Breast Procedures FAQ Morristown New Jersey
Q: Free TRAM Flap Vs. Pedicled TRAM Flap Breast reconstruction.
Breast procedures FAQ Morristown New Jersey. What is the difference between the free TRAM flap surgery and the pedicled TRAM flap surgery for breast reconstruction?A: As a plastic surgeon who has performed hundreds and hundreds of pedicle TRAM flap procedures since it’s inception, I must say that it is a very safe procedure. This operation has a lower risk of complication and can be performed in any community hospital. The most critical part of the abdominal wall (the lower part) is affected the same way in both free and pedicle procedures. In unilateral procedures the weakness of the abdominal wall has been minimal. Even in bilateral cases, with proper abdominal wall reconstruction and post operative physical therapy the patients can do sit-ups. The advantages are less operating time. Less chances of total flap loss , no need for microsurgery and when done properly a very low risk of complication.
Q: Nervous About Breast Reconstruction with Mastectomy Is it ok to do immediate breast reconstruction after mastectomy?.
My oncologist has recommended I have a mastectomy – I was diagnosed with breast cancer – and I’m going to have the surgery. He told me I could have reconstructive surgery on the breast at the same time–but I’m nervous about that. It just seems that the breast should be given time to heal and make sure that everything is ok first–but my doctor doesn’t seem to think that’s an issue. Is it ok to have reconstruction at the same time as mastectomy–or are there advantages to waiting?
A: As the breast reconstruction has become more and more successful the immediate reconstruction has become very popular. Today the majority of patients have immediate reconstruction at the time of their mastectomy. The benefits certainly out-weigh the slight increased risk.
Q: What’s Your Position on AlloDerm? Is alloderm useful to prevent capsular contraction?
I have severe scaring from breast implant and need to have another procedure to remove scar and re insert implant. Doctor suggest to put in AlloDerm to minimize future scaring. I am very conservative and not really convinced that I want it. It’s a foreign object that could have unnecessary complications, how small the chance it might be. It’s not like I had a mastectomy. Would you say there’s a good arguement for and against the AlloDerm in breast implants? Thank you for your time.
A: I have a lot of experience with Alloderm as well as Flex HD and Allomax. These products have in my opinion, revolutionized the implant based breast reconstruction. I believe they do lessen capsular contraction. ADMs have also been used in revision of breast augmentation complications, like rippling, capsular contraction and implant displacements. The problem in using them in cosmetic patients is the high cost which often is not reimbursed by insurance.
Q: Alloderm for Breast Reconstruction?
This is being tauted widely as the best breast reconstruction procedure out there for women to get through this terrifying and tramatic experience. Unfortunately, many doctors do NOT know how to do this procedure yet, hence it is not widely available leaving patients to not be able to have it as an option insurance-wise. I have never heard anyone say anything about Alloderm not being sterile and not wanting to put it near an implant. Can you please elaborate?
A: Alloderm is one of the allografts available. These are called acellular dermal matrix or ADM.
Alloderm, is a product made by life cell corporation. It is the first to popularize the product for breast reconstruction. This product is a cadaveric skin that has been treated to not cause rejection. The dermal collagen matrix is repopulated by the host’s cells and integrated in the body. Alloderm was not truly sterile as it had been treated with antibiotics to be aseptic. Now we uae a sterile Alloderm. There are other products on the market now. Some of them are sterile. These products have revolutionized the implant breast reconstruction. And have made the surgery much more successful. Any surgeon doing breast reconstruction routinely should offer these products and at least discuss the pros and cons with the patients.
Q: Breast Augmentation Before and After Pictures, what to look for?
I’m in the process of deciding whether or not to have breast implants, and I’m looking at all of these – can I have some expert tips on what to look for in the before and after pictures?
See the breast augmentation pictures on our site in the before and after photos gallery
A: As you go to different web sites you see all kinds of before and after pictures. It is important to find a web site where the pictures are shown in the three standard views on all patients. It is also important that you see different types on breasts to see how the results can vary, because each one requires a different approach. It is easy to get a good result in an ideal candidate for breast augmentation, but it is a lot harder to get a good result in a patient who is not an ideal candidate. If you see hundreds of augmentation pictures where the before pictures are all similar, don’t be positively impressed.
