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Base width and Breast Implants.

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This post is a bit technical, but if you are considering Breast Augmentation, base width is incredibly important to your Plastic Surgeon when deciding on your implant type and size.

Base width is a measurement of how wide your breast is from side to side and from top to bottom. A “normal” side to side measurement is about 16 or 17 cm but a lot of women seeking implants have a narrower BW, more in the 14 cm range.

The significance of base width is that you want to choose an implant whose diameter fits within your breasts’ original ‘boundaries’. In other words, if your breast is 14 cm wide we want to use an implant that has a diameter of 14 cm or less. Otherwise, depending on how much breast you have to start with, you may be able to see a clear transition where your more narrow breast base sits on top of the wider implant. It can give you a ‘stacked ring’ look, like the little kids toy.

Variance in base width is one of the reason implant manufacturers started making high profile breast implants. These implants., volume for volume, fit better under the breast of a more petite woman yet still give a nice full appearance.

So, when you are at your consultation and your surgeon starts measuring your breasts, this is what we are checking on. It enables us to give you the best advice on your implant choice.

Lee Corbett, MD

www.CorbettCosmeticSurgery.com

502.721.0330

All posts on this blog are presented by Louisville Breast Augmentation Surgeon, Dr. Lee Corbett.

For the first time in a while, I had a patient request her implants be placed through her under arm. This is a very nice but less common approach so I thought it was worth a little discussion.

The most common approach for implant placement is an under the breast crease incision, followed by peri-areolar (nipple edge) and then trans-axillary (armpit).

The obvious advantage to this approach is that there is no scar left on the breast. The scar in the armpit typically heals very well and is barely noticable.

The disadvantages are that special endoscopic equipment is needed, which in some facilities can increase cost. It is also a little more difficult to release the muscle so the risk of the implant riding high after surgery is a little higher than if the other access points are used. Finally, if you experience a bleeding problem or need any kind of revision surgery, a second incision will probably need to be made. These situations are rare, but do occur.

So, this is a really nice way to place implants. Kind of slick actually! There are a couple of potential drawbacks you need to consider but if you really don’t want a scar on the breast it is the way to go. Just make sure to have a good discussion with your surgeon and you should be fine.

Lee Corbett, MD
https://www.corbettcosmeticsurgery.com/
502.721.0330

All posts on this blog are presented by Louisville breast implant surgeon, Dr. Lee Corbett.

My answer to this question is ‘yes’.

An implant in and of itself does nothing to interfere with your breast’s function. The implant just sits there either under the breast or under the muscle. The breast is on top and should react to the hormones of pregnancy as expected.

The potential for problems with breast feeding comes from the insertion route. If the implant is placed thru an incision in the crease under the breast or thru the underarm, I don’t think there should be any problems. There is not really any milk producing breast tissue in these areas to disturb. Now, if the implant is placed through a nipple incision, some milk ducts will be disturbed and problems with breast feeding do become a reality. The chances of problems are fairly high in some studies so this route merits some thought by those considering more children.

My advice is to just stay off the nipple if you are contemplating breast feeding in the future. It’s that simple. The other two approaches are perfectly acceptable.

Lee Corbett, MD

www.CorbettCosmeticSurgery.com

502.721.0330

All posts on this blog are by Louisville  Breast Augmentation surgeon, Dr. Lee Corbett.

Mentor and Allergan (formerly Inamed) saline-filled breast implants are approved for: (1) reconstruction (primary reconstruction and revision-reconstruction) in women of any age and (2) augmentation (primary augmentation and revision-augmentation) in women 18 years or older.

Mentor and Allergan silicone gel-filled breast implants are approved for: (1) reconstruction (primary reconstruction and revision-reconstruction) in women of any age and (2) augmentation (primary augmentation and revision-augmentation) in women 22 years or older.

FDA restricts the marketing of breast implants for augmentation to women of a minium age because young women’s breasts continue to develop through their late teens and early 20s and because there is a concern that young women may not be mature enough to make an informed decision about the potential risks. However, there is there is no age restriction on the marketing of these products for reconstruction, so as to allow young women to have access to breast implants to replace breast tissue that has been removed due to cancer or trauma or that has failed to develop properly due to a severe breast abnormality.

As for devices that are not approved for marketing, there are various age criteria and other restrictions for women who receive breast implants as part of a clinical study. Contact one of the companies conducting a study for more information.

FDA approved saline-filled breast implants for augmentation in women ages 18 and older. FDA approved silicone gel-filled implants for women ages 22 and older. The age restrictions are different because the risks are different for the two products.  For example, silicone gel-filled implants will require frequent MRI monitoring to detect silent rupture (a rupture that can go undetected by you or your doctor).  There is no risk of silent rupture for saline-filled implants. In addition, the health consequences of a ruptured saline-filled breast implant are different from those of a ruptured silicone gel-filled breast implant.

