Below is the extremely interesting case of a patient who is now four weeks postoperative for augmentation mammoplasty as well as abdominal contouring as well as thigh liposculpture at six months of age undergoing radiation therapy for neuroblastoma of the gastric or stomach region.  The patient on preoperative photograph has loss of fatty tissue and some muscle development along the left lateral wall.  The umbilicus is shifted to the left.  She was very disturbed in her clothes through the years of the extra fat along the iliac crest roll or hip lower flank area as well as the periumbilical lower abdomen and epigastric area which rolled up upon her pants.  She also is very unhappy with the gynoid appearance of her lower third showing severe lipodystrophy of both the inner and outer thigh in a pear-like figure.  The patient underwent abdominal CT scan showing no fascial defects or hernias on the abdominal wall along the right side of the umbilicus and therefore she was safe to undergo tumescent liposuction of the epigastric right area and the hip as well as of course to sculp the thighs. 

The patient underwent augmentation mammoplasty procedure with a 210 cc saline implant through the subpectoral periareolar approach as well as tumescent liposuction removing over 1.2 liters of fat of the periumbilical, right hip, lower flank and contouring of the inner and outer thighs. 

The patient is ecstatic with her results.  Most importantly, when she wears her clothes and pants, the fat no longer rolls up above the jean line.  She underwent the Linder Bi-directional Flank Liposuction Technique, both in the vertical and oblique plane on the right hip and smoothed out the lower epigastric area.  The thighs are beautifully contoured and she cannot be happier.

This is an extremely interesting case as a young six-month old with a very rare tumor of a stomach.  She had undergone cobalt and radiation therapy which caused necrosis and complete atrophy of the left abdominal wall.  It is always a challenge, but it is very pleasing to be able to help patients not only with cosmetic appearance, but certainly the functional impairments that they have throughout their everyday lives.

Many patients present to Dr. Linder for breast revision surgery.  They have concerns over “feeling something that is just not right” within one or both breasts.  It is important to decipher whether there is a mass, lesion, scar tissue contracture or the implant edge that is leading the patient to this disfigurement and/or palpability of a mass versus the edge of the bag.  With saline implants, scar tissue contracture can lead to enfolding of the bag and with a Baker IV contracture, can lead to pointing and deformity of the implant causing the edge to feel obvious and palpable.  Patients often do not know whether this is the implant edge or a mass.  If there is any question and the surgeon cannot decipher a mass from the edge of an implant, diagnostic radiographic testing should be performed.  With saline implants, mammograms and ultrasounds are sufficient.  With silicone gel implants, an MRI can be used in order to determine whether there is a rupture of the cell of the implant as well as to determine the integrity of the implant itself.  Any suspicious mass within the breast should be diagnosed by mammogram ultrasound and if necessary, tissue biopsy through FNA (fine needle aspiration) or true core biopsy.  Because of the significant rate of breast cancer in women (approximately one out of every eight and a half women may develop breast cancer), all masses in our practice are looked at seriously and diagnosed through proper diagnostic and/or biopsies. 

Scar tissue contracture may certainly lead to distortion of the implant causing palpability of the edge of an implant.  Patients often are not sure what this edge is, whether this is a mass or the bag edge.  With silicone gel implants, it is more difficult to detect the edges of the implant on enfolding and therefore MRIs are very useful.  Most importantly, any time a woman’s breast feels different, we must decipher lesions, palpable masses, pre-malignant tumors versus implant edge versus scar tissue contracture.

Because Dr. Linder performs so many surgeries where scarring is such a significant part of his procedures, including mastopexies, breast lifts, abdominoplasties and breast augmentations, reducing the scarring is absolutely a main necessity.  The best product that we have used, certainly in the last decade, has been Kelo-cote or Bio Corneum.  Kelo-cote is a silicone gel spray which is used twice a day after sutures are removed, usually on day 14 to day 21, for at least three months.  The silicone gel spray greatly reduces the redness as well as hypertrophic keloiding of the scars and has smoothed out scars beautifully over the last two years. 

Look out for the next one and two-minute infomercials from Kelo-cote where Dr. Linder has been used as a scar expert for Advanced Bio Technology.  Because we believe so wholeheartedly in the use of Kelo-cote, giving worldwide testimonial as to the benefits of Kelo-cote, goes without reservation.  We look forward to seeing the Kelo-cote used worldwide and on television sets throughout the country.

