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Added: Lizzete Mallett - Date: 14.11.2021 01:12 - Views: 44405 - Clicks: 5598

The women who choose this practice for breast augmentation surgery want to feel more confident about their breast appearance, to look great in form-fitting clothing, to get rid of their padded bras and swimsuit tops, and to have more options when shopping for clothes or when looking through their closet for what to wear to an important event or just out to lunch with friends — but they do not want to look like their appearance is the result of a surgical procedure.

There are more breast implant options than ever before for breast augmentation patients in the United States. We now have four companies that have FDA approval to market and sell breast implants. Three of them offer cohesive silicone gel implants and conventional single-chamber saline implants: Allergan, Mentor and Sientra. This implant represents an attempt to create a saline implant that feels more natural than conventional saline implants, but that does not require a radiologic test to monitor the status of the implant like the MRI scan you will need if you want to know if one or both of your silicone gel implants have ruptured.

Round silicone gel implants are available with both smooth and textured surfaces, which have some differences with respect to implant performance. Saline implants all have a smooth shell, while shaped silicone gel implants all have a textured shell. In this practice we place only round breast implants cohesive silicone gel, structured saline and conventional salineas shaped implants have been shown to provide no observable improvement in augmented breast shape compared to round implants, and they have a I want Raleigh boobies of rotation which, when it occurs, requires another trip to the O.

There are instead lots of implant options, and there are pros and cons for each implant option that you might consider. Given the natural breast that you are starting with and your goals for the outcome of your breast augmentation surgery, there is quite likely an implant choice — that combination of implant fill material silicone gel vs.

The most important step in the process is finding a surgeon who both understands your goal for the outcome of the surgery, and who has experience with all of these implant options. And who has a relationship, I should add, with all of these implant companies. A natural-appearing breast is noticeably fuller in the lower pole below the nipple than it is in the upper pole.

In profile viewing from the sidethe upper pole slopes gradually from where the breast begins in the upper chest down to the nipple, and the lower pole is full and rounded. For any patient considering breast augmentation, there is an implant size above which the upper pole begins to look rounded, convex, and unnaturally full.

Click for more breast augmentation photos. Implant selection is of course a critically important part of the process, but it is but one of many factors that lead to a lasting, natural-appearing breast augmentation result. Patient education and preoperative preparation, surgeon experience, operative technique, precise implant pocket dissection, protective implant insertion technique, implant-stabilizing incision closure technique and attentive post-operative patient management are all absolutely critical components of success in natural-appearing breast augmentation.

Natural-appearing breast augmentation can be achieved for all patients if the surgery is performed by an experienced surgeon who uses biodimensional planning techniques to assure the selection of an appropriate implant type, profile and size, who selects an appropriate approach to implant placement, who pays great attention to detail in the operating room and who provides patients with detailed instructions for and attentive care in the postoperative phase.

They look great, they wear what they want to and fill out their clothes nicely, and the fact that their breast appearance is a result of a breast augmentation surgery is their little secret. When the goal of this operation is a natural-appearing breast enhancement, the can be absolutely beautiful. However, if the goal is to create an excessively full breast profile which is out I want Raleigh boobies proportion to the shoulders, waist and hips, then the — by definition — never appear natural.

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These patients not infrequently end up having a series of operations to address problems related to the excessive implant volume. Make sure you choose a surgeon who understands your goals, who takes time to show you why a certain implant is a great choice for you, and who clearly explains all aspects of the procedure to you. You should also know this: the process of having breast augmentation surgery can and should be a pleasant experience for the patient, with a quick recovery and return to non-strenuous activity, if measures are taken to minimize postoperative discomfort.

It is our pleasure and privilege to provide natural-appearing breast augmentation and a rapid-recovery breast augmentation experience for our patients from North Carolina, from around the United States and from around the world.

Read DR. The answer to that question depends on a of factors, including your preop breast appearance, what your lifestyle is like, what breast volume you would like to have and what is pleasing to you aesthetically.

