Breast Augmentation and Liposuction Blog - Dr. Bottger

A number of newer trends emerged at the recent American Society of Plastic Surgeons meeting in Seattle.

In regard to facial rejuvenation more emphasis is being placed on volume and restoration in the form of fat grafting. By using very small cannula's, fat removed by liposuction, typically from the abdomen, is injected into the face. Such volume restoration to the upper and lower eyelids may circumvent the need for more aggressive class blepharoplasty procedures which actually remove fat and may produce a more gaunt or skeletalized appearance. Grafting of the cheek regions may also be added to various face lifting techniques to recreate the volume associated with a youthful face.

A number of panels and discussions focused on newer techniques for fat removal. Smart and slim liposuction utilizes a laser attached cannula's which vaporize fat cells. The resultant liquefied fat is subsequently removed by standard aspiration.

Bodylite is a new device which utilizes radio waves to break up and destroy or "melt" fat cells. This device has not yet been approved by the FDA for use in the United States.

Supposed advantages of these newer techniques include reduced bruising and swelling and potentially increased skin tightening. Thus far, however, no definitive evidence was shown showing that the newer liposuction methods produce any better results than can be obtained with standard tumescent technique.

A new innovation has recently been introduced for the placement of silicone gel implants in breast augmentation. The device is remarkably simple, resembling the funnels used by pastry chefs to decorate cakes. The breast implant is placed into the funnel, the funnel tip is inserted into the incision, and the implant is virtually "squeezed" into the dissected pocket, almost like a liquid. The device provides a number of advantages. The first is less trauma to the breast implant. Normally placement of a gel implant requires a fair amount of aggressive manipulation, which has the potential of damaging or weakening the implant shell. This trauma could theoretically lead to a greater chance for ultimate implant rupture.

Also, the Keller funnel allows placement of the implant without the device touching the skin or operative field. This is significant in that contamination of the implant shell with bacteria is felt to be a major cause of capsular contracture, leading to firm or hard beasts. The final advantage of the device is the ability to utilize smaller incisions and therefore, have shorter final scars. This, also, allows for more incisional placement options.

I have found this device to be of great value in my silicone gel breast augmentation patients.

According to one study, 34% of women who chose breast implant reoperation sought a larger implant. Clearly, the expense, exposure to surgery and recovery time involved make choosing the right breast implant size the first time an important matter.

Dr. Bottger's expertise in helping each woman achieve her preferred look covers choosing the size, shape and placement of the implants. While the trend is toward smaller, more proportional implants, he will determine the best technique to obtain whatever contour you prefer, the first time.

Before having breast implant surgery, it's best to be at an optimal weight. Losing weight after breast implant surgery can affect the tautness and shape of your breasts. It's best to lose excess weight first.

If you are considering any other body enhancements such as a tummy tuck, or future pregnancies and breastfeeding, it's very important to discuss this with Dr. Bottger. Breastfeeding is an especially important consideration. Although most women have no problems breastfeeding after having breast implants, you will want to know how your implants might affect your breastfeeding plans.

Please contact cosmetic surgeon, David Bottger, M.D. at one of his Pennsylvania plastic surgery offices in Philadelphia, Newtown Square, Bryn Mawr, or West Chester when you are ready for your breast implant size consultation.

Online customer reviews are a popular resource for people looking for a cosmetic surgeon. Some websites are solely dedicated to online opinions, while others have specific areas where you can post your opinion.

We highly value your opinions! Below are a list of websites that make it easy for you to share honest feedback about your experience with Dr. David A. Bottger. Please take a minute to share your opinion and post a review of your experience with our office at these review sites:

• Google - Google uses a rating system that allows you to assign up to five stars for excellent service and write a quick review to share your experience. Visit our profile and share your opinion.
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We hope you had a positive experience with Dr. David A. Bottger. Thank you for taking the time to share your experience.

