Saline and silicone implants

In summary, implant position placement submuscular versus subglandular depends upon each individual woman’s anatomy, amount of breast tissue and also preference of the final appearance of the breast.  In general, in thinner women, a more natural appearance is accomplished by placing the implant using the dual plane technique or submuscular.

The annual meeting of ISAPS 2010 in San Francisco here at the Moscone Convention Center has been an informative and educational experience.  This has been an exciting meeting with beautiful weather and fine dining.  Topics have included AP issues in plastic surgery as well as multiple sessions.  Session one was specifically regarding Periocular Rejuvenation, describing both cosmetic and reconstructive surgery of the periorbital region.

Session two is specific to Facial Rejuvenation.  Section Three, Rhinoplasty, with Nasal Reconstruction.  Fourth session is corresponding to Aesthetic Breast Surgery which was fascinating; and Session Five was associated with Aesthetic Reconstructive Surgery.  This is an International Society Meeting with doctors from throughout the globe, extending from countries, including Columbia, Switzerland, London, Paris, Australia, Spain and China.  Once again, this is an excellent meeting with both educational and informative objectiveness.  Please see letter from Governor Arnold Schwarzenegger specific to attendees.

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.

breastimplantlasvegas.com

Breastimplantlasvegas.com will be launched in the very near future.  This site has been developed in order to educate patients with breast augmentation surgery in general.  We go through all the specifics and facts of breast augmentation surgery, including the history of breast augmentation, the chemical composition of silicone itself, the postoperative care and management of breast augmented patients, identification cards from your breast implant surgery, as well as postoperative recovery time.

With respect to saline implants, great detail is given as to the surgical technique and candidates for saline versus silicone gel implants.  With silicone implants themselves, the 7-year complication rate for primary versus secondary augmentation patients is given, courtesy of Natrelle Collections.  Placement of implants as well as implant shapes, including high profile moderate plus and moderate profile implants, are described in detail, including examples of before and after photographs.  Breast deformities are also described, including breast asymmetry, tubular breast deformity, pectus carinatum and pectus excavatum.  Photograph examples are also given. 

Finally, breast implant revision, which is a large component of Dr. Linder’s practice, is described with respect to breast asymmetry, capsular contracture, ruptured implants, double-bubble breast deformity, cleavage, both primary as well as revision, implant malposition, severe bottoming out, volume revisions, anatomically shaped implants, symmastia, implant explantation and scarring on the breast mound itself.  You may also refer to breastrevisionsurgeon.com and lasvegasbreastrevision.com  for more details on breast revision surgery.

Again, the main purpose of this site is to become an encyclopedia of wealth of information to educate women throughout the world, as well as Beverly Hills and Las Vegas, Nevada on breast augmentation and breast revision surgery itself.  I hope you find this very useful.

model

The patient was to undergo a removal and replacement of implants that were over a decade old, but she had a mass that was approximately 3×5 cm and it was well loculated in the right upper breast.  Even though the ultrasound was normal or negative, did not show any evidence of malignancy, I believed that this should be biopsied intraoperatively with removal and replacement of the implants.  In the operating room, bilateral removal and replacement of implants, open capsulectomy and excisional biopsy of the right breast mass was performed.  The mass was hard, somewhat calcified and very thick.  It was sent to our excellent pathologist at the UCLA Medical Center for diagnostic purposes.  The diagnosis came back ductal carcinoma, which was invasive.  Thank God we took the initiative to do a biopsy at this time even in the face of a false negative report on her ultrasound where she was asked to repeat the ultrasound in six months to one year.  Who knows what the state of this patient would be in six months to one year.  There is a chance that she may not be alive in six months to one year. 

As a result, I believe in my practice all tumors, especially tumors or breast lesions that are enlarging rapidly over a short period of time, should be considered seriously biopsied either with fine needle aspiration, TruKor, or excisional biopsy.

Recently, the U.S. Preventive Services Task Force has changed the screening mammography for women in the United States to 50 years of age.  I believe this is a very controversial subject and topic and there are pros and cons certainly on both sides of the issue.  However, as a Board Certified Plastic and Reconstructive Surgeon,  a Diplomate of the American Board of Plastic Surgery, a Fellow of the American College of Surgeons and as a specialist in breast surgery, including breast augmentation, breast revision, breast lifts and breast reduction surgery, I strongly oppose this new change for several reasons. 

First of all, breast cancer is one of the most common forms of malignancy found in women in the United States today.  Screening mammographies in general are quite inexpensive, ranging between $80 and $150.  I believe this is a small price to pay to detect early pre-malignant or malignant cancers in younger females in their 30’s and 40’s.  

Mammogram X Ray Example

Personally, I believe that all women at 40 years of age, regardless of family history, should have screening mammographies unequivocally.  Patients who undergo breast surgery, including implants, breast reductions and breast lifts should undergo preoperative diagnostic and screening mammographies at the age of 35.  Multiple studies have shown that mammograms at 40 years of age save lives.  Dr. Vogel has cited several lines of evidence which support the American Cancer Society’s recommendation for screening mammographies for women between the age of 40 and 49, including evidence of early detection of breast cancer and how it does save lives as seen in the Journal of American Medicine in the 1995 issue.  Certainly, increasing screening mammographies to 50 years of age will save billions of dollars a year, but at what price?  Unquestionably, cancers will be undetected in women in their 30’s and 40’s with an increased risk of metastasis and certainly an increased risk of mortality.  In fact, in my practice we have performed breast reconstruction operations for bilateral mastectomy patients in their late 20’s and early 30’s.  If these patients had not had mammographies they would certainly be dead.  Therefore, for the above reasons, I will continue to recommend mammograms for all women at the age of 40, for any woman with a family diathesis of breast cancer at the age of 35 and for all women who undergo any type of breast surgery as well at the age of 35.