breast surgery guide

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Breast Implants Guide By: Dr. Albert McGrath (Especially for Boostyourbust.com)

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Page 1: Breast Surgery Guide

Breast Implants Guide

By:

Dr. Albert McGrath (Especially for Boostyourbust.com)

Page 2: Breast Surgery Guide

Contents

1. Introduction

2. Breast Enlargement Surgery is Able to Change Your Look!

3. Learn about the History of Breast Enlargement

4. Breast Augmentation Surgery Tips

5. What Type of Breast Implants to Choose?

6. Learn How to Choose Your Breast Implant Size

7. Anatomy of Breast Implants

8. Saline Breast Implants against Silicone Implants

9. “Gummy Bear” Breast Implants

10. Auxiliary and Alternative Techniques in Enlargement of the Breast

11. What Should a Woman Expect from Before and After the Operation of

Breast Augmentation?

12. Risks and Side Effects of Breast Implants

13. What are the Complications of Breast Augmentation?

14. How Much Are You Going to Pay for Breast Augmentation?

15. Beware of a Cheaper Breast Enlargement Surgery!

16. Which Plastic Surgeon to Choose?

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Disclaimer: The information in this guide is for informative purposes only. Before acting on any information, make sure you consult your physician in real life (not over the internet or email) and take his or her advice. Introduction If at this moment you are reading our guideline about breast augmentation surgery you are on the right way! Have you decided to undergo the enlargement of the breast and change your appearance? You do not know what to do at the beginning and how to get detailed information about every step on the way to reach your dream? Our guide will help you in all aspects. You will be able to get all the recommendations and necessary knowledge about all the procedures of breast augmentation. The first part of our guideline contains the information about the facts that breast enlargement surgery is able to change your look. Moreover, the second part tells you about the history of breast enlargement. Then it will be interesting to learn about breast augmentation surgery tips. In the fourth part you will know about various types of breast implants and decide on your implants. Afterwards, you will be explained how you should choose you breast implant size and learn about anatomy of the implants. You will be able to discover for you three types of breast implants: saline, silicone and “Gummy Bear” implants. You are proposed auxiliary and alternative techniques in enlargement of the breast. One more part will give you the information about expectations of women before and after the operation of breast augmentation. You will have a great possibility to learn about risks and side effects of breast implants, main complications and all the costs. In two final parts we give you useful information on how to beware of a cheaper breast enlargement surgery and which plastic surgeon to choose for your own operation. After reading our guideline you will know all the secrets of the operation!

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Breast Enlargement Surgery is Able to Change Your Look! It is impossible to know the exact number of people who would like to change their look because nowadays there is just a great number of people who are interested in changing the appearance of their bodies. Giving such a wonderful chance many people will have a great possibility to explore the opportunity of expected changes. When the opportunity is provided the best decision is to catch it. Does it come to your mind that there is someone who wouldn’t like to look good or even perfect? Of course not, because we are living with hope for the better and, therefore, almost all of us are usually worried about our appearance and their good look so that to have changes in life and be self-satisfied. These days we live in time when everyone can undergo a cosmetic operation and change the way he or she looks at present moment. There are certain reasons why people are ready to go through this procedure. No doubt, it is painful but it is possible to overcome pain in order to have perfect results at the end. There are different parts of the body people can be dissatisfied with. Some people are utterly interested in their facial features; others are concerned about their bodies. According to many polls a great part of women is worried about the size and shape of their breasts. In most cases these people were women with a small size of breasts who would like to add more sexuality to their appearance. Some women can’t live with a feeling that their breasts are smaller than others. In fact not every woman who had quite a large size of breasts when interrogated said that her breasts were small. Everything is relative as we can see. Everybody has an individual point of view towards his or her appearance and breasts in our case. It is a crucial thing to look for and read about breast enlargement surgery before somebody is going to opt for breast augmentation. A person should be aware of the process itself, the steps before and after the operation and possible pros and cons. You will be able to find the information with the help of our guideline on breast enlargements and learn about all the particularities of this procedure. There will be no problems with a research of the guideline. You should just type the name of it and you will be given a hint about its location. Learn about the History of Breast Enlargement For a long time women were looking for a solution of how to enlarge the size of breast. Some generations ago there were only few simple methods of how to make breast fuller and larger. The most popular method to do that was to pad the chest area with different materials in order to push the breasts up. Between 1800s and 1900s other ways tried to appear so that to make the breast larger instead of just make it bigger. At the end of 1800s there was an injected form of breast augmentation that was called paraffin. All women thought that this form was able to make the chest area bigger and many women used it for a long time during this era. The form worked only temporarily and after some time of usage caused plenty of infections and uneven lumps. The arising infections were connected with microbes transfer. Moreover, at that time there were no widespread knowledge about bacteria and it was difficult to prevent and cure infections. However the organism rejected foreign materials. Starting from 1920s these breast augmentation forms were not used any more. Then fat transfer gained its popularity and was used for

