bothered with the feeling of having enlarged breasts


Depending on their condition, adolescents may benefit from male breast reduction. However, they may require a secondary procedure should their breasts continue to develop as they get older. During your consultation, Dr.  will determine if you qualify for gynecomastia surgery.


You may also be a good candidate for male breast reduction surgery if you:


    Have already tried to correct this condition with alternative medical treatments
    Do not have a life-threatening illness or medical condition that could impair healing
    Do not smoke or use drugs


Procedural Details of Male Breast Reduction


The goal of gynecomastia correction surgery is to provide the patient with a flattened, more masculine chest contour. Dr. Jazayeri may recommend an excision technique or liposuction, or both, to reduce the size of your breasts. Excision is performed when glandular tissue or excess skin needs to be removed. A breast lift may also be necessary if the areola needs to be reduced in size or if the nipple requires repositioning. If your gynecomastia is the result of excess fatty tissue, only liposuction may be necessary. Also known as “lipoplasty,” this body contouring procedure entails the use of a thin hollow tube (cannula) for loosening excess fat and a vacuum suction for removing it. Both excision and liposuction would be used if you suffer from having an over-abundance of glandular tissue, fatty tissue, and excess skin. Please note that any type of gynecomastia correction procedure will require incisions. Although they will be placed in the natural contours of your chest area in order to conceal them, scarring may be visible. Depending on the procedure, oral medication, intravenous sedation or general anesthesia may be used.

Recovery

Following your gynecomastia correction surgery, you may feel a bit sore and experience some swelling and bruising. (Dr. Jazayeri may prescribe the proper medications to help provide greater comfort.) The appropriate dressings or bandages will be applied to the incision area. In order to minimize swelling and provide support to your new chest contour during the healing process, an elastic bandage or support garment may be used. You may also have a small, thin tube temporarily place under the skin, which will drain any excess blood or fluid that may accumulate.


Downtime for breast reduction surgery is fairly short, as you should be up and walking around soon after surgery and be able to return to working within a couple of days. Typically, you should wait at least two to four weeks after surgery before going back to strenuous activities, heavy exercise, and contact sports.

Mommy Makeover

Pregnancy may result in changes in the shape of breasts and abdominal area. These changes typically result in loss of breast volume, and sagging of breast tissue. The same may occur in the abdominal region, resulting in loose skin, stretch marks, and a "beer-belly" appearance due to weakness of the abdominal muscles.


Most patients undergo breast augmentation with or without a lift and tummy tuck. This results in a balanced, youthful look to the body. In most cases, both procedures can be performed at the same time, thus reducing recovery time and cost.


"Mommy makeover" is a catch phrase, which has become very popular in plastic surgery, & addresses the changes which occur in the breast and abdomen after pregnancy. However, it is important to realize the same changes occur in patients who have had major weight loss.


After pregnancy, the breast will lose volume and may become deflated. The skin and the nipple may also become loose and drop (nipple ptosis). If the patient’s nipple position is adequate and there is no loose skin, then a breast augmentation alone will restore the lost volume. If, however, there is ptosis, then a breast lift (mastopexy) will also be required. There are three types of mastopexy: donut (peri-areolar), vertical (lolli-pop) and full (anchor). The type of breast lift required will be determined at the time of consultation.


The abdominal skin after surgery will stretch. In some patients, the amount of stretch is minimal. However, in most patients stretch marks occur and the skin loses its elasticity, resulting in hanging skin. The fascia (thick white layer) between the abdominal muscles also stretches, in order to accommodate the fetus. After delivery, this weakness remains. The medical term for this condition is rectus diastasis. The abdominal contents then push against the weakened fascia, resulting in a “beer belly” appearance. In our practice, we perform three types of abdominoplasty: mini, standard, and extended. The type of tummy tuck required will be determined at the time of consultation. Usually, the patient will have excess fat around the flanks (love handles). Liposuction of the flanks will be performed at the time of surgery.


The ideal candidate for a mommy makeover surgery is healthy and should be at or within 20 pounds of their ideal weight. However, if the abdominal skin fat is very thick, and the skin cannot be moved easily, then the patient must lose more weight.


The recovery for mommy makeover is similar to a C-section. The patient must refrain from exercise or heavy activity for at least 6 weeks. After 6 weeks, gradual exercise can be resumed as tolerated. No abdominal sit-ups or exercise is recommended for six months. Since the rectus diastasis is corrected, it is essential to allow the repair to become as strong as possible.


The recommendation by the American Society of Plastic Surgeons is to limit outpatient surgery anesthesia time to 6 hours. In majority of patients, the mommy makeover surgery can be performed in this time limit. However, if the anticipated anesthesia time is longer, then the surgeries must be broken into two or more stages.



 tumescent technique for liposuction at his Santa Ana practice. The benefits of this technique are more even removal of fat and less bruising. Common areas include the abdomen and flanks (love handles), inner and outer thighs and medial knees, neck, and the male breast.
What Is Liposuction?

Liposuction was originally invented in the 1970's by a French gynecologist. Since it was found to be an effective method, it was brought to the United States immediately, and with time, the instrumentation and method was refined. Liposuction is a very safe and effective procedure if the right candidate is chosen. The ideal patient for liposuction is at or within 10 pounds from their ideal weight. Typically, the patient exercises and watches their diet, yet is unable to lose fat in certain parts of the body.

The Procedure

Liposuction involves making small stab incisions close to the area of surgery. Then a small metallic tube with holes at the end is connected to a solution containing pain medication and adrenaline. The adrenaline is added to reduce the amount of bleeding. The solution is then infiltrated in the areas which are going to be liposuctioned. The solution minimizes pain, bleeding, and bruising. This is called the tumescent technique, and is the standard for performing liposuction. After several minutes, different size metallic cannulas with holes at the end are used to remove the fat. The cannula is attached to a special liposuction machine, which allows the fat to be suctioned.

Is It Right For Me?

For liposuction to be effective, the skin must have normal elasticity so it can retract after the excess fat is removed. If the skin is loose, liposuction will worsen the problem.


Typical areas of liposuction include the neck, arms, male breast (gynecomastia), abdomen, flanks (love handles), inner and outer thighs and inner knees.


It is important to realize liposuction is not a weight loss procedure, and should not be used in lieu of controlled dieting or weight-reduction surgery. Fat is similar to cotton, it occupies a lot of space but does not weigh as much as muscle or bone. Large volume liposuction will reduce the volume but not necessary result in significant weight loss.


The American Society of Plastic Surgeons has defined large volume liposuction, as any liposuction which removes more than 5 liters (1.3 gallons) of fat and tumescent solution. For these procedures, the recommendation is for the patient to remain overnight in the hospital or surgery center, for proper fluid management. Our recommendation is to break the surgeries into stages, to minimize the risk of complications.

After The Surgery

After liposuction, the patient must wear a snug-fitting garment over the area of liposuction in order to minimize swelling and allow the skin to retract properly. The garments can be discontinued 4 weeks after the procedure. During the healing period, no excessive physical activity or exercise is recommended.


In certain cases, such as small areas of liposuction, the procedure can be performed in the office setting with local anesthesia and oral medication.











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Tummy Tuck / Abdominoplasty


Tummy tucks are indicated for patients who have loose, hanging skin of the abdomen. This is usually due to pregnancy, but it can also occur after major weight loss. Pregnancy or major weight gain will stretch the abdominal skin. This may result in stretch marks, and the elasticity of skin may be lost, resulting in hanging skin. Pregnancy can also weaken the strong fascia (white fibers) between the abdominal muscles (the six pack muscles), resulting in the abdominal contents pushing against the weak fascia. The medical term for this condition is rectus diastasis. This will result in a "beer belly" appearance.

Types of Tummy Tucks
Mini Tummy Tuck

A mini tummy tuck is indicated for patients who have loose skin in the lowest, central portion of their abdomen only. These patients do not have any loose skin near or above the umbilicus (belly button), and have no rectus diastasis. The mini-abdominoplasty scar will be as long as or slightly longer than a C-section.

Standard Tummy Tuck

In a standard abdominoplasty, the incision is from "hip to hip". In these patients, there is loose skin above the umbilicus and possibly below as well. There is also rectus diastasis present. The skin is separated from the abdominal wall and the umbilicus and is raised to the edge of the rib cage. The rectus diastasis is repaired and then the excess skin is removed. A new "hole" is created for the umbilicus to come through. Two to three drains are placed under the skin to collect any fluid build-up. The drains are usually removed in 7-9 days, depending on their output.

Extended Tummy Tuck

An extended tummy tuck is indicated for patients who have loose skin extending into the flanks (love handles). The procedure is similar to a standard abdominoplasty with the exception of a longer scar. Commonly, the patient will have excess fat around the flanks, and liposuction of the flank area will be performed with the abdominoplasty (either standard or extended). The recovery for a tummy tuck is similar to a C-section. The patient should refrain from any physical activity or exercise for 6 weeks. After 6 weeks, graduated exercise can be resumed as tolerated. In case of standard or extended abdominoplasty, sit-ups or abdominal exercises are not recommended. This is to allow the rectus diastasis repair to become as strong as possible.


The ideal candidate for tummy tuck is at or within 10 pounds of their ideal weight. However, it can be performed on patients who are slightly more overweight (up to 20 pounds over ideal weight) if the abdominal skin is very loose and can be easily pulled down.

The Procedure

Tummy tuck surgery can be a very effective means of tightening the stomach area. Therefore, patient candidacy is important. Ideal tummy tuck surgery patients are:


    Healthy adults who are within their normal weight range
    Affected by excess fat that is concentrated on the midsection
    Bothered by loose, hanging abdominal skin

By removing unwanted fat and sagging skin from the area, and then tightening underlying muscles, Dr. Jazayeri can help reveal a more slender and attractive midsection.





FACELIFT


What is a facelift?


A facelift or "rhytidectomy" is a surgical procedure designed to improve the most visible signs of the aging process by eliminating excess fat, tightening the muscles beneath the skin of the neck, and removing sagging skin. It doesn't stop the aging process but merely "sets the clock back".


How long does a facelift last?


No one can say for sure. The clock is turned back, but keeps on running. Ten years later, you will look better than if you never had surgery. Many patients never have a second lift, while others may desire further surgery seven to 15 years later.


Can surgery be done without scars?


The scars from facelift surgery usually fade and are barely perceptible. In some patients, especially younger ones, endoscopic surgery can be used to lift the eyebrows, remove frown lines, elevate the cheek and jowls, and tighten the neck. This endoscopic surgery can be done with tiny scars. However, if there is excessive skin, it must be removed for the best results through standard facelift incisions.


How long will I be out of work?


Most patients are able to return to work in two to three weeks. You should allow four to eight weeks before major social engagements.


How can I hide things during the time until I return to normal?


Your surgeon will discuss post-operative camouflage techniques with you prior to your surgery, but be assured that while almost everyone has some sort of temporary side effect such as bruising and swelling, there are makeup techniques that both men and women can use almost immediately to disguise them. Generally speaking, makeup techniques can be used soon after surgery to cover discolorations, and to hide incision lines after the stitches have been removed and the incision is completely closed. Camouflage Cosmetics include three basic types of products: Concealers to hide incision lines and discolorations; contour shadows to disguise swelling; and color correctors to neutralize color in reddened skin.


Color correctors disguise yellowish discolorations or the pinkness that follows chemical peel and dermabrasion. Lavender neutralizes or removes yellow, and green has a similar effect on red. It will take a little patience and practice to master camouflage techniques, but most post-op patients feel its well worth the effort.


BLEPHAROPLASTY (Eye Lid Surgery)


Blepharoplasty (eye lid surgery) is a procedure used to improve the appearance of upper and lower eye lid region.


The upper eye lids typically develop excess hanging skin with age or genetics. However, it is also important to rule out actual drop of the eye brows (brow ptosis). If, from side view, the patient has "hooding" (the lateral eye lid skin forms a hood over the lower eye lid region) then brow ptosis is present and must be corrected. This is done by a brow lift procedure. If the ptosis is not corrected and only excess skin is removed, the brow ptosis will become worse. If only excess upper eye lid skin is present, an upper blepharoplasty is performed to remove the excess skin. Very rarely, excess fat (if truly indicated) may be removed. However, removing too much fat will result in a hollow eye, which is not youthful. The incision is made about 7mm (0.3 inches) above the eye lash line and is easily hidden.


The lower blepharoplasty procedure addresses the prominent fat pockets and, in some cases, excess skin of the lower eye lid region. Currently, I prefer the transconjunctival approach. If the patient has no loose skin, the incision is made inside the eye lid skin, thus avoiding any outside scars. Through this approach, the fat can be mobilized and removed, if truly indicated. As with the upper eye lid, it is best to avoid removing fat, as it will result in hollowness. I typically reposition and re-drape the fat, like a curtain, underneath the skin. This will smooth out the bulging of the fat, and will give a more youthful look to the lower eye lid.


As with face lift surgery, these procedures help the foundation of the house. However, the house may still need a "paint job". If the patient has wrinkly skin with lines around the eyes, these can be addressed with a combination of laser resurfacing, Botox, and fillers.


The recovery for eye lid surgery is similar to a face lift. Most patients can go to a social event, with make-up, two weeks after surgery. The first week, the eyes will be swollen and some bruising may be evident. The final result may take 3-6 months.


Chin Augmentation


This cosmetic surgery procedure is indicated for patients with a flat chin. It is a common procedure that can help to effectively bring balance to the overall facial structure. A flat chin, or a “weak chin,” may be the result of a congenital deficiency, age-related bone absorption, or facial trauma.


It is not uncommon for a chin surgery patient to also elect rhinoplasty as well. This is because the size of the chin may appear to magnify or minimize the size of the nose. Therefore, if you want both of these procedures performed, you may anticipate a dramatic effect and more harmonious balance to your facial features. Your silhouette (side profile) will especially be more defined, which can help raise your self-confidence and improve your self-image.


You may qualify for chin surgery if you are:


    Physically and psychologically healthy
    Realistic in your expectations
    Unhappy that your chin is not proportional to the rest of your face

Individuals who have certain dental problems or extreme “microgenia,” the medical term for having inadequate underlying bone structure in the chin, may not be good candidates for this procedure. During your consultation with Dr. Jazayeri, he will determine if chin augmentation is right for you.

Procedural Details of Mentoplasty

You have two surgical options for chin augmentation: enhancement with an implant or reshaping of the jaw bone. In most cases, a chin implant is used for augmentation. This implant is made of a synthetic material that feels similar to the natural tissue that is usually found in the chin. The incision can be placed in one of two areas – in the natural crease line just under the chin or where the gums and lower lip meet, inside the mouth. Studies have shown that the chin incision results in a lower complication rate and, therefore, is the preferred method of placement. Dr. Jazayeri will delicately stretch the tissue to custom fit the particular shape and size of the implant. Fine sutures will be used to close the incision. You will have no visible scarring if you choose to have the chin implant inserted inside the mouth. Should the implant be placed under the chin, the scar will be only slightly visible. This cosmetic surgery procedure can be performed under light sedation or general anesthesia.


During your consultation, Dr. Jazayeri can discuss your options with soft tissue augmentation with fillers (Juvederm, Radiesse, etc.), which offer a temporary chin enhancement.

Recovery

A dressing will be applied immediately after surgery, which will need to remain in place for about two to three days. Special tape will be placed on the skin to keep the implant in place. These tapes are typically removed in seven days. No chewing or using a straw is allowed for the first seven days. You may anticipate some tenderness after your procedure; should you experience any post-operative discomfort, certain pain-relieving medications can be prescribed. It is common for chin implant surgery patients to feel a stretched, tight sensation after your procedure, which typically subsides within a week. Lip numbness is also common and usually improves in two to four weeks.


It is important that you follow Dr. Jazayeri’s instructions regarding your recovery period. Because the ability to chew will be limited directly after chin augmentation, you may be required to adopt a liquid and soft food diet for the following few days.


Most swelling should be gone after about six to eight weeks, and final results will be apparent. Normal activity can resume after approximately 10 days, but rigorous activity should be avoided for at least the first few weeks after chin augmentation surgery.


Facelift


Although Botox and fillers have benefits for mild facial aging, face lift is still indicated for advanced aging of the face. A face/neck lift will improve the neck line, provide projection to the cheek area, and give a more youthful look to the face. This procedure is often complemented by upper and lower blepharoplasty (removal of excess skin and improving the puffiness around the eyes), and brow lift (to correct excessive hanging of the eyebrows).


Rhytidectomy means removal of lines. However, this is a misnomer, as face lift is not as much about removing lines as repositioning of the tissues under the skin.


A standard face lift mainly addresses the jowls (the hanging bulge on either side of the chin). However, to obtain harmony, a mid face-lift, which addresses the cheeks, is usually required. Once these issues are addressed, then the rest of the face will appear "out of synch." Typically, there will be excess eye lid skin or droopiness of the eyebrows, which may require either an upper blepharoplasty or a brow lift. There may be prominent fat deposits of the lower eyelids, which can be managed with a lower blepharoplasty. The neck typically will have loose skin and muscle under the skin (so called "turkey neck"). Therefore, for the final face lift result to look natural, all of these issues must be addressed. This is usually done in one setting. However, the surgeries can be broken down into two stages, if indicated.


The face lift incision starts in front of ear, with extension into the temple, if a brow lift is needed. The incision then goes behind the ear and ends at the junction of the hair line with the posterior neck. This extension is performed only if a neck lift is performed. There will be an incision under the chin bone as well, to tighten the loose muscles in the center of the neck (platysmaplasty).


The skin of the face is elevated, usually up to and slightly past the cheek bone area. Then, using sutures, the loose tissue under the skin is re-oriented in the desired direction. Typically aging causes the tissues of the face to go down and medially. Therefore, the usual direction of tightening is upward and laterally. Once the tissues are re-oriented and the cheek area is augmented, the excess skin is conservatively removed. It is important not to rely too much on skin tightening, as the final result will look very unnatural.


A face lift will "remodel" the foundation of the face. However, for best result, a "paint job" may be needed as well. This "paint job" will improve or eliminate the remaining lines on the face. Typically, this is accomplished by a combination of laser resurfacing, Botox and fillers.


In terms of recovery, the usual patient can go to a party, with make-up, two weeks after surgery. However, the swelling will take at least 3 months to completely resolve.




Ear Surgery (“Otoplasty”)


Prominent ("Bat") ears, a condition known as macrotia, can be a source of great embarrassment for many individuals. If you are interested in correcting this problem for you or your child, you may anticipate natural-looking results with ear surgery under the care of Dr. Jazayeri at Elán Institute for Plastic Surgery.


This cosmetic surgery procedure involves repositioning the ears into a more anatomical position, providing an overall more pleasing facial appearance. One or both ears may protrude in varying degrees, but this is not associated with hearing loss as macrotia is strictly an aesthetic problem. Ear surgery is a highly individualized procedure, and although you may want to prevent stares in public, teasing of you or your child, and to eliminate feelings of self-consciousness and shame, it is important that you do not undergo otoplasty to fulfill someone else’s needs or to achieve perfection.


In order to qualify for otoplasty, you should be:


    Realistic in your goals and expectations
    Healthy without a life-threatening illness and any medical conditions that may impair healing
    A non-smoker

Children, specifically, have their own requirements. If you want your child to undergo ear surgery, he or she must:


    Be at least five years old or have cartilage that is stable enough for correction
    Not have any untreated chronic ear infections
    Be cooperative and follow instructions well
    Have the ability to communicate his or her feelings
    Be comfortable with the idea as well as discussion of surgery

Procedural Steps for Ear Surgery


Dr. Jazayeri will recommend the best choice of anesthesia for you; local, intravenous sedation, or general anesthesia may be administered.


The incision is typically made behind the ears, in order to conceal any possible visible scarring. Should your incisions need to be made on the front of the ear, they will be made within its folds so they are not noticeable. Based on your, or your child’s condition, particular surgical techniques will be used during surgery. You may require a newly created or increased antihelical fold, which is made just inside the rim of the ear. In addition, you may also need to reduce the enlarged conchal cartilage; this is the largest and deepest concavity of the external ear. Dr. Jazayeri will use internal, non-removable sutures to secure the newly shaped cartilage in place, and close the incision with external stitches. He will delicately perform this procedure, and avoid providing you with an unnatural “pinned back” appearance

Recovery

You may feel discomfort directly after ear surgery. This is normal and can be controlled with pain medication. Although you may feel itchy under bandages, you must leave these intact and not remove them. Removing these bandages for any reason could compromise the results of your procedure, and possibly require a secondary surgery. Otoplasty results are permanent, and are immediately noticeable after the initial phase of healing is complete and the dressing is removed.




Fat Transfer (“Autologous Fat Grafting” or “Fat Transplantation”)


The fat transfer technique is continuing to gain momentum as a leading cosmetic solution. This is because it can benefit various areas of the body, including features of the face and body. At Elán Institute for Plastic Surgery, men and women can learn about their options with this modern technique. Dr. Jazayeri can use fat to provide a more youthful appearance and/or to correct a deformity by increasing the volume of subcutaneous fat (fat that sits just beneath the skin).


This process entails extraction of fat cells from one area of the body and injecting it into another. The advantage of this procedure is being able to enhance a particular region of the body by using a natural “filler” (which may result in permanent correction). Fat injections can be used for lip augmentation, filling nasolabial folds (cheek lines), and rejuvenating the hands. However, fat can be injected to virtually any part of the body to correct deformities or enhance the area.


You may be a good candidate for the fat transfer method if you are physically healthy and of relatively normal weight, and are realistic in your expectations and goals. If you have a history of poor wound healing, you may not qualify for the fat transfer technique. During your consultation, you will be evaluated and Dr. Jazayeri will determine if fat transfer is right for you.

Details of the Fat Transfer Procedure

The redistribution of fat entails a two-part process; the fat from the patient’s body is taken via liposuction from one area before being injected into another. Therefore, an advantage of the fat transfer procedure is the fact that the patient is able to eliminate unwanted pockets of excess fat in addition to having another area enhanced.


After using liposuction to remove fat cells from certain areas from the body, the cells will be harvested, and then injected as a filler to a specific area of the face or body. The fat transfer procedure is typically performed with the use of a local anesthetic with sedation for large amounts of fat, and smaller amounts may only require local anesthesia. The amount of time fat grafting takes depends on the extent of the procedure. Typically, however, it can take up to a few hours.


The first part of the procedure involves suctioning fat from the donor area. Depending on where you store excess pockets of fat and where you want to slim down, Dr. Jazayeri will remove fat cells with a specialized syringe from the region, such as the abdomen, thighs, or buttocks. Next, the harvested fat cells will need to be isolated from the other fluids that were initially collected by spinning the collected tissue very quickly, or centrifuging the collected tissue. After this process is complete, Dr. Jazayeri can use these isolated cells to inject them in a particular area, where a filler is needed. A separate, smaller hypodermic needle is used for injection.

Recovery

Although there is the risk that fat cells can be reabsorbed by the body, the outcome of fat grafting is typically a success, providing long-lasting results if you are committed to a healthy lifestyle. You should be able to enjoy your new look for at least three months to about three years, or more, before opting for additional treatment. Depending on the area, up to 60 percent of fat cells may be re-absorbed. Dr. Jazayeri typically will over-correct these areas, anticipating some fat loss. However, secondary procedures may be necessary to obtain the final result. It is important to follow Dr. Jazayeri’s instructions regarding this procedure. Ice packs or cold packs may or may not be recommended for the first 24 to 48 hours of your surgery. If you receive fat injections in your facial skin, you should avoid wearing cosmetics for several days.


You may experience mild or moderate bruising, while swelling may be moderate to severe. But this is short-lived, lasting anywhere from one to three days. All side effects should have completely subsided between two and four weeks.




RHINOPLASTY



Rhinoplasty (nose surgery) is a procedure for improving the shape and the functional aspect of the nose. The shape of the nose is primarily dependent on genetics and racial background. Most patients seeking rhinoplasty are looking for a nasal shape which is proportional to their face. It is important, however, for the patient to have realistic expectations and realize the final shape of the nose is limited by anatomy and skin thickness.


It is important to realize when the outside (visible) portion of the nose is altered, it is important to address the inside of the nose as well. Typically, patients have slightly deviated septum (the supporting cartilage in the middle of the nose) and may have enlarged turbinates. The turbinates resemble worms which outline the inside of the nose, across from the septum. They are lined with nasal mucosa and help humidify the air we breathe. Typically these turbinates may become enlarged due to allergies or a significantly deviated septum. If the nasal shape is refined without addressing the septum and turbinates, the patient may end up with significant breathing problems.


Dr. Jazayeri uses the open technique in the majority of his rhinoplasty (nasal) surgeries performed at his office near Orange County. This technique allows for excellent visualization of the entire nasal framework, thus minimizing the chance of asymmetry.

Reasons for Rhinoplasty

Rhinoplasty (nose surgery) can significantly improve the appearance and utility of the nose. For those who choose to undergo the procedure for cosmetic reasons, rhinoplasty can correct a variety of unwanted features, which may include:


    Prominent nasal bumps
    Excessively wide, narrow, or asymmetric nostrils
    Bulbous or pointed tips

As a cosmetic and reconstructive surgeon, Dr. Jazayeri has a great deal of experience in correcting specific problems while enhancing the quality and appearance of the patient's face.


The beautiful results of our past patients can be seen in before and after rhinoplasty photos.

Types of Rhinoplasty Procedures

    Closed method: The traditional method involves making all the incisions inside the nose and the nostrils (the holes of the nose). The advantage of the closed technique is less dissection and swelling with the a potentially faster recovery. However, the view of the entire nose is limited and the chance of asymmetry is higher.
    Open method: The same incisions are used with the addition of an extra incision at the columella (the bridge of skin which connects the middle of the nose to the face). This allows the skin to be separated form the entire nasal frame work, allowing full view of the nose. Currently, this is the most common approach used for noses which require "the works". The advantage of this technique is better chance of symmetry and allows certain procedures to be performed which are not possible with the closed approach. The disadvantage is the increased chance of swelling, which may take longer to subside. The columella scar is also a concern. However, if the procedure is performed by a well-trained board certified plastic surgeon, the risk of unsightly scarring is rare to non-existent, assuming a normal post-operative healing process.

After The Procedure


After a full rhinoplasty, the patient will have a splint on the nose and packing inside. Typically, the splint and the packing are removed 7-8 days after surgery. The patient should refrain from wearing glasses or engage in any moderate to heavy physical activity for 4 weeks. Although the improvement in the nasal shape is immediately apparent, it will take at least 6 months for the final result.


What will my nose look like after surgery?


In general, rhinoplasty is designed to reduce excess cartilage and bone in the nose, removing irregularities and bumps to give a straightened, smooth and, usually, smaller appearance. Adding tissue to enhance certain features of the nose can also occur. The overall trend in modern rhinoplasty is away from over-reduction of tissue which can reduce the ability to breath through the nose and towards individualized treatment of each segment of the nose to give a balanced and refined look without compromising function.


How long does the surgery take and what kind of anesthesia is used?


Usually, Rhinoplasty takes from one to three hours depending on the complexity of the condition of the nose. Most patients have sedation prior to and during the procedure while some patients request a general anesthesia. Nearly all rhinoplasty operations are done as outpatient surgeries.


Is there a lot of bruising afterwards and how long will it last?


This depends again on how complex the procedure is, but in general most patients experience five to seven days of purple discoloration and swelling around the eyes and upper cheeks. The nose itself will be swollen for around ten to fourteen days or longer, but subtle resolution of the swelling at the tip of the nose can take many months after surgery to go away.


I have trouble breathing through my nose and have terrible sinus problems. Will my insurance policy pay for rhinoplasty?


The condition described is usually associated with a deviated septum or a bent internal framework of the nose. Most of the time this results from trauma such as a broken nose but many patients with this condition cannot recall an episode where this might have occurred. The condition described in this question however, could also result from allergies or the two conditions can exist simultaneously.


Careful examination is needed before surgery to separate the two conditions. While individual insurance policies can vary, in general, functional surgery to improve breathing is considered a covered benefit in many group policies. If additional correction of a Cosmetic deformity of the nose is done at the same time the cost of this part of the procedure is usually not covered by insurance.


Where are the incisions placed during nose surgery?


In general, most or all of the incisions in rhinoplasty are hidden in the inside of the nostril. While external incisions hidden in the creases where the nose meets the cheek can be used to narrow the nose, incisions on the bridge or tip are not usually used in Cosmetic surgery of the nose.


Will my nose grow after surgery?


In general, our noses tend to elongate as we enter the middle years of our life and drooping of the tip of the nose can occur in the later years as elasticity disappears from the body. While undergoing a Cosmetic rhinoplasty as a teenager or young adult will not prevent the effects of aging on the nose, the final shape that results from this surgery is expected to last a lifetime and regrowth of bumps and deformities corrected by the operation is a rare occurrence.


INJECTABLE FILLERS


At our office, we provide a full range of injectable fillers, such as Restylane ®, Radiesse ®, and collagen. However, as newer and better fillers become available in the market, our choice of injectable material may change. The fillers are used to improve permanent lines on the face. They can also be used to augment the lip, cheek, or chin area. In many instances, the best result is obtained by combining the filler with Botox, with our without laser resurfacing of the area.


BOTOX COSMETIC


The lines on the face are formed due to constant, chronic muscle movement under the skin. These lines are commonly seen on the forehead, between the eyebrows, and around the eyes.