Indications for use of The Dr. Linder Bra include: 1) as a sleeping beauty bra for women, with or without breast implants, to maintain the shape of their breasts throughout the evening so as to not have continued or recurrent skin laxity and loss of firmness to the breast; 2) as a training bra that can be used for the aerobic and anaerobic workouts to maintain the shape of their breasts during vigorous athletic activities as well as during Pilates; 3) as a pregnancy bra, due to the patented adjustable straps on the side of the chest wall, they can be adjusted to three different sizes and can be used for women in their 9-months pregnancy period as well as post-pregnancy during breast feeding; and 4) can be used post-surgically for breast cancer as well as elective cosmetic breast surgical procedures, including breast reduction, breast augmentation, mastectomy as well as breast cancer reconstructive patients. 

This Bra is not a surgical bra per se, but rather 24/7 hour bra that again can be used for training, sleep bra and beauty bra to maintain women’s breasts, every day bra to be used throughout the world, as well as for pregnant women whose breasts will enlarge over nine months and finally for post-surgical patients. 

The Linder product line will include The Linder Sport, which is the Linder Bra without the zipper in the front as well as The Linder Band, which will be useful for the abdominal area to reduce the abdominal midriff area up to two inches.  The Linder Bra manufacturers with the highest quality of approximately 95% cotton and 5% Spandex as bi-directional stretch, which thereby means has compression which will also allow women to perspire without development of consistent sweat within the bra.  It has excellent evaporative properties and will also have the adjustable straps on the sides with the Ford Steel Clip System which can be adjusted in three different sizes along the chest wall diameter.  This is a very unique bra.  It has been trademarked and is patent-pending at this time.  Manufacturing is occurring and should be completed in the next couple of months. 

Look forward to the informercial as well as selling of the products in multiple stores as well as training stores, sporting good stores and pregnancy stores for women.  We are very excited about The Dr. Linder Bra which will be very useful for women throughout the world for all their maintenance as well as training and post-surgical pregnancy needs.

The building of this site is now complete and breastimplantlasvegas.com  is now online, can be found at the bottom of drlinder.com or on Goggle itself.  This site was built to educate women worldwide on all the different aspects of breast augmentation surgery. 

We are excited that this site specifically yields information that women will desire when considering primary or secondary augmentation mammoplasty procedure.  Subcategories do include “Augmentation Mammoplasty using Silicone Gel versus Saline Implants, Breast Deformities, including asymmetry, tubular breast, breast hypertrophy, pectus excavatum, and pectus carinatum, are described as well as augmentation with concomitant breast lifting, implant positioning, shapes, profiles, as well as reconstruction and revision.  This site is an excellent compliment to breastrevisionsurgeon.com and lasvegasbreastrevision.com .

Finally, breast health and Natrelle’s implant warranty information is given to patients for future reference.  We hope you find this site to be extremely educational and informative when considering primary augmentation mammoplasty procedure or revision of your past breast surgery.

The below patient presents with severe Baker IV capsular contracture with malpositioning of implants, done through the transaxillary approach.  Her preoperative view shows complete distortion with superior retropositioning of the implant with hardening and a grotesque appearance to her breast.  The patient works in the entertainment industry and this is obviously distressful for her in that her breasts do not appear normal in way fashion. 

In order to correct this problem, an open capsulectomy was performed bilaterally.  A new implant was replaced and lowered with an open inferior capsulotomy, anterior capsulectomy and a formal mastopexy using the inferior pedicle Wise-pattern technique was performed in an anchor-like fashion in order to remove the redundant skin.  Notice, her postoperative view with a normal appearance to bilateral breast, good symmetry, nipple areolar complex symmetry is excellent, and she now has a normal appearance to her breast. 

Double bubble breast deformities require skill, experience and judgment, which can be found with Board Certified Plastic Surgeons.

In certain patients, especially those who are thin and have ectomorphic build, high profile implants are an excellent choice for augmentation mammoplasty procedure.  We place implants in the majority of patients, including this example below, using the dual plane technique, two-thirds under the muscle and one-third lateral above. 

High Profile Implants - Post Op

The periareolar approach was used and the incision is made underneath the nipple.  Patients who are very thin, ectomorphic build and have very short inframammary folds may do well with a high profile saline or silicone gel implant because it will reduce the lateral width of the bag which maintains their tapered appearance, reduces matronly appearance and allows for a more soft appearance in the upper pole.  The oblique view shows a softening of the upper pole under the subpectoral major muscle.  This patient has done extraordinarily well and is the usual and typical case of a high profile saline implant placed in an ectomorphic built patient.