For breast augmentation, the U.S. Food and Drug Administration (FDA) approves saline-filled breast implants for women age 18 and older and silicone-filled implants for women age 22 and older. These are age recommendations, not legal restrictions, and teens under age 18 are actually able to get breast augmentation as long as they have parental consent.

There are many reasons why it may be inappropriate for teens to undergo breast augmentation surgery:

• Women's breasts can continue to develop into the 20s, so the breasts they have at age 16 may look completely different at 23.
• Teenagers may not be mature enough to fully understand the potential risks and complications that can arise as a result of breast implants.
• On average, breast implants have a lifespan of 10 years, so getting implants at a young age can possibly require many additional surgeries over the patient's lifetime.
• Breast implants can impede milk production after pregnancy, so women who plan to become pregnant in the future may have difficulties breastfeeding.
• Body image is a hot topic with teenage girls, and some may feel that breast implants will help to make them more popular. This is not a healthy reason to get implants.

According to a February 2009 article, "the Italian Health Ministry is considering banning teenagers from undergoing breast augmentation surgery, citing the health risks" or medical complications that can occur when a woman is not fully mature. For now, there are no age bans in the United States.

The debate over what age is the appropriate age for breast augmentation will continue as long as there is no definitive legal restriction. If you are considering breast implants for your teenager and would like to discuss the decision with Dr. David Bottger, please contact us today for a free breast implant age analysis consultation. We serve patients in Delaware and in and around the Philadelphia, Pennsylvania area.

There is no definitive right or wrong answer when it comes to breast implant placement on the chest. Depending on the patient’s physical characteristics, activity level and the type of implant being used, the patient and surgeon should work together to determine the best placement of the implants to achieve the desired results.

Implant Placement Options

There are several choices when it comes to implant placement:

• Subglandular plane, located under the breast tissue
• Submuscular plane, located under the pectoralis muscle or chest wall
• Dual plane, located under both the breast tissue and pectoralis muscle

Subglandular Plane

This location allows for a very natural appearance and movement, and cleavage can be easily created. However, capsular contracture is often more common in this location and mammography results can be difficult to accurately interpret.

Submuscular Plane

This is the preferred location for saline implants because it is less likely to:

• Show rippling
• Interfere with mammograms
• Cause capsular contracture

Dual Plane

Dual plane placement creates very aesthetically pleasing, natural-looking breasts that have a natural slope to the top of the breasts.

What works well for one patient may not be the right answer for another. Breast implant placement is a very personal decision that should be discussed in depth with your cosmetic surgeon.

If you would like a free breast implant consultation with a reputable cosmetic surgeon to discuss these and other breast implant options, please contact cosmetic surgeon Dr. David Bottger today.

Most women who have breast augmentation surgery from a reputable, experienced cosmetic surgeon like Dr. Bottger are very happy with the results. However, even the most satisfied patients may require implant removal or replacement at some point during the lifetime of the implants, which is on average 10 years.

There are certain circumstances in which implant removal or replacement is essential:

• Implant rupture: Saline implant ruptures are usually very obvious, as the solution will be easily and safely absorbed into the body causing the implant to deflate. Silicone ruptures are not always as evident, which is why occasional testing is recommended to ensure that the foreign substance is not entering the body.
• Capsular contracture: This complication can occur when the tissue lining that forms around the implant begins to shrink and subsequently squeezes the implant. The implant can become hard and painful for the patient as well as visibly distorted.
• Implant rippling: Often occurring in women who have thin, soft breast tissue, implant folds, creases and wrinkles can sometimes be visually apparent. These distortions can be very distressing for the patient.

Other problems that can warrant removal or replacement include:

• Asymmetry
• Infection
• Bleeding
• Poor wound healing
• Breast sagging or drooping

Some women simply wish to return to their “normal” size and request that their implants be removed.

If you are unhappy with your breast implants and are considering removal or replacement, please contact Pennsylvania cosmetic surgeon Dr. David Bottger today for a free consultation to discuss your situation and the options available.