Botox injection into the muscle temporarily paralyzes the muscle, thus preventing or improving these lines. The effect of Botox may last up to 6 months (with repeated injections).


Ideally, Botox should be used before static lines are formed (lines which are visible when the face is not animated). Once static lines are present, the effect of Botox is minimal to moderate. Other treatments such as laser resurfacing, chemical peel, or dermabrasion is recommended.




SCLEROTHERAPY (Spider-Vein Treatment)


Spider veins (telangectasia) are a very common problem affecting men and women of all ages. In women, the condition may worsen after pregnancy. Spider veins are typically seen in the lower legs, but may occur anywhere on the body and face.


Sclerotherapy involves injection of a special agent into the spider-vein, causing scarring and improvement in the appearance of the vein. This is an outpatient procedure and requires no anesthesia.




Pricing & Financing


General Questions


About the Procedure


Face Lift


Breast Augmentation


Liposuction


Rhinoplasty





 Plastic & Cosmetic Surgeons:

    Maher M. Anous, MD, FACS
    William Bruno, MD
    Andrew T. Cohen, MD, FACS
    Ron Hazani, MD, FACS
    Jason R. Hess, MD
    Richard Hodnett, MD, FACS
    Charles Hsu, MD
    Rafi Israel, MD
    Payam Jarrah-Nejad, MD, FACS
    Louis R. Mandris, MD
    Kenneth Siporin, MD

Shane Sheibani, MD














    Plastic & Cosmetic Surgery
    Body Lifts
    BOTOX® Cosmetic
    BOTOX® for Hyperhydrosis
    Breast Augmentation
    Breast Augmentation Revision
    Breast Implants
    Breast Lifts
    Breast Reconstruction
    Breast Reduction
    Buttock Enhancements
    Captique™
    Chin and Cheek Augmentation
    Collagen
    Cosmetic Surgery Revision
    Dysport™
    Ear Surgery
    Eyelid Surgery
    Facelift
    Fat Transfer Surgery
    Forehead/Brow Lift
    Juvederm™
    Latisse™
    Lip Augmentation
    Liposuction
    Male Breast Reduction
    Mommy Makeover
    Neck Lift
    Panniculectomy
    Pectoral Implants
    Post Bariatric Reconstruction
    Restylane®
    Rhinoplasty
    Rhinoplasty Revision
    Skin Tightening
    Thigh Lift
    ThreadLift™
    Tummy Tuck

    Podiatry

    Weight Loss, Bariatric & Banding

    Laser & Skin Care

    Orthopedic & Sports Medicine

    Cosmetic & Implant Dentistry

    Lasik & Ophthalmology

    Female Corrective
    & Vaginal Rejuvenation

    Hair Restoration & Transplant

    Hyperhidrosis & Excessive Sweating


 
Hand Surgery

One of the tell-tale signs of aging is thinning of the skin on top of the hand, resulting in exposure of the veins and tendons of the hand. Some practitioners use dermal fillers like Restylane®, Radiesse®, and Juvederm™ for hand rejuvenation, but in the past few years, it has appeared that results are longer-lasting with the use of fat injections. Dr. Jazayeri provides patients the opportunity to attain a more youthful look and feel to the hands with fat transfer to the dorsum of the hand, after extracting the fat from another part of the body with the use of liposuction.


The hands are one of the first areas of the body to show visible signs of aging; and because the hands are visible and unclothed, this can make a person feel embarrassed and want to hide them. Fortunately, the fat transfer, or “fat grafting,” process can help improve several problem areas of the hands, such as wrinkles, sun spots, and deep grooves. Dr. Jazayeri can provide you with more youthful, smoother, and attractive hands with this procedure. He will examine your hands and determine if fat transfer is the best method to meet your needs. You may qualify for hand rejuvenation if you are healthy and have realistic goals and expectations.

Procedural Steps for Hand Surgery

Dr. Jazayeri will recommend the type of anesthesia that is best for you; general anesthesia or local anesthesia with or without intravenous sedation may be used.


Prior to injecting fat into the hands, an area of the body that has an excess storage of fat (i.e., lower abdomen, buttocks, thighs, saddlebags) will receive liposuction. After being extracted, the harvested fat will then be purified and injected into the dorsum of the hand. The hands’ fullness will be restored, and the skin will become plumper, and veins will be less dramatic and apparent. Dr. Jazayeri will distribute the fat evenly. Typically, the fat will be injected between the tendons in order to mask any noticeable scarring. The total volume of fat injected into your hands will depend on the amount of volume needed. The procedure could last from 30 minutes to one hour.

Recovery

Dr. Jazayeri will complete your fat transfer procedure by closing the incisions with sutures. He will then apply a hand dressing/bandage. In addition, the harvest site incisions will be closed and steri-strips will be applied. There is no downtime for hand rejuvenation; however, you may experience some minimal discomfort after the procedure. The majority of patients are able to resume most normal activities within 48 hours of their fat transfer procedure. However, heavy manual labor or weight lifting is not recommended for the first seven to 10 days. Over time, some of the fat may be reabsorbed by the body; therefore, additional treatment sessions may be needed.


In addition to fat grafting, Dr. Jazayeri may recommend laser resurfacing of the hands to reduce or eliminate brown spots and tighten the skin.


 
SKIN CARE

Improving one's skin is always part of maintaining a youthful appearance. At our office, we provide multiple solutions to your concerns. Many options are available, and each patient will have a personalized program tailored to their specific need. These options can be as simple as using a skin care regimen, or as complex as surgery. In between these two extremes, there is the option of using fillers, Botox, and laser resurfacing.


We are proud to offer the Dermaceutic Spot Peel, the latest sensation in facial peels. The advantage of this peel is quick application, minimal pain, no need for skin pre-conditioning, and minimal down-time.


We realize each patient's skin is unique and one type of peel may not provide the best result for each individual. We also offer the Vivité Glycolic Treatment and the Vivité line of products as well.Breast Lift - Mastopexy


Pregnancy and breastfeeding often take their toll on the shape of the breasts. This is mainly due to excessive enlargement and stretching of the breast tissues and skin. After pregnancy, breast volume is lost while the stretched skin remains unchanged resulting in the typical saggy deflated shape. Similar changes are also noted in cases of weight gain followed by weight loss.


Women with sagging breasts often feel a loss of feminine appeal and become self-conscious. Most patients are under the impression that an augmentation with breast implants at most will be required to correct their problem. Unfortunately only minimal sagging can be corrected by augmenting the breasts with implants. If implants are used in breasts that are already sagging the result will most likely be poor. This is because the weight of the implant will cause further stretching and sagging of the breast skin.


Mastopexy is an operation that removes the excess skin and lifts the breasts and the nipples to their normal, youthful position. One can compare the breast skin to a bag that contains not enough breast tissue. While we cannot create breast tissue, we can certainly trim and tailor the overstretched skin to fit snuggly around the existing breast. Lifted breasts usually look rounder, firmer and perkier. The surgical technique is designed to hide incisions as much as possible. The operation is performed under general anesthesia. All suturing is performed beneath the skin; therefore there are no stitches to be removed. Recovery is 7 to 10 days. Upper body exercises, jogging and aerobics should be avoided for 6 weeks. Patients are advised to stay away from anti-inflammatory medication such as aspirin, Advil, Ibuprophen and Motrin, starting 2 weeks prior to surgery and continue avoiding such medications 10 days post operatively.

Scar less Breast Lift (Internal Mastopexy / Internal Lift)

I am very excited about my unique breast lifting technique which I perform on patients who are having breast implant surgery and have mild to moderate sagging. The technique lifts the breasts and nipples internally without the need for any additional scars. This is performed through the same small incision through which the implants are inserted. Internal Mastopexy cannot be performed as an individual procedure for breast lifting. It is only performed in conjunction with breast implants. However, patients who have had breast implants previously and are noticing that their breast tissues are sagging over their implants may also benefit from the Internal Mastopexy operation. This technique significantly enhances and improves the end result of Breast Augmentation by raising and relocating the sagging nipple and areola, in comparison to basic Breast Augmentation. Recovery time is 7 to 10 days. Activity restrictions for this procedure are similar to Breast Augmentation.


For detailed information regarding Internal Mastopexy, please refer to the featured article on Internal Lift (Internal Mastopexy) on our website.


Beverly Hills beauty isn't always exactly what it seems. Many of the beautiful people you see walking down the streets, in the stores, and on TV have had or will have some plastic surgery in their lives. Also, nowhere else in the world is plastic surgery more accepted than it is in Beverly Hills! If you're thinking about having cosmetic plastic surgery, there's really no better place than Beverly Hills to get work done. The doctors are discreet, the results are stunning, and you can even find plenty of financing opportunities.


Beverly Hills Physicians.com is one of the largest networks of beauty and health care providers in California. Though specialists primarily inclue plastic surgeons, the network hosts physicians, dentists, and aestheticians for all categories of beauty and wellness.


When it comes to plastic surgery in Beverly Hills or Los Angeles, the stars and everyday people all agree that Beverly Hills Physicians is the best in the business. A visit to Beverly Hills Physicians is like being on your very own makeover reality show. At Beverly Hills Physicians.com, we strive to provide you with the most reputable professionals within all facets of beauty: cosmetic dentistry, laser treatments, female corrective surgery, LASIK eye surgery, health and wellness services, and much more. As a patient of the Beverly Hills Physicians.com beauty network, you will have access to preferred patient pricing and incomparable customer service.


As a plastic surgery specialist, Beverly Hills Physicians.com provides highly-trained cosmetic surgeons and medical staff, spa-like facilities, and unparalleled patient services.


The professionals at Beverly Hills Physicians have been featured in glamour magazines like Elle, Cosmopolitan, and Bazaar, consulted on awards shows, and provided commentary for entertainment shows like Extra, Entertainment Tonight, and Tyra.


Our highly-trained plastic surgeons will sculpt and enhance your natural beauty. With over 100 years of combined experience, our surgeons provide unsurpassed medical expertise and commitment to patient education and care. Our plastic and cosmetic surgeons will assist you in achieving the figure of your desires.


We have experienced consultants who will guide you through your surgical experience at any of the Beverly Hills Physicians.com locations (Los Angeles, Beverly Hills and other centers in Southern California). Your consultant will recommend a qualified doctor to meet your surgical needs, in addition to assisting you with financing, pre-operative and post-operative care.


Peace of mind is invaluable to our patients and to our plastic surgeons. All of our surgical facilities are fully accredited by the American Association for Ambulatory Healthcare, and each center (like Beverly Hills, Encino, Thousand Oaks, Valencia, Pasadena, Long Beach and Oxnard) is equipped with state-of-the-art instruments.


Beverly Hills Plastic Surgeons · Beverly Hills Plastic Surgery · Beverly Hills Breast Augmentation · Breast Implants · Los Angeles Breast Lifts · Los Angeles Breast Reduction · Body Lifts · BOTOX® Cosmetic · Botox® for Hyperhydrosis · Chin and Cheek Augmentation · Los Angeles Eyelid Surgery · Facelift · Forehead Lift · Juvederm ·Lip Augmentation · Los Angeles Liposuction · Male Breast Reduction - Gynecomastia · Neck Lift · Restylane® · Rhinoplasty · ThreadLift™ · Tummy Tuck · Obesity Banding · Weight Loss Surgery · Podiatry · Podiatrist · Bunion · Hammertoe · Foot Doctor · Links · En Español


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plastic surgery, surgery [Credit: © Robert Llewellyn/Corbis]the functional, structural, and aesthetic restoration of all manner of defects and deformities of the human body. The term plastic surgery stems from the Greek word plastikos, meaning “to mold” or “to form.” Modern plastic surgery has evolved along two broad themes: reconstruction of anatomic defects and aesthetic enhancement of normal form. The surgical principles of plastic surgery remain focused on preserving vascularity, replacing like tissue with like tissue, respecting anatomic zones, and fostering wound healing by minimizing tissue trauma. As a diverse surgical specialty, the discipline of plastic surgery not only interacts with other disciplines of medicine but also merges medical science with the art of physical restoration. It couples careful evaluation of defects with sophisticated arrangements of tissue to improve the uniformity and natural resemblance of repair. Innovative techniques used in plastic surgery are largely the result of the successful clinical application of advances in tissue engineering, nanotechnology, and gene therapy.

Table Of Contents
Early developments in plastic surgery

The modern definition of plastic surgery is rooted in ancient medicine. The Sanskrit text Sushruta-samhita, written about 600 bce by ancient Indian medical practitioner Sushruta, describes, with surprising modernity, a quintessential plastic surgical procedure: the reconstruction of mutilated noses using tissue bridged from the cheek. During the Renaissance, Italian surgeon Gaspare Tagliacozzi and French surgeon Ambroise Paré adopted these early procedures and kindled a modern fascination with the use of local and distant tissue to reconstruct complex wounds. In the 19th century German surgeon Karl Ferdinand von Gräfe first invoked the term plastic when describing creative reconstructions of the nose in his text Rhinoplastik (1818). In the United States the organizing bodies of plastic surgery were founded between the world wars, with the American Society of Plastic Surgeons established in 1931 and the American Board of Plastic Surgery established in 1937. In the 1960s and ’70s the pioneering work of Canadian-born American surgeon Harry J. Buncke, Japanese surgeon Susumu Tamai, and Austrian surgeon Hanno Millesi resulted in the integration of procedures and techniques that defined microsurgery (surgery on very small structures requiring the use of a microscope).


plastic surgery [Credit: © Comstock/Thinkstock]Aesthetic, or cosmetic, surgery entered into the public consciousness with the advent of refinements that rendered safe the rejuvenation of the face and body through procedures such as face-lifts, breast augmentation, and liposuction. This was coupled with an increasing emphasis on minimally invasive procedures, such as injections of botulinum toxin (Botox) and cosmetic soft-tissue fillers (e.g., collagen and hyaluronic acid).

Table Of Contents
Surgical principles

The basic premise of soft tissue reconstruction is fixing deformities with normal tissue that shares similar characteristics with the damaged tissue. Respect for tissue physiology and mechanics is important in both reconstructive and aesthetic plastic surgery. Hence, delicate handling of tissue with instruments, judicious elevation of tissue to minimize vascular disruption, and precise alignment of tissue planes are all important elements of technique.

Grafts and flaps

tissue engineering [Credit: Vo Trung Dung/Corbis SYGMA]Closure of wounds is a central tenet of reconstructive surgery. Many wounds can be closed primarily (with direct suture repair). However, if the defect is sufficiently large, skin may be taken from other parts of the body and transferred to the area of the wound. Skin grafts are thin layers of skin taken from a remote location that are secured to the site of repair with bolsters, which serve to facilitate eventual integration of the donor skin into the wound.


Larger, more complex wounds have a greater volume and can involve exposed vital structures, such as vessels, nerves, tendon, bone, viscera, and other organs. Such wounds require coverage via transposed or transplanted composite segments of skin, subcutaneous tissue, muscle, and, in some cases, bone and nerve. These tissue constructs are maintained by their own defined blood supply and are called flaps. The pioneering work of Australian plastic surgeon Ian Taylor led to the characterization of angiosomes—the networks of blood vessels that supply flaps—which has allowed for rational matching of flaps to defects. Flaps may be transferred from neighbouring tissue, or they may be disconnected from their original blood supply and reconnected using microsurgical technique to another set of vessels adjacent to the defect.


plastic surgery: breast implant [Credit: © iStockphoto/Thinkstock]The use of implants or expander devices can also increase the amount of soft tissue. These devices are useful in cases when a patient has a limited amount of donor skin—for example, in those who are severely burned or in children who have large congenital moles. Implants and expander devices have also been adapted for breast reconstruction following mastectomy in breast cancer patients and for aesthetic breast augmentation.

Craniofacial surgery

Congenital and traumatic defects of the head and neck region fall under the scope of plastic surgery. Cleft lip and cleft palate deformities, premature fusion of skull elements, and persistent clefts in the facial skeleton require complex soft tissue and bone rearrangement. The introduction of internal fixation systems that use screws and plates has greatly facilitated congenital reconstructions as well as correction of traumatic fractures. Novel permutations of these fixation devices have been developed; for example, distraction osteogenesis is a technique used to induce bone growth from hypoplastic (incompletely developed) bone by traction exerted by moveable plate systems. Biomaterials, such as absorbable plate systems and bone cements, are being improved continually and are often used in pediatric craniofacial surgery.


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Hand surgery


By virtue of its unique anatomy and functional importance, restoration of hand deformities is a shared focus of both plastic surgeons and orthopedic surgeons. Congenital defects involving the hand range from absent or incomplete development (agenesis) to anomalies of limb structures. Traumatic insult may give rise to complex wounds, fractured bones, severed nerves and tendons, or amputations. In the appropriate context, severed digits and limbs may be replanted with microsurgical connections of vessels and nerves. Rehabilitation of the hand is a critical aspect of surgical care, since loss of strength and motion may occur following injury and reconstruction.

Aesthetic surgery

Aesthetic, or cosmetic, surgery is the enhancement of normal structures that are subject to age-related changes or that have unusual features that are distressing to the patient. The procedures used to address these issues are often performed in the physician’s office (as opposed to a hospital) and are relatively simple, entailing only injections of botulinum toxin or hyaluronic soft-tissue filler. In some cases, however, these procedures are complex, involving elective surgery to correct deformities of the nose or to remove excess sagging skin on the face. The practice of plastic surgery has moved beyond plastic surgeons, and there are many other physicians, such as dermatologists and otolaryngologists, who have the skill to perform these procedures.


The same principles that govern reconstructive surgery are applied to aesthetic surgery: replace like with like, respect anatomic boundaries, minimize tissue trauma, and preserve vascular integrity. Aesthetic surgery is also concerned with scars, especially their length and visibility, and modifications to classic procedures such as face-lifts are made to minimize and hide scars. While age-related changes can weaken the support structures of skin and soft tissue, the advent of bariatric surgery in obese patients can create analogous changes in the tissues of the arms, chest, abdomen, and thighs. Corresponding lifts of these parts of the body can be performed.


Botox injection [Credit: © Thinkstock Images/Jupiterimages]Other aesthetic surgeries can reduce or augment parts of the body that are perceived to be too large or too small; common examples include the nose or breasts. In addition, the judicious use of liposuction can improve contour in areas that are unbalanced by excess fat. For the face the use of botulinum toxin can weaken the underlying muscles that create some wrinkles; other wrinkles can be softened by injection of hyaluronic acid. Chemical peels, dermabrasion, and lasers can be used to smooth the fine wrinkles that can form in the uppermost layers of skin.


The heightened public interest in aesthetic surgery also creates clinical, ethical, and medicolegal challenges. A clear understanding of indications, techniques, and complications is important for both surgeon and patient to ensure safe and efficacious outcomes.

Saleh M. ShenaqJohn Kim
plastic surgery - Student Encyclopedia (Ages 11 and up)

    The medical specialty of plastic surgery is concerned with the reshaping of body tissues. The word plastic comes from the Greek plastikos, meaning "to shape" or "to form." The specialty includes both reconstructive and cosmetic surgery. Reconstructive surgery is used to repair malformed or damaged tissue or to replace lost tissue, such as from birth defects, accidents, disease, or cancer surgery. Its primary aims are to restore impaired function and to help people with deformities look as normal as possible. Cosmetic, or aesthetic, surgery is performed on normal, healthy tissue solely to make a person look younger or more attractive. A visually pleasing result is a goal of both reconstructive and cosmetic surgery, and plastic surgeons rely on their aesthetic judgment as well as their mastery of intricate surgical techniques and knowledge of wound healing.


 cosmetic surgery
The Oxford Companion to the Body | 2001 | COLIN BLAKEMORE and SHELIA JENNETT | Copyright

cosmetic surgery The close of the twentieth century marked the centenary of modern surgical intervention to alter the image of the body. A list of the most common operations which were developed over the past century and are understood as ‘cosmetic’ procedures today are shown in the table.


Cosmetic operations


Operations on the face


Forehead lift: tightens the forehead and raises the brow


Facelift (rhytidectomy): tightens the jowls and neck


Eyelid tightening (blepharoplasty): tightens the eyelids


Rhinoplasty (nose job): changes the appearance of the nose


Otoplasty (ear pinback): brings the ears closer to the head


Facial implants (chin, cheek): makes the cheek or chin more prominent


Hair transplantation: treats male pattern baldness


Scar revision: improves the appearance of scars


Skin resurfacing (laser, peel, dermabrasion): smoothes the skin


Operations on the body


Breast enlargement: enhances the size of the breast


Breast tightening (mastopexy): tightens the skin of the breast


Breast reduction: reduces the size of the breast


Breast reconstruction: rebuilds the breast after cancer


Abdominoplasty (tummy tuck): tightens skin and removes extra fat


Mini-abdominoplasty: removes the lower abdominal pouching


Liposuction: removes extra fat


Arm lift: tightens the skin of the upper arm


Gynecomastia resection (large breasts in men): reduces breast size



It is, of course, evident that virtually all procedures which could be conceptualized as cosmetic or aesthetic can also have a reconstructive dimension. Breast reconstruction, which used the same type of implant as breast augmentation, was the focus of a major debate within both medical and feminist circles in the US in the 1990s, as to whether it was reconstructive or aesthetic surgery. During the closing decades of the twentieth century these procedures, and also aesthetic orthodontics, came to be a common undertaking. Aesthetic surgery became a focus of interest — being patient-initiated, and non-reimbursable by private or state third-party payers.


While aesthetic surgery is related in many ways to other physical interventions, from hairweaving to tattooing and body piercing, it is performed in the quite different context of the institution of medicine. The surgical interventions are understood by doctors and patients alike as aesthetic rather than reconstructive. Even though the term ‘aesthetic surgery’ was acknowledged only recently, the practice of surgical interventions devoted to making people ‘beautiful’ rather than to any direct reconstruction of physical anomalies is relatively recent. There is a necessary if rather arbitrary distinction between reconstructive (plastic) surgery and aesthetic (cosmetic) surgery — between not having a nose and having a nose that you dislike. The first represents a functional fault. There is something wrong with the body as well as an unfortunate appearance — a hare lip, a missing jaw, a lost ear — and your desire is to repair the function of the body. Part of that function is, of course, an aesthetic one. Cosmetic surgery, which is part of, and grew from, reconstructive surgery, stresses the latter, subordinate, but essential aspect of the reconstruction. We imagine our bodies as intact and read our intactness as ‘beauty’. You may have a functional nose, a jaw, a breast, but it does not represent your self-image of the beautiful nose, jaw, or breast. It inhales, chews, or lactates, but it is not appropriate. The distinction between reconstructive and aesthetic surgery is an arbitrary one. Certain interventions have been labelled as inherently different — such as breast reconstruction vs. breast augmentation, even though the procedures are similar. The former are understood as a means of restoring physical completeness to the body image and therefore of restoring the psyche to a ‘happy’ state; the latter can be dismissed as ‘vogue fashions’ ( R. V. S. Thompson, Kay-Kilner Prize Essay, 1994). Feminists in the 1990s, such as the American poet Audre Lorde, who underwent a radical mastectomy, argued against breast reconstruction as a refusal to acknowledge the realities of the woman's body. In the Middle Ages, Guy de Chauliac, perhaps the most important surgeon of his time, defined the role of surgery as being threefold: solvit continuum (separating the fused), jungit separatum (connecting the divided), and exstirpat superfluum (removing the extraneous). There is no discussion in his or other texts of that period about the creation of new body parts or their augmentation or reconstruction, although it is evident that virtually all primarily reconstructive surgical procedures also had an aesthetic dimension, even then. As early as the Edwin Smith Surgical Papyrus (3000 bce), surgeons were concerned about the cosmetic results of their interventions. The Egyptians were careful to suture the edges of facial wounds. Even fractures of the nose-bones were dealt with by forcing them into normal positions by means of ‘two plugs of linen, saturated with grease’ inserted into the nostrils. The Roman physician Aulus Cornelius Celsus stressed the ‘beautiful’ suture. This approach can be followed through to the late nineteenth and early twentieth century, with plastic surgeons such as Erich Lexer stressing the cosmetic ends of an operation as ‘an always more appreciated requirement of modern surgery’. Such a stress on the neatness and beauty of the closure was part of the image of the return to function following the operation, for the beautiful was a sign of the healthy — but of the healthy body, not the healthy mind.


Yet even as we understand aesthetic surgery as a means of altering our body's ‘image’ it becomes a means not only of changing our bodies but of shaping our psyches. Aesthetic surgery remains rooted in a presumed relationship between the body and the mind. Sculpting the body comes to be a form of reshaping the psyche.


The central assumption of aesthetic surgery is that if you understand your body as ‘bad’ you are bound to be ‘unhappy’. And in our day and age, being unhappy seems to be identified with being sick. And if you are sick, you should be cured! The idea that you can cure the soul by altering the form of the body became commonplace in the twentieth century. It is the other side of the coin from the argument that to cure specific bodily symptoms you need to ‘heal’ the psyche.


Elaine Scarry has remarked in her classic work The Body In Pain (1985),

… at particular moments when there is within a society a crisis of belief — that is, when some central idea or ideology of cultural construct has ceased to elicit a population's belief either because it is manifestly fictitious or because it has for some reason been divested of ordinary forms of transubstantiation — the sheer material factualness of the human body will be borrowed to lend that cultural construct the aura of “realness” and “certainty”.

It is this realness and certainty ascribed to an imagined as well as the real body which is operated upon by the aesthetic surgeon.


During a period of revolutionary change in science, from the mid nineteenth to the early twentieth centuries, two major developments took place which enabled surgeons to introduce aesthetic changes, and patients to overcome their anxiety and undertake such procedures. Antisepsis and anaesthesia became central to the practice of surgery, following the discovery of ether anaesthesia in 1846 and the development by the 1880s of local anaesthesia. The movement toward antisepsis paralleled the development of anaesthesia: the model for antisepsis provided by Joseph Lister in 1867 became generally accepted by the end of the century. Aesthetic surgery became a context in which the ideology of the medical alteration of the body (and its state) was accepted by both the patient and the physician. All of these concerns can be understood as concerns of ‘hygiene’ in the broadest nineteenth-century sense, a hygiene of the state of both the body and the psyche. This set the stage for the development of the procedures used today. Take the case of Jacques Joseph, a young German-Jewish surgeon practising in fin-de-siècle Berlin. In 1896 Joseph undertook a corrective procedure on a child with protruding ears (otoplasty), which, although successful, caused Joseph to be dismissed from the staff of the orthopaedic clinic at the Berlin Charité. One simply did not undertake surgical procedures for vanity's sake, he was told upon his dismissal. The child was not suffering from any physical ailment which could be cured through surgery. Yet, according to the child's mother, he had suffered from humiliation in school because of his protruding ears. It was the unhappiness of the child that Joseph was correcting. The significance of protruding ears was clear to Jacques Joseph and his contemporaries at that time. There is an old trope in European culture about the Jew's ears that can be found throughout the anti-Semitic literature of the fin de siècle, and it is also a major sub-theme of one of the great works of world literature, Heinrich Mann's Man of Straw (1918). In that novel, Mann's self-serving convert, Jadassohn (Judas's son?) ‘looked so Jewish’ because of his ‘huge, red, prominent ears’ which he eventually went to Paris to have cosmetically reduced; his ears signified his poor character. Jacques Joseph went on to pioneer the intranasal procedure for the reduction of the size of the nose and came to be known among the Jewish community in Berlin as ‘Nose-Joseph’.


The social and psychological significance of the introduction of aesthetic surgery is relevant to other external markers of difference, from ageing (face lifts), to sexuality (transsexual surgery), to notions of beauty of face (orthodontics) and of body (liposuction). The norms of the acceptable change with time, but the desire to become invisible, to become a member of a class or group to which one does not naturally belong, maintains itself over the entire history of aesthetic surgery.


Sander L. Gilman


Bibliography


Gilman, S. L. (2000) Making the body beautiful: a cultural history of aesthetic surgery. Princeton University Press, Princeton.

Maltz, M. (1946). Evolution of plastic surgery. Froben Press, New York.
Wallace, A. F. (1982). The progress of plastic surgery: an introductory history. Willem A. Meeuws, Oxford.

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Cosmetic breast surgery


Breast augmentation is a procedure to change the size or shape of the breasts.


See also:


    Breast reconstruction - natural tissue
    Breast reconstruction - implants
    Breast lift

Description


Cosmetic breast surgery may be done at an outpatient surgery clinic or in a hospital.


    Most women receive general anesthesia for this surgery. You will be asleep and pain-free.
    You may also be given medicine to relax you and local anesthesia. You will be awake and will receive medicine to numb your breast area to block pain.

There are many different ways to place breast implants:


    In the most common technique, the surgeon will make surgical cut on the underside of your breast, in the natural skin fold. Your surgeon will place the implant through this opening. Your scar may be a little more visible if you are younger, thin, and have not yet had children.
    The implant may be placed through a surgical cut under your arm. Your surgeon may perform this surgery using an endoscope (a tool with a camera and surgical instruments at the end that is inserted through a vein). There will be no scar around your breast, but you may have a visible scar on the underside of your arm.
    The surgeon may make a cut around the edge of your areola, the darkened area around your nipple. The implant is placed through this opening. You may have more problems with breastfeeding and loss of sensation around your nipple with this method.
    A newer technique involves placing a saline implant through a surgical cut near your belly button. An endoscope is used to move the implant up to the breast area. Once in place, the implant is filled with saline.