Q: 750cc – I want to have the largest breasts.
I would like to be a extremely large size. I was hoping with 750cc breast implant I could have that with smooth round moderate PLUS profile saline……….. 750cc moderate plus profile saline overfilled to 1100cc I want larger fuller close together breast. Is this a good choice?
A: If your breast is larger to begin with you can get a larger implant. In general the larger the implant gets, the more unstable it becomes in the long term. Therefore a reputable and knowledgeable plastic surgeon would try to protect you from your own desires, if he or she thinks that a procedure is harmful to you. I look at the patients chest wall dimensions, the breast base diameter, the skin quality, the soft tissue characteristics to decide how large I can make a breast. I respect the patient’s desire but I also want the results to be long lasting and avoid re-operations and complications.
Q: Most Cost Effective Breast Lift and Augmentation Procedure?
I need a Breast lift and augmentation, I have an over-sized areolas (more than 2 inches in diameter). My nipples are very small, nearly inverted. I have no cleavage as my breasts are far apart. LOL! Can I just start over?
I definitely want Breast Implants. Any suggestions on what I should do that would be cost effective? I want to cry. I’m so miserable.
A: The most cost effective augmentation lift procedure.
I must say the most cost effective way is do it once and get good results. These are not the easiest operations and I see many patients in my office who had the procedure done elsewhere and who are dissatisfied and now they have to spend the same money or more to redo everything. Find a plastic surgeon with a lot of experience in breast reshaping who can get you the best result in one operation. Even if it costs more initially it will be cheaper in the long run. I have about 28 years of experience doing all kinds of breast surgery in my practice. For some of these augmentation mastopexy operations that kind of experience is needed.
Q: Will Losing Weight After Breast Lift Affect the Results?
A: Does loosing weight cause recurrence of breast ptosis?
Significant weight loss call cause breast ptosis. That is why massive weight loss patients often need a breast lift and breast reduction by liposuction, the so called scar less reduction, does not correct the droopiness.
Q: Lollipop Vs Benelli Lift for Sagging Breasts?
I have been advised that I have substantial breast sagging, (26 cm). Out of the three doctors I saw, only recommended a Lollipop lift whereas one surgeon told me I can have 5.5 cm lift with the Benelli Lift and no puckering or implant.
Is this realistic? I don’t want the vertical scar but don’t want a dodgy job. Is puckering permanent and is it better than a vertical scar?
A: Benelli ( Circumareolar lift) vs vertical.
If you have too much ptosis. The periareolar lift will flatten your breasts and give you a pancake look. You are better off with vertical lift. Remember, unfortunately there is always a direct relationship between the better shape of the breast and the amount of scars. There are three type of breast scar patterns, the periareolar or Benelli, the lollipup or vertical and the standard anchor shape or the inverted T. The decision on what to use is based on the severity of breast droop.
Q: How Long Does a Breast Lift Last?
I have been wanting to get a breast lift (mastopexy) for a long time, but I am worried that I’ll spend thousands and end up with the same saggy breasts. Am I right to be concerned?
A: How long does the breast lift last?
There is no question that the recurrence of breast ptosis happens but it is usually a bottoming out phenomenon and the position of the nipple is maintained. In general if a breast is larger the recurrence happens earlier. If your breasts are small the lift is stable. An implant will help the longevity of the breast lift procedure.
Q: Does a Breast Lift Always Result in Dramatically Smaller Breasts?
I went in for an uplift on my size 36 g breast and have come out a 36 D, I am traumatized by the whole operation and very upset at being so small.
I knew he would have to reduce them but not by 3 cup sizes, is this normal? do they have to always make your breast much smaller to achieve this?
A: Do the breasts get smaller after a loft?
The breast lift should not significantly make the breasts smaller. In fact a lift could make the breast look bigger. There often remains a hollowness on the upper pole of the breasts which is very difficult to restore with a lift alone. That is why an implant is often needed to get the optimal result. You have to make sure that you did not get a breast reduction instead of a lift.
