Aesthetic Plastic Surgery Blog | Dr. Linderman

Your friends may or may not notice changes from your cosmetic surgery depending on what procedure was performed, your age and the degree of change produced. Lets take three types of surgery : Facelift, Tummy Tuck, and Breast Augmentation.

Whether your friends will know that you have a facelift is not always predictable. Modern facelifts tend to produce a more natural result with well placed scars that are difficult to see after they mature. This may take up to six months. If you are older with excessive excess skin and neck fat, the post operative result may be more drastic and therefore more noticeable. A younger patient with a more moderate lift may appear more rested and youthful but friends may not be able to say what is different about your appearance.

Following a full tummy tuck and appearing in a two piece bathing suit, a definite change will be noticeable even though your surgical scars will be hidden in your bathing suit line. Depending upon size of your breast implants and your preoperative size, your new look may be noticeable by your friends. The clothing you wear and the observation skills of your family and friends are contributing factors.

Tuberous breast deformity is a developmental abnormality of the breast resulting in constriction of the base of the breast and my be associated with lack of development of breast tissue in the medial or lateral lower quadrants or upper medial and lateral quadrants. Various combinations can occur with the lower quadrants affected more commonly. The constriction of the breast produces a tubular narrow shape. The deformity may involve one or both breasts. Treatment of this conditioned requires an experienced plastic surgeon with knowledge of the anatomical causes of this condition.
Often the skin enveloped may require modification by mastopexy and the volume discrepancy corrected with breast augmentation. Adjustment or lowering of the inframammary fold is usually required.

At the present time saline implants are more commonly used than silicone implants. However since the release of silicone gel implants in 2006, the number of patients requesting them has continued to increase. Factors affecting the more common use of saline include overall cost, surgeon experience, and patients’ perception of safety with saline implants.

With over 30 years of experience, Dr. Richard Linderman of Aesthetic Plastic Surgery of Indiana, has been able to obtain excellent results for his patients using both saline and silicone gel implants. Depending on patients’ expectations and physical examination, Dr. Linderman will help you make the right choice of which type of implant is best for you.

Hardening of breast implants or capsular contracture can occur after breast augmentation surgery due to the formation of a hard inelastic scar capsule forming around the breast implants. Following breast augmentation, I instruct my patients to begin a series of breast massage exercises in the early post operative period to promote the development of soft pliable scar capsule to maintain a soft breast. These exercises are done for 2-3 minutes at least two times a day and continued for at least a year. They cannot be overdone or harm the integrity of the breast implants. The breast incision scar will take 12 –18 months to soften and fade. The same process of maturation occurs with the scar capsule around the breast implants. When your breast scars have faded to a white color, maturation of your implant scar capsule will follow.

Although procedures have been described to reduce the size of breast eliminating the vertical scar, they have not been generally accepted because of ultimate results and the problem of adapting the technique to most breast sizes. Most patients requesting breast reduction have significant breast ptosis and require nipple elevation, which may not be adequately corrected.

Most patients obtain a good result from Botox injection that lasts around six months however some recurrence of muscle activity may be notice in four months. After injection, the results should become apparent within three to four days. Bruising is minimal as is pain from the injection process and is done by Dr. Linderman is his office.

Breast augmentation is one of the popular procedures performed in cosmetic surgery. Women who wish to improve the breast size and shape are typical patients for breast enhancement surgery. The modern age of breast augmentation begin in the 1960s with the development of the silicone gel implant by Cronin and the inflatable saline implant by Jenny. Although these implants have undergone some modification since their original development, they are still very similar to the original implants. Unfortunately the same cannot be said about FDA monitoring of these medical devices. In 1992 the Food and Drug Administration [FDA] placed severe restrictions on the use of silicone gel implants and effectively removed them from the market. After much study and research the FDA approved gel implants for all women over age 21. The original allegations that silicone gel implants posed serious health risks such as autoimmune disorders and connective tissue disease were never supported by clinical trials and research.

Saline Breast Implant

Since the removal of silicone gel implants from the general market in the early 1990s, saline breast implants have been the procedure of choice for breast augmentation. Implants have been developed in different shapes and sizes to accommodate anatomic variations in patients. Texturing of the shell of implants was developed to try to reduce the incidence of capsular contracture or breast hardness.

One of the advantages of saline implants is the ability to detect implant rupture or deflation. When a deflation occurs the implants flattens like a tire and the body safely absorbs the saline. Deflated implants are easily replaced often under local anesthesia. For most saline implants the deflation rate is around 5% over a ten-year period. Current implants are covered by a lifetime replacement warranty provided by the manufacturers.

Silicone Breast Implant

Current silicone gel implants have a similar outer shell as saline implants. However in contrast to saline implants the shell is filled with a silicone gel, which has a higher viscosity and more natural feel than saline. Recent modifications of the gel have made it more cohesive so that if a rupture were to occur, the gel tends not to migrate. Gel implants are available with texturing of the shell that in some studies has shown to decrease scar formation around the implant. Modification of the outer shell has eliminated “gel bleed” or migration microscopic amounts of gel through the outer shell. Silicone gel implants tend to have a more natural feel but require a larger incision of about 5cm to insert the implants. Rupture of a silicone gel implant is more difficult to determine and may require and MRI scan to evaluate. Silicone gel implants are more expensive.

Learn more about silicone breast implant-are they the right choice for you?
Learn more about breast augmentation incisions.

If you are considering breast augmentation surgery, contact Dr. Richard Linderman at Aesthetic Plastic Surgery for a free consultation to see if you are a candidate for this popular procedure. Dr. Linderman is board certified by the American Board of Plastic Surgery with over thirty years of experience. He has performed over 5000 breast augmentations.

The placement of prosthetic breast implants will have no effect on a woman’s hormones. The implants are usually placed underneath the chest wall muscle. Breast sensitivity and the ability to nurse should not be affected.

Typically most injectible fillers provide an improvement for around six months. However with repeated sessions, less filler may be required to obtain the same result and may last somewhat longer. At the first treatment it is important to use enough volume to produce the best result as long-term patient satisfaction is higher and less product may be required with subsequent treatments.

When a patient presents with a malpositioned breast implant that sits too high, a capsulotomy may be indicated. The pectoralis muscle or scar tissue formation around the breast implant may cause superior displacement. A capsulotomy opens the scar tissue and may be used to enlarge the pocket inferiorly to allow the breast implant to be properly positioned.