Breast implants may be placed either directly behind the breast tissue (subglandular) or behind the outer layer of chest wall muscles (submuscular). The type of implant and implant surgery can affect:


    How much pain you have after the procedure
    The appearance of your breast
    The risk of the implant breaking or leaking in the future
    Your future mammograms

Your surgeon can help you decide which procedure is best for you.

Breast liftWatch this video about:Breast lift

Why the Procedure is Performed


Breast augmentation is done to increase the size of your breasts.


A breast lift, or mastopexy, is usually done to lift sagging, loose breasts. The size of the areola, the dark pink skin surrounding the nipple, can also be reduced.


Talk with a plastic surgeon if you are considering cosmetic breast surgery. Discuss how you expect to look and feel better. Keep in mind the desired result is improvement, not perfection. Emotional stability is an important factor. Breast surgery can renew your self-confidence and improve your appearance, but the rest is up to you.

Risks

Risks for any surgery are:


    Bleeding
    Infection

Risks for any anesthesia are:


    Reactions to medicines
    Breathing problems, pneumonia
    Heart problems

Risks for breast surgery are:


    Difficulty breastfeeding
    Loss of feeling in the nipple area
    Small scars, usually in an area where they do not show much. Some women may have thickened, raised scars.
    Uneven position of your nipples
    Different size or shape of the two breasts
    It is normal for your body to create a “capsule” made up of scar tissue around your new breast implant. This helps keep the implant in place. Sometimes, this capsule becomes thickened and larger and may cause a change in the shape of your breast, hardening of breast tissue, or some pain.
    Breaking or leakage of the implant
    Visible rippling of the implant

The emotional risks of surgery may include feeling that your breasts don't look perfect, or you may be disappointed with people's reactions to your “new” breasts.

Before the Procedure

Always tell your doctor or nurse:


    If you are or could be pregnant
    What drugs you are taking, even drugs, supplements, or herbs you bought without a prescription

During the days before your surgery:


    You may need mammograms or breast x-rays before surgery. Your plastic surgeon will do a routine breast exam.
    Several days before surgery, you may be asked to stop taking aspirin, ibuprofen (Advil, Motrin), warfarin (Coumadin), and any other drugs that make it hard for your blood to clot.
    Ask your doctor which drugs you should still take on the day of surgery.
    You may need to fill prescriptions for pain medicine before surgery.
    Arrange for someone to drive you home after surgery and help you around the house for 1 or 2 a days.
    If you smoke, try to stop. Ask your doctor or nurse for help.

On the day of the surgery:


    You will usually be asked not to drink or eat anything after midnight the night before surgery.
    Take the drugs your doctor told you to take with a small sip of water.
    Wear or bring loose clothing that buttons or zips in front and a soft, loose-fitting bra with no underwire.
    Your doctor or nurse will tell you when to arrive at the hospital.

After the Procedure


You may need to stay overnight in the hospital. Some women can go home when their anesthesia wears off and they can walk, drink water, get to the bathroom safely, and have pain they can manage at home.


After breast augmentation surgery, a bulky gauze dressing will be wrapped around your breasts and chest, or you might wear a surgical bra. Drainage tubes may be attached to your breasts. These will be removed within 3 days.


Sometimes doctors also recommend massaging the breast starting 5 days after surgery to reduce hardening of the capsule that surrounds the implant. Ask your doctor first before massaging over your implants.

Outlook (Prognosis)

You are likely to have a very good outcome from breast surgery. You may feel better about your appearance and yourself. Also, the pain or skin symptoms you had (such as striation) will disappear. You may need to wear a special supportive bra for a few months to reshape your breasts.


Scars are permanent and are often more visible in the year after surgery. They will fade after this. Your surgeon will try to place the incisions so that your scars are as hidden as possible. Your scars should not be noticeable, even in low-cut clothing, since incisions are usually made on the underside of the breast.

Alternative Names

Breast augmentation; Breast implants; Implants - breast; Mammaplasty

References

Burns JL, Blackwell SJ. Plastic surgery. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 73.


Sarwer DB. The psychological aspects of cosmetic breast augmentation. Plast Reconstr Surg. 2007 Dec;120(7 Suppl 1):110S-117S.


Hölmich LR, Lipworth L, McLaughlin JK, Friis S. Breast implant rupture and connective tissue disease: a review of the literature. Plast Reconstr Surg. 2007 Dec;120(7 Suppl 1):62S-69S.


McLaughlin JK, Lipworth L, Fryzek JP, Ye W, Tarone RE, Nyren O. Long-term cancer risk among Swedish women with cosmetic breast implants: an update of a nationwide study. J Natl Cancer Inst. 2006 Apr 19;98(8):557-60.


Wiener TC. Relationship of incision choice to capsular contracture. Aesthetic Plast Surg. 2008 Mar;32(2):303-6.

Update Date: 2/8/2011

Updated by: David A. Lickstein, MD, FACS, specializing in cosmetic and reconstructive plastic surgery, Palm Beach Gardnes, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.


 Breast implant
From Wikipedia, the free encyclopedia
Jump to: navigation, search
Breast implant: the pre-operative (left) and post-operative (right) aspects of a young woman’s bilateral breast augmentation with high-profile, 500cc silicone-gel implants.
Breast implant: The post-operative aspect of a breast cancer mastectomy; the woman is a candidate for a primary breast-reconstruction procedure of her right breast.

A breast implant is a medical prosthesis used to augment, reconstruct, or create the physical form of breasts. Applications include correcting the size, form, and feel of a woman’s breasts in post–mastectomy breast reconstruction; for correcting congenital defects and deformities of the chest wall; for aesthetic breast augmentation; and for creating breasts in the male-to-female transsexual patient.


There are three general types of breast implant device, defined by the filler material: saline, silicone, and composite. The saline implant has an elastomer silicone shell filled with sterile saline solution; the silicone implant has an elastomer silicone shell filled with viscous silicone gel; and the alternative composition implants featured miscellaneous fillers, such as soy oil, polypropylene string, et cetera. In surgical practice, for the reconstruction of a breast, the tissue expander device is a temporary breast prosthesis used to form and establish an implant pocket for the permanent breast implant. For the correction of male breast and chest-wall defects and deformities, the pectoral implant is the breast prosthesis used for the reconstruction and the aesthetic repair of a man’s chest. (See: gynecomastia and mastopexy)

Contents

    1 History
    2 Types of breast implant device
    3 The patient
    4 Surgical procedures
        4.1 Indications
        4.2 Incision types
        4.3 Implant pocket placement
        4.4 Post-surgical recovery
    5 Complications
        5.1 Implant rupture
        5.2 Capsular contracture
        5.3 Repair and revision surgeries
    6 Alleged complications
        6.1 Systemic disease and sickness
        6.2 Platinum toxicity
    7 Implants and breast-feeding
    8 Implants and mammography
    9 U.S. FDA approval
    10 Criticism
    11 See also
    12 References
    13 External links

History

Breast implant: Dr. Vincenz Czerny (1842–1916) a pioneer in breast reconstruction surgery.

The 19th century


Since the late nineteenth century, breast implant devices have been used to surgically augment the size (volume), modify the shape (contour), and enhance the feel (tact) of a woman’s breasts. In 1895, surgeon Vincenz Czerny effected the earliest breast implant emplacement when he used the patient's autologous adipose tissue, harvested from a benign lumbar lipoma, to repair the asymmetry of the breast from which he had removed a tumor.[1] In 1889, surgeon Robert Gersuny experimented with paraffin injections, with disastrous results. From the first half of the twentieth century, physicians used other substances as breast implant fillers — ivory, glass balls, ground rubber, ox cartilage, Terylene wool, gutta-percha, Dicora, polyethylene chips, Ivalon (polyvinyl alcohol – formaldehyde polymer sponge), a polyethylene sac with Ivalon, polyether foam sponge (Etheron), polyethylene tape (Polystan) strips wound into a ball, polyester (polyurethane foam sponge) Silastic rubber, and teflon-silicone prostheses.[2]


The 20th century


In the mid-twentieth century, Morton I. Berson, in 1945, and Jacques Maliniac, in 1950, each performed flap-based breast augmentations by rotating the patient’s chest wall tissue into the breast to increase its volume. Furthermore, throughout the 1950s and the 1960s, plastic surgeons used synthetic fillers — including silicone injections received by some 50,000 women, from which developed silicone granulomas and breast hardening that required treatment by mastectomy.[3] In 1961, the American plastic surgeons Thomas Cronin and Frank Gerow, and the Dow Corning Corporation, developed the first silicone breast prosthesis, filled with silicone gel; in due course, the first augmentation mammoplasty was performed in 1962 using the Cronin–Gerow Implant, prosthesis model 1963. In 1964, the French company Laboratoires Arion developed and manufactured the saline breast implant, filled with saline solution, and then introduced for use as a medical device in 1964.[4]

Types of breast implant device
Breast implant: saline solution filled breast implant device models.
The original breast implant: Cronin–Gerow Implant, prosthesis model 1963, an anatomic (tear-shaped) design that featured a posterior fastener made of Dacron.
Breast implant: Late-generation models of Silicone gel-filled prostheses.

There are three types of breast implant used for mammoplasty, breast reconstruction, and breast augmentation procedures


    saline implant filled with sterile saline solution.
    silicone implant filled with viscous silicone gel.
    alternative-composition implant with miscellaneous fillers (e.g. soy oil, polypropylene string, etc.) that are no longer manufactured.

I. — Saline implants


    Surgical technology

The saline breast implant is filled with saline solution (biological-concentration salt water 0.90% w/v of NaCl, ca. 300 mOsm/L.). The early models were a relatively delicate technology that were prone to failure, usually shell breakage, leakage of the saline filler, and deflation of the prosthesis. Contemporary models of saline breast implant are made with stronger, room-temperature vulcanized (RTV) shells made of a silicone elastomer. The study In vitro Deflation of Pre-filled Saline Breast Implants (2006) reported that the rates of deflation (filler leakage) of the pre-filled saline breast implant made it a second choice for corrective breast surgery, after the silicone gel type of breast implant.[4] Nonetheless, in the 1990s, in U.S. medicine, the saline breast implant was the usual breast prosthesis applied for breast augmentation, given the unavailability of silicone implants, because of the import restrictions of the U.S. Food and Drug Administration.


    Surgical technique

The saline breast implant was developed to facilitate a more conservative surgical technique, of smaller and fewer cuts to the breast, for emplacing an empty breast-implant device through a smaller surgical incision.[5] In surgical praxis, after having emplaced the empty breast implants into the implant pockets, the plastic surgeon then fills each breast prosthesis with saline solution, and, because the required insertion incisions are small, the resultant incision-scars will be smaller than the surgical scar usual to the long incision required for inserting pre-filled, silicone-gel implants. Although the saline breast implant can yield good-to-excellent results of breast size, contour, and feel, when compared to silicone-implant results, the saline implant is likelier to cause cosmetic problems such as rippling, wrinkling, and being noticeable to the eye and to the touch. This is especially true for women with very little breast tissue, and for post-mastectomy reconstruction patients; thus, silicone-gel implants are the superior prosthetic device for breast augmentation and for breast reconstruction. In the case of the woman with much breast tissue, for whom partial submuscular emplacement is the recommended surgical technique, saline breast implants can afford an aesthetic “look” of breast size and contour (though not feel) much like that afforded by the silicone implant.[6]


II. — Silicone gel implants


As a medical device technology, there are five (5) generations of silicone breast implant, each defined by common model-manufacturing techniques.


First generation


The Cronin–Gerow Implant, prosthesis model 1963, was a tear-drop-shaped sac (silicone rubber envelope) filled with viscous silicone-gel. To reduce the rotation of the emplaced breast-implant upon the chest wall, it was affixed to the implant pocket with a fastener-patch of Dacron material (Polyethylene terephthalate) attached to the rear of the breast implant shell.[7]


Second generation


In the 1970s, the first technological development, a thinner device-shell and a thinner, low-cohesion silicone-gel filler, improved the functionality and verisimilitude (size, look, and feel) of the silicone breast implant. Yet, in clinical practice, the second-generation proved fragile, and suffered greate





Interested in Plastic Surgery?

If you care about your appearance, and you want to find a top quality surgeon at an affordable price, then Click here to contact us right now.

We have several locations in Southern California so we're nearby wherever you are. We use the most advanced technology, the latest techniques, and our award-winning, expert surgeons are among the best in the business, yet we also have the most competitive prices in the US.

We have financing plans available, and we're currently offering free, private consultations with our expert doctors.

So, if you are considering breast implants, liposuction, tummy tuck, breast augmentation, nose refinement, or any other Cosmetic surgery, please click here to contact 123 New Me to set up a consultation. Your information will remain strictly confidential.





Cosmetic Surgery and Laser Surgery

The plastic surgery specialty encompasses both reconstructive surgery and aesthetic surgery, popularly referred to as Cosmetic Surgery. Reconstructive surgery restores or improves physical function and minimizes disfigurement from accidents, disease or birth defects. While not essential to physical health, aesthetic surgery can make a significant contribution to the quality of life by improving the appearance of normal body features and enhancing self-image.

An increasing number of Americans elect aesthetic surgery to change the way they look. Some have noticeable changes made, others subtle refinements. The decision to have aesthetic surgery is usually based on personal factors, as well as the accepted values of our society.

Breast Augmentation ( Implants and Fillers )

Breast augmentation, technically known as augmentation mammoplasty, is a surgical procedure to enhance the size and shape of a woman's breast for a number of reasons. Breast augmentation is usually done to balance a difference in breast size, to improve body contour, or as a reconstructive technique following surgery. To assist you in obtaining a better body, 123 New Me can offer Surgeons with accumulated surgical experience of more than 30 years. Read More >

Body Contouring ( Liposuction and "Tummy Tuck" )

Body Contouring, Liposuction and Abdominoplasty, are procedures to improve the appearance of your body contours. Liposuction is a procedure that can help sculpt the body by removing unwanted fat from specific areas, including the abdomen, hips, buttocks, thighs, knees, upper arms, chin, cheeks and neck. Although no type of liposuction is a substitute for dieting and exercise, liposuction can remove stubborn areas of fat that do not respond to traditional weight-loss methods. Read More >

Face Lift

A Facelift (technically known as Rhytidectomy) cannot stop the aging process, but it will be able to "set back the clock," improving the most visible signs of aging by removing excess fat, tightening underlying muscles, and redraping the skin of your face and neck. Read More >

Rhinoplasty

Rhinoplasty (or Nose Refinement Surgery) is the most intricate Cosmetic surgery performed today. Rhinoplasty can reduce or increase the size of your nose, change the shape of the tip or the bridge, narrow the span of the nostrils, or change the angle between your nose and your upper lip. It may also correct a birth defect or injury, or help relieve some breathing problems. Read More >

Skin Rejuviation ( Botox and Injectable Fillers )

Fat Transfer, Collagen and BOTOX injections are procedures used i n improvement of the facial features and relaxation of the fine facial lines and wrinkles. Read More >

Hair & Tattoo Removal ( Laser Treatment )

Laser Treatment Procedure performed by 123 New Me include Laser Hair Removal, Laser Tattoo Removal, Laser Facial Resur facing and other General Laser Surgery Procedures. Endermology, Micro-dermabrasi on and other Cosmetic procedures are also available at our practice. Read More >

Anti-Aging

While Cosmetic Surgery emphasizes external improvement, Anti-Aging Me dicine addresses the internal improvement. Anti-Aging is the most advanced field of medicine committed to the reversal of the cellular damage and aging process through maximal hormonal and nutritional balance. Read More >









Interested in Plastic Surgery?

If you care about your appearance, and you want to find a top quality surgeon at an affordable price, then Click here to contact us right now.

We have several locations in Southern California so we're nearby wherever you are. We use the most advanced technology, the latest techniques, and our award-winning, expert surgeons are among the best in the business, yet we also have the most competitive prices in the US.

We have financing plans available, and we're currently offering free, private consultations with our expert doctors.

So, if you are considering breast implants, liposuction, tummy tuck, breast augmentation, nose refinement, or any other Cosmetic surgery, please click here to contact 123 New Me to set up a consultation. Your information will remain strictly confidential.





Cosmetic Surgery and Laser Surgery

The plastic surgery specialty encompasses both reconstructive surgery and aesthetic surgery, popularly referred to as Cosmetic Surgery. Reconstructive surgery restores or improves physical function and minimizes disfigurement from accidents, disease or birth defects. While not essential to physical health, aesthetic surgery can make a significant contribution to the quality of life by improving the appearance of normal body features and enhancing self-image.

An increasing number of Americans elect aesthetic surgery to change the way they look. Some have noticeable changes made, others subtle refinements. The decision to have aesthetic surgery is usually based on personal factors, as well as the accepted values of our society.

Breast Augmentation ( Implants and Fillers )

Breast augmentation, technically known as augmentation mammoplasty, is a surgical procedure to enhance the size and shape of a woman's breast for a number of reasons. Breast augmentation is usually done to balance a difference in breast size, to improve body contour, or as a reconstructive technique following surgery. To assist you in obtaining a better body, 123 New Me can offer Surgeons with accumulated surgical experience of more than 30 years. Read More >

Body Contouring ( Liposuction and "Tummy Tuck" )

Body Contouring, Liposuction and Abdominoplasty, are procedures to improve the appearance of your body contours. Liposuction is a procedure that can help sculpt the body by removing unwanted fat from specific areas, including the abdomen, hips, buttocks, thighs, knees, upper arms, chin, cheeks and neck. Although no type of liposuction is a substitute for dieting and exercise, liposuction can remove stubborn areas of fat that do not respond to traditional weight-loss methods. Read More >

Face Lift

A Facelift (technically known as Rhytidectomy) cannot stop the aging process, but it will be able to "set back the clock," improving the most visible signs of aging by removing excess fat, tightening underlying muscles, and redraping the skin of your face and neck. Read More >

Rhinoplasty

Rhinoplasty (or Nose Refinement Surgery) is the most intricate Cosmetic surgery performed today. Rhinoplasty can reduce or increase the size of your nose, change the shape of the tip or the bridge, narrow the span of the nostrils, or change the angle between your nose and your upper lip. It may also correct a birth defect or injury, or help relieve some breathing problems. Read More >

Skin Rejuviation ( Botox and Injectable Fillers )

Fat Transfer, Collagen and BOTOX injections are procedures used i n improvement of the facial features and relaxation of the fine facial lines and wrinkles. Read More >

Hair & Tattoo Removal ( Laser Treatment )

Laser Treatment Procedure performed by 123 New Me include Laser Hair Removal, Laser Tattoo Removal, Laser Facial Resur facing and other General Laser Surgery Procedures. Endermology, Micro-dermabrasi on and other Cosmetic procedures are also available at our practice. Read More >

Anti-Aging

While Cosmetic Surgery emphasizes external improvement, Anti-Aging Me dicine addresses the internal improvement. Anti-Aging is the most advanced field of medicine committed to the reversal of the cellular damage and aging process through maximal hormonal and nutritional balance. Read More >







FAQ's

PRICING AND FINANCING QUESTIONS

How much do the consultations cost?

Absolutely nothing, the consultations are free! You will meet your surgeon for an initial consultation, a pre-op consultation and several post-op consultations, all which are free of charge.

Are there any extra costs I should know about?

The price for the procedure will include everything except anesthesia (approximately $400 - $600 depending on the procedure), blood test, laboratory and handling ($150 ) and your surgical garment ($60 - $150). Click here to visit our pricing page.

Is there an extra discount for having more than one procedure?

Yes, if you are having more than one procedure done, you can expect a substantial discount on the standard rates.

I do not have enough cash to pay for my procedure, can you help?

Yes, we offer assistance in obtaining financing from accredited patient financing institutions. For more information, please reference our finance page by clicking here.

Does my medical insurance cover Cosmetic surgery?

Most medial insurance plans do not cover elective surgery, but in those cases they do - 123 New Me is more than happy to accept medical coverage. You should ask your medical insurance provider and schedule an appointment with our surgeons to find out the options for your particular case.

GENERAL QUESTIONS

Who do I contact if I want more information about your procedures, the practice and the surgeons?

Please contact the 123 New Me to get in touch with one of our Cosmetic consultants.

Where can I see before- and after photos of procedures performed by your surgeons?

Before and after photos are available on our website by clicking here. You are also welcome to view the pictures during your initial complementary consultation with our experienced surgeons.

Are your surgeons Board Certified?

Our surgeons are highly skilled and experienced surgeons with immaculate training. They are diplomates of either American Board of Plastic Surgery or the American Board of Cosmetic Surgery.

Is there any age restriction for people to come in and get a consultation?

No, patients of all ages approach our clinic, and the surgeons that work here also perform reconstructive surgery, which sometimes is needed by young people.

What are your office hours?

123 New Me has a 24/7 phone line open to our patients and customers. Our hours for consultation and surgery vary depending on your preferences. The easiest way to schedule an appointment is to contact the 123 New Me and we'll set up a consultation for you. Late evening consultations can be scheduled to accomodate each patient individually.

ABOUT THE PROCEDURE

What is the difference between Cosmetic and reconstructive surgery?

Cosmetic surgery is performed to reshape normal structures of the body in order to improve the patient's appearance and self-esteem. Cosmetic surgery is usually not covered by health insurance because it is elective.

Reconstructive surgery is performed on abnormal structures of the body, caused by congenital defects, developmental abnormalities, trauma, infection, tumors or disease. It is generally performed to improve function, but may also be done to approximate a normal appearance. Reconstructive surgery is generally covered by most health insurance policies although coverage for specific procedures and levels of coverage may vary greatly. There are a number of "gray areas" in coverage for plastic surgery that sometimes require special consideration by an insurance carrier. These areas usually involved surgical operations which may be reconstructive or Cosmetic, depending on each patient's situation. For example, eyelid surgery (blepharoplasty) - a procedure normally performed to achieve Cosmetic improvement may be covered if the eyelids are drooping severely and obscuring a patient's vision.

Will It Hurt?

During a procedure anesthesia ensures that you're comfortable and feel no pain. If general anesthesia is used, you'll even sleep through the entire operation After surgery any pain of discomfort you may experience can usually be controlled through medication and will usually subside in a matter of days.

Will there be scars?

To most surgical Cosmetic procedures the answer is yes. Will they be noticeable- Probably not. Your surgeon will make every effort to keep scars as minimal as possible and try to hide them in the natural lines and creases of your skin. For the majority of procedures, your scars will fade over time and become barely visible.

Is it safe?

Millions of Cosmetic procedures are performed successfully every year and complications are usually rare and uncommon. But no matter how easy, simple or safe today's Cosmetic surgery may seem to be, you must remember that it is still surgery and with any surgery there are certain risks involved.

How long will it last?

The duration of the results is very specific to the procedure performed. In general, procedures that are performed to correct or reshape nature's small defects such as surgery of the nose, breast augmentation/reduction and chin augmentation, the benefits may last a lifetime. For those that focus on rejuvenation such as a face lift, forehead lift chemical peel or eyelid surgery, the results can last 5 - 10 years

Will people be able to tell?

In general, most Cosmetic procedures enhance your looks or minimize perceived flaws naturally, and often go unnoticed. You may be asked if you've been exercising, lost weight or have begun a rejuvenating routine. Typically, no one will know unless you tell.

How soon can I return to work?

Again, this differs widely on the procedure that has been performed, but on average, most Cosmetic surgery patients are back to work within 3 to 10 days

How many people undergo Cosmetic surgery each year?

Nearly 3.5 million Cosmetic surgery procedures are performed each year.

At what age do most people have Cosmetic surgery?

About one-third of Cosmetic surgery patients are between 35 and 50. About 22 percent are 26 to 34, 18 percent are 25 and under and 27 percent are over 51.

How many men have Cosmetic surgery?

Almost 700,000 Cosmetic procedures are performed on men each year. And the number gets larger each year as men grow increasingly comfortable with the concept of Cosmetic surgery for themselves.

What are the most popular procedures for men?

- hair transplantation/restoration
- chemical peel
- liposuction
- sclerotherapy (vein treatment)
- eyelid surgery

LIPOSUCTION QUESTIONS

What is Liposuction?

Liposuction is the surgical vacuuming of fat from beneath the surface of the skin. It is used to reduce fullness in any area of the body. It is an excellent method of spot reduction but is not an effective method of weight loss.

What is the tumescent technique?

The tumescent technique involves injection beneath the skin of large volumes of salt water containing lidocaine, a local anesthetic and small amounts of adrenaline, a naturally occurring hormone which shrinks blood vessels. By injecting this solution to the fat prior to performing liposuction the plastic surgeon numbs the tissues and shrinks the blood vessels thereby eliminating pain and reducing and minimizing bleeding, bruising, and swelling. The tumescent technique permits some patients who were previously treated under general anesthesia to be treated under local anesthesia with sedation.

Who is a candidate for liposuction?

Generally people who have localized areas of protruding fat achieve the most dramatic results. Patients who are slightly overweight can benefit from liposuction. It is best to be at or near your normal weight. Good skin elasticity permits the skin to shrink easily to the reduced contour. There are no absolute age limits for liposuction.

What areas are most frequently treated?

In women, the single most frequently treated areas are the outer thighs, followed by the stomach. In men, the flank area or "love handles" are treated most frequently.

Can liposuction tighten up a loose neck?

If there is excess fat in the area under the chin and the skin is taut, liposuction alone can produce a more sculpted, angular, and youthful jaw line. If, however, the skin of the neck is loose or hanging, even if there is excess fat, liposuction alone will not produce the desired result. Patients with loose skin usually require a face and neck lift in addition to or instead of liposuction. In general, most patients who benefit from liposuction of the neck are under 40. Most patients over 40 will require some surgical skin tightening.

Liposuction seems very simple and safe. Are there any dangers?

Although liposuction is very safe and effective, it is a surgical procedure and can cause complications such as infection, bleeding, and nerve damage. In addition, aesthetic complications such as skin irregularity or waviness can occur if too much fat has been removed. Fortunately, complications are uncommon and most patients are satisfied with their results.

Do you do liposuction of the abdomen?

Yes, sometimes it is recommended to perform a liposuction of the abdomen instead of a tummy tuck.

BREAST AUGMENTATION QUESTIONS

Is your price quote for the breast augmentation including both breasts?

Most definitely yes, the prices for procedures like breast augmentation, eyelid surgery etc. are always quoted in pairs.

Why are you not offering silicon breast implants?

Despite the popularity and great results with silicon breast implants, the use of silicon is currently under federal investigation, disabling us from using them in our procedures.

Is it possible to perform the breast implant procedure via the armpit or bellybutton?

Yes, our armpit and bellybutton procedures are becoming increasingly popular, since they leave no visible scars.

Can you breast feed after having a breast enlargement?

Yes, the functions of your breast are in no way limited by the implants.

Is it true you have to replace breast implants every 10-15 years?

Some patients need to replace their implants if their breast starts sagging, or if the implant should be leaking. The implants we use have a lifetime guarantee, however, so the implants will be replaced at no cost to the patient.

Can breast augmentation be done without taking any pain medication whatsoever?

Yes, there is no requirement to take pain killers after any procedure, but most patients find it comforting to ease the pain - especially since the muscles after a breast augmentation can be rather sore.

FACELIFT

What is a facelift?

A facelift or "rhytidectomy" is a surgical procedure designed to improve the most visible signs of the aging process by eliminating excess fat, tightening the muscles beneath the skin of the neck, and removing sagging skin. It doesn't stop the aging process but merely "sets the clock back".

How long does a facelift last?

No one can say for sure. The clock is turned back, but keeps on running. Ten years later, you will look better than if you never had surgery. Many patients never have a second lift, while others may desire further surgery seven to 15 years later.

Can surgery be done without scars?

The scars from facelift surgery usually fade and are barely perceptible. In some patients, especially younger ones, endoscopic surgery can be used to lift the eyebrows, remove frown lines, elevate the cheek and jowls, and tighten the neck. This endoscopic surgery can be done with tiny scars. However, if there is excessive skin, it must be removed for the best results through standard facelift incisions.

How long will I be out of work?

Most patients are able to return to work in two to three weeks. You should allow four to eight weeks before major social engagements.

How can I hide things during the time until I return to normal?

Your surgeon will discuss post-operative camouflage techniques with you prior to your surgery, but be assured that while almost everyone has some sort of temporary side effect such as bruising and swelling, there are makeup techniques that both men and women can use almost immediately to disguise them. Generally speaking, makeup techniques can be used soon after surgery to cover discolorations, and to hide incision lines after the stitches have been removed and the incision is completely closed. Camouflage Cosmetics include three basic types of products: Concealers to hide incision lines and discolorations; contour shadows to disguise swelling; and color correctors to neutralize color in reddened skin.

Color correctors disguise yellowish discolorations or the pinkness that follows chemical peel and dermabrasion. Lavender neutralizes or removes yellow, and green has a similar effect on red. It will take a little patience and practice to master camouflage techniques, but most post-op patients feel its well worth the effort.

RHINOPLASTY

What will my nose look like after surgery?