This information was taken directly from the FDA website.

Lee Corbett, MD

www.CorbettCosmeticSurgery.com

502.721.0330

All  posts on this blog are presented by Kentucky Breast Augmentation surgeon, Dr. Lee Corbett

FDA has approved four breast implants for marketing in the U.S.:

  • In May 2000, Mentor and Allergan (formerly Inamed) received approval for saline-filled breast implants. These implants were approved for breast augmentation in women 18 years or older and for breast reconstruction in women of any age.
  • In November 2006, Allergan and Mentor received approval for their silicone gel-filled breast implants. These implants were approved for breast augmentation in women 22 years or older and for breast reconstruction in women of any age.

All breast implants other than these four approved devices are considered investigational devices, including the more-cohesive (“gummy bear”) implants. For a woman to receive an investigational breast implant in the U.S., she must enroll in a clinical study.

This post was taken from the FDA website.

Lee Corbett, MD

www.CorbettCosmeticSurgery.com

502.721.0330

All posts on this blog are presented by Louisville, Kentucky breast augmentation surgeon, Dr. Lee Corbett.

What are some of the important factors I should consider when deciding whether or not to get breast implants?
Some important factors to consider include:
* Breast implants do not last forever. If you decide to get breast implants, you will likely need additional surgeries on your breasts over your lifetime due to complications or unsatisfactory cosmetic outcomes.
* Many of the changes to your breasts following implantation cannot be undone. If you later choose to have your implants removed and not replaced, your breasts will not change back to the way they looked before your implant surgery. You may have permanent dimpling, puckering, wrinkling, or other cosmetic changes.
* When you have your implants replaced (revision), your risk of complications increases compared to your first (primary) surgery.
* Routine mammograms to screen for breast cancer will be more difficult with breast implants.
* Breast implants may affect your ability to breast feed, either by reducing or eliminating milk production.
Factors to consider specifically about silicone gel-filled breast implants include:
* If your silicone gel-filled breast implant ruptures, you may have no symptoms. This is called a silent rupture because, most of the time, neither you nor your doctor will know that your implant has ruptured.
* The best way to determine whether or not your silicone gel-filled implant has ruptured is with an MRI examination. You should have your first MRI three years after your implant surgery and every two years thereafter.
* Over your lifetime, the cost of MRI screening may exceed the cost of your initial surgery. This cost may not be covered by medical insurance.
Some important factors to consider include:
* Breast implants do not last forever. If you decide to get breast implants, you will likely need additional surgeries on your breasts over your lifetime due to complications or unsatisfactory cosmetic outcomes.
* Many of the changes to your breasts following implantation cannot be undone. If you later choose to have your implants removed and not replaced, your breasts will not change back to the way they looked before your implant surgery. You may have permanent dimpling, puckering, wrinkling, or other cosmetic changes.
* When you have your implants replaced (revision), your risk of complications increases compared to your first (primary) surgery.
* Routine mammograms to screen for breast cancer will be more difficult with breast implants.
* Breast implants may affect your ability to breast feed, either by reducing or eliminating milk production.
Factors to consider specifically about silicone gel-filled breast implants include:
* If your silicone gel-filled breast implant ruptures, you may have no symptoms. This is called a silent rupture because, most of the time, neither you nor your doctor will know that your implant has ruptured.
* The best way to determine whether or not your silicone gel-filled implant has ruptured is with an MRI examination. You should have your first MRI three years after your implant surgery and every two years thereafter.
* Over your lifetime, the cost of MRI screening may exceed the cost of your initial surgery. This cost may not be covered by medical insurance.
*****This post was taken from the FDA website on breast implants.*****
Lee Corbett, MD
502-721-0330
The posts on this blog are authored, unless specifically noted, by Louisville, Kentucky cosmetic plastic surgeon Lee Corbett.

This is a loaded question and your answer depends upon whom you ask.

Lifts alone and implants alone are fairly straightforward operations. Not much controversy there.

When we combine the procedures things change though. Here’s why.

These two operations are fundamentally opposed. An implant operation is a stretching operation. A lift operation is a tightening operation. Adding an implant to the breast adds weight to the breast. Patients who need lifts have skin that can’t support the weight of the breasts as they are. How can we expect the skin to support the breast and an implant? Well, on a level, we can’t.

There are also marking issues. When we do a lift, we will mark the breast pre-op, and follow our lines. It is pretty straight forward. Well, if I mark your breast pre-op and then put an implant in, all of my marks are invalid. So the operation is more difficult.

If it’s so bad, should it be done? Personally, I think it’s reasonable to do it together, but only if the patient realizes that the chances of needing a revision are higher than if the two are done seperately. In my practice, I do a lot of lift and implant combination procedures because a lot of women need it.