Q: Benelli Lift + Implants Instead of Lollipop Lift for Large Breasts?
I would very much appreciate your help. I lost 77 lbs. several years. All of my skin snapped back just fine except my breasts. Most people who see me in a swimsuit can’t believe I ever lost weight. I want to get a lift, implants, and an asymmetry correction. I want to avoid the vertical scar. Is there any way I can get away with it? I would even be willing to have one Benelli-type lift + implants and then go back for another. What do you think?
A: Benelli (periareolar lift) vs vertical lollipup lift.
Generally speaking I reserve the periareolar lift for mild case of breast ptosis. This operation reduces the breast skin around the areola and causes some flatness (lack of projection) I have pre. Op and post op photos of both procedures on my web site. A vertical lift is a more powerful procedure and provides you with a better nipple projection. So remember the results are not equal. You have to see a plastic surgeon with many years of experience in breast surgery.
Q: Breast Implant Removal Outcome?
I recently had breast implants put in from my size A and went to a C. It has almost been one year and I am looking to remove them because I am not satisfied and would like to go back to my previous looks. What would the outcome most likely be?
A: The outcome of breast implant removal
It really depends on the proportion between you breast tissue and implant volume. If there is more breast tissue than implant and the implant is not very large you should have a good result after implant removal. If the implant is very big in proportion to the original breast size, a mastopexy might be necessary. You can also replace with another implant.
Q: How Do I Find a Trustworthy Doctor for Breast Explantation?
I need to get an explantation, but don’t have any idea how to find a surgeon. How do I find a trustworthy doctor to do the procedure? My GP couldn’t help me with this question. I live in Florida.
A: How to find a plastic surgeon in my home town
Go to the web site of the American Society for Aesthetic Plastic Surgery (Surgery.org) Put you zip code. You will find a list of plastic surgeons in your area. These are all certified by the American Board of Plastic Surgery and have experience in all cosmetic procedures.
Q: What Happens to the Pocket After Breast Implant Removal?
If the capsule is not taken out? Can you feel it? What happens to the pocket when breast implants are removed?
A: What happens to the breast implant pocket after removal
If the silicone implant is intact it is not necessary to remove the pocket unless it is calcified. If there was a silicone implant that was ruptured and the capsule is contaminated with free silicone the capsule will need to be removed. When I leave the capsule in I usually rub it with a dry gauze to induce adhesion to collapse the pocket. I have never seen a problem but a small fluid collection could theoretically happen, which is not a problem.
Q: Aesthetic Result After Breast Implant Removal?
I had a silent breast implant rupture (no encapsulation). My breasts are both soft. The implants are 10 years old, mushy, and soft, and I have at least a B cup of my own tissue (sub-dermal implants). They are not droopy. Will I be deformed after having my breast implants removed? I’m very scared, my aesthetic result is important to me. What will I look like after explantation? What should I expect? Will I need a breast lift? Will all my own tissue be removed, leaving me with concave “puppy dog ears”?
A: Results after breast implant removal.
It really depends on the proportion between you breast tissue and implant volume. If there is more breast tissue than implant and the implant is not very large you should have a good result after implant removal. If the implant is very big in proportion to the original breast size, a mastopexy might be necessary. You can also replace it with another implant.
Q: Should I Get Breast Implants if I Plan on Getting Pregnant Later?
Is it recommended to have breast implants before having a child? How will the breast look after breast feeding? Ijust want my breast perky but very natural. I feel I have a lot of extra skin on my breasts. I want to see what the doctor recomends for size.
A: should one get breast implant before pregnancy?
I don’t think it matters. If your breasts are small they get bigger with augmentation and after pregnancy they get even bigger but return to pre-pregnancy size after you finish breast feeding. If your breasts are already big then they may get too big during pregnancy and that might be a problem for you. In that case you should wait till after the pregnancy to get the augmentation.
Q: Waited for Breast Implants Until I Was Done Breastfeeding?