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For a of reasons this practice offers only round implants for breast augmentation; our decision to stop placing shaped implants as of is discussed in another section. Traditional, single-chamber saline implants are also available from Sientra, Mentor and Allergan. All available saline implants have a smooth shell, as saline-filled implants with a textured surface shell have a higher failure rate and are therefore no longer produced.

Textured surface silicone gel implants, on the other hand, do not have a higher failure rate than smooth surface silicone gel implants. So if you go with traditional or structured saline implants, your implants will by default have a smooth shell. If you go with a shaped silicone gel implant, your implants will by default have a textured shell. If you prefer round silicone gel implants, which is the most commonly placed implant around the world today, you and your surgeon will need to decide between smooth surface and textured surface implants.

Textured surface implants were originally developed with the hope in mind of reducing the rate of capsular contracture CC. The general consensus in the plastic surgery literature for many years has been that there does not seem to be a ificant difference in the contracture rate between smooth and textured surface implants, but some recent data from the implant companies I want Raleigh boobies that some textured surface implants do have a slightly lower rate of capsular contracture. The difference in the CC rate is small, however, and one needs a large study with many patients enrolled to observe a difference.

So for a single patient any potential small difference in CC rates in smooth vs textured implants, in my opinion, is not that relevant. There are a of steps that a surgeon can take to reduce the risk of capsular contracture that are much more ificant than the type of implant shell that is selected.

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about the things we do to prevent capsular contracture at The Plastic Surgery Center here: What can be done to prevent capsular contracture? Up until recently, most U. Saline implants were ly available in smooth and textured versions, however the textured shell saline implants had a higher deflation rate and fell out of favor. So the primary implant used in the United States for almost a decade and a half was a smooth-surface saline implant, and when the FDA lifted the moratorium in most American surgeons transitioned to using smooth-surface silicone gel implants.

Cohesive round silicone gel breast implants are appealing in that the gel inside is cohesive i. Cohesive not highly cohesive implants best mimic natural breast tissue. Smooth shell breast implants, in patients with thin breast tissue, are perhaps a little less likely to be palpable and outwardly visible than textured surface breast implants. This slight difference is less relevant when the implants are placed behind the pectoralis major muscle, which enhances concealment of the implants in the upper pole and cleavage area.

My personal textured implant preference is to not use aggressively textured implants. In patients with good breast skin tone and adequate breast tissue to conceal the implants, I think that textured surface round implants are a great choice.

I prefer smooth surface round implants when the breast tissues are thin, or when there is some skin laxity but not enough to absolutely require a simultaneous mastopexy. If the breasts I want Raleigh boobies a little droopy, you want an implant that will settle into the somewhat droopy breasts, not one that may tend to stay in a higher position on the chest wall because of the surface texturing.

I also prefer smooth surface implants for patients having an augmentation mastopexy. With breast skin laxity and thinning there is a slightly greater chance of implant palpability and visibility, so my preference is for smooth implants in those patients. If there is better skin and breast tissue tone, then textured surface breast implants are fine for augmentation mastopexy.

You may have read about or heard discussed in the media a form of lymphoma lymphatic system cancer called ALCL that is now known to occur rarely in patients with breast implants.

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While this very rare and treatable cancer appears to be more common with textured surface implants compared to smooth surface implants, the majority of cases have been associated with aggressively textured implants and older generation implants which are not used in this practice. Additionally, implant bacterial colonization and low-grade infection also appear to be a likely causative factor or at least promoting factor for ALCL.

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In my opinion, less aggressively textured implants remain a perfectly acceptable implant option. As with any breast augmentation procedure, they should be placed using techniques that drastically reduce the possibility of bacterial colonization: triple antibiotic irrigation, insertion using a sterile funnel, use of a nipple barrier, not using a periareolar incision, etc.

These are general concepts and not necessarily absolute preferences, and many additional factors are evaluated when selecting the best implant for each patient. The thought process behind implant selection takes into consideration not only what is likely to contribute to a successful outcome immediately postop, but also what is likely to remain stable and aesthetically ideal over time.