In general, rhinoplasty is designed to reduce excess cartilage and bone in the nose, removing irregularities and bumps to give a straightened, smooth and, usually, smaller appearance. Adding tissue to enhance certain features of the nose can also occur. The overall trend in modern rhinoplasty is away from over-reduction of tissue which can reduce the ability to breath through the nose and towards individualized treatment of each segment of the nose to give a balanced and refined look without compromising function.

How long does the surgery take and what kind of anesthesia is used?

Usually, Rhinoplasty takes from one to three hours depending on the complexity of the condition of the nose. Most patients have sedation prior to and during the procedure while some patients request a general anesthesia. Nearly all rhinoplasty operations are done as outpatient surgeries.

Is there a lot of bruising afterwards and how long will it last?

This depends again on how complex the procedure is, but in general most patients experience five to seven days of purple discoloration and swelling around the eyes and upper cheeks. The nose itself will be swollen for around ten to fourteen days or longer, but subtle resolution of the swelling at the tip of the nose can take many months after surgery to go away.

I have trouble breathing through my nose and have terrible sinus problems. Will my insurance policy pay for rhinoplasty?

The condition described is usually associated with a deviated septum or a bent internal framework of the nose. Most of the time this results from trauma such as a broken nose but many patients with this condition cannot recall an episode where this might have occurred. The condition described in this question however, could also result from allergies or the two conditions can exist simultaneously.

Careful examination is needed before surgery to separate the two conditions. While individual insurance policies can vary, in general, functional surgery to improve breathing is considered a covered benefit in many group policies. If additional correction of a Cosmetic deformity of the nose is done at the same time the cost of this part of the procedure is usually not covered by insurance.

Where are the incisions placed during nose surgery?

In general, most or all of the incisions in rhinoplasty are hidden in the inside of the nostril. While external incisions hidden in the creases where the nose meets the cheek can be used to narrow the nose, incisions on the bridge or tip are not usually used in Cosmetic surgery of the nose.

Will my nose grow after surgery?

In general, our noses tend to elongate as we enter the middle years of our life and drooping of the tip of the nose can occur in the later years as elasticity disappears from the body. While undergoing a Cosmetic rhinoplasty as a teenager or young adult will not prevent the effects of aging on the nose, the final shape that results from this surgery is expected to last a lifetime and regrowth of bumps and deformities corrected by the operation is a rare occurrence.



Pricing & Financing

General Questions

About the Procedure

Face Lift

Breast Augmentation

Liposuction

Rhinoplasty




 Plastic & Cosmetic Surgeons:

    Maher M. Anous, MD, FACS
    William Bruno, MD
    Andrew T. Cohen, MD, FACS
    Ron Hazani, MD, FACS
    Jason R. Hess, MD
    Richard Hodnett, MD, FACS
    Charles Hsu, MD
    Rafi Israel, MD
    Payam Jarrah-Nejad, MD, FACS
    Louis R. Mandris, MD
    Kenneth Siporin, MD

Shane Sheibani, MD













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plastic surgery, surgery [Credit: © Robert Llewellyn/Corbis]the functional, structural, and aesthetic restoration of all manner of defects and deformities of the human body. The term plastic surgery stems from the Greek word plastikos, meaning “to mold” or “to form.” Modern plastic surgery has evolved along two broad themes: reconstruction of anatomic defects and aesthetic enhancement of normal form. The surgical principles of plastic surgery remain focused on preserving vascularity, replacing like tissue with like tissue, respecting anatomic zones, and fostering wound healing by minimizing tissue trauma. As a diverse surgical specialty, the discipline of plastic surgery not only interacts with other disciplines of medicine but also merges medical science with the art of physical restoration. It couples careful evaluation of defects with sophisticated arrangements of tissue to improve the uniformity and natural resemblance of repair. Innovative techniques used in plastic surgery are largely the result of the successful clinical application of advances in tissue engineering, nanotechnology, and gene therapy.
Table Of Contents
Early developments in plastic surgery

The modern definition of plastic surgery is rooted in ancient medicine. The Sanskrit text Sushruta-samhita, written about 600 bce by ancient Indian medical practitioner Sushruta, describes, with surprising modernity, a quintessential plastic surgical procedure: the reconstruction of mutilated noses using tissue bridged from the cheek. During the Renaissance, Italian surgeon Gaspare Tagliacozzi and French surgeon Ambroise Paré adopted these early procedures and kindled a modern fascination with the use of local and distant tissue to reconstruct complex wounds. In the 19th century German surgeon Karl Ferdinand von Gräfe first invoked the term plastic when describing creative reconstructions of the nose in his text Rhinoplastik (1818). In the United States the organizing bodies of plastic surgery were founded between the world wars, with the American Society of Plastic Surgeons established in 1931 and the American Board of Plastic Surgery established in 1937. In the 1960s and ’70s the pioneering work of Canadian-born American surgeon Harry J. Buncke, Japanese surgeon Susumu Tamai, and Austrian surgeon Hanno Millesi resulted in the integration of procedures and techniques that defined microsurgery (surgery on very small structures requiring the use of a microscope).

plastic surgery [Credit: © Comstock/Thinkstock]Aesthetic, or cosmetic, surgery entered into the public consciousness with the advent of refinements that rendered safe the rejuvenation of the face and body through procedures such as face-lifts, breast augmentation, and liposuction. This was coupled with an increasing emphasis on minimally invasive procedures, such as injections of botulinum toxin (Botox) and cosmetic soft-tissue fillers (e.g., collagen and hyaluronic acid).
Table Of Contents
Surgical principles

The basic premise of soft tissue reconstruction is fixing deformities with normal tissue that shares similar characteristics with the damaged tissue. Respect for tissue physiology and mechanics is important in both reconstructive and aesthetic plastic surgery. Hence, delicate handling of tissue with instruments, judicious elevation of tissue to minimize vascular disruption, and precise alignment of tissue planes are all important elements of technique.
Grafts and flaps

tissue engineering [Credit: Vo Trung Dung/Corbis SYGMA]Closure of wounds is a central tenet of reconstructive surgery. Many wounds can be closed primarily (with direct suture repair). However, if the defect is sufficiently large, skin may be taken from other parts of the body and transferred to the area of the wound. Skin grafts are thin layers of skin taken from a remote location that are secured to the site of repair with bolsters, which serve to facilitate eventual integration of the donor skin into the wound.

Larger, more complex wounds have a greater volume and can involve exposed vital structures, such as vessels, nerves, tendon, bone, viscera, and other organs. Such wounds require coverage via transposed or transplanted composite segments of skin, subcutaneous tissue, muscle, and, in some cases, bone and nerve. These tissue constructs are maintained by their own defined blood supply and are called flaps. The pioneering work of Australian plastic surgeon Ian Taylor led to the characterization of angiosomes—the networks of blood vessels that supply flaps—which has allowed for rational matching of flaps to defects. Flaps may be transferred from neighbouring tissue, or they may be disconnected from their original blood supply and reconnected using microsurgical technique to another set of vessels adjacent to the defect.

plastic surgery: breast implant [Credit: © iStockphoto/Thinkstock]The use of implants or expander devices can also increase the amount of soft tissue. These devices are useful in cases when a patient has a limited amount of donor skin—for example, in those who are severely burned or in children who have large congenital moles. Implants and expander devices have also been adapted for breast reconstruction following mastectomy in breast cancer patients and for aesthetic breast augmentation.
Craniofacial surgery

Congenital and traumatic defects of the head and neck region fall under the scope of plastic surgery. Cleft lip and cleft palate deformities, premature fusion of skull elements, and persistent clefts in the facial skeleton require complex soft tissue and bone rearrangement. The introduction of internal fixation systems that use screws and plates has greatly facilitated congenital reconstructions as well as correction of traumatic fractures. Novel permutations of these fixation devices have been developed; for example, distraction osteogenesis is a technique used to induce bone growth from hypoplastic (incompletely developed) bone by traction exerted by moveable plate systems. Biomaterials, such as absorbable plate systems and bone cements, are being improved continually and are often used in pediatric craniofacial surgery.

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Hand surgery

By virtue of its unique anatomy and functional importance, restoration of hand deformities is a shared focus of both plastic surgeons and orthopedic surgeons. Congenital defects involving the hand range from absent or incomplete development (agenesis) to anomalies of limb structures. Traumatic insult may give rise to complex wounds, fractured bones, severed nerves and tendons, or amputations. In the appropriate context, severed digits and limbs may be replanted with microsurgical connections of vessels and nerves. Rehabilitation of the hand is a critical aspect of surgical care, since loss of strength and motion may occur following injury and reconstruction.
Aesthetic surgery

Aesthetic, or cosmetic, surgery is the enhancement of normal structures that are subject to age-related changes or that have unusual features that are distressing to the patient. The procedures used to address these issues are often performed in the physician’s office (as opposed to a hospital) and are relatively simple, entailing only injections of botulinum toxin or hyaluronic soft-tissue filler. In some cases, however, these procedures are complex, involving elective surgery to correct deformities of the nose or to remove excess sagging skin on the face. The practice of plastic surgery has moved beyond plastic surgeons, and there are many other physicians, such as dermatologists and otolaryngologists, who have the skill to perform these procedures.

The same principles that govern reconstructive surgery are applied to aesthetic surgery: replace like with like, respect anatomic boundaries, minimize tissue trauma, and preserve vascular integrity. Aesthetic surgery is also concerned with scars, especially their length and visibility, and modifications to classic procedures such as face-lifts are made to minimize and hide scars. While age-related changes can weaken the support structures of skin and soft tissue, the advent of bariatric surgery in obese patients can create analogous changes in the tissues of the arms, chest, abdomen, and thighs. Corresponding lifts of these parts of the body can be performed.

Botox injection [Credit: © Thinkstock Images/Jupiterimages]Other aesthetic surgeries can reduce or augment parts of the body that are perceived to be too large or too small; common examples include the nose or breasts. In addition, the judicious use of liposuction can improve contour in areas that are unbalanced by excess fat. For the face the use of botulinum toxin can weaken the underlying muscles that create some wrinkles; other wrinkles can be softened by injection of hyaluronic acid. Chemical peels, dermabrasion, and lasers can be used to smooth the fine wrinkles that can form in the uppermost layers of skin.

The heightened public interest in aesthetic surgery also creates clinical, ethical, and medicolegal challenges. A clear understanding of indications, techniques, and complications is important for both surgeon and patient to ensure safe and efficacious outcomes.
Saleh M. ShenaqJohn Kim
plastic surgery - Student Encyclopedia (Ages 11 and up)

    The medical specialty of plastic surgery is concerned with the reshaping of body tissues. The word plastic comes from the Greek plastikos, meaning "to shape" or "to form." The specialty includes both reconstructive and cosmetic surgery. Reconstructive surgery is used to repair malformed or damaged tissue or to replace lost tissue, such as from birth defects, accidents, disease, or cancer surgery. Its primary aims are to restore impaired function and to help people with deformities look as normal as possible. Cosmetic, or aesthetic, surgery is performed on normal, healthy tissue solely to make a person look younger or more attractive. A visually pleasing result is a goal of both reconstructive and cosmetic surgery, and plastic surgeons rely on their aesthetic judgment as well as their mastery of intricate surgical techniques and knowledge of wound healing.


 cosmetic surgery
The Oxford Companion to the Body | 2001 | COLIN BLAKEMORE and SHELIA JENNETT | Copyright

cosmetic surgery The close of the twentieth century marked the centenary of modern surgical intervention to alter the image of the body. A list of the most common operations which were developed over the past century and are understood as ‘cosmetic’ procedures today are shown in the table.

Cosmetic operations

Operations on the face

Forehead lift: tightens the forehead and raises the brow

Facelift (rhytidectomy): tightens the jowls and neck

Eyelid tightening (blepharoplasty): tightens the eyelids

Rhinoplasty (nose job): changes the appearance of the nose

Otoplasty (ear pinback): brings the ears closer to the head

Facial implants (chin, cheek): makes the cheek or chin more prominent

Hair transplantation: treats male pattern baldness

Scar revision: improves the appearance of scars

Skin resurfacing (laser, peel, dermabrasion): smoothes the skin

Operations on the body

Breast enlargement: enhances the size of the breast

Breast tightening (mastopexy): tightens the skin of the breast

Breast reduction: reduces the size of the breast

Breast reconstruction: rebuilds the breast after cancer

Abdominoplasty (tummy tuck): tightens skin and removes extra fat

Mini-abdominoplasty: removes the lower abdominal pouching

Liposuction: removes extra fat

Arm lift: tightens the skin of the upper arm

Gynecomastia resection (large breasts in men): reduces breast size


It is, of course, evident that virtually all procedures which could be conceptualized as cosmetic or aesthetic can also have a reconstructive dimension. Breast reconstruction, which used the same type of implant as breast augmentation, was the focus of a major debate within both medical and feminist circles in the US in the 1990s, as to whether it was reconstructive or aesthetic surgery. During the closing decades of the twentieth century these procedures, and also aesthetic orthodontics, came to be a common undertaking. Aesthetic surgery became a focus of interest — being patient-initiated, and non-reimbursable by private or state third-party payers.

While aesthetic surgery is related in many ways to other physical interventions, from hairweaving to tattooing and body piercing, it is performed in the quite different context of the institution of medicine. The surgical interventions are understood by doctors and patients alike as aesthetic rather than reconstructive. Even though the term ‘aesthetic surgery’ was acknowledged only recently, the practice of surgical interventions devoted to making people ‘beautiful’ rather than to any direct reconstruction of physical anomalies is relatively recent. There is a necessary if rather arbitrary distinction between reconstructive (plastic) surgery and aesthetic (cosmetic) surgery — between not having a nose and having a nose that you dislike. The first represents a functional fault. There is something wrong with the body as well as an unfortunate appearance — a hare lip, a missing jaw, a lost ear — and your desire is to repair the function of the body. Part of that function is, of course, an aesthetic one. Cosmetic surgery, which is part of, and grew from, reconstructive surgery, stresses the latter, subordinate, but essential aspect of the reconstruction. We imagine our bodies as intact and read our intactness as ‘beauty’. You may have a functional nose, a jaw, a breast, but it does not represent your self-image of the beautiful nose, jaw, or breast. It inhales, chews, or lactates, but it is not appropriate. The distinction between reconstructive and aesthetic surgery is an arbitrary one. Certain interventions have been labelled as inherently different — such as breast reconstruction vs. breast augmentation, even though the procedures are similar. The former are understood as a means of restoring physical completeness to the body image and therefore of restoring the psyche to a ‘happy’ state; the latter can be dismissed as ‘vogue fashions’ ( R. V. S. Thompson, Kay-Kilner Prize Essay, 1994). Feminists in the 1990s, such as the American poet Audre Lorde, who underwent a radical mastectomy, argued against breast reconstruction as a refusal to acknowledge the realities of the woman's body. In the Middle Ages, Guy de Chauliac, perhaps the most important surgeon of his time, defined the role of surgery as being threefold: solvit continuum (separating the fused), jungit separatum (connecting the divided), and exstirpat superfluum (removing the extraneous). There is no discussion in his or other texts of that period about the creation of new body parts or their augmentation or reconstruction, although it is evident that virtually all primarily reconstructive surgical procedures also had an aesthetic dimension, even then. As early as the Edwin Smith Surgical Papyrus (3000 bce), surgeons were concerned about the cosmetic results of their interventions. The Egyptians were careful to suture the edges of facial wounds. Even fractures of the nose-bones were dealt with by forcing them into normal positions by means of ‘two plugs of linen, saturated with grease’ inserted into the nostrils. The Roman physician Aulus Cornelius Celsus stressed the ‘beautiful’ suture. This approach can be followed through to the late nineteenth and early twentieth century, with plastic surgeons such as Erich Lexer stressing the cosmetic ends of an operation as ‘an always more appreciated requirement of modern surgery’. Such a stress on the neatness and beauty of the closure was part of the image of the return to function following the operation, for the beautiful was a sign of the healthy — but of the healthy body, not the healthy mind.

Yet even as we understand aesthetic surgery as a means of altering our body's ‘image’ it becomes a means not only of changing our bodies but of shaping our psyches. Aesthetic surgery remains rooted in a presumed relationship between the body and the mind. Sculpting the body comes to be a form of reshaping the psyche.

The central assumption of aesthetic surgery is that if you understand your body as ‘bad’ you are bound to be ‘unhappy’. And in our day and age, being unhappy seems to be identified with being sick. And if you are sick, you should be cured! The idea that you can cure the soul by altering the form of the body became commonplace in the twentieth century. It is the other side of the coin from the argument that to cure specific bodily symptoms you need to ‘heal’ the psyche.

Elaine Scarry has remarked in her classic work The Body In Pain (1985),
… at particular moments when there is within a society a crisis of belief — that is, when some central idea or ideology of cultural construct has ceased to elicit a population's belief either because it is manifestly fictitious or because it has for some reason been divested of ordinary forms of transubstantiation — the sheer material factualness of the human body will be borrowed to lend that cultural construct the aura of “realness” and “certainty”.

It is this realness and certainty ascribed to an imagined as well as the real body which is operated upon by the aesthetic surgeon.

During a period of revolutionary change in science, from the mid nineteenth to the early twentieth centuries, two major developments took place which enabled surgeons to introduce aesthetic changes, and patients to overcome their anxiety and undertake such procedures. Antisepsis and anaesthesia became central to the practice of surgery, following the discovery of ether anaesthesia in 1846 and the development by the 1880s of local anaesthesia. The movement toward antisepsis paralleled the development of anaesthesia: the model for antisepsis provided by Joseph Lister in 1867 became generally accepted by the end of the century. Aesthetic surgery became a context in which the ideology of the medical alteration of the body (and its state) was accepted by both the patient and the physician. All of these concerns can be understood as concerns of ‘hygiene’ in the broadest nineteenth-century sense, a hygiene of the state of both the body and the psyche. This set the stage for the development of the procedures used today. Take the case of Jacques Joseph, a young German-Jewish surgeon practising in fin-de-siècle Berlin. In 1896 Joseph undertook a corrective procedure on a child with protruding ears (otoplasty), which, although successful, caused Joseph to be dismissed from the staff of the orthopaedic clinic at the Berlin Charité. One simply did not undertake surgical procedures for vanity's sake, he was told upon his dismissal. The child was not suffering from any physical ailment which could be cured through surgery. Yet, according to the child's mother, he had suffered from humiliation in school because of his protruding ears. It was the unhappiness of the child that Joseph was correcting. The significance of protruding ears was clear to Jacques Joseph and his contemporaries at that time. There is an old trope in European culture about the Jew's ears that can be found throughout the anti-Semitic literature of the fin de siècle, and it is also a major sub-theme of one of the great works of world literature, Heinrich Mann's Man of Straw (1918). In that novel, Mann's self-serving convert, Jadassohn (Judas's son?) ‘looked so Jewish’ because of his ‘huge, red, prominent ears’ which he eventually went to Paris to have cosmetically reduced; his ears signified his poor character. Jacques Joseph went on to pioneer the intranasal procedure for the reduction of the size of the nose and came to be known among the Jewish community in Berlin as ‘Nose-Joseph’.

The social and psychological significance of the introduction of aesthetic surgery is relevant to other external markers of difference, from ageing (face lifts), to sexuality (transsexual surgery), to notions of beauty of face (orthodontics) and of body (liposuction). The norms of the acceptable change with time, but the desire to become invisible, to become a member of a class or group to which one does not naturally belong, maintains itself over the entire history of aesthetic surgery.

Sander L. Gilman

Bibliography

Gilman, S. L. (2000) Making the body beautiful: a cultural history of aesthetic surgery. Princeton University Press, Princeton.
Maltz, M. (1946). Evolution of plastic surgery. Froben Press, New York.
Wallace, A. F. (1982). The progress of plastic surgery: an introductory history. Willem A. Meeuws, Oxford.

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Cosmetic breast surgery

Breast augmentation is a procedure to change the size or shape of the breasts.

See also:

    Breast reconstruction - natural tissue
    Breast reconstruction - implants
    Breast lift

Description

Cosmetic breast surgery may be done at an outpatient surgery clinic or in a hospital.

    Most women receive general anesthesia for this surgery. You will be asleep and pain-free.
    You may also be given medicine to relax you and local anesthesia. You will be awake and will receive medicine to numb your breast area to block pain.

There are many different ways to place breast implants:

    In the most common technique, the surgeon will make surgical cut on the underside of your breast, in the natural skin fold. Your surgeon will place the implant through this opening. Your scar may be a little more visible if you are younger, thin, and have not yet had children.
    The implant may be placed through a surgical cut under your arm. Your surgeon may perform this surgery using an endoscope (a tool with a camera and surgical instruments at the end that is inserted through a vein). There will be no scar around your breast, but you may have a visible scar on the underside of your arm.
    The surgeon may make a cut around the edge of your areola, the darkened area around your nipple. The implant is placed through this opening. You may have more problems with breastfeeding and loss of sensation around your nipple with this method.
    A newer technique involves placing a saline implant through a surgical cut near your belly button. An endoscope is used to move the implant up to the breast area. Once in place, the implant is filled with saline.

Breast implants may be placed either directly behind the breast tissue (subglandular) or behind the outer layer of chest wall muscles (submuscular). The type of implant and implant surgery can affect:

    How much pain you have after the procedure
    The appearance of your breast
    The risk of the implant breaking or leaking in the future
    Your future mammograms

Your surgeon can help you decide which procedure is best for you.
Breast liftWatch this video about:Breast lift

Why the Procedure is Performed

Breast augmentation is done to increase the size of your breasts.

A breast lift, or mastopexy, is usually done to lift sagging, loose breasts. The size of the areola, the dark pink skin surrounding the nipple, can also be reduced.

Talk with a plastic surgeon if you are considering cosmetic breast surgery. Discuss how you expect to look and feel better. Keep in mind the desired result is improvement, not perfection. Emotional stability is an important factor. Breast surgery can renew your self-confidence and improve your appearance, but the rest is up to you.
Risks

Risks for any surgery are:

    Bleeding
    Infection

Risks for any anesthesia are:

    Reactions to medicines
    Breathing problems, pneumonia
    Heart problems

Risks for breast surgery are:

    Difficulty breastfeeding
    Loss of feeling in the nipple area
    Small scars, usually in an area where they do not show much. Some women may have thickened, raised scars.
    Uneven position of your nipples
    Different size or shape of the two breasts
    It is normal for your body to create a “capsule” made up of scar tissue around your new breast implant. This helps keep the implant in place. Sometimes, this capsule becomes thickened and larger and may cause a change in the shape of your breast, hardening of breast tissue, or some pain.
    Breaking or leakage of the implant
    Visible rippling of the implant

The emotional risks of surgery may include feeling that your breasts don't look perfect, or you may be disappointed with people's reactions to your “new” breasts.
Before the Procedure

Always tell your doctor or nurse:

    If you are or could be pregnant
    What drugs you are taking, even drugs, supplements, or herbs you bought without a prescription

During the days before your surgery:

    You may need mammograms or breast x-rays before surgery. Your plastic surgeon will do a routine breast exam.
    Several days before surgery, you may be asked to stop taking aspirin, ibuprofen (Advil, Motrin), warfarin (Coumadin), and any other drugs that make it hard for your blood to clot.
    Ask your doctor which drugs you should still take on the day of surgery.
    You may need to fill prescriptions for pain medicine before surgery.
    Arrange for someone to drive you home after surgery and help you around the house for 1 or 2 a days.
    If you smoke, try to stop. Ask your doctor or nurse for help.

On the day of the surgery:

    You will usually be asked not to drink or eat anything after midnight the night before surgery.
    Take the drugs your doctor told you to take with a small sip of water.
    Wear or bring loose clothing that buttons or zips in front and a soft, loose-fitting bra with no underwire.
    Your doctor or nurse will tell you when to arrive at the hospital.

After the Procedure

You may need to stay overnight in the hospital. Some women can go home when their anesthesia wears off and they can walk, drink water, get to the bathroom safely, and have pain they can manage at home.

After breast augmentation surgery, a bulky gauze dressing will be wrapped around your breasts and chest, or you might wear a surgical bra. Drainage tubes may be attached to your breasts. These will be removed within 3 days.

Sometimes doctors also recommend massaging the breast starting 5 days after surgery to reduce hardening of the capsule that surrounds the implant. Ask your doctor first before massaging over your implants.
Outlook (Prognosis)

You are likely to have a very good outcome from breast surgery. You may feel better about your appearance and yourself. Also, the pain or skin symptoms you had (such as striation) will disappear. You may need to wear a special supportive bra for a few months to reshape your breasts.

Scars are permanent and are often more visible in the year after surgery. They will fade after this. Your surgeon will try to place the incisions so that your scars are as hidden as possible. Your scars should not be noticeable, even in low-cut clothing, since incisions are usually made on the underside of the breast.
Alternative Names

Breast augmentation; Breast implants; Implants - breast; Mammaplasty
References

Burns JL, Blackwell SJ. Plastic surgery. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 73.

Sarwer DB. The psychological aspects of cosmetic breast augmentation. Plast Reconstr Surg. 2007 Dec;120(7 Suppl 1):110S-117S.

Hölmich LR, Lipworth L, McLaughlin JK, Friis S. Breast implant rupture and connective tissue disease: a review of the literature. Plast Reconstr Surg. 2007 Dec;120(7 Suppl 1):62S-69S.

McLaughlin JK, Lipworth L, Fryzek JP, Ye W, Tarone RE, Nyren O. Long-term cancer risk among Swedish women with cosmetic breast implants: an update of a nationwide study. J Natl Cancer Inst. 2006 Apr 19;98(8):557-60.

Wiener TC. Relationship of incision choice to capsular contracture. Aesthetic Plast Surg. 2008 Mar;32(2):303-6.
Update Date: 2/8/2011

Updated by: David A. Lickstein, MD, FACS, specializing in cosmetic and reconstructive plastic surgery, Palm Beach Gardnes, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

 Breast implant
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Breast implant: the pre-operative (left) and post-operative (right) aspects of a young woman’s bilateral breast augmentation with high-profile, 500cc silicone-gel implants.
Breast implant: The post-operative aspect of a breast cancer mastectomy; the woman is a candidate for a primary breast-reconstruction procedure of her right breast.

A breast implant is a medical prosthesis used to augment, reconstruct, or create the physical form of breasts. Applications include correcting the size, form, and feel of a woman’s breasts in post–mastectomy breast reconstruction; for correcting congenital defects and deformities of the chest wall; for aesthetic breast augmentation; and for creating breasts in the male-to-female transsexual patient.

There are three general types of breast implant device, defined by the filler material: saline, silicone, and composite. The saline implant has an elastomer silicone shell filled with sterile saline solution; the silicone implant has an elastomer silicone shell filled with viscous silicone gel; and the alternative composition implants featured miscellaneous fillers, such as soy oil, polypropylene string, et cetera. In surgical practice, for the reconstruction of a breast, the tissue expander device is a temporary breast prosthesis used to form and establish an implant pocket for the permanent breast implant. For the correction of male breast and chest-wall defects and deformities, the pectoral implant is the breast prosthesis used for the reconstruction and the aesthetic repair of a man’s chest. (See: gynecomastia and mastopexy)
Contents

    1 History
    2 Types of breast implant device
    3 The patient
    4 Surgical procedures
        4.1 Indications
        4.2 Incision types
        4.3 Implant pocket placement
        4.4 Post-surgical recovery
    5 Complications
        5.1 Implant rupture
        5.2 Capsular contracture
        5.3 Repair and revision surgeries
    6 Alleged complications
        6.1 Systemic disease and sickness
        6.2 Platinum toxicity
    7 Implants and breast-feeding
    8 Implants and mammography
    9 U.S. FDA approval
    10 Criticism
    11 See also
    12 References
    13 External links

History
Breast implant: Dr. Vincenz Czerny (1842–1916) a pioneer in breast reconstruction surgery.

The 19th century

Since the late nineteenth century, breast implant devices have been used to surgically augment the size (volume), modify the shape (contour), and enhance the feel (tact) of a woman’s breasts. In 1895, surgeon Vincenz Czerny effected the earliest breast implant emplacement when he used the patient's autologous adipose tissue, harvested from a benign lumbar lipoma, to repair the asymmetry of the breast from which he had removed a tumor.[1] In 1889, surgeon Robert Gersuny experimented with paraffin injections, with disastrous results. From the first half of the twentieth century, physicians used other substances as breast implant fillers — ivory, glass balls, ground rubber, ox cartilage, Terylene wool, gutta-percha, Dicora, polyethylene chips, Ivalon (polyvinyl alcohol – formaldehyde polymer sponge), a polyethylene sac with Ivalon, polyether foam sponge (Etheron), polyethylene tape (Polystan) strips wound into a ball, polyester (polyurethane foam sponge) Silastic rubber, and teflon-silicone prostheses.[2]

The 20th century

In the mid-twentieth century, Morton I. Berson, in 1945, and Jacques Maliniac, in 1950, each performed flap-based breast augmentations by rotating the patient’s chest wall tissue into the breast to increase its volume. Furthermore, throughout the 1950s and the 1960s, plastic surgeons used synthetic fillers — including silicone injections received by some 50,000 women, from which developed silicone granulomas and breast hardening that required treatment by mastectomy.[3] In 1961, the American plastic surgeons Thomas Cronin and Frank Gerow, and the Dow Corning Corporation, developed the first silicone breast prosthesis, filled with silicone gel; in due course, the first augmentation mammoplasty was performed in 1962 using the Cronin–Gerow Implant, prosthesis model 1963. In 1964, the French company Laboratoires Arion developed and manufactured the saline breast implant, filled with saline solution, and then introduced for use as a medical device in 1964.[4]
Types of breast implant device
Breast implant: saline solution filled breast implant device models.
The original breast implant: Cronin–Gerow Implant, prosthesis model 1963, an anatomic (tear-shaped) design that featured a posterior fastener made of Dacron.
Breast implant: Late-generation models of Silicone gel-filled prostheses.