I had silicone implants under the muscle in 1989. They were great… Got them after one child. Now, 18 years later and breastfeeding 3 more…. I now need a breast lift. I am not sure I want the scars, but I may only have about 1 inch of skin visible under my nipple.
A: Do breast implants cause the breasts to droop after pregnancy and breast feeding.
Pregnancy and breast feeding can cause breasts to sag (ptosis). The presence of an implant does not make a difference. The way you describe your condition lets me guess that your implants might be too high and lowering of the implants might be enough to improve your appearance. In minor cases of breast ptosis, a periareolar mastopexy (donut mastopexy) could be enough to improve the appearance without too much scaring.
Q: Under wire Bra and Breast Implants, Safe?
I have had saline implants for nearly 1yr. Is it ok to wear under wire bras at this point? Just recently I am finding it painful. Obviously, if it hurts I’m going to stop wearing the under wire . But I was wondering if I shouldn’t be wearing them at all. Thanks for your help.
A:Is it ok to wear under wire bras after breast augmentation.
The only time I don’t recommend an under wire bra is in the first six weeks after surgery. After that initial healing time I let the patients wear under wire if they so desire, provided the bra is properly fitted so that it matches the shape of the augmented breast. For example an old under wire bra may not be appropriate after augmentation.
Q: Safe to Get Breast Implants with SVT?
I have always wanted to get breast implants and now that I’m done having kids. I would like to get them soon. The only thing holding me back is I have SVT and am on a beta-blocker is it safe for me to be put to sleep and to go under the knife. I am 30, I also have Celiac.
A: Breast augmentation in patients with medical conditions such as svt.
Breast augmentation is an elective procedure. One has to be extremely careful that no serious complication happens during surgery. If you have a condition such as svt ( supra ventricular tachicardia) a cardiology clearance has to be obtained prior to surgery. The surgeon needs to discuss the condition with the cardiologist and the anesthesiologist to make sure that if this becomes a problem during surgery appropriate treatment is immediately available.
Q: Infection after breast augmentation surgery
I had breast implants done on October 4th. I had a suture from inside try to come through and the nurse pulled it out and trimmed it. Ever since then, I’ve had an infection. Have been on two types of antibiotics and they go away and then come back. Today I have one pretty bad spot that’s sort of bleeding, not much infection pus or anything (I know it sounds sickening) but I’m freaking. I’ve been cleaning the area with Hibiclens and putting antibiotic ointment on it and keeping it covered with gauze. Any other suggestions? Heat perhaps? There’s no pain and the area’s not warm to touch, it’s just yucky.
A: Infection after breast augmentation.
Infection is very rare after breast augmentation. I usually use a technique where there is minimal handling of the implants and minimal contact with the patient’s skin. We also use prophylactic antibiotics. In my hands the infection has been extremely rare. Having said that the infection can occur with any surgery and when it happens one needs to remove the implant let everything heal and reinsert the implant months later.
You have to be careful to differentiate between a reel infection which involves the implant and a superficial infection due to rejected suture material. These superficial infections can be treated by removing the sutures, antibiotics by mouth ( not ointments) and warm soaks.
Q: Breast Implant Scars
I want larger breasts but I’m afraid that the scars will be obvious when I wear a swimsuit. Where and how big would the scars be if I got breast implants?
A: Scars after breast implant surgery?
There is always a scar after breast implant surgery but the scars can be minimal or well hidden depending on the type of implant and where the incision is made. In general the saline implants can be inserted through a smaller incision because the implant can be placed empty and rolled on itself through a very small incision. To place a gel implant one needs to make a larger incision in general twice the size of an incision for a saline implant.
As far as the location is concerned the most common location is the infra mammary. This incision gives the most direct access to the sub muscular or sub glandular space and is well hidden by the breast itself. Sometime an incision is placed under the areola. This location is preferred by some surgeon because the scar is between the skin and the areola which can provide a camouflage effect to the incision. There is also the axillary incision (the arm pit) which is preferred by some. This incision avoids a scar on the breast itself but the implant placement is more difficult and therefore more unpredictable . Same thing is true for umbilical incision.