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For example, an athletic patient who is a distance runner is often best served, in my opinion, by textured surface breast implants, as the textured surface provides a greater likelihood of the implants remaining in an aesthetically ideal position over years of sustained, high-impact exercise.

The take-home message is this: there are more available breast implant options than ever before, so you want to see a surgeon who has experience with and therefore some expert opinions about all of the implants that you are considering. The best decision is always a well-informed decision that takes into consideration all of the currently available options and all of the latest, scientifically-based information about those options. You are best-served, without question, by a board-certified plastic surgeon who is up-to-date on the current breast implant literature and who has a working relationship with all of the FDA-approved implant companies.

The truth is that all four of the currently FDA-approved implant manufacturers make good products, and the differences between them are, with some exceptions, fairly subtle. Competition between implant makers has been a very good thing for the consumer, as each company strives to develop manufacturing advances and new implant features — including completely new implant des — that provide products that are both safer and more natural appearing.

Some plastic surgeons are loyal to a single implant manufacturer. No single implant maker has an implant available for every possible combination of implant volume, base diameter and projection. The great advantage of working with all of the FDA-approved breast implant companies is that it enables a surgeon to provide patients with the widest range of implant options. Sientra and Ideal Implant stand out from the other two breast implant manufacturers in one very ificant way: they sell their implants exclusively to board-certified plastic surgeons.

The leaders of these two companies are so committed to producing the best possible outcomes for breast augmentation patients that they will only allow their products to be placed by physicians who have completed plastic surgery residency. In an era where ER docs, family physicians and oral surgeons among others — and no, I am not making this up, search it online are offering breast augmentation, Sientra and Ideal Implant are the only two companies that have taken a stand on the issue of which physicians are qualified to use their products.

This commitment is respected and appreciated by all residency-trained and board-certified plastic surgeons, and should serve as a bold statement to the consumer that Sientra and Ideal Implant put excellent breast augmentation ahead of corporate profits. In my practice I use implants made by all four U. For any given patient, there is a limited range of implant sizes and profiles that will produce a natural-appearing breast enhancement.

In working with all four breast implant manufacturers, I have more options available for each patient. The bottom line: you can potentially get a great result I want Raleigh boobies breast implants made by any of these four companies. It is really a matter of sorting out, ideally with the guidance of a board-certified plastic surgeon who has a working relationship with all four implant companies, which particular implant type, size and profile is the best choice for your individual needs.

Women considering breast augmentation now have the luxury of deciding between three kinds of breast implants: cohesive silicone gel implants approved for cosmetic use by the FDA inconventional single-chamber saline implants, and structured saline implants. There are a of pros and cons to consider with each type of implant, however the most important thing to know is that patient satisfaction is very high with all three.

The de and manufacturing process for the outer shell has also improved a great deal, resulting in ificantly lower implant shell failure rates. These improvements make gel implants much more appealing as long-term medical devices, and because of these major improvements and positive data from clinical trials the FDA cleared them for cosmetic use in One very important issue to consider is implant palpability, i.

Silicone gel, structured saline and conventional saline implants are soft to the touch and compressible. Most surgeons and patients agree, however, that silicone gel breast implants tend to feel much more natural than saline breast implants, at least in patients who are starting out with a relatively small breast volume say A to Band that structured saline implants fall somewhere in between. Because saline is non-viscous, it tends to allow the edges of the implant to collapse and this makes the implant edges of a conventional, single-chamber saline implant much more easily palpable in a patient who has a small preoperative breast volume.

This will be quite obvious to you when you examine samples of saline and silicone gel implants during your consultation. As suggested above, the degree to which this difference is noticeable postoperatively varies a great deal with regard to two factors: the amount of breast tissue that exists prior to augmentation, I want Raleigh boobies the size of the implant that is used.