There are three types of breast implant used for mammoplasty, breast reconstruction, and breast augmentation procedures

    saline implant filled with sterile saline solution.
    silicone implant filled with viscous silicone gel.
    alternative-composition implant with miscellaneous fillers (e.g. soy oil, polypropylene string, etc.) that are no longer manufactured.

I. — Saline implants

    Surgical technology

The saline breast implant is filled with saline solution (biological-concentration salt water 0.90% w/v of NaCl, ca. 300 mOsm/L.). The early models were a relatively delicate technology that were prone to failure, usually shell breakage, leakage of the saline filler, and deflation of the prosthesis. Contemporary models of saline breast implant are made with stronger, room-temperature vulcanized (RTV) shells made of a silicone elastomer. The study In vitro Deflation of Pre-filled Saline Breast Implants (2006) reported that the rates of deflation (filler leakage) of the pre-filled saline breast implant made it a second choice for corrective breast surgery, after the silicone gel type of breast implant.[4] Nonetheless, in the 1990s, in U.S. medicine, the saline breast implant was the usual breast prosthesis applied for breast augmentation, given the unavailability of silicone implants, because of the import restrictions of the U.S. Food and Drug Administration.

    Surgical technique

The saline breast implant was developed to facilitate a more conservative surgical technique, of smaller and fewer cuts to the breast, for emplacing an empty breast-implant device through a smaller surgical incision.[5] In surgical praxis, after having emplaced the empty breast implants into the implant pockets, the plastic surgeon then fills each breast prosthesis with saline solution, and, because the required insertion incisions are small, the resultant incision-scars will be smaller than the surgical scar usual to the long incision required for inserting pre-filled, silicone-gel implants. Although the saline breast implant can yield good-to-excellent results of breast size, contour, and feel, when compared to silicone-implant results, the saline implant is likelier to cause cosmetic problems such as rippling, wrinkling, and being noticeable to the eye and to the touch. This is especially true for women with very little breast tissue, and for post-mastectomy reconstruction patients; thus, silicone-gel implants are the superior prosthetic device for breast augmentation and for breast reconstruction. In the case of the woman with much breast tissue, for whom partial submuscular emplacement is the recommended surgical technique, saline breast implants can afford an aesthetic “look” of breast size and contour (though not feel) much like that afforded by the silicone implant.[6]

II. — Silicone gel implants

As a medical device technology, there are five (5) generations of silicone breast implant, each defined by common model-manufacturing techniques.

First generation

The Cronin–Gerow Implant, prosthesis model 1963, was a tear-drop-shaped sac (silicone rubber envelope) filled with viscous silicone-gel. To reduce the rotation of the emplaced breast-implant upon the chest wall, it was affixed to the implant pocket with a fastener-patch of Dacron material (Polyethylene terephthalate) attached to the rear of the breast implant shell.[7]

Second generation

In the 1970s, the first technological development, a thinner device-shell and a thinner, low-cohesion silicone-gel filler, improved the functionality and verisimilitude (size, look, and feel) of the silicone breast implant. Yet, in clinical practice, the second-generation proved fragile, and suffered greater incidences of shell rupture, and of “silicone gel bleed” (filler leakage through an intact shell). The consequent, increased incidence-rates of medical complications (e.g. capsular contracture) precipitated U.S. government faulty-product class action-lawsuits against the Dow Corning Corporation, and other manufacturers of prosthetic breast prostheses.

    The second technological development was a polyurethane foam coating for the implant shell; it reduced the incidence of capsular contracture by causing an inflammatory reaction that impeded the formation of a capsule of fibrous collagen tissue around the breast implant. Nevertheless, the medical use of polyurethane-coated breast implants was briefly discontinued because of the potential health-risk posed by 2,4-toluenediamine (TDA), a carcinogenic by-product of the chemical breakdown of the implant’s polyurethane foam coating.[8] After reviewing the medical data, the U.S. Food and Drug Administration concluded that TDA-induced breast cancer was an infinitesimal health-risk to women with breast implants, and did not justify legally requiring physicians to explain the matter to their patients. In the event, polyurethane-coated breast implants remain in plastic surgical practice in Europe and in South America; in the U.S., no breast implant manufacturer has sought the FDA’s approval for American medical sale.[9]

    The third technological development was the double lumen breast-implant, a double-cavity device composed of a silicone-implant within a saline-implant. The two-fold, technical goal was: (i) the cosmetic benefits of silicone-gel (the inner lumen) enclosed in saline solution (the outer lumen); (ii) a breast-implant device the volume of which is post-operatively adjustable. Nevertheless, the more complex design of the double-lumen breast-implant suffered a device-failure rate greater than that of single-lumen breast implants. The contemporary versions of Second generation devices, presented in 1984, are the “Becker Expandable” models of breast implant device, used primarily for breast reconstruction.

Third and Fourth generations

In the 1980s, the models of the Third and of the Fourth generations of breast-implant devices were sequential advances in manufacturing technology, e.g. elastomer-coated shells that decreased gel-bleed (filler leakage), and a thicker filler (increased-cohesion) gel. Sociologically, the manufacturers then designed and fabricated varieties of anatomic models (natural breast) and shaped models (round, tapered) that realistically corresponded with the breast and body types presented by women patients. The tapered models of breast implant have a uniformly textured surface, to reduce rotation; the round models of breast implant are available in smooth-surface and textured-surface types.

Fifth generation

Since the mid-1990s, the Fifth generation of silicone breast implant is made of a semi-solid gel that mostly eliminates filler leakage (silicone gel bleed) and silicone migration from the breast to elsewhere in the body. The studies Experience with Anatomical Soft Cohesive Silicone gel Prosthesis in Cosmetic and Reconstructive Breast Implant Surgery (2004) and Cohesive Silicone gel Breast Implants in Aesthetic and Reconstructive Breast Surgery (2005) reported low incidence rates of capsular contracture and of device-shell rupture, improved medical safety and technical efficacy greater than earlier generations of breast implant device.[10][11][12]
The patient
Further information: Body dysmorphic disorder, Body image, and Beauty
Breast implant: the pre-operative aspects (left), and the post-operative aspects (right) of a bilateral primary augmentation with medium-volume (350cc) saline impants emplaced submuscularly through an inframmary fold (IMF) incision.

Psychology

The breast augmentation patient usually is a young woman whose personality profile indicates psychological distress about her personal appearance and her body (self image), and a history of having endured criticism (teasing) about the aesthetics of her person.[13] The studies Body Image Concerns of Breast Augmentation Patients (2003) and Body Dysmorphic Disorder and Cosmetic Surgery (2006) reported that the woman who underwent breast augmentation surgery also had undergone psychotherapy, suffered low self-esteem, presented frequent occurrences of psychological depression, had attempted suicide, and suffered body dysmorphia, a type of mental illness. Post-operative patient surveys about mental health and quality-of-life, reported improved physical health, physical appearance, social life, self-confidence, self-esteem, and satisfactory sexual functioning. Furthermore, the women reported long-term satisfaction with their breast implant outcomes; some despite having suffered medical complications that required surgical revision, either corrective or aesthetic. Likewise, in Denmark, 8.0 per cent of breast augmentation patients had a pre-operative history of psychiatric hospitalization.[14][15][16][17][18][19][20][21][22]

Mental health

In 2008, the longitudinal study Excess Mortality from Suicide and other External Causes of Death Among Women with Cosmetic Breast Implants (2007), reported that women who sought breast implants are almost 3.0 times as likely to commit suicide as are women who have not sought breast implants. Compared to the standard suicide-rate for women of the general populace, the suicide-rate for women with augmented breasts remained constant until 10-years post-implantation, yet, it increased to 4.5 times greater at the 11-year mark, and so remained until the 19-year mark, when it increased to 6.0 times greater at 20-years post-implantation. Moreover, additional to the suicide-risk, women with breast implants also faced a trebled death-risk from alcoholism and the abuse of prescription and recreational drugs.[23][24] Although seven (7) studies have statistically connected a woman’s breast augmentation to a greater suicide-rate, the research indicates that breast augmenation surgery does not increase the death rate; and that, in the first instance, it is the psychopathologically-inclined woman who is likelier to undergo a breast augmentation procedure.[25][26][27][28][29][30]

The study Effect of Breast Augmentation Mammoplasty on Self-Esteem and Sexuality: A Quantitative Analysis (2007), reported that the women attributed their improved self image, self-esteem, and increased, satisfactory sexual functioning to having undergone breast augmentation; the cohort, aged 21–57 years, averaged post-operative self-esteem increases that ranged from 20.7 to 24.9 points on the 30-point Rosenberg self-esteem scale, which data supported the 78.6 per cent increase in the woman’s libido, relative to her pre-operative level of libido.[31] Therefore, before agreeing to any surgery, the plastic surgeon evaluates and considers the woman’s mental health to determine if breast implants can positively affect her self-esteem and sexual functioning.
Surgical procedures
Indications

A mammoplasty procedure for the emplacement of breast implant devices has three (3) purposes:

    primary reconstruction — the replacement of breast tissues damaged by trauma (blunt, penetrating, blast), disease (breast cancer), and failed anatomic development (tuberous breast deformity).
    revision and reconstruction — to revise (correct) the outcome of a previous breast reconstruction surgery.
    primary augmentation — to aesthetically augment the size, form, and feel of the breasts.

The operating room (OR) time of post–mastectomy breast reconstruction, and of breast augmentation surgery is determined by the procedure employed, the type of incisions, the breast implant (type and materials), and the pectoral locale of the implant pocket.
Incision types

Breast implant emplacement is performed with five (5) types of surgical incisions:

    Inframammary — an incision made to the infra-mammary fold (IMF), which affords maximal access for precise dissection of the tissues and emplacement of the breast implants. It is the preferred surgical technique for emplacing silicone-gel implants, because it better exposes the breast tissue–pectoralis muscle interface; yet, IMF implantation can produce thicker, slightly more visible surgical scars.
    Periareolar — a border-line incision along the periphery of the areola, which provides an optimal approach when adjustments to the IMF position are required, or when a mastopexy (breast lift) is included to the primary mammoplasty procedure. In periareolar emplacement, the incision is around the medial-half (inferior half) of the areola’s circumference. Silicone gel implants can be difficult to emplace via periareolar incision, because of the short, five-centimetre length (~ 5.0 cm) of the required access-incision. Aesthetically, because the scars are at the areola’s border (periphery), they usually are less visible than the IMF-incision scars of women with light-pigment areolae; when compared to cutaneous-incision scars, the modified epithelia of the areolae are less prone to (raised) hypertrophic scars.
    Transaxillary — an incision made to the axilla (armpit), from which the dissection tunnels medially, to emplace the implants, either bluntly or with an endoscope (illuminated video microcamera), without producing visible scars on the breast proper; yet, it is likelier to produce inferior asymmetry of the implant-device position. Therefore, surgical revision of transaxillary emplaced breast implants usually requires either an IMF incision or a periareolar incision.
    Transumbilical — a trans-umbilical breast augmentation (TUBA) is a less common implant-device emplacement technique wherein the incision is at the umbilicus (navel), and the dissection tunnels superiorly, up towards the bust. The TUBA approach allows emplacing the breast implants without producing visible scars upon the breast proper; but makes appropriate dissection and device-emplacement more technically difficult. A TUBA procedure is performed bluntly — without the endoscope’s visual assistance — and is not appropriate for emplacing (pre-filled) silicone-gel implants, because of the great potential for damaging the elastomer silicone shell of the breast implant during its manual insertion through the short (~2.0 cm) incision at the navel, and because pre-filled silicone gel implants are incompressible, and cannot be inserted through so small an incision.[32]
    Transabdominal — as in the TUBA procedure, in the transabdominoplasty breast augmentation (TABA), the breast implants are tunneled superiorly from the abdominal incision into bluntly dissected implant pockets, whilst the patient simultaneously undergoes an abdominoplasty.[33]

Implant pocket placement
Breast implant emplacement: cross-sectional scheme of a subglandular breast prosthesis implantation (1) and of a submuscular breast prosthesis implantation (2).

The four (4) surgical approaches to emplacing a breast implant to the implant pocket are described in anatomical relation to the pectoralis major muscle.

    Subglandular — the breast implant is emplaced to the retromammary space, between the breast tissue (the gland) and the pectoralis major muscle, which most approximates the plane of normal breast tissue, and affords the most aesthetic results. Yet, in women with thin pectoral soft-tissue, the subglandular position is likelier to show the ripples and wrinkles of the underlying implant. Moreover, the capsular contracture incidence rate is slightly greater with subglandular implantation.
    Subfascial — the breast implant is emplaced beneath the fascia of the pectoralis major muscle; this is a variant of the subglandular position.[34] The technical advantages of the subfascial implant-pocket technique are debated; proponent surgeons report that the layer of fascial tissue provides greater implant coverage and better sustains its position.[35]
    Subpectoral (dual plane) — the breast implant is emplaced beneath the pectoralis major muscle, after the surgeon releases the inferior muscular attachments, with or without partial dissection of the subglandular plane. Resultantly, the upper pole of the implant is partially beneath the pectoralis major muscle, while the lower pole of the implant is in the subglandular plane. This implantation technique achieves maximal coverage of the upper pole of the implant, whilst allowing the expansion of the implant’s lower pole; however, “animation deformity”, the movement of the implants in the subpectoral plane can be excessive for some patients.[36]
    Submuscular — the breast implant is emplaced beneath the pectoralis major muscle, without releasing the inferior origin of the muscle proper. Total muscular coverage of the implant can be achieved by releasing the lateral muscles of the chest wall — either the serratus muscle or the pectoralis minor muscle, or both — and suturing it, or them, to the pectoralis major muscle. In breast reconstruction surgery, the submuscular implantation approach effects maximal coverage of the breast implants.

Post-surgical recovery

The surgical scars of a breast augmentation mammoplasty develop approximately at 6-weeks post-operative, and fade within months. Depending upon the daily-life physical activities required of the woman, the breast augmentation patient usually resumes her normal life at 1-week post-operative. Moreover, women whose breast implants were emplaced beneath the chest muscles (submuscular placement) usually have a longer, slightly more painful convalescence, because of the healing of the incisions to the chest muscles. Usually, she does not exercise or engage in strenuous physical activities for approximately 6 weeks. During the initial post-operative recovery, the woman is encouraged to regularly exercise (flex and move) her arm to alleviate pain and discomfort; if required, analgesic indwelling medication catheters can alleviate pain.[37][38] Moreover, significantly improved patient recovery has resulted from refined breast-device implantation techniques (submuscular, subglandular) that allow 95 per cent of women to resume their normal lives at 24-hours post-procedure, without bandages, fluid drains, pain pumps, catheters, medical support brassières, or narcotic pain medication.[39][40][41][42]
Complications

The plastic surgical emplacement of breast-implant devices, either for breast reconstruction or for aesthetic purpose, presents the same health risks common to surgery, such as adverse reaction to anesthesia, hematoma (post-operative bleeding), seroma (fluid accumulation), incision-site breakdown (wound infection). Complications specific to breast augmentation include breast pain, altered sensation, impeded breast-feeding function, visible wrinkling, asymmetry, thinning of the breast tissue, and symmastia, the “bread loafing” of the bust that interrupts the natural plane between the breasts. Specific treatments for the complications of indwelling breast implants — capsular contracture and capsular rupture — are periodic MRI monitoring and physical examinations. Furthermore, complications and re-operations related to the implantation surgery, and to tissue expanders (implant place-holders during surgery) can cause unfavorable scarring in approximately 6–7 per cent of the patients. [43][44][45] Statistically, 20 per cent of women who underwent cosmetic implantation, and 50 per cent of women who underwent breast reconstruction implantation, required their explantation at the 10-year mark.[46]
Implant rupture
An explanted breast implant: the red, fibrous capsule (left), the ruptured silicone implant (center), and the leaked, transparent filler-gel (right).

Because a breast implant is a Class III medical device of limited product-life, the principal rupture-rate factors are its age and design; nonetheless, a breast implant device can retain its mechanical integrity for decades in a woman’s body.[47] When a saline breast implant ruptures, leaks, and empties, it quickly deflates, and thus can be readily explanted (surgically removed). The follow-up report, Natrelle Saline-filled Breast Implants: a Prospective 10-year Study (2009) indicated rupture-deflation rates of 3–5 per cent at 3-years post-implantation, and 7–10 per cent rupture-deflation rates at 10-years post-implantation.[48] When a silicone breast implant ruptures it usually does not deflate, yet the filler gel does leak from it, which can migrate to the implant pocket; therefore, an intracapsular rupture (in-capsule leak) can become an extracapsular rupture (out-of-capsule leak), and each occurrence is resolved by explantation. Although the leaked silicone filler-gel can migrate from the chest tissues to elsewhere in the woman’s body, most clinical complications are limited to the breast and armpit areas, usually manifested as granulomas (inflammatory nodules) and axillary lymphadenopathy (enlarged lymph glands in the armpit area).[49][50][51]

The suspected mechanisms of breast-implant rupture are:

    damage during implantation
    damage during (other) surgical procedures
    chemical degradation of the breast implant shell
    trauma (blunt trauma, penetrating trauma, blast trauma)
    mechanical pressure of traditional mammographic breast examination [52]

From the long-term MRI data for single-lumen breast implants, the European literature about Second generation silicone-gel breast implants (1970s design), reported silent device-rupture rates of 8–15 per cent at 10-years post-implantation (15–30% of the patients).[53][54][55] In 2009, a branch study of the U.S. FDA’s core clinical trials for primary breast augmentation surgery patients, reported low device-rupture rates of 1.1 per cent at 6-years post-implantation.[56] The first series of MRI evaluations of the silicone breast implants with thick filler-gel reported a device-rupture rate of 1.0 per cent, or less, at the median 6-year device-age.[57] Statistically, the manual examination (palpation) of the woman is inadequate for accurately evaluating if a breast implant has ruptured. The study, The Diagnosis of Silicone Breast-implant Rupture: Clinical Findings Compared with Findings at Magnetic Resonance Imaging (2005), reported that, in asymptomatic patients, only 30 per cent of the of ruptured breast implants is accurately palpated and detected by an experienced plastic surgeon, whereas MRI examinations accurately detected 86 per cent of breast-implant ruptures.[58] Thus, the U.S. FDA recommended scheduled MRI examinations, as silent-rupture screenings, beginning at the 3-year-mark post-implantation, and then every two years, thereafter.[43] Nonetheless, beyond the U.S., the medical establishments of other nations have not endorsed routine magnetic resonance image (MRI) screening, proposing that such a radiologic examination be reserved for two purposes: (i) for the woman with a suspected breast-implant rupture; and (ii) for the confirmation of mammographic and ultrasonic studies that indicate the presence of a ruptured breast implant.[59] Furthermore, The Effect of Study design Biases on the Diagnostic Accuracy of Magnetic Resonance Imaging for Detecting Silicone Breast Implant Ruptures: a Meta-analysis (2011) reported that the breast-screening MRIs of asymptomatic women might be overestimating the incidence of breast-implant rupture.[60] Nonetheless, the U.S. Food and Drug Administration emphasised that “breast implants are not lifetime devices. The longer a woman has silicone gel-filled breast implants, the more likely she is to experience complications.”[61]
Capsular contracture
Capsular contracture is a breast-implant complication, such as the Baker scale Grade IV contraction of a subglandular silicone implant in the right breast.
Main article: Capsular contracture

The human body’s immune response to a surgically installed foreign object — breast implant, cardiac pacemaker, orthopedic prosthesis — is to encapsulate it with scar tissue capsules of tightly woven collagen fibers, in order to maintain the integrity of the body by isolating the foreign object, and so tolerate its presence. Capsular contracture — which should be distinguished from normal capsular tissue — occurs when the collagen-fiber capsule thickens and compresses the breast implant; it is a painful complication that might distort either the breast implant, or the breast, or both. The cause of capsular contracture is unknown, but the common incidence factors include bacterial contamination, device-shell rupture, filler leakage, and hematoma. The surgical implantation procedures that have reduced the incidence of capsular contracture include submuscular emplacement, the use of breast implants with a textured surface (polyurethane-coated);[62][63][64] limited pre-operative handling of the implants, limited contact with the chest skin of the implant pocket before the emplacement of the breast implant, and irrigation of the recipient site with triple-antibiotic solutions.[65][66]

The correction of capsular contracture might require an open capsulotomy (surgical release) of the collagen-fiber capsule, or the removal, and possible replacement, of the breast implant. Furthermore, in treating capsular contracture, the closed capsulotomy (disruption via external manipulation) once was a common maneuver for treating hard capsules, but now is a discouraged technique, because it can rupture the breast implant. Non-surgical treatments for collagen-fiber capsules include massage, external ultrasonic therapy, leukotriene pathway inhibitors such as zafirlukast (Accolate) or montelukast (Singulair), and pulsed electromagnetic field therapy (PEMFT).[67][68][69][70]
Repair and revision surgeries

When the woman is unsatisfied with the outcome of the augmentation mammoplasty; or when technical or medical complications occur; or because of the breast implants’ limited product life (Class III medical device, in the U.S.), it is likely she might require replacing the breast implants. The common revision surgery indications include major and minor medical complications, capsular contracture, shell rupture, and device deflation.[52] Revision incidence rates were greater for breast reconstruction patients, because of the post-mastectomy changes to the soft-tissues and to the skin envelope of the breast, and to the anatomical borders of the breast, especially in women who received adjuvant external radiation therapy.[52] Moreover, besides breast reconstruction, breast cancer patients usually undergo revision surgery of the nipple-areola complex (NAC), and symmetry procedures upon the opposite breast, to create a bust of natural appearance, size, form, and feel. Carefully matching the type and size of the breast implants to the patient’s pectoral soft-tissue characteristics reduces the incidence of revision surgery. Appropriate tissue matching, implant selection, and proper implantation technique, the re-operation rate was 3.0 per cent at the 7-year-mark, compared with the re-operation rate of 20 per cent at the 3-year-mark, as reported by the U.S. Food and Drug Administration.[71][72]
Alleged complications
Systemic disease and sickness
The chest X-ray of a woman with bilaterally emplaced breast implants.

Since the 1990s, reviews of the studies that sought causal links between silicone-gel breast implants and systemic disease reported no link between the implants and subsequent systemic and autoimmune diseases.[59][73][74][75] Nonetheless, during the 1990s, thousands of women claimed sicknesses they believed were caused by their breast implants, including neurological and rheumatological health problems.

In the study Long-term Health Status of Danish Women with Silicone Breast Implants (2004), the national healthcare system of Denmark reported that women with implants did not risk a greater incidence and diagnosis of autoimmune disease, when compared to same-age women in the general population; that the incidence of musculoskeletal disease was lower among women with breast implants than among women who had undergone other types of cosmetic surgery; and that they had a lower incidence rate than like women in the general population.[76][77]

Follow-up longitudinal studies of these breast implant patients confirmed the previous findings on the matter.[78] European and North American studies reported that women who underwent augmentation mammoplasty, and any plastic surgery procedure, tended to be healthier and wealthier than the general population, before and after implantation; that plastic surgery patients had a lower standardized mortality ratio than did patients for other surgeries; yet faced an increased risk of death by lung cancer than other plastic surgery patients. Moreover, because only one study, the Swedish Long-term Cancer Risk Among Swedish Women with Cosmetic Breast Implants: an Update of a Nationwide Study (2006), controlled for tobacco smoking information, the data were insufficient to establish verifiable statistical differences between smokers and non-smokers that might contribute to the higher lung cancer mortality rate of women with breast implants.[79][80] The long-term study of 25,000 women, Mortality among Canadian Women with Cosmetic Breast Implants (2006), reported that the “findings suggest that breast implants do not directly increase mortality in women.”[81]

A 2001 study, Silicone gel Breast Implant Rupture, Extracapsular Silicone, and Health Status in a Population of Women, reported increased incidences of fibromyalgia among women who suffered extracapsular silicone-gel leakage than among women whose breast implants neither ruptured nor leaked.[82] The study later was criticized as significantly methodologically flawed, and a number of large subsequent follow-up studies have not shown any evidence of a causal device–disease association. After investigating, the U.S. FDA has concluded “the weight of the epidemiological evidence published in the literature does not support an association between fibromyalgia and breast implants.”.[83][84] Recent systemic review by Lipworth (2011)[85] concludes that "any claims that remain regarding an association between cosmetic breast implants and CTDs are not supported by the scientific literature".
Platinum toxicity

The manufacture of silicone breast implants requires the metallic element platinum as a catalyst to accelerate the transformation of silicone oil into silicone gel for making the elastomer silicone shells, and for making other medical-silicone devices.[86] The literature indicates that trace quantities of platinum leak from such types of silicone breast implant; therefore, platinum is present in the surrounding pectoral tissue(s). The rare pathogenic consequence is an accumulation of platinum in the bone marrow, from where blood cells might deliver it to nerve endings, thus causing nervous system disorders such as blindness, deafness, and nervous tics (involuntary muscle contractions).[86] In 2002, the U.S. Food and Drug Administration reviewed the studies on the human biological effects of breast-implant platinum, and reported little causal evidence of platinum toxicity to women with breast implants.[87] Furthermore, in the journal Analytical Chemistry, the study Total Platinum Concentration and Platinum Oxidation States in Body Fluids, Tissue, and Explants from Women Exposed to Silicone and Saline Breast Implants by IC-ICPMS (2006), proved controversial for claiming to have identified previously undocumented toxic platinum oxidative states in vivo.[88] Later, in a letter to the readers, the editors of Analytical Chemistry published their concerns about the faulty experimental design of the study, and warned readers to “use caution in evaluating the conclusions drawn in the paper.”[89] Furthermore, after reviewing the research data of the study, and other pertinent literature, the U.S. FDA reported that the data do not support the findings presented; that the platinum used, in new-model breast-implant devices, likely is not ionized, and therefore is not a significant risk to the health of the women.[90]
Implants and breast-feeding
The functional breast: a mammary gland in medias res, feeding an infant.
Breast implant: Cross-section scheme of the mammary gland.
1. Chest wall
2. Pectoralis muscles
3. Lobules
4. Nipple
5. Areola
6. Milk duct
7. Fatty tissue
8. Skin envelope

The functional breast

The breasts are apocrine glands that produce milk for the feeding of infant children; each breast has a nipple within an areola (nipple-areola complex, NAC), the skin color of which varies from pink to dark brown, and has sebaceous glands. Within the mammary gland, the lactiferous ducts produce breast milk, and are distributed throughout the breast, with two-thirds of the tissue within 30-mm of the base of the nipple. In each breast, 4–18 lactiferous ducts drain to the nipple; the glands-to-fat ratio is 2:1 in lactating women, and to 1:1 in non-lactating women; besides milk glands, the breast is composed of connective tissue (collagen, elastin), adipose tissue (white fat), and the suspensory Cooper's ligaments. The peripheral nervous system innervation of the breast is by the anterior and lateral cutaneous branches of the fourth-, fifth-, and sixth intercostal nerves, while the Thoracic spinal nerve 4 (T4) innervating the dermatomic area supplies sensation to the nipple-areola complex.[91][92]

Digestive contamination and systemic toxicity are the principal infant-health concerns; the leakage of breast implant filler to the breast milk, and if the filler is dangerous to the nursing infant. Breast implant device fillers are biologically inert — saline filler is salt water, and silicone filler is indigestible — because each substance is chemically inert, and environmentally common. Moreover, proponent physicians have said there “should be no absolute contraindication to breast-feeding by women with silicone breast implants.”[93][94] In the early 1990s, at the beginning of the silicone breast-implant sickness occurrences, small-scale, non-random studies (i.e. “patients came with complaints, which might have many sources”, not “doctors performed random tests”) indicated possible breast-feeding complications from silicone implants; yet no study reported device–disease causality.[94]

The augmented breast

Women with breast implants are able to breast-feed; however implant devices may cause functional breast-feeding difficulties, especially the mammoplasty procedures that feature periareolar incisions and subglandular emplacement, which have greater incidences of breast-feeding difficulties. Surgery may also damage the lactiferous ducts and the nerves of the nipple-areola complex (NAC).[95][96][97]

Functional breast-feeding difficulies arise if the surgeon cut the milk ducts or the major nerves innervating the breast, or if the milk glands were otherwise damaged. Milk duct and nerve damage are more common to the periareolar incision implantation procedure, which cuts tissue near the nipple, whereas other implantation incision-plans — IMF (Inframammary Fold), TABA (Trans-Axillary Breast Augmentation), TUBA (Trans-Umbilical Breast Augmentation) — avoid the tissue of the nipple-areola complex; if the woman is concerned about possible breast-feeding difficulties, the periareolar incisions can be effected to reduce damage to the milk ducts and to the nerves of the NAC. The milk glands are affected most by subglandular implants (under the gland), and by large-sized breast implants, which pinch the lactiferous ducts and impede milk flow. Small-sized breast implants, and submuscular implantation, cause fewer breast-function problems; however, women have successfully breast-fed after undergoing periareolar incisions and subglandular emplacement.[97]
Implants and mammography
Breast implant: Mammographs:
Normal breast (left) and cancerous breast (right).