In the end, what universally happens, is that the implant will settle and the breast is not quite as perky as it was in the first few weeks or months after surgery. You will see a big improvement compared to pre-op, but the implant just wont stay quite as high as it was intially placed.

If you are considering this combination, make sure you and your surgeon are on the same page. I do this with my patients and things turn out very well.

Lee Corbett, MD

www.CorbettCosmeticSurgery.com

502.721.0330

All posts on this blog are authored by Dr. Lee Corbett, a Louisville, Kentucky breast augmentation specialist.

I know this sounds crazy and I know you are going to get in front of that mirror asap, but don’t take too much stock in what you first see. This is one of those “trust me” things. After doing over a thousand Breast Augmentations in Louisville, I just know.

Why am I saying this, because of swelling. When we put these implants in the breast starts to swell before you even leave the operating room. Now, if we use silicone implants that go on top of the muscle, the swelling is much less and goes away more quickly. So, after 4 or 5 days, when you look in the mirror, you should get a pretty good idea of how things are going to look.

Saline is a whole different ballgame. At the 3 to 5 day period you are maximally swollen. That muscle will swell and you will look like you have implants up to your collar bones. The soft tissue under your arms will swell as will the breast itself. The skin will be stiff and shiney. So don’t even look because this is NOT how your breasts will be once you are healed. Now, healing varies from person to person. Some women have lost most of their swelling at 2 to 3 weeks, others take 2 to 3 months. I don’t even think about recommending you buying nice bras until after your second post op visit, which is at the 2 month point. Even then I tell some of you to hold off.

The bottom line is that even though everyone knows she is going to be swollen, the swelling is a lot worse than some of you anticipate. That triggers pure panic for some women that is just unnecessary. If you have saline implants, pay no attention the shape and size of your breast for the first 7 to 10 days…it’s all going to change and change for the better!

Lee Corbett, MD

www.CorbettCosmeticSurgery.com

502.721.0330

All posts on this blog are authored by Louisville Cosmetic Plastic Surgeon, Dr. Lee Corbett. Dr. Corbett specializes in cosmetic plastic surgery including facelifts, browlifts, blepharoplasy, Botox, Juvederm, Restylane, breast augmentation, breast lifts, breast reductions, body lifts, liposuction,  and tummy tucks.

The answer is they don’t. Instead, your body forms a hard shell around the implant in the form of a capsule.

Whenever we implant something in the human body, be it a breast implant, pacemaker, or a chemotherapy port, your body makes a wall of scar around the foreign object. Your immune system knows ‘you’ and ‘not you’. When it encounters your implants, the immune system checks it out and it knows it’s not ‘you’. If the implants were living things your body would attack it and try to kill it. Since it can’t kill it, it forms a layer of scar around the implant. Think of it as your body trying to quarantine the implant.

So capsule formation is a 100% natural, expected event. You get an implant, you’re going to get a capsule. Normally the capsules are paper thin and inconsequential. In 12 to 13% of the cases the capsules thicken. In these cases the capsule can range from something you can only feel to a situation where they cause the breast to appear misshapen, very hard and even uncomfortable to the patient. We call this capsular contracture and this is what makes the breast feel so firm.

Lee Corbett, MD

www.CorbettCosmeticSurgery.com

502.721.0030

All posts on this blog are authored by Louisville Cosmetic Plastic Surgeon, Dr. Lee Corbett. Dr. Corbett specializes in cosmetic plastic surgery including facelifts, browlifts, blepharoplasy, Louisville Botox, Juvederm, Restylane, breast augmentation, breast lifts, breast reductions, body lifts, liposuction,  and tummy tucks.

A “Mommy Makeover” is a cutesy name someone came up with for the operations we typically perform on women who have had kids. I am preaching to the choir, but pregnancy obviously takes a pretty big hit on your breasts and tummy. A Mommy Makeover represents some combination of breast and tummy procedure.

For the breasts, a lot of women have just lost the upper breast fullness and only will need an implant. Others have maintained size but now the breast droops (see my previous blog on droop) and they need a lift. Many women opt for an implant with  lift combination to reverse the changes we see from pregnancy, aging, and breastfeeding.

On the torso, one of the biggest complaints I hear are a changed distribution of fat. You weigh the same as before your kids but your shape has changed. Most commonly I see fat in the waist & hip areas that need liposuction. Skin and muscular laxity are also common complaints. If your skin and muscles took a big hit we can address this with a tummy tuck. If your skin is good but you can’t get rid of that last little fatty pooch, we can also treat that with lipo.

So, a Mommy Makeover isn’t anything new, just a good marketing idea to catch your eye.

Lee Corbett, MD

www.CorbettCosmeticSurgery.com

502.721.0330

All posts on this blog are authored by Louisville mommy makeover surgeon Dr. Lee Corbett.