In such a patient a saline implant is usually very easy to feel through the skin, and may even be visible externally — especially in the lateral aspect of the augmented breast where the tissue covering the implants is the thinnest. The difference in feel between saline and silicone gel implants will be less noticeable to a patient who is more full-figured and whose pre-operative bra size is a full B or especially a C cup.

In some fuller-figured patients saline implants may be undetectable by palpation meaning they feel completely natural. Saline implant palpability is primarily a matter, therefore, of how much natural tissue there is to disguise the implant.

Another important difference between gel and conventional saline I want Raleigh boobies implants is what happens if the implant shell fails. Most patients have little tolerance for having just one augmented breast, of course, and a saline deflation thus requires a return to the operating room to replace that implant. As there is no outward that the implant has failed, the only way to discover that a gel implant has ruptured is to undergo a radiologic test such as an MRI, which is the best means currently available for diagnosing silicone gel implant failure.

The FDA recommends that women receiving gel implants have MRIs at certain intervals postoperatively to monitor the status of their implants I want Raleigh boobies is an FDA recommendation but not a requirement. The FDA also recommends that patients with a ruptured silicone gel breast implant have the implant removed and replaced. And unlike silicone gel breast implants, a radiologic study like an MRI scan is not required to detect a structured saline implant shell failure. If the outer, smaller chamber of and Ideal Implant leaks and empties then the implant loses a relatively small percentage of its total volume and the augmented breast will appear slightly smaller than the other side, so implant replacement is not urgent.

If the larger, inner chamber leaks and empties then the affected breast will appear much smaller than the other side, and immediate replacement of that Ideal Implant will be necessary. A tall, broad-shouldered patient with small A-cup breasts may require cc implants to achieve a C-cup breast volume postoperatively, while a shorter patient with medium B-cup breasts may only need a cc implant to achieve a C-cup breast volume.

During the consultation process it is important for patients to be given the opportunity to examine a large of sample implants to get a sense of how implants vary according to base diameter, projection and volume. Sample implants can be placed in a soft, non-padded bra to give prospective patients a sense of what their postoperative breast profile will be with a given implant volume.

Sample implants and breast forms placed in I want Raleigh boobies non-padded bra, evaluated both without a shirt on and while wearing a form-fitting shirt, are a very useful means of helping patients to determine what implant volume is most appealing to them.

Once the implant pockets have been created, sterile sizers can be placed in the implant pockets and the upper half of the O. These sizers are available not only for each implant size but also for each implant profile low, low plus, moderate, moderate plus, high, extra high. Pre-filled gel sizers are used for silicone gel implant augmentations, while Inflatable sizers are used for saline implant augmentation. Preoperative measurements that are made by your plastic surgeon such as breast base diameter, upper pole tissue thickness and lower pole skin stretch are of critical importance.

For every patient there is a fairly specific range of implant volumes that will create a breast profile that would be considered natural-appearing. And for each patient there is an implant volume and profile at which the upper pole of the breast begins to appear unnatural. If your goal is a natural-appearing breast enhancement, make sure that the surgeon you select clearly understands your aesthetic ideal, and that you feel confident that they are committed to and capable of providing you with that kind of result. There is, of course, a range of implant volumes and profiles for each patient that could potentially produce a plausibly natural-appearing result.

Many patients do ask that the largest implant volume be selected that does not produce an unnatural fullness in the upper pole. By using sample implants and breast forms in consultation, and in some cases by using breast implant sizers during the surgery to confirm exactly what breast implant profile and volume produces the best breast appearance, patients can be provided with the closest possible approximation of their preoperative goals, and can be assured of a natural-appearing result. Three incisional approaches to breast augmentation have been widely used: inframammary fold the crease at the bottom of the breasttrans-axillary underarm area and periareolar along the inferior border of the areolas.

Many board-certified plastic surgeons — myself included — have abandoned the periareolar incision, as we now know that it is associated with a higher risk of capsular contracture and scar contracture compared to the other two approaches.

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BREAST AUGMENTATION