The presence of radiologically opaque breast implants might interfere with the radiographic sensitivity of the mammograph. In this case, an Eklund view mammogram is required, wherein the breast implant is manually displaced against the chest wall and the breast is pulled forward, so that the mammograph can visualize the internal tissues; nonetheless, approximately one-third of the breast tissue remains inadequately visualized, resulting in an increased incidence of false-negative mammograms.[98]

Breast cancer studies of women with implants reported no significant differences in disease stage at the time of diagnosis; prognoses are similar in both groups, with augmented patients at a lower risk for subsequent cancer recurrence or death.[99][100] Conversely, the use of implants for breast reconstruction after breast cancer mastectomy appears to have no negative effect upon the incidence of cancer-related death.[101] That patients with breast implants are more often diagnosed with palpable — but not larger — tumors indicates that equal-sized tumors might be more readily palpated in augmented patients, which might compensate for the impaired mammogram images.[64] The palpability is consequent to breast tissue thinning by compression, innately smaller breasts a priori, and that the implant serves as a radio-opaque base against which a cancerous tumor can be differentiated.[102] The implant device has no clinical bearing upon lumpectomy breast conservation surgery for patients who developed breast cancer post-implantation, and it does not interfere with external beam radiation treatments (XRT); post-treatment incidence of breast-tissue fibrosis is common, and thus an increased rate of capsular contracture.[103]
U.S. FDA approval
Breast implant: the Food and Drug Administration, the medical device authority for the U.S.

In 1988, twenty-six years after the 1962 introduction of breast implants filled with silicone gel, the U.S. Food and Drug Administration (FDA) investigated breast-implant failures and the subsequent complications, and re-classified breast implant devices as Class III medical devices, and required from manufacturers the documentary data substantiating the safety and efficacy of their breast implant devices.[104] In 1992, the FDA placed silicone-gel breast implants in moratorium in the U.S., because there was “inadequate information to demonstrate that breast implants were safe and effective”. Nonetheless, medical access to silicone-gel breast implant devices continued for clinical studies of post-mastectomy breast reconstruction, the correction of congenital deformities, and the replacement of ruptured silicone-gel implants. The FDA required from the manufacturers the clinical trial data, and permitted their providing breast implants to the breast augmentation patients for the statistical studies required by the U.S. Food and Drug Administration.[104] In mid–1992, the FDA approved an adjunct study protocol for silicone-gel filled implants for breast reconstruction patients, and for revision-surgery patients. Also in 1992, the Dow Corning Corporation, a silicone products and breast-implant manufacturer, announced the discontinuation of five implant-grade silicones, but would continue producing 45 other, medical-grade, silicone materials—three years later, in 1995, the Dow Corning Corporation went bankrupt when it faced 19,000 breast-implant sickness lawsuits.[104]

    In 1997, the U.S. Department of Health and Human Services (HHS) appointed the Institute of Medicine (IOM) of the U.S. National Academy of Sciences (NAS) to investigate the potential risks of operative and post-operative complications from the emplacement of silicone breast implants. The IOM’s review of the safety and efficacy of silicone gel-filled breast implants, reported that the “evidence suggests diseases or conditions, such as connective tissue diseases, cancer, neurological diseases, or other systemic complaints or conditions are no more common in women with breast implants, than in women without implants”; subsequent studies and systemic review found no causal link between silicone breast implants and disease.[104]

Breast implant: the U.S. Department of Health and Human Services verifies the scientific, medical, and clinical data of medical devices.

    In 1998, the U.S. FDA approved adjunct study protocols for silicone-gel filled implants only for breast reconstruction patients and for revision-surgery patients; and also approved the Dow Corning Corporation’s Investigational Device Exemption (IDE) study for silicone-gel breast implants for a limited number of breast augmentation-, reconstruction-, and revision-surgery patients.[104]

    In 1999, the Institute of Medicine published the Safety of Silicone Breast Implants (1999) study that reported no evidence that saline-filled and silicone-gel filled breast implant devices caused systemic health problems; that their use posed no new health or safety risks; and that local complications are “the primary safety issue with silicone breast implants”, in distinguishing among routine and local medical complications and systemic health concerns.”[104][105][106]

    In 2000, the FDA approved saline breast implant Premarket Approval Applications (PMA) containing the type and rate data of the local medical complications experienced by the breast surgery patients.[107] “Despite complications experienced by some women, the majority of those women still in the Inamed Corporation and Mentor Corporation studies, after three years, reported being satisfied with their implants.”[104] The premarket approvals were granted for breast augmentation, for women at least 18 years old, and for women requiring breast reconstruction.[108][109]

    In 2006, for the Inamed Corporation and for the Mentor Corporation, the U.S. Food and Drug Administration lifted its restrictions against using silicone-gel breast implants for breast reconstruction and for augmentation mammoplasty. Yet, the approval was conditional upon accepting FDA monitoring, the completion of 10-year-mark studies of the women who already had the breast implants, and the completion of a second, 10-year-mark study of the safety of the breast implants in 40,000 other women.[110] The FDA warned the public that breast implants do carry medical risks, and recommended that women who undergo breast augmentation should periodically undergo MRI examinations to screen for signs of either shell rupture or of filler leakage, or both conditions; and ordered that breast surgery patients be provided with detailed, informational brochures explaining the medical risks of using silicone-gel breast implants.[104]

The U.S. Food and Drug Administration established the age ranges for women seeking breast implants; for breast reconstruction, silicone-gel filled implants and saline-filled implants were approved for women of all ages; for breast augmentation, saline implants were approved for women 18 years of age and older; silicone implants were approved for women 22 years of age and older. [4]. Because each breast implant device entails different medical risks, the minimum age of the patient for saline breast implants is different from the minimum age of the patient for silicone breast implants — because of the filler leakage and silent shell-rupture risks; thus, periodic MRI screening examinations are the recommended post-operative, follow-up therapy for the patient. [5] In other countries, in Europe and Oceania, the national health ministries’ breast-implant policies do not endorse periodic MRI screening of asymptomatic patients, but suggest palpation proper — with or without an ultrasonic screening — to be sufficient post-operative therapy for most patients.
Criticism

In the early 1990s, the national health ministries of the listed countries reviewed the pertinent studies for causal links among silicone-gel breast implants and systemic and auto-immune diseases. The collective conclusion is that there is no evidence establishing a causal connection between the implantation of silicone breast implants and either type of disease. The affected women complained of systemic disease manifested as fungal, neurologic, and rheumatologic ailments. The Danish study Long-term Health Status of Danish Women with Silicone Breast Implants (2004) reported that women who had breast implants for an average of 19 years were no more likely to report an excessive number of rheumatic disease symptoms than would the women of the control group.[76] The follow-up study Mortality Rates Among Augmentation Mammoplasty Patients: An Update (2006) reported a decreased standardized mortality ratio and an increased risk of lung cancer death among breast-implant patients, than among patients for other types
of plastic surgery; the mortality rate differences were attributed to tobacco smoking.[111] The study Mortality Among Canadian Women with Cosmetic Breast Implants (2006), about some 25,000 women with breast implants, reported a 43 per cent lower rate of breast cancer among them than among the general populace, and a lower-than-average risk of cancer.[81]


FAQ's

PRICING AND FINANCING QUESTIONS

How much do the consultations cost?

Absolutely nothing, the consultations are free! You will meet your surgeon for an initial consultation, a pre-op consultation and several post-op consultations, all which are free of charge.

Are there any extra costs I should know about?

The price for the procedure will include everything except anesthesia (approximately $400 - $600 depending on the procedure), blood test, laboratory and handling ($150 ) and your surgical garment ($60 - $150). Click here to visit our pricing page.

Is there an extra discount for having more than one procedure?

Yes, if you are having more than one procedure done, you can expect a substantial discount on the standard rates.

I do not have enough cash to pay for my procedure, can you help?

Yes, we offer assistance in obtaining financing from accredited patient financing institutions. For more information, please reference our finance page by clicking here.

Does my medical insurance cover Cosmetic surgery?

Most medial insurance plans do not cover elective surgery, but in those cases they do - 123 New Me is more than happy to accept medical coverage. You should ask your medical insurance provider and schedule an appointment with our surgeons to find out the options for your particular case.

GENERAL QUESTIONS

Who do I contact if I want more information about your procedures, the practice and the surgeons?

Please contact the 123 New Me to get in touch with one of our Cosmetic consultants.

Where can I see before- and after photos of procedures performed by your surgeons?

Before and after photos are available on our website by clicking here. You are also welcome to view the pictures during your initial complementary consultation with our experienced surgeons.

Are your surgeons Board Certified?

Our surgeons are highly skilled and experienced surgeons with immaculate training. They are diplomates of either American Board of Plastic Surgery or the American Board of Cosmetic Surgery.

Is there any age restriction for people to come in and get a consultation?

No, patients of all ages approach our clinic, and the surgeons that work here also perform reconstructive surgery, which sometimes is needed by young people.

What are your office hours?

123 New Me has a 24/7 phone line open to our patients and customers. Our hours for consultation and surgery vary depending on your preferences. The easiest way to schedule an appointment is to contact the 123 New Me and we'll set up a consultation for you. Late evening consultations can be scheduled to accomodate each patient individually.

ABOUT THE PROCEDURE

What is the difference between Cosmetic and reconstructive surgery?

Cosmetic surgery is performed to reshape normal structures of the body in order to improve the patient's appearance and self-esteem. Cosmetic surgery is usually not covered by health insurance because it is elective.

Reconstructive surgery is performed on abnormal structures of the body, caused by congenital defects, developmental abnormalities, trauma, infection, tumors or disease. It is generally performed to improve function, but may also be done to approximate a normal appearance. Reconstructive surgery is generally covered by most health insurance policies although coverage for specific procedures and levels of coverage may vary greatly. There are a number of "gray areas" in coverage for plastic surgery that sometimes require special consideration by an insurance carrier. These areas usually involved surgical operations which may be reconstructive or Cosmetic, depending on each patient's situation. For example, eyelid surgery (blepharoplasty) - a procedure normally performed to achieve Cosmetic improvement may be covered if the eyelids are drooping severely and obscuring a patient's vision.

Will It Hurt?

During a procedure anesthesia ensures that you're comfortable and feel no pain. If general anesthesia is used, you'll even sleep through the entire operation After surgery any pain of discomfort you may experience can usually be controlled through medication and will usually subside in a matter of days.

Will there be scars?

To most surgical Cosmetic procedures the answer is yes. Will they be noticeable- Probably not. Your surgeon will make every effort to keep scars as minimal as possible and try to hide them in the natural lines and creases of your skin. For the majority of procedures, your scars will fade over time and become barely visible.

Is it safe?

Millions of Cosmetic procedures are performed successfully every year and complications are usually rare and uncommon. But no matter how easy, simple or safe today's Cosmetic surgery may seem to be, you must remember that it is still surgery and with any surgery there are certain risks involved.

How long will it last?

The duration of the results is very specific to the procedure performed. In general, procedures that are performed to correct or reshape nature's small defects such as surgery of the nose, breast augmentation/reduction and chin augmentation, the benefits may last a lifetime. For those that focus on rejuvenation such as a face lift, forehead lift chemical peel or eyelid surgery, the results can last 5 - 10 years

Will people be able to tell?

In general, most Cosmetic procedures enhance your looks or minimize perceived flaws naturally, and often go unnoticed. You may be asked if you've been exercising, lost weight or have begun a rejuvenating routine. Typically, no one will know unless you tell.

How soon can I return to work?

Again, this differs widely on the procedure that has been performed, but on average, most Cosmetic surgery patients are back to work within 3 to 10 days

How many people undergo Cosmetic surgery each year?

Nearly 3.5 million Cosmetic surgery procedures are performed each year.

At what age do most people have Cosmetic surgery?

About one-third of Cosmetic surgery patients are between 35 and 50. About 22 percent are 26 to 34, 18 percent are 25 and under and 27 percent are over 51.

How many men have Cosmetic surgery?

Almost 700,000 Cosmetic procedures are performed on men each year. And the number gets larger each year as men grow increasingly comfortable with the concept of Cosmetic surgery for themselves.

What are the most popular procedures for men?

- hair transplantation/restoration
- chemical peel
- liposuction
- sclerotherapy (vein treatment)
- eyelid surgery

LIPOSUCTION QUESTIONS

What is Liposuction?

Liposuction is the surgical vacuuming of fat from beneath the surface of the skin. It is used to reduce fullness in any area of the body. It is an excellent method of spot reduction but is not an effective method of weight loss.

What is the tumescent technique?

The tumescent technique involves injection beneath the skin of large volumes of salt water containing lidocaine, a local anesthetic and small amounts of adrenaline, a naturally occurring hormone which shrinks blood vessels. By injecting this solution to the fat prior to performing liposuction the plastic surgeon numbs the tissues and shrinks the blood vessels thereby eliminating pain and reducing and minimizing bleeding, bruising, and swelling. The tumescent technique permits some patients who were previously treated under general anesthesia to be treated under local anesthesia with sedation.

Who is a candidate for liposuction?

Generally people who have localized areas of protruding fat achieve the most dramatic results. Patients who are slightly overweight can benefit from liposuction. It is best to be at or near your normal weight. Good skin elasticity permits the skin to shrink easily to the reduced contour. There are no absolute age limits for liposuction.

What areas are most frequently treated?

In women, the single most frequently treated areas are the outer thighs, followed by the stomach. In men, the flank area or "love handles" are treated most frequently.

Can liposuction tighten up a loose neck?

If there is excess fat in the area under the chin and the skin is taut, liposuction alone can produce a more sculpted, angular, and youthful jaw line. If, however, the skin of the neck is loose or hanging, even if there is excess fat, liposuction alone will not produce the desired result. Patients with loose skin usually require a face and neck lift in addition to or instead of liposuction. In general, most patients who benefit from liposuction of the neck are under 40. Most patients over 40 will require some surgical skin tightening.

Liposuction seems very simple and safe. Are there any dangers?

Although liposuction is very safe and effective, it is a surgical procedure and can cause complications such as infection, bleeding, and nerve damage. In addition, aesthetic complications such as skin irregularity or waviness can occur if too much fat has been removed. Fortunately, complications are uncommon and most patients are satisfied with their results.

Do you do liposuction of the abdomen?

Yes, sometimes it is recommended to perform a liposuction of the abdomen instead of a tummy tuck.

BREAST AUGMENTATION QUESTIONS

Is your price quote for the breast augmentation including both breasts?

Most definitely yes, the prices for procedures like breast augmentation, eyelid surgery etc. are always quoted in pairs.

Why are you not offering silicon breast implants?

Despite the popularity and great results with silicon breast implants, the use of silicon is currently under federal investigation, disabling us from using them in our procedures.

Is it possible to perform the breast implant procedure via the armpit or bellybutton?

Yes, our armpit and bellybutton procedures are becoming increasingly popular, since they leave no visible scars.

Can you breast feed after having a breast enlargement?

Yes, the functions of your breast are in no way limited by the implants.

Is it true you have to replace breast implants every 10-15 years?

Some patients need to replace their implants if their breast starts sagging, or if the implant should be leaking. The implants we use have a lifetime guarantee, however, so the implants will be replaced at no cost to the patient.

Can breast augmentation be done without taking any pain medication whatsoever?

Yes, there is no requirement to take pain killers after any procedure, but most patients find it comforting to ease the pain - especially since the muscles after a breast augmentation can be rather sore.

FACELIFT

What is a facelift?

A facelift or "rhytidectomy" is a surgical procedure designed to improve the most visible signs of the aging process by eliminating excess fat, tightening the muscles beneath the skin of the neck, and removing sagging skin. It doesn't stop the aging process but merely "sets the clock back".

How long does a facelift last?

No one can say for sure. The clock is turned back, but keeps on running. Ten years later, you will look better than if you never had surgery. Many patients never have a second lift, while others may desire further surgery seven to 15 years later.

Can surgery be done without scars?

The scars from facelift surgery usually fade and are barely perceptible. In some patients, especially younger ones, endoscopic surgery can be used to lift the eyebrows, remove frown lines, elevate the cheek and jowls, and tighten the neck. This endoscopic surgery can be done with tiny scars. However, if there is excessive skin, it must be removed for the best results through standard facelift incisions.

How long will I be out of work?

Most patients are able to return to work in two to three weeks. You should allow four to eight weeks before major social engagements.

How can I hide things during the time until I return to normal?

Your surgeon will discuss post-operative camouflage techniques with you prior to your surgery, but be assured that while almost everyone has some sort of temporary side effect such as bruising and swelling, there are makeup techniques that both men and women can use almost immediately to disguise them. Generally speaking, makeup techniques can be used soon after surgery to cover discolorations, and to hide incision lines after the stitches have been removed and the incision is completely closed. Camouflage Cosmetics include three basic types of products: Concealers to hide incision lines and discolorations; contour shadows to disguise swelling; and color correctors to neutralize color in reddened skin.

Color correctors disguise yellowish discolorations or the pinkness that follows chemical peel and dermabrasion. Lavender neutralizes or removes yellow, and green has a similar effect on red. It will take a little patience and practice to master camouflage techniques, but most post-op patients feel its well worth the effort.

RHINOPLASTY

What will my nose look like after surgery?

In general, rhinoplasty is designed to reduce excess cartilage and bone in the nose, removing irregularities and bumps to give a straightened, smooth and, usually, smaller appearance. Adding tissue to enhance certain features of the nose can also occur. The overall trend in modern rhinoplasty is away from over-reduction of tissue which can reduce the ability to breath through the nose and towards individualized treatment of each segment of the nose to give a balanced and refined look without compromising function.

How long does the surgery take and what kind of anesthesia is used?

Usually, Rhinoplasty takes from one to three hours depending on the complexity of the condition of the nose. Most patients have sedation prior to and during the procedure while some patients request a general anesthesia. Nearly all rhinoplasty operations are done as outpatient surgeries.

Is there a lot of bruising afterwards and how long will it last?

This depends again on how complex the procedure is, but in general most patients experience five to seven days of purple discoloration and swelling around the eyes and upper cheeks. The nose itself will be swollen for around ten to fourteen days or longer, but subtle resolution of the swelling at the tip of the nose can take many months after surgery to go away.

I have trouble breathing through my nose and have terrible sinus problems. Will my insurance policy pay for rhinoplasty?

The condition described is usually associated with a deviated septum or a bent internal framework of the nose. Most of the time this results from trauma such as a broken nose but many patients with this condition cannot recall an episode where this might have occurred. The condition described in this question however, could also result from allergies or the two conditions can exist simultaneously.

Careful examination is needed before surgery to separate the two conditions. While individual insurance policies can vary, in general, functional surgery to improve breathing is considered a covered benefit in many group policies. If additional correction of a Cosmetic deformity of the nose is done at the same time the cost of this part of the procedure is usually not covered by insurance.

Where are the incisions placed during nose surgery?

In general, most or all of the incisions in rhinoplasty are hidden in the inside of the nostril. While external incisions hidden in the creases where the nose meets the cheek can be used to narrow the nose, incisions on the bridge or tip are not usually used in Cosmetic surgery of the nose.

Will my nose grow after surgery?

In general, our noses tend to elongate as we enter the middle years of our life and drooping of the tip of the nose can occur in the later years as elasticity disappears from the body. While undergoing a Cosmetic rhinoplasty as a teenager or young adult will not prevent the effects of aging on the nose, the final shape that results from this surgery is expected to last a lifetime and regrowth of bumps and deformities corrected by the operation is a rare occurrence.



Pricing & Financing

General Questions

About the Procedure

Face Lift

Breast Augmentation

Liposuction

Rhinoplasty




 Plastic & Cosmetic Surgeons:

    Maher M. Anous, MD, FACS
    William Bruno, MD
    Andrew T. Cohen, MD, FACS
    Ron Hazani, MD, FACS
    Jason R. Hess, MD
    Richard Hodnett, MD, FACS
    Charles Hsu, MD
    Rafi Israel, MD
    Payam Jarrah-Nejad, MD, FACS
    Louis R. Mandris, MD
    Kenneth Siporin, MD

Shane Sheibani, MD













    Plastic & Cosmetic Surgery
    Body Lifts
    BOTOX® Cosmetic
    BOTOX® for Hyperhydrosis
    Breast Augmentation
    Breast Augmentation Revision
    Breast Implants
    Breast Lifts
    Breast Reconstruction
    Breast Reduction
    Buttock Enhancements
    Captique™
    Chin and Cheek Augmentation
    Collagen
    Cosmetic Surgery Revision
    Dysport™
    Ear Surgery
    Eyelid Surgery
    Facelift
    Fat Transfer Surgery
    Forehead/Brow Lift
    Juvederm™
    Latisse™
    Lip Augmentation
    Liposuction
    Male Breast Reduction
    Mommy Makeover
    Neck Lift
    Panniculectomy
    Pectoral Implants
    Post Bariatric Reconstruction
    Restylane®
    Rhinoplasty
    Rhinoplasty Revision
    Skin Tightening
    Thigh Lift
    ThreadLift™
    Tummy Tuck

    Podiatry

    Weight Loss, Bariatric & Banding

    Laser & Skin Care

    Orthopedic & Sports Medicine

    Cosmetic & Implant Dentistry

    Lasik & Ophthalmology

    Female Corrective
    & Vaginal Rejuvenation

    Hair Restoration & Transplant

    Hyperhidrosis & Excessive Sweating


 
 


Beverly Hills beauty isn't always exactly what it seems. Many of the beautiful people you see walking down the streets, in the stores, and on TV have had or will have some plastic surgery in their lives. Also, nowhere else in the world is plastic surgery more accepted than it is in Beverly Hills! If you're thinking about having cosmetic plastic surgery, there's really no better place than Beverly Hills to get work done. The doctors are discreet, the results are stunning, and you can even find plenty of financing opportunities.

Beverly Hills Physicians.com is one of the largest networks of beauty and health care providers in California. Though specialists primarily inclue plastic surgeons, the network hosts physicians, dentists, and aestheticians for all categories of beauty and wellness.

When it comes to plastic surgery in Beverly Hills or Los Angeles, the stars and everyday people all agree that Beverly Hills Physicians is the best in the business. A visit to Beverly Hills Physicians is like being on your very own makeover reality show. At Beverly Hills Physicians.com, we strive to provide you with the most reputable professionals within all facets of beauty: cosmetic dentistry, laser treatments, female corrective surgery, LASIK eye surgery, health and wellness services, and much more. As a patient of the Beverly Hills Physicians.com beauty network, you will have access to preferred patient pricing and incomparable customer service.

As a plastic surgery specialist, Beverly Hills Physicians.com provides highly-trained cosmetic surgeons and medical staff, spa-like facilities, and unparalleled patient services.

The professionals at Beverly Hills Physicians have been featured in glamour magazines like Elle, Cosmopolitan, and Bazaar, consulted on awards shows, and provided commentary for entertainment shows like Extra, Entertainment Tonight, and Tyra.

Our highly-trained plastic surgeons will sculpt and enhance your natural beauty. With over 100 years of combined experience, our surgeons provide unsurpassed medical expertise and commitment to patient education and care. Our plastic and cosmetic surgeons will assist you in achieving the figure of your desires.

We have experienced consultants who will guide you through your surgical experience at any of the Beverly Hills Physicians.com locations (Los Angeles, Beverly Hills and other centers in Southern California). Your consultant will recommend a qualified doctor to meet your surgical needs, in addition to assisting you with financing, pre-operative and post-operative care.

Peace of mind is invaluable to our patients and to our plastic surgeons. All of our surgical facilities are fully accredited by the American Association for Ambulatory Healthcare, and each center (like Beverly Hills, Encino, Thousand Oaks, Valencia, Pasadena, Long Beach and Oxnard) is equipped with state-of-the-art instruments.

Beverly Hills Plastic Surgeons · Beverly Hills Plastic Surgery · Beverly Hills Breast Augmentation · Breast Implants · Los Angeles Breast Lifts · Los Angeles Breast Reduction · Body Lifts · BOTOX® Cosmetic · Botox® for Hyperhydrosis · Chin and Cheek Augmentation · Los Angeles Eyelid Surgery · Facelift · Forehead Lift · Juvederm ·Lip Augmentation · Los Angeles Liposuction · Male Breast Reduction - Gynecomastia · Neck Lift · Restylane® · Rhinoplasty · ThreadLift™ · Tummy Tuck · Obesity Banding · Weight Loss Surgery · Podiatry · Podiatrist · Bunion · Hammertoe · Foot Doctor · Links · En Español

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plastic surgery, surgery [Credit: © Robert Llewellyn/Corbis]the functional, structural, and aesthetic restoration of all manner of defects and deformities of the human body. The term plastic surgery stems from the Greek word plastikos, meaning “to mold” or “to form.” Modern plastic surgery has evolved along two broad themes: reconstruction of anatomic defects and aesthetic enhancement of normal form. The surgical principles of plastic surgery remain focused on preserving vascularity, replacing like tissue with like tissue, respecting anatomic zones, and fostering wound healing by minimizing tissue trauma. As a diverse surgical specialty, the discipline of plastic surgery not only interacts with other disciplines of medicine but also merges medical science with the art of physical restoration. It couples careful evaluation of defects with sophisticated arrangements of tissue to improve the uniformity and natural resemblance of repair. Innovative techniques used in plastic surgery are largely the result of the successful clinical application of advances in tissue engineering, nanotechnology, and gene therapy.
Table Of Contents
Early developments in plastic surgery

The modern definition of plastic surgery is rooted in ancient medicine. The Sanskrit text Sushruta-samhita, written about 600 bce by ancient Indian medical practitioner Sushruta, describes, with surprising modernity, a quintessential plastic surgical procedure: the reconstruction of mutilated noses using tissue bridged from the cheek. During the Renaissance, Italian surgeon Gaspare Tagliacozzi and French surgeon Ambroise Paré adopted these early procedures and kindled a modern fascination with the use of local and distant tissue to reconstruct complex wounds. In the 19th century German surgeon Karl Ferdinand von Gräfe first invoked the term plastic when describing creative reconstructions of the nose in his text Rhinoplastik (1818). In the United States the organizing bodies of plastic surgery were founded between the world wars, with the American Society of Plastic Surgeons established in 1931 and the American Board of Plastic Surgery established in 1937. In the 1960s and ’70s the pioneering work of Canadian-born American surgeon Harry J. Buncke, Japanese surgeon Susumu Tamai, and Austrian surgeon Hanno Millesi resulted in the integration of procedures and techniques that defined microsurgery (surgery on very small structures requiring the use of a microscope).

plastic surgery [Credit: © Comstock/Thinkstock]Aesthetic, or cosmetic, surgery entered into the public consciousness with the advent of refinements that rendered safe the rejuvenation of the face and body through procedures such as face-lifts, breast augmentation, and liposuction. This was coupled with an increasing emphasis on minimally invasive procedures, such as injections of botulinum toxin (Botox) and cosmetic soft-tissue fillers (e.g., collagen and hyaluronic acid).
Table Of Contents
Surgical principles

The basic premise of soft tissue reconstruction is fixing deformities with normal tissue that shares similar characteristics with the damaged tissue. Respect for tissue physiology and mechanics is important in both reconstructive and aesthetic plastic surgery. Hence, delicate handling of tissue with instruments, judicious elevation of tissue to minimize vascular disruption, and precise alignment of tissue planes are all important elements of technique.
Grafts and flaps

tissue engineering [Credit: Vo Trung Dung/Corbis SYGMA]Closure of wounds is a central tenet of reconstructive surgery. Many wounds can be closed primarily (with direct suture repair). However, if the defect is sufficiently large, skin may be taken from other parts of the body and transferred to the area of the wound. Skin grafts are thin layers of skin taken from a remote location that are secured to the site of repair with bolsters, which serve to facilitate eventual integration of the donor skin into the wound.

Larger, more complex wounds have a greater volume and can involve exposed vital structures, such as vessels, nerves, tendon, bone, viscera, and other organs. Such wounds require coverage via transposed or transplanted composite segments of skin, subcutaneous tissue, muscle, and, in some cases, bone and nerve. These tissue constructs are maintained by their own defined blood supply and are called flaps. The pioneering work of Australian plastic surgeon Ian Taylor led to the characterization of angiosomes—the networks of blood vessels that supply flaps—which has allowed for rational matching of flaps to defects. Flaps may be transferred from neighbouring tissue, or they may be disconnected from their original blood supply and reconnected using microsurgical technique to another set of vessels adjacent to the defect.

plastic surgery: breast implant [Credit: © iStockphoto/Thinkstock]The use of implants or expander devices can also increase the amount of soft tissue. These devices are useful in cases when a patient has a limited amount of donor skin—for example, in those who are severely burned or in children who have large congenital moles. Implants and expander devices have also been adapted for breast reconstruction following mastectomy in breast cancer patients and for aesthetic breast augmentation.
Craniofacial surgery

Congenital and traumatic defects of the head and neck region fall under the scope of plastic surgery. Cleft lip and cleft palate deformities, premature fusion of skull elements, and persistent clefts in the facial skeleton require complex soft tissue and bone rearrangement. The introduction of internal fixation systems that use screws and plates has greatly facilitated congenital reconstructions as well as correction of traumatic fractures. Novel permutations of these fixation devices have been developed; for example, distraction osteogenesis is a technique used to induce bone growth from hypoplastic (incompletely developed) bone by traction exerted by moveable plate systems. Biomaterials, such as absorbable plate systems and bone cements, are being improved continually and are often used in pediatric craniofacial surgery.

