Aesthetic Plastic Surgery Blog | Dr. Linderman

In December of 2006 the FDA gave approval to Mentor and Inamed Corporations to release silicone gel implants to the market for cosmetic breast augmentation. This again gives cosmetic surgery patients the option to choose between silicone gel breast implants and saline filled breast implants for breast enhancement. Gel implants have generally not been available to the public except under severe restrictions since their removal in 1991.

What has changed? The manufacturers have submitted long term investigational studies that have satisfied the FDA's original reservations concerning the safety of these devices. In fact gel implants are perhaps the most studied medical device released to the market. The FDA has placed several restrictions on the use of silicone gel for breast augmentation and it is my feeling that they are overly burdensome and create increased economic costs for the patients.

I would like to discuss the pros and cons of both saline and gel implants. Which has a more natural feel? The gel implants do have a more natural feel and consistency. They are designed with a newer more viscous gel with less chance of spread if the implant should leak. The membrane or outer shell is less porous helping to eliminate gel bleed, which is migration of small amounts of silicone across the shell, which was a problem with older implants.

Can these implants leak or deflate? Both implants can leak but saline implant leakage is easier to detect as they completely deflate and can be easily replaced. Gel implants may leak but this may be asymtomatic and more difficult to determine. The FDA has recommended regular MRI examinations, which can be quite costly to the patient. Even though there might be a slight leakage, the question is raised what should be done in patients without symptoms. No cosmetic change in the breast, no pain, and no palpable abnormality. Is the silicone that leaks a health hazard? All of the exhaustive studies done on these devices would indicate no. What would be done depends on the patient. Replacement may be indicated. If you consider yourself a more anxious person, then gel implants may not be the best choice. If the cosmetic feel is very important and the additional surgery and maintenance costs are not a factor and your anxiety level is low then gel implants may be the right choice for you. Indeed there are some patients who are better candidates for gel implants because of previous surgery or thin skin. In the final analysis it is between you and your surgeon. A good reference source to learn more about gel implants is www.breastimplantstoday.com. Contact Dr. Richard Linderman at Aesthetic Plastic Surgery of Indiana if you are considering breast augmentation. With over 28 years of experience with both types of implants, he can help you make an informed choice that meets your expectations.

Following breast augmentation, Dr. Linderman instructs all of his patients in stretching exercises and beast massage. Stretching exercises when begun early have been shown to reduce postoperative pain and speed recovery. Breast massage is helpful in promoting breast softness and preventing the onset of capsular contracture of breast hardness.

Breast augmentation will not correct nipple inversion. Correction of nipple inversion can easily be performed at the same time as breast augmentation with minimal discomfort and cost. Some patients with mild nipple inversion that is sporadic in nature due to lack of scarring of the nipple ducts may notice occasional temporary improvement with breast augmentation but this is uncommon.

Patients that present with lines of the forehead, crows feet areas and base of the nose that are due to overactive muscle contraction are excellent candidates for Botox which paralyzes the underlying muscle causing the lines. In some cases wrinkles are deep and long standing and may benefit from a filler such as Restylane to improve volume. Patients with wrinkles around the mouth and prominent nasolabial folds are good candidates for volume replacement with injectable fillers. To see if you are a good candidate for these non invasive procedures, make and appointment with Dr. Richard Linderman of Aesthetic Plastic Surgery of Indiana.

Standard facelift surgery involves surgical elevation of the skin of the temple; cheeks and neck along with tightening of the underlying muscles to improve the jaw line, remove jowls, tighten neck skin and lift the cheeks. Incisions may vary in length and position according to surgeon preference and the individual patient. Scars usually run in the crease in front of the ear and may extend behind the ear and into the hair with a facelift. Scars may be extended into the temporal hair or placed at the hairline to avoid sideburn alteration. Neck dissection is typically done in a standard facelift and may be more or less extensive depending upon muscle and skin laxity. Sometimes a small incision under the chin is required and a chin implant may be place to increase projection.
Another variant is a short scar facelift with incision limited to in front of the ear. This is a less invasive procedure and ideal for patients with earlier signs of aging.

These procedures are usually cosmetic in nature and not covered by insurance.