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Hand surgery

By virtue of its unique anatomy and functional importance, restoration of hand deformities is a shared focus of both plastic surgeons and orthopedic surgeons. Congenital defects involving the hand range from absent or incomplete development (agenesis) to anomalies of limb structures. Traumatic insult may give rise to complex wounds, fractured bones, severed nerves and tendons, or amputations. In the appropriate context, severed digits and limbs may be replanted with microsurgical connections of vessels and nerves. Rehabilitation of the hand is a critical aspect of surgical care, since loss of strength and motion may occur following injury and reconstruction.
Aesthetic surgery

Aesthetic, or cosmetic, surgery is the enhancement of normal structures that are subject to age-related changes or that have unusual features that are distressing to the patient. The procedures used to address these issues are often performed in the physician’s office (as opposed to a hospital) and are relatively simple, entailing only injections of botulinum toxin or hyaluronic soft-tissue filler. In some cases, however, these procedures are complex, involving elective surgery to correct deformities of the nose or to remove excess sagging skin on the face. The practice of plastic surgery has moved beyond plastic surgeons, and there are many other physicians, such as dermatologists and otolaryngologists, who have the skill to perform these procedures.

The same principles that govern reconstructive surgery are applied to aesthetic surgery: replace like with like, respect anatomic boundaries, minimize tissue trauma, and preserve vascular integrity. Aesthetic surgery is also concerned with scars, especially their length and visibility, and modifications to classic procedures such as face-lifts are made to minimize and hide scars. While age-related changes can weaken the support structures of skin and soft tissue, the advent of bariatric surgery in obese patients can create analogous changes in the tissues of the arms, chest, abdomen, and thighs. Corresponding lifts of these parts of the body can be performed.

Botox injection [Credit: © Thinkstock Images/Jupiterimages]Other aesthetic surgeries can reduce or augment parts of the body that are perceived to be too large or too small; common examples include the nose or breasts. In addition, the judicious use of liposuction can improve contour in areas that are unbalanced by excess fat. For the face the use of botulinum toxin can weaken the underlying muscles that create some wrinkles; other wrinkles can be softened by injection of hyaluronic acid. Chemical peels, dermabrasion, and lasers can be used to smooth the fine wrinkles that can form in the uppermost layers of skin.

The heightened public interest in aesthetic surgery also creates clinical, ethical, and medicolegal challenges. A clear understanding of indications, techniques, and complications is important for both surgeon and patient to ensure safe and efficacious outcomes.
Saleh M. ShenaqJohn Kim
plastic surgery - Student Encyclopedia (Ages 11 and up)

    The medical specialty of plastic surgery is concerned with the reshaping of body tissues. The word plastic comes from the Greek plastikos, meaning "to shape" or "to form." The specialty includes both reconstructive and cosmetic surgery. Reconstructive surgery is used to repair malformed or damaged tissue or to replace lost tissue, such as from birth defects, accidents, disease, or cancer surgery. Its primary aims are to restore impaired function and to help people with deformities look as normal as possible. Cosmetic, or aesthetic, surgery is performed on normal, healthy tissue solely to make a person look younger or more attractive. A visually pleasing result is a goal of both reconstructive and cosmetic surgery, and plastic surgeons rely on their aesthetic judgment as well as their mastery of intricate surgical techniques and knowledge of wound healing.


 cosmetic surgery
The Oxford Companion to the Body | 2001 | COLIN BLAKEMORE and SHELIA JENNETT | Copyright

cosmetic surgery The close of the twentieth century marked the centenary of modern surgical intervention to alter the image of the body. A list of the most common operations which were developed over the past century and are understood as ‘cosmetic’ procedures today are shown in the table.

Cosmetic operations

Operations on the face

Forehead lift: tightens the forehead and raises the brow

Facelift (rhytidectomy): tightens the jowls and neck

Eyelid tightening (blepharoplasty): tightens the eyelids

Rhinoplasty (nose job): changes the appearance of the nose

Otoplasty (ear pinback): brings the ears closer to the head

Facial implants (chin, cheek): makes the cheek or chin more prominent

Hair transplantation: treats male pattern baldness

Scar revision: improves the appearance of scars

Skin resurfacing (laser, peel, dermabrasion): smoothes the skin

Operations on the body

Breast enlargement: enhances the size of the breast

Breast tightening (mastopexy): tightens the skin of the breast

Breast reduction: reduces the size of the breast

Breast reconstruction: rebuilds the breast after cancer

Abdominoplasty (tummy tuck): tightens skin and removes extra fat

Mini-abdominoplasty: removes the lower abdominal pouching

Liposuction: removes extra fat

Arm lift: tightens the skin of the upper arm

Gynecomastia resection (large breasts in men): reduces breast size


It is, of course, evident that virtually all procedures which could be conceptualized as cosmetic or aesthetic can also have a reconstructive dimension. Breast reconstruction, which used the same type of implant as breast augmentation, was the focus of a major debate within both medical and feminist circles in the US in the 1990s, as to whether it was reconstructive or aesthetic surgery. During the closing decades of the twentieth century these procedures, and also aesthetic orthodontics, came to be a common undertaking. Aesthetic surgery became a focus of interest — being patient-initiated, and non-reimbursable by private or state third-party payers.

While aesthetic surgery is related in many ways to other physical interventions, from hairweaving to tattooing and body piercing, it is performed in the quite different context of the institution of medicine. The surgical interventions are understood by doctors and patients alike as aesthetic rather than reconstructive. Even though the term ‘aesthetic surgery’ was acknowledged only recently, the practice of surgical interventions devoted to making people ‘beautiful’ rather than to any direct reconstruction of physical anomalies is relatively recent. There is a necessary if rather arbitrary distinction between reconstructive (plastic) surgery and aesthetic (cosmetic) surgery — between not having a nose and having a nose that you dislike. The first represents a functional fault. There is something wrong with the body as well as an unfortunate appearance — a hare lip, a missing jaw, a lost ear — and your desire is to repair the function of the body. Part of that function is, of course, an aesthetic one. Cosmetic surgery, which is part of, and grew from, reconstructive surgery, stresses the latter, subordinate, but essential aspect of the reconstruction. We imagine our bodies as intact and read our intactness as ‘beauty’. You may have a functional nose, a jaw, a breast, but it does not represent your self-image of the beautiful nose, jaw, or breast. It inhales, chews, or lactates, but it is not appropriate. The distinction between reconstructive and aesthetic surgery is an arbitrary one. Certain interventions have been labelled as inherently different — such as breast reconstruction vs. breast augmentation, even though the procedures are similar. The former are understood as a means of restoring physical completeness to the body image and therefore of restoring the psyche to a ‘happy’ state; the latter can be dismissed as ‘vogue fashions’ ( R. V. S. Thompson, Kay-Kilner Prize Essay, 1994). Feminists in the 1990s, such as the American poet Audre Lorde, who underwent a radical mastectomy, argued against breast reconstruction as a refusal to acknowledge the realities of the woman's body. In the Middle Ages, Guy de Chauliac, perhaps the most important surgeon of his time, defined the role of surgery as being threefold: solvit continuum (separating the fused), jungit separatum (connecting the divided), and exstirpat superfluum (removing the extraneous). There is no discussion in his or other texts of that period about the creation of new body parts or their augmentation or reconstruction, although it is evident that virtually all primarily reconstructive surgical procedures also had an aesthetic dimension, even then. As early as the Edwin Smith Surgical Papyrus (3000 bce), surgeons were concerned about the cosmetic results of their interventions. The Egyptians were careful to suture the edges of facial wounds. Even fractures of the nose-bones were dealt with by forcing them into normal positions by means of ‘two plugs of linen, saturated with grease’ inserted into the nostrils. The Roman physician Aulus Cornelius Celsus stressed the ‘beautiful’ suture. This approach can be followed through to the late nineteenth and early twentieth century, with plastic surgeons such as Erich Lexer stressing the cosmetic ends of an operation as ‘an always more appreciated requirement of modern surgery’. Such a stress on the neatness and beauty of the closure was part of the image of the return to function following the operation, for the beautiful was a sign of the healthy — but of the healthy body, not the healthy mind.

Yet even as we understand aesthetic surgery as a means of altering our body's ‘image’ it becomes a means not only of changing our bodies but of shaping our psyches. Aesthetic surgery remains rooted in a presumed relationship between the body and the mind. Sculpting the body comes to be a form of reshaping the psyche.

The central assumption of aesthetic surgery is that if you understand your body as ‘bad’ you are bound to be ‘unhappy’. And in our day and age, being unhappy seems to be identified with being sick. And if you are sick, you should be cured! The idea that you can cure the soul by altering the form of the body became commonplace in the twentieth century. It is the other side of the coin from the argument that to cure specific bodily symptoms you need to ‘heal’ the psyche.

Elaine Scarry has remarked in her classic work The Body In Pain (1985),
… at particular moments when there is within a society a crisis of belief — that is, when some central idea or ideology of cultural construct has ceased to elicit a population's belief either because it is manifestly fictitious or because it has for some reason been divested of ordinary forms of transubstantiation — the sheer material factualness of the human body will be borrowed to lend that cultural construct the aura of “realness” and “certainty”.

It is this realness and certainty ascribed to an imagined as well as the real body which is operated upon by the aesthetic surgeon.

During a period of revolutionary change in science, from the mid nineteenth to the early twentieth centuries, two major developments took place which enabled surgeons to introduce aesthetic changes, and patients to overcome their anxiety and undertake such procedures. Antisepsis and anaesthesia became central to the practice of surgery, following the discovery of ether anaesthesia in 1846 and the development by the 1880s of local anaesthesia. The movement toward antisepsis paralleled the development of anaesthesia: the model for antisepsis provided by Joseph Lister in 1867 became generally accepted by the end of the century. Aesthetic surgery became a context in which the ideology of the medical alteration of the body (and its state) was accepted by both the patient and the physician. All of these concerns can be understood as concerns of ‘hygiene’ in the broadest nineteenth-century sense, a hygiene of the state of both the body and the psyche. This set the stage for the development of the procedures used today. Take the case of Jacques Joseph, a young German-Jewish surgeon practising in fin-de-siècle Berlin. In 1896 Joseph undertook a corrective procedure on a child with protruding ears (otoplasty), which, although successful, caused Joseph to be dismissed from the staff of the orthopaedic clinic at the Berlin Charité. One simply did not undertake surgical procedures for vanity's sake, he was told upon his dismissal. The child was not suffering from any physical ailment which could be cured through surgery. Yet, according to the child's mother, he had suffered from humiliation in school because of his protruding ears. It was the unhappiness of the child that Joseph was correcting. The significance of protruding ears was clear to Jacques Joseph and his contemporaries at that time. There is an old trope in European culture about the Jew's ears that can be found throughout the anti-Semitic literature of the fin de siècle, and it is also a major sub-theme of one of the great works of world literature, Heinrich Mann's Man of Straw (1918). In that novel, Mann's self-serving convert, Jadassohn (Judas's son?) ‘looked so Jewish’ because of his ‘huge, red, prominent ears’ which he eventually went to Paris to have cosmetically reduced; his ears signified his poor character. Jacques Joseph went on to pioneer the intranasal procedure for the reduction of the size of the nose and came to be known among the Jewish community in Berlin as ‘Nose-Joseph’.

The social and psychological significance of the introduction of aesthetic surgery is relevant to other external markers of difference, from ageing (face lifts), to sexuality (transsexual surgery), to notions of beauty of face (orthodontics) and of body (liposuction). The norms of the acceptable change with time, but the desire to become invisible, to become a member of a class or group to which one does not naturally belong, maintains itself over the entire history of aesthetic surgery.

Sander L. Gilman

Bibliography

Gilman, S. L. (2000) Making the body beautiful: a cultural history of aesthetic surgery. Princeton University Press, Princeton.
Maltz, M. (1946). Evolution of plastic surgery. Froben Press, New York.
Wallace, A. F. (1982). The progress of plastic surgery: an introductory history. Willem A. Meeuws, Oxford.

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Cosmetic breast surgery

Breast augmentation is a procedure to change the size or shape of the breasts.

See also:

    Breast reconstruction - natural tissue
    Breast reconstruction - implants
    Breast lift

Description

Cosmetic breast surgery may be done at an outpatient surgery clinic or in a hospital.

    Most women receive general anesthesia for this surgery. You will be asleep and pain-free.
    You may also be given medicine to relax you and local anesthesia. You will be awake and will receive medicine to numb your breast area to block pain.

There are many different ways to place breast implants:

    In the most common technique, the surgeon will make surgical cut on the underside of your breast, in the natural skin fold. Your surgeon will place the implant through this opening. Your scar may be a little more visible if you are younger, thin, and have not yet had children.
    The implant may be placed through a surgical cut under your arm. Your surgeon may perform this surgery using an endoscope (a tool with a camera and surgical instruments at the end that is inserted through a vein). There will be no scar around your breast, but you may have a visible scar on the underside of your arm.
    The surgeon may make a cut around the edge of your areola, the darkened area around your nipple. The implant is placed through this opening. You may have more problems with breastfeeding and loss of sensation around your nipple with this method.
    A newer technique involves placing a saline implant through a surgical cut near your belly button. An endoscope is used to move the implant up to the breast area. Once in place, the implant is filled with saline.

Breast implants may be placed either directly behind the breast tissue (subglandular) or behind the outer layer of chest wall muscles (submuscular). The type of implant and implant surgery can affect:

    How much pain you have after the procedure
    The appearance of your breast
    The risk of the implant breaking or leaking in the future
    Your future mammograms

Your surgeon can help you decide which procedure is best for you.
Breast liftWatch this video about:Breast lift

Why the Procedure is Performed

Breast augmentation is done to increase the size of your breasts.

A breast lift, or mastopexy, is usually done to lift sagging, loose breasts. The size of the areola, the dark pink skin surrounding the nipple, can also be reduced.

Talk with a plastic surgeon if you are considering cosmetic breast surgery. Discuss how you expect to look and feel better. Keep in mind the desired result is improvement, not perfection. Emotional stability is an important factor. Breast surgery can renew your self-confidence and improve your appearance, but the rest is up to you.
Risks

Risks for any surgery are:

    Bleeding
    Infection

Risks for any anesthesia are:

    Reactions to medicines
    Breathing problems, pneumonia
    Heart problems

Risks for breast surgery are:

    Difficulty breastfeeding
    Loss of feeling in the nipple area
    Small scars, usually in an area where they do not show much. Some women may have thickened, raised scars.
    Uneven position of your nipples
    Different size or shape of the two breasts
    It is normal for your body to create a “capsule” made up of scar tissue around your new breast implant. This helps keep the implant in place. Sometimes, this capsule becomes thickened and larger and may cause a change in the shape of your breast, hardening of breast tissue, or some pain.
    Breaking or leakage of the implant
    Visible rippling of the implant

The emotional risks of surgery may include feeling that your breasts don't look perfect, or you may be disappointed with people's reactions to your “new” breasts.
Before the Procedure

Always tell your doctor or nurse:

    If you are or could be pregnant
    What drugs you are taking, even drugs, supplements, or herbs you bought without a prescription

During the days before your surgery:

    You may need mammograms or breast x-rays before surgery. Your plastic surgeon will do a routine breast exam.
    Several days before surgery, you may be asked to stop taking aspirin, ibuprofen (Advil, Motrin), warfarin (Coumadin), and any other drugs that make it hard for your blood to clot.
    Ask your doctor which drugs you should still take on the day of surgery.
    You may need to fill prescriptions for pain medicine before surgery.
    Arrange for someone to drive you home after surgery and help you around the house for 1 or 2 a days.
    If you smoke, try to stop. Ask your doctor or nurse for help.

On the day of the surgery:

    You will usually be asked not to drink or eat anything after midnight the night before surgery.
    Take the drugs your doctor told you to take with a small sip of water.
    Wear or bring loose clothing that buttons or zips in front and a soft, loose-fitting bra with no underwire.
    Your doctor or nurse will tell you when to arrive at the hospital.

After the Procedure

You may need to stay overnight in the hospital. Some women can go home when their anesthesia wears off and they can walk, drink water, get to the bathroom safely, and have pain they can manage at home.

After breast augmentation surgery, a bulky gauze dressing will be wrapped around your breasts and chest, or you might wear a surgical bra. Drainage tubes may be attached to your breasts. These will be removed within 3 days.

Sometimes doctors also recommend massaging the breast starting 5 days after surgery to reduce hardening of the capsule that surrounds the implant. Ask your doctor first before massaging over your implants.
Outlook (Prognosis)

You are likely to have a very good outcome from breast surgery. You may feel better about your appearance and yourself. Also, the pain or skin symptoms you had (such as striation) will disappear. You may need to wear a special supportive bra for a few months to reshape your breasts.

Scars are permanent and are often more visible in the year after surgery. They will fade after this. Your surgeon will try to place the incisions so that your scars are as hidden as possible. Your scars should not be noticeable, even in low-cut clothing, since incisions are usually made on the underside of the breast.
Alternative Names

Breast augmentation; Breast implants; Implants - breast; Mammaplasty
References

Burns JL, Blackwell SJ. Plastic surgery. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 73.

Sarwer DB. The psychological aspects of cosmetic breast augmentation. Plast Reconstr Surg. 2007 Dec;120(7 Suppl 1):110S-117S.

Hölmich LR, Lipworth L, McLaughlin JK, Friis S. Breast implant rupture and connective tissue disease: a review of the literature. Plast Reconstr Surg. 2007 Dec;120(7 Suppl 1):62S-69S.

McLaughlin JK, Lipworth L, Fryzek JP, Ye W, Tarone RE, Nyren O. Long-term cancer risk among Swedish women with cosmetic breast implants: an update of a nationwide study. J Natl Cancer Inst. 2006 Apr 19;98(8):557-60.

Wiener TC. Relationship of incision choice to capsular contracture. Aesthetic Plast Surg. 2008 Mar;32(2):303-6.
Update Date: 2/8/2011

Updated by: David A. Lickstein, MD, FACS, specializing in cosmetic and reconstructive plastic surgery, Palm Beach Gardnes, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

 Breast implant
From Wikipedia, the free encyclopedia
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Breast implant: the pre-operative (left) and post-operative (right) aspects of a young woman’s bilateral breast augmentation with high-profile, 500cc silicone-gel implants.
Breast implant: The post-operative aspect of a breast cancer mastectomy; the woman is a candidate for a primary breast-reconstruction procedure of her right breast.

A breast implant is a medical prosthesis used to augment, reconstruct, or create the physical form of breasts. Applications include correcting the size, form, and feel of a woman’s breasts in post–mastectomy breast reconstruction; for correcting congenital defects and deformities of the chest wall; for aesthetic breast augmentation; and for creating breasts in the male-to-female transsexual patient.

There are three general types of breast implant device, defined by the filler material: saline, silicone, and composite. The saline implant has an elastomer silicone shell filled with sterile saline solution; the silicone implant has an elastomer silicone shell filled with viscous silicone gel; and the alternative composition implants featured miscellaneous fillers, such as soy oil, polypropylene string, et cetera. In surgical practice, for the reconstruction of a breast, the tissue expander device is a temporary breast prosthesis used to form and establish an implant pocket for the permanent breast implant. For the correction of male breast and chest-wall defects and deformities, the pectoral implant is the breast prosthesis used for the reconstruction and the aesthetic repair of a man’s chest. (See: gynecomastia and mastopexy)
Contents

    1 History
    2 Types of breast implant device
    3 The patient
    4 Surgical procedures
        4.1 Indications
        4.2 Incision types
        4.3 Implant pocket placement
        4.4 Post-surgical recovery
    5 Complications
        5.1 Implant rupture
        5.2 Capsular contracture
        5.3 Repair and revision surgeries
    6 Alleged complications
        6.1 Systemic disease and sickness
        6.2 Platinum toxicity
    7 Implants and breast-feeding
    8 Implants and mammography
    9 U.S. FDA approval
    10 Criticism
    11 See also
    12 References
    13 External links

History
Breast implant: Dr. Vincenz Czerny (1842–1916) a pioneer in breast reconstruction surgery.

The 19th century

Since the late nineteenth century, breast implant devices have been used to surgically augment the size (volume), modify the shape (contour), and enhance the feel (tact) of a woman’s breasts. In 1895, surgeon Vincenz Czerny effected the earliest breast implant emplacement when he used the patient's autologous adipose tissue, harvested from a benign lumbar lipoma, to repair the asymmetry of the breast from which he had removed a tumor.[1] In 1889, surgeon Robert Gersuny experimented with paraffin injections, with disastrous results. From the first half of the twentieth century, physicians used other substances as breast implant fillers — ivory, glass balls, ground rubber, ox cartilage, Terylene wool, gutta-percha, Dicora, polyethylene chips, Ivalon (polyvinyl alcohol – formaldehyde polymer sponge), a polyethylene sac with Ivalon, polyether foam sponge (Etheron), polyethylene tape (Polystan) strips wound into a ball, polyester (polyurethane foam sponge) Silastic rubber, and teflon-silicone prostheses.[2]

The 20th century

In the mid-twentieth century, Morton I. Berson, in 1945, and Jacques Maliniac, in 1950, each performed flap-based breast augmentations by rotating the patient’s chest wall tissue into the breast to increase its volume. Furthermore, throughout the 1950s and the 1960s, plastic surgeons used synthetic fillers — including silicone injections received by some 50,000 women, from which developed silicone granulomas and breast hardening that required treatment by mastectomy.[3] In 1961, the American plastic surgeons Thomas Cronin and Frank Gerow, and the Dow Corning Corporation, developed the first silicone breast prosthesis, filled with silicone gel; in due course, the first augmentation mammoplasty was performed in 1962 using the Cronin–Gerow Implant, prosthesis model 1963. In 1964, the French company Laboratoires Arion developed and manufactured the saline breast implant, filled with saline solution, and then introduced for use as a medical device in 1964.[4]
Types of breast implant device
Breast implant: saline solution filled breast implant device models.
The original breast implant: Cronin–Gerow Implant, prosthesis model 1963, an anatomic (tear-shaped) design that featured a posterior fastener made of Dacron.
Breast implant: Late-generation models of Silicone gel-filled prostheses.

There are three types of breast implant used for mammoplasty, breast reconstruction, and breast augmentation procedures

    saline implant filled with sterile saline solution.
    silicone implant filled with viscous silicone gel.
    alternative-composition implant with miscellaneous fillers (e.g. soy oil, polypropylene string, etc.) that are no longer manufactured.

I. — Saline implants

    Surgical technology

The saline breast implant is filled with saline solution (biological-concentration salt water 0.90% w/v of NaCl, ca. 300 mOsm/L.). The early models were a relatively delicate technology that were prone to failure, usually shell breakage, leakage of the saline filler, and deflation of the prosthesis. Contemporary models of saline breast implant are made with stronger, room-temperature vulcanized (RTV) shells made of a silicone elastomer. The study In vitro Deflation of Pre-filled Saline Breast Implants (2006) reported that the rates of deflation (filler leakage) of the pre-filled saline breast implant made it a second choice for corrective breast surgery, after the silicone gel type of breast implant.[4] Nonetheless, in the 1990s, in U.S. medicine, the saline breast implant was the usual breast prosthesis applied for breast augmentation, given the unavailability of silicone implants, because of the import restrictions of the U.S. Food and Drug Administration.

    Surgical technique

The saline breast implant was developed to facilitate a more conservative surgical technique, of smaller and fewer cuts to the breast, for emplacing an empty breast-implant device through a smaller surgical incision.[5] In surgical praxis, after having emplaced the empty breast implants into the implant pockets, the plastic surgeon then fills each breast prosthesis with saline solution, and, because the required insertion incisions are small, the resultant incision-scars will be smaller than the surgical scar usual to the long incision required for inserting pre-filled, silicone-gel implants. Although the saline breast implant can yield good-to-excellent results of breast size, contour, and feel, when compared to silicone-implant results, the saline implant is likelier to cause cosmetic problems such as rippling, wrinkling, and being noticeable to the eye and to the touch. This is especially true for women with very little breast tissue, and for post-mastectomy reconstruction patients; thus, silicone-gel implants are the superior prosthetic device for breast augmentation and for breast reconstruction. In the case of the woman with much breast tissue, for whom partial submuscular emplacement is the recommended surgical technique, saline breast implants can afford an aesthetic “look” of breast size and contour (though not feel) much like that afforded by the silicone implant.[6]

II. — Silicone gel implants

As a medical device technology, there are five (5) generations of silicone breast implant, each defined by common model-manufacturing techniques.

First generation

The Cronin–Gerow Implant, prosthesis model 1963, was a tear-drop-shaped sac (silicone rubber envelope) filled with viscous silicone-gel. To reduce the rotation of the emplaced breast-implant upon the chest wall, it was affixed to the implant pocket with a fastener-patch of Dacron material (Polyethylene terephthalate) attached to the rear of the breast implant shell.[7]

Second generation

In the 1970s, the first technological development, a thinner device-shell and a thinner, low-cohesion silicone-gel filler, improved the functionality and verisimilitude (size, look, and feel) of the silicone breast implant. Yet, in clinical practice, the second-generation proved fragile, and suffered greater incidences of shell rupture, and of “silicone gel bleed” (filler leakage through an intact shell). The consequent, increased incidence-rates of medical complications (e.g. capsular contracture) precipitated U.S. government faulty-product class action-lawsuits against the Dow Corning Corporation, and other manufacturers of prosthetic breast prostheses.

    The second technological development was a polyurethane foam coating for the implant shell; it reduced the incidence of capsular contracture by causing an inflammatory reaction that impeded the formation of a capsule of fibrous collagen tissue around the breast implant. Nevertheless, the medical use of polyurethane-coated breast implants was briefly discontinued because of the potential health-risk posed by 2,4-toluenediamine (TDA), a carcinogenic by-product of the chemical breakdown of the implant’s polyurethane foam coating.[8] After reviewing the medical data, the U.S. Food and Drug Administration concluded that TDA-induced breast cancer was an infinitesimal health-risk to women with breast implants, and did not justify legally requiring physicians to explain the matter to their patients. In the event, polyurethane-coated breast implants remain in plastic surgical practice in Europe and in South America; in the U.S., no breast implant manufacturer has sought the FDA’s approval for American medical sale.[9]

    The third technological development was the double lumen breast-implant, a double-cavity device composed of a silicone-implant within a saline-implant. The two-fold, technical goal was: (i) the cosmetic benefits of silicone-gel (the inner lumen) enclosed in saline solution (the outer lumen); (ii) a breast-implant device the volume of which is post-operatively adjustable. Nevertheless, the more complex design of the double-lumen breast-implant suffered a device-failure rate greater than that of single-lumen breast implants. The contemporary versions of Second generation devices, presented in 1984, are the “Becker Expandable” models of breast implant device, used primarily for breast reconstruction.

Third and Fourth generations

In the 1980s, the models of the Third and of the Fourth generations of breast-implant devices were sequential advances in manufacturing technology, e.g. elastomer-coated shells that decreased gel-bleed (filler leakage), and a thicker filler (increased-cohesion) gel. Sociologically, the manufacturers then designed and fabricated varieties of anatomic models (natural breast) and shaped models (round, tapered) that realistically corresponded with the breast and body types presented by women patients. The tapered models of breast implant have a uniformly textured surface, to reduce rotation; the round models of breast implant are available in smooth-surface and textured-surface types.

Fifth generation

Since the mid-1990s, the Fifth generation of silicone breast implant is made of a semi-solid gel that mostly eliminates filler leakage (silicone gel bleed) and silicone migration from the breast to elsewhere in the body. The studies Experience with Anatomical Soft Cohesive Silicone gel Prosthesis in Cosmetic and Reconstructive Breast Implant Surgery (2004) and Cohesive Silicone gel Breast Implants in Aesthetic and Reconstructive Breast Surgery (2005) reported low incidence rates of capsular contracture and of device-shell rupture, improved medical safety and technical efficacy greater than earlier generations of breast implant device.[10][11][12]
The patient
Further information: Body dysmorphic disorder, Body image, and Beauty
Breast implant: the pre-operative aspects (left), and the post-operative aspects (right) of a bilateral primary augmentation with medium-volume (350cc) saline impants emplaced submuscularly through an inframmary fold (IMF) incision.

Psychology

The breast augmentation patient usually is a young woman whose personality profile indicates psychological distress about her personal appearance and her body (self image), and a history of having endured criticism (teasing) about the aesthetics of her person.[13] The studies Body Image Concerns of Breast Augmentation Patients (2003) and Body Dysmorphic Disorder and Cosmetic Surgery (2006) reported that the woman who underwent breast augmentation surgery also had undergone psychotherapy, suffered low self-esteem, presented frequent occurrences of psychological depression, had attempted suicide, and suffered body dysmorphia, a type of mental illness. Post-operative patient surveys about mental health and quality-of-life, reported improved physical health, physical appearance, social life, self-confidence, self-esteem, and satisfactory sexual functioning. Furthermore, the women reported long-term satisfaction with their breast implant outcomes; some despite having suffered medical complications that required surgical revision, either corrective or aesthetic. Likewise, in Denmark, 8.0 per cent of breast augmentation patients had a pre-operative history of psychiatric hospitalization.[14][15][16][17][18][19][20][21][22]

Mental health

In 2008, the longitudinal study Excess Mortality from Suicide and other External Causes of Death Among Women with Cosmetic Breast Implants (2007), reported that women who sought breast implants are almost 3.0 times as likely to commit suicide as are women who have not sought breast implants. Compared to the standard suicide-rate for women of the general populace, the suicide-rate for women with augmented breasts remained constant until 10-years post-implantation, yet, it increased to 4.5 times greater at the 11-year mark, and so remained until the 19-year mark, when it increased to 6.0 times greater at 20-years post-implantation. Moreover, additional to the suicide-risk, women with breast implants also faced a trebled death-risk from alcoholism and the abuse of prescription and recreational drugs.[23][24] Although seven (7) studies have statistically connected a woman’s breast augmentation to a greater suicide-rate, the research indicates that breast augmenation surgery does not increase the death rate; and that, in the first instance, it is the psychopathologically-inclined woman who is likelier to undergo a breast augmentation procedure.[25][26][27][28][29][30]

The study Effect of Breast Augmentation Mammoplasty on Self-Esteem and Sexuality: A Quantitative Analysis (2007), reported that the women attributed their improved self image, self-esteem, and increased, satisfactory sexual functioning to having undergone breast augmentation; the cohort, aged 21–57 years, averaged post-operative self-esteem increases that ranged from 20.7 to 24.9 points on the 30-point Rosenberg self-esteem scale, which data supported the 78.6 per cent increase in the woman’s libido, relative to her pre-operative level of libido.[31] Therefore, before agreeing to any surgery, the plastic surgeon evaluates and considers the woman’s mental health to determine if breast implants can positively affect her self-esteem and sexual functioning.
Surgical procedures
Indications

A mammoplasty procedure for the emplacement of breast implant devices has three (3) purposes:

    primary reconstruction — the replacement of breast tissues damaged by trauma (blunt, penetrating, blast), disease (breast cancer), and failed anatomic development (tuberous breast deformity).
    revision and reconstruction — to revise (correct) the outcome of a previous breast reconstruction surgery.
    primary augmentation — to aesthetically augment the size, form, and feel of the breasts.

The operating room (OR) time of post–mastectomy breast reconstruction, and of breast augmentation surgery is determined by the procedure employed, the type of incisions, the breast implant (type and materials), and the pectoral locale of the implant pocket.
Incision types

Breast implant emplacement is performed with five (5) types of surgical incisions:

    Inframammary — an incision made to the infra-mammary fold (IMF), which affords maximal access for precise dissection of the tissues and emplacement of the breast implants. It is the preferred surgical technique for emplacing silicone-gel implants, because it better exposes the breast tissue–pectoralis muscle interface; yet, IMF implantation can produce thicker, slightly more visible surgical scars.
    Periareolar — a border-line incision along the periphery of the areola, which provides an optimal approach when adjustments to the IMF position are required, or when a mastopexy (breast lift) is included to the primary mammoplasty procedure. In periareolar emplacement, the incision is around the medial-half (inferior half) of the areola’s circumference. Silicone gel implants can be difficult to emplace via periareolar incision, because of the short, five-centimetre length (~ 5.0 cm) of the required access-incision. Aesthetically, because the scars are at the areola’s border (periphery), they usually are less visible than the IMF-incision scars of women with light-pigment areolae; when compared to cutaneous-incision scars, the modified epithelia of the areolae are less prone to (raised) hypertrophic scars.
    Transaxillary — an incision made to the axilla (armpit), from which the dissection tunnels medially, to emplace the implants, either bluntly or with an endoscope (illuminated video microcamera), without producing visible scars on the breast proper; yet, it is likelier to produce inferior asymmetry of the implant-device position. Therefore, surgical revision of transaxillary emplaced breast implants usually requires either an IMF incision or a periareolar incision.
    Transumbilical — a trans-umbilical breast augmentation (TUBA) is a less common implant-device emplacement technique wherein the incision is at the umbilicus (navel), and the dissection tunnels superiorly, up towards the bust. The TUBA approach allows emplacing the breast implants without producing visible scars upon the breast proper; but makes appropriate dissection and device-emplacement more technically difficult. A TUBA procedure is performed bluntly — without the endoscope’s visual assistance — and is not appropriate for emplacing (pre-filled) silicone-gel implants, because of the great potential for damaging the elastomer silicone shell of the breast implant during its manual insertion through the short (~2.0 cm) incision at the navel, and because pre-filled silicone gel implants are incompressible, and cannot be inserted through so small an incision.[32]
    Transabdominal — as in the TUBA procedure, in the transabdominoplasty breast augmentation (TABA), the breast implants are tunneled superiorly from the abdominal incision into bluntly dissected implant pockets, whilst the patient simultaneously undergoes an abdominoplasty.[33]

Implant pocket placement
Breast implant emplacement: cross-sectional scheme of a subglandular breast prosthesis implantation (1) and of a submuscular breast prosthesis implantation (2).

The four (4) surgical approaches to emplacing a breast implant to the implant pocket are described in anatomical relation to the pectoralis major muscle.

    Subglandular — the breast implant is emplaced to the retromammary space, between the breast tissue (the gland) and the pectoralis major muscle, which most approximates the plane of normal breast tissue, and affords the most aesthetic results. Yet, in women with thin pectoral soft-tissue, the subglandular position is likelier to show the ripples and wrinkles of the underlying implant. Moreover, the capsular contracture incidence rate is slightly greater with subglandular implantation.
    Subfascial — the breast implant is emplaced beneath the fascia of the pectoralis major muscle; this is a variant of the subglandular position.[34] The technical advantages of the subfascial implant-pocket technique are debated; proponent surgeons report that the layer of fascial tissue provides greater implant coverage and better sustains its position.[35]
    Subpectoral (dual plane) — the breast implant is emplaced beneath the pectoralis major muscle, after the surgeon releases the inferior muscular attachments, with or without partial dissection of the subglandular plane. Resultantly, the upper pole of the implant is partially beneath the pectoralis major muscle, while the lower pole of the implant is in the subglandular plane. This implantation technique achieves maximal coverage of the upper pole of the implant, whilst allowing the expansion of the implant’s lower pole; however, “animation deformity”, the movement of the implants in the subpectoral plane can be excessive for some patients.[36]
    Submuscular — the breast implant is emplaced beneath the pectoralis major muscle, without releasing the inferior origin of the muscle proper. Total muscular coverage of the implant can be achieved by releasing the lateral muscles of the chest wall — either the serratus muscle or the pectoralis minor muscle, or both — and suturing it, or them, to the pectoralis major muscle. In breast reconstruction surgery, the submuscular implantation approach effects maximal coverage of the breast implants.

Post-surgical recovery

The surgical scars of a breast augmentation mammoplasty develop approximately at 6-weeks post-operative, and fade within months. Depending upon the daily-life physical activities required of the woman, the breast augmentation patient usually resumes her normal life at 1-week post-operative. Moreover, women whose breast implants were emplaced beneath the chest muscles (submuscular placement) usually have a longer, slightly more painful convalescence, because of the healing of the incisions to the chest muscles. Usually, she does not exercise or engage in strenuous physical activities for approximately 6 weeks. During the initial post-operative recovery, the woman is encouraged to regularly exercise (flex and move) her arm to alleviate pain and discomfort; if required, analgesic indwelling medication catheters can alleviate pain.[37][38] Moreover, significantly improved patient recovery has resulted from refined breast-device implantation techniques (submuscular, subglandular) that allow 95 per cent of women to resume their normal lives at 24-hours post-procedure, without bandages, fluid drains, pain pumps, catheters, medical support brassières, or narcotic pain medication.[39][40][41][42]
Complications

The plastic surgical emplacement of breast-implant devices, either for breast reconstruction or for aesthetic purpose, presents the same health risks common to surgery, such as adverse reaction to anesthesia, hematoma (post-operative bleeding), seroma (fluid accumulation), incision-site breakdown (wound infection). Complications specific to breast augmentation include breast pain, altered sensation, impeded breast-feeding function, visible wrinkling, asymmetry, thinning of the breast tissue, and symmastia, the “bread loafing” of the bust that interrupts the natural plane between the breasts. Specific treatments for the complications of indwelling breast implants — capsular contracture and capsular rupture — are periodic MRI monitoring and physical examinations. Furthermore, complications and re-operations related to the implantation surgery, and to tissue expanders (implant place-holders during surgery) can cause unfavorable scarring in approximately 6–7 per cent of the patients. [43][44][45] Statistically, 20 per cent of women who underwent cosmetic implantation, and 50 per cent of women who underwent breast reconstruction implantation, required their explantation at the 10-year mark.[46]
Implant rupture
An explanted breast implant: the red, fibrous capsule (left), the ruptured silicone implant (center), and the leaked, transparent filler-gel (right).

Because a breast implant is a Class III medical device of limited product-life, the principal rupture-rate factors are its age and design; nonetheless, a breast implant device can retain its mechanical integrity for decades in a woman’s body.[47] When a saline breast implant ruptures, leaks, and empties, it quickly deflates, and thus can be readily explanted (surgically removed). The follow-up report, Natrelle Saline-filled Breast Implants: a Prospective 10-year Study (2009) indicated rupture-deflation rates of 3–5 per cent at 3-years post-implantation, and 7–10 per cent rupture-deflation rates at 10-years post-implantation.[48] When a silicone breast implant ruptures it usually does not deflate, yet the filler gel does leak from it, which can migrate to the implant pocket; therefore, an intracapsular rupture (in-capsule leak) can become an extracapsular rupture (out-of-capsule leak), and each occurrence is resolved by explantation. Although the leaked silicone filler-gel can migrate from the chest tissues to elsewhere in the woman’s body, most clinical complications are limited to the breast and armpit areas, usually manifested as granulomas (inflammatory nodules) and axillary lymphadenopathy (enlarged lymph glands in the armpit area).[49][50][51]

The suspected mechanisms of breast-implant rupture are:

    damage during implantation
    damage during (other) surgical procedures
    chemical degradation of the breast implant shell
    trauma (blunt trauma, penetrating trauma, blast trauma)
    mechanical pressure of traditional mammographic breast examination [52]

From the long-term MRI data for single-lumen breast implants, the European literature about Second generation silicone-gel breast implants (1970s design), reported silent device-rupture rates of 8–15 per cent at 10-years post-implantation (15–30% of the patients).[53][54][55] In 2009, a branch study of the U.S. FDA’s core clinical trials for primary breast augmentation surgery patients, reported low device-rupture rates of 1.1 per cent at 6-years post-implantation.[56] The first series of MRI evaluations of the silicone breast implants with thick filler-gel reported a device-rupture rate of 1.0 per cent, or less, at the median 6-year device-age.[57] Statistically, the manual examination (palpation) of the woman is inadequate for accurately evaluating if a breast implant has ruptured. The study, The Diagnosis of Silicone Breast-implant Rupture: Clinical Findings Compared with Findings at Magnetic Resonance Imaging (2005), reported that, in asymptomatic patients, only 30 per cent of the of ruptured breast implants is accurately palpated and detected by an experienced plastic surgeon, whereas MRI examinations accurately detected 86 per cent of breast-implant ruptures.[58] Thus, the U.S. FDA recommended scheduled MRI examinations, as silent-rupture screenings, beginning at the 3-year-mark post-implantation, and then every two years, thereafter.[43] Nonetheless, beyond the U.S., the medical establishments of other nations have not endorsed routine magnetic resonance image (MRI) screening, proposing that such a radiologic examination be reserved for two purposes: (i) for the woman with a suspected breast-implant rupture; and (ii) for the confirmation of mammographic and ultrasonic studies that indicate the presence of a ruptured breast implant.[59] Furthermore, The Effect of Study design Biases on the Diagnostic Accuracy of Magnetic Resonance Imaging for Detecting Silicone Breast Implant Ruptures: a Meta-analysis (2011) reported that the breast-screening MRIs of asymptomatic women might be overestimating the incidence of breast-implant rupture.[60] Nonetheless, the U.S. Food and Drug Administration emphasised that “breast implants are not lifetime devices. The longer a woman has silicone gel-filled breast implants, the more likely she is to experience complications.”[61]
Capsular contracture
Capsular contracture is a breast-implant complication, such as the Baker scale Grade IV contraction of a subglandular silicone implant in the right breast.
Main article: Capsular contracture

The human body’s immune response to a surgically installed foreign object — breast implant, cardiac pacemaker, orthopedic prosthesis — is to encapsulate it with scar tissue capsules of tightly woven collagen fibers, in order to maintain the integrity of the body by isolating the foreign object, and so tolerate its presence. Capsular contracture — which should be distinguished from normal capsular tissue — occurs when the collagen-fiber capsule thickens and compresses the breast implant; it is a painful complication that might distort either the breast implant, or the breast, or both. The cause of capsular contracture is unknown, but the common incidence factors include bacterial contamination, device-shell rupture, filler leakage, and hematoma. The surgical implantation procedures that have reduced the incidence of capsular contracture include submuscular emplacement, the use of breast implants with a textured surface (polyurethane-coated);[62][63][64] limited pre-operative handling of the implants, limited contact with the chest skin of the implant pocket before the emplacement of the breast implant, and irrigation of the recipient site with triple-antibiotic solutions.[65][66]

The correction of capsular contracture might require an open capsulotomy (surgical release) of the collagen-fiber capsule, or the removal, and possible replacement, of the breast implant. Furthermore, in treating capsular contracture, the closed capsulotomy (disruption via external manipulation) once was a common maneuver for treating hard capsules, but now is a discouraged technique, because it can rupture the breast implant. Non-surgical treatments for collagen-fiber capsules include massage, external ultrasonic therapy, leukotriene pathway inhibitors such as zafirlukast (Accolate) or montelukast (Singulair), and pulsed electromagnetic field therapy (PEMFT).[67][68][69][70]
Repair and revision surgeries

When the woman is unsatisfied with the outcome of the augmentation mammoplasty; or when technical or medical complications occur; or because of the breast implants’ limited product life (Class III medical device, in the U.S.), it is likely she might require replacing the breast implants. The common revision surgery indications include major and minor medical complications, capsular contracture, shell rupture, and device deflation.[52] Revision incidence rates were greater for breast reconstruction patients, because of the post-mastectomy changes to the soft-tissues and to the skin envelope of the breast, and to the anatomical borders of the breast, especially in women who received adjuvant external radiation therapy.[52] Moreover, besides breast reconstruction, breast cancer patients usually undergo revision surgery of the nipple-areola complex (NAC), and symmetry procedures upon the opposite breast, to create a bust of natural appearance, size, form, and feel. Carefully matching the type and size of the breast implants to the patient’s pectoral soft-tissue characteristics reduces the incidence of revision surgery. Appropriate tissue matching, implant selection, and proper implantation technique, the re-operation rate was 3.0 per cent at the 7-year-mark, compared with the re-operation rate of 20 per cent at the 3-year-mark, as reported by the U.S. Food and Drug Administration.[71][72]
Alleged complications
Systemic disease and sickness
The chest X-ray of a woman with bilaterally emplaced breast implants.

Since the 1990s, reviews of the studies that sought causal links between silicone-gel breast implants and systemic disease reported no link between the implants and subsequent systemic and autoimmune diseases.[59][73][74][75] Nonetheless, during the 1990s, thousands of women claimed sicknesses they believed were caused by their breast implants, including neurological and rheumatological health problems.

In the study Long-term Health Status of Danish Women with Silicone Breast Implants (2004), the national healthcare system of Denmark reported that women with implants did not risk a greater incidence and diagnosis of autoimmune disease, when compared to same-age women in the general population; that the incidence of musculoskeletal disease was lower among women with breast implants than among women who had undergone other types of cosmetic surgery; and that they had a lower incidence rate than like women in the general population.[76][77]

Follow-up longitudinal studies of these breast implant patients confirmed the previous findings on the matter.[78] European and North American studies reported that women who underwent augmentation mammoplasty, and any plastic surgery procedure, tended to be healthier and wealthier than the general population, before and after implantation; that plastic surgery patients had a lower standardized mortality ratio than did patients for other surgeries; yet faced an increased risk of death by lung cancer than other plastic surgery patients. Moreover, because only one study, the Swedish Long-term Cancer Risk Among Swedish Women with Cosmetic Breast Implants: an Update of a Nationwide Study (2006), controlled for tobacco smoking information, the data were insufficient to establish verifiable statistical differences between smokers and non-smokers that might contribute to the higher lung cancer mortality rate of women with breast implants.[79][80] The long-term study of 25,000 women, Mortality among Canadian Women with Cosmetic Breast Implants (2006), reported that the “findings suggest that breast implants do not directly increase mortality in women.”[81]

A 2001 study, Silicone gel Breast Implant Rupture, Extracapsular Silicone, and Health Status in a Population of Women, reported increased incidences of fibromyalgia among women who suffered extracapsular silicone-gel leakage than among women whose breast implants neither ruptured nor leaked.[82] The study later was criticized as significantly methodologically flawed, and a number of large subsequent follow-up studies have not shown any evidence of a causal device–disease association. After investigating, the U.S. FDA has concluded “the weight of the epidemiological evidence published in the literature does not support an association between fibromyalgia and breast implants.”.[83][84] Recent systemic review by Lipworth (2011)[85] concludes that "any claims that remain regarding an association between cosmetic breast implants and CTDs are not supported by the scientific literature".
Platinum toxicity

The manufacture of silicone breast implants requires the metallic element platinum as a catalyst to accelerate the transformation of silicone oil into silicone gel for making the elastomer silicone shells, and for making other medical-silicone devices.[86] The literature indicates that trace quantities of platinum leak from such types of silicone breast implant; therefore, platinum is present in the surrounding pectoral tissue(s). The rare pathogenic consequence is an accumulation of platinum in the bone marrow, from where blood cells might deliver it to nerve endings, thus causing nervous system disorders such as blindness, deafness, and nervous tics (involuntary muscle contractions).[86] In 2002, the U.S. Food and Drug Administration reviewed the studies on the human biological effects of breast-implant platinum, and reported little causal evidence of platinum toxicity to women with breast implants.[87] Furthermore, in the journal Analytical Chemistry, the study Total Platinum Concentration and Platinum Oxidation States in Body Fluids, Tissue, and Explants from Women Exposed to Silicone and Saline Breast Implants by IC-ICPMS (2006), proved controversial for claiming to have identified previously undocumented toxic platinum oxidative states in vivo.[88] Later, in a letter to the readers, the editors of Analytical Chemistry published their concerns about the faulty experimental design of the study, and warned readers to “use caution in evaluating the conclusions drawn in the paper.”[89] Furthermore, after reviewing the research data of the study, and other pertinent literature, the U.S. FDA reported that the data do not support the findings presented; that the platinum used, in new-model breast-implant devices, likely is not ionized, and therefore is not a significant risk to the health of the women.[90]
Implants and breast-feeding
The functional breast: a mammary gland in medias res, feeding an infant.
Breast implant: Cross-section scheme of the mammary gland.
1. Chest wall
2. Pectoralis muscles
3. Lobules
4. Nipple
5. Areola
6. Milk duct
7. Fatty tissue
8. Skin envelope

The functional breast

The breasts are apocrine glands that produce milk for the feeding of infant children; each breast has a nipple within an areola (nipple-areola complex, NAC), the skin color of which varies from pink to dark brown, and has sebaceous glands. Within the mammary gland, the lactiferous ducts produce breast milk, and are distributed throughout the breast, with two-thirds of the tissue within 30-mm of the base of the nipple. In each breast, 4–18 lactiferous ducts drain to the nipple; the glands-to-fat ratio is 2:1 in lactating women, and to 1:1 in non-lactating women; besides milk glands, the breast is composed of connective tissue (collagen, elastin), adipose tissue (white fat), and the suspensory Cooper's ligaments. The peripheral nervous system innervation of the breast is by the anterior and lateral cutaneous branches of the fourth-, fifth-, and sixth intercostal nerves, while the Thoracic spinal nerve 4 (T4) innervating the dermatomic area supplies sensation to the nipple-areola complex.[91][92]

Digestive contamination and systemic toxicity are the principal infant-health concerns; the leakage of breast implant filler to the breast milk, and if the filler is dangerous to the nursing infant. Breast implant device fillers are biologically inert — saline filler is salt water, and silicone filler is indigestible — because each substance is chemically inert, and environmentally common. Moreover, proponent physicians have said there “should be no absolute contraindication to breast-feeding by women with silicone breast implants.”[93][94] In the early 1990s, at the beginning of the silicone breast-implant sickness occurrences, small-scale, non-random studies (i.e. “patients came with complaints, which might have many sources”, not “doctors performed random tests”) indicated possible breast-feeding complications from silicone implants; yet no study reported device–disease causality.[94]

The augmented breast

Women with breast implants are able to breast-feed; however implant devices may cause functional breast-feeding difficulties, especially the mammoplasty procedures that feature periareolar incisions and subglandular emplacement, which have greater incidences of breast-feeding difficulties. Surgery may also damage the lactiferous ducts and the nerves of the nipple-areola complex (NAC).[95][96][97]

Functional breast-feeding difficulies arise if the surgeon cut the milk ducts or the major nerves innervating the breast, or if the milk glands were otherwise damaged. Milk duct and nerve damage are more common to the periareolar incision implantation procedure, which cuts tissue near the nipple, whereas other implantation incision-plans — IMF (Inframammary Fold), TABA (Trans-Axillary Breast Augmentation), TUBA (Trans-Umbilical Breast Augmentation) — avoid the tissue of the nipple-areola complex; if the woman is concerned about possible breast-feeding difficulties, the periareolar incisions can be effected to reduce damage to the milk ducts and to the nerves of the NAC. The milk glands are affected most by subglandular implants (under the gland), and by large-sized breast implants, which pinch the lactiferous ducts and impede milk flow. Small-sized breast implants, and submuscular implantation, cause fewer breast-function problems; however, women have successfully breast-fed after undergoing periareolar incisions and subglandular emplacement.[97]
Implants and mammography
Breast implant: Mammographs:
Normal breast (left) and cancerous breast (right).

The presence of radiologically opaque breast implants might interfere with the radiographic sensitivity of the mammograph. In this case, an Eklund view mammogram is required, wherein the breast implant is manually displaced against the chest wall and the breast is pulled forward, so that the mammograph can visualize the internal tissues; nonetheless, approximately one-third of the breast tissue remains inadequately visualized, resulting in an increased incidence of false-negative mammograms.[98]

Breast cancer studies of women with implants reported no significant differences in disease stage at the time of diagnosis; prognoses are similar in both groups, with augmented patients at a lower risk for subsequent cancer recurrence or death.[99][100] Conversely, the use of implants for breast reconstruction after breast cancer mastectomy appears to have no negative effect upon the incidence of cancer-related death.[101] That patients with breast implants are more often diagnosed with palpable — but not larger — tumors indicates that equal-sized tumors might be more readily palpated in augmented patients, which might compensate for the impaired mammogram images.[64] The palpability is consequent to breast tissue thinning by compression, innately smaller breasts a priori, and that the implant serves as a radio-opaque base against which a cancerous tumor can be differentiated.[102] The implant device has no clinical bearing upon lumpectomy breast conservation surgery for patients who developed breast cancer post-implantation, and it does not interfere with external beam radiation treatments (XRT); post-treatment incidence of breast-tissue fibrosis is common, and thus an increased rate of capsular contracture.[103]
U.S. FDA approval
Breast implant: the Food and Drug Administration, the medical device authority for the U.S.

In 1988, twenty-six years after the 1962 introduction of breast implants filled with silicone gel, the U.S. Food and Drug Administration (FDA) investigated breast-implant failures and the subsequent complications, and re-classified breast implant devices as Class III medical devices, and required from manufacturers the documentary data substantiating the safety and efficacy of their breast implant devices.[104] In 1992, the FDA placed silicone-gel breast implants in moratorium in the U.S., because there was “inadequate information to demonstrate that breast implants were safe and effective”. Nonetheless, medical access to silicone-gel breast implant devices continued for clinical studies of post-mastectomy breast reconstruction, the correction of congenital deformities, and the replacement of ruptured silicone-gel implants. The FDA required from the manufacturers the clinical trial data, and permitted their providing breast implants to the breast augmentation patients for the statistical studies required by the U.S. Food and Drug Administration.[104] In mid–1992, the FDA approved an adjunct study protocol for silicone-gel filled implants for breast reconstruction patients, and for revision-surgery patients. Also in 1992, the Dow Corning Corporation, a silicone products and breast-implant manufacturer, announced the discontinuation of five implant-grade silicones, but would continue producing 45 other, medical-grade, silicone materials—three years later, in 1995, the Dow Corning Corporation went bankrupt when it faced 19,000 breast-implant sickness lawsuits.[104]

    In 1997, the U.S. Department of Health and Human Services (HHS) appointed the Institute of Medicine (IOM) of the U.S. National Academy of Sciences (NAS) to investigate the potential risks of operative and post-operative complications from the emplacement of silicone breast implants. The IOM’s review of the safety and efficacy of silicone gel-filled breast implants, reported that the “evidence suggests diseases or conditions, such as connective tissue diseases, cancer, neurological diseases, or other systemic complaints or conditions are no more common in women with breast implants, than in women without implants”; subsequent studies and systemic review found no causal link between silicone breast implants and disease.[104]

Breast implant: the U.S. Department of Health and Human Services verifies the scientific, medical, and clinical data of medical devices.

    In 1998, the U.S. FDA approved adjunct study protocols for silicone-gel filled implants only for breast reconstruction patients and for revision-surgery patients; and also approved the Dow Corning Corporation’s Investigational Device Exemption (IDE) study for silicone-gel breast implants for a limited number of breast augmentation-, reconstruction-, and revision-surgery patients.[104]

    In 1999, the Institute of Medicine published the Safety of Silicone Breast Implants (1999) study that reported no evidence that saline-filled and silicone-gel filled breast implant devices caused systemic health problems; that their use posed no new health or safety risks; and that local complications are “the primary safety issue with silicone breast implants”, in distinguishing among routine and local medical complications and systemic health concerns.”[104][105][106]

    In 2000, the FDA approved saline breast implant Premarket Approval Applications (PMA) containing the type and rate data of the local medical complications experienced by the breast surgery patients.[107] “Despite complications experienced by some women, the majority of those women still in the Inamed Corporation and Mentor Corporation studies, after three years, reported being satisfied with their implants.”[104] The premarket approvals were granted for breast augmentation, for women at least 18 years old, and for women requiring breast reconstruction.[108][109]

    In 2006, for the Inamed Corporation and for the Mentor Corporation, the U.S. Food and Drug Administration lifted its restrictions against using silicone-gel breast implants for breast reconstruction and for augmentation mammoplasty. Yet, the approval was conditional upon accepting FDA monitoring, the completion of 10-year-mark studies of the women who already had the breast implants, and the completion of a second, 10-year-mark study of the safety of the breast implants in 40,000 other women.[110] The FDA warned the public that breast implants do carry medical risks, and recommended that women who undergo breast augmentation should periodically undergo MRI examinations to screen for signs of either shell rupture or of filler leakage, or both conditions; and ordered that breast surgery patients be provided with detailed, informational brochures explaining the medical risks of using silicone-gel breast implants.[104]

The U.S. Food and Drug Administration established the age ranges for women seeking breast implants; for breast reconstruction, silicone-gel filled implants and saline-filled implants were approved for women of all ages; for breast augmentation, saline implants were approved for women 18 years of age and older; silicone implants were approved for women 22 years of age and older. [4]. Because each breast implant device entails different medical risks, the minimum age of the patient for saline breast implants is different from the minimum age of the patient for silicone breast implants — because of the filler leakage and silent shell-rupture risks; thus, periodic MRI screening examinations are the recommended post-operative, follow-up therapy for the patient. [5] In other countries, in Europe and Oceania, the national health ministries’ breast-implant policies do not endorse periodic MRI screening of asymptomatic patients, but suggest palpation proper — with or without an ultrasonic screening — to be sufficient post-operative therapy for most patients.
Criticism

In the early 1990s, the national health ministries of the listed countries reviewed the pertinent studies for causal links among silicone-gel breast implants and systemic and auto-immune diseases. The collective conclusion is that there is no evidence establishing a causal connection between the implantation of silicone breast implants and either type of disease. The affected women complained of systemic disease manifested as fungal, neurologic, and rheumatologic ailments. The Danish study Long-term Health Status of Danish Women with Silicone Breast Implants (2004) reported that women who had breast implants for an average of 19 years were no more likely to report an excessive number of rheumatic disease symptoms than would the women of the control group.[76] The follow-up study Mortality Rates Among Augmentation Mammoplasty Patients: An Update (2006) reported a decreased standardized mortality ratio and an increased risk of lung cancer death among breast-implant patients, than among patients for other types
of plastic surgery; the mortality rate differences were attributed to tobacco smoking.[111] The study Mortality Among Canadian Women with Cosmetic Breast Implants (2006), about some 25,000 women with breast implants, reported a 43 per cent lower rate of breast cancer among them than among the general populace, and a lower-than-average risk of cancer.[81]
 
 
 
 
 
 
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