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enlargements. This old procedure resembled the same procedure that is held nowadays. Fat was extracted from adipose areas and directly injected into breasts. Fat gave a temporary difference in size. Then it was discovered that with time the body reabsorbed most of the fat that was implanted into breasts and the size became almost the same as at the beginning. Because of this and the high risk of getting an infection the number of potential patients for the operation greatly reduced. Later there was a sponge that appeared and was also inserted into the breasts so that to give a size. The problem with this material was the following: it dried up in a year and became hard and caused discomfort, pain and had an awkward appearance. Some time later it was discovered that sponges could cause breast cancer and finally they lost popularity. This event is known to the history as a moment of the silicone appearance. And, therefore, a new form of implants was created – silicone. In 1960s doctors used silicon as an implant for breast enlargements. This material didn’t turn out to be effective as a direct injection led to the appearance of lumps. The first silicone implant was made in 1961 and began to gain its popularity. Silicone turned the history of the procedure upside down, it was a great sensation as the shape and the feel were natural and there were fewer complications. Women were really happy to finally find an essential and efficacious solution that worked well and caused few problems. A new form was used for about 20 years and then it was withdrawn in favor of a saline-filled form. It was even foreseen that in case of a rupture saline-filled implants will do less damage in comparison with silicone implants. In 1980s it was banned to use silicone gel as there were safety issues. Anyway they came back these days and gained widespread use in various sizes and shapes in order to be tailored to any body’s needs. Moreover, there were some options that could be used only due to rigorous testing and superior medical knowledge. On the whole the history of breast enlargement is very long and should be learned in details so that to understand it. This history is filled with errors, trials and success. It was full of everything, all possible ups and downs. The long history helped us to gain confidence and these days we are able to go in to the procedure with trust in perfect results. Breast Augmentation Surgery Tips Many effective researches were carried out in the medical field in order to conduct breast augmentation surgery with safe and risk free consequences for many years after operations. This sphere is not a new one and people of all the latest centuries went through a lot of heavy and painful experiences before they were able to have the access to the most common and simple ways of doing these operations and do not come across many serious side effects. Nowadays there are known many different procedures for enlargement of the breasts or, in other words, breast augmentation and reconstruction or correction of the breast size. Everything depends on what a person requires and what are the main reasons for the necessity of the operation that are in many cases hidden from doctors. Moreover, there is a good thing that patients use. Some insurance companies pay all the costs of certain treatments. Such an opportunity also raises the interest of women in breast augmentation.

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Further it is necessary to mention the main causes for enlargement of the breasts. There are some causes that require certain types of treatments. First of all, this variant is possible when it is a question of beauty and health. No doubt, every woman wants to have a beautiful appearance. It is very difficult to find a perfect beauty as all women have different bodies of different shapes and sizes. More and more people, especially women, opt for surgical operations in order to change their appearance. It became almost impossible to change ourselves owing to some other methods. These days surgery is gaining popularity very fast. The breast may change the size after pregnancy and breast feeling of a baby. There are many women who go to surgeons and ask to have a breast reduction. This common procedure is called breast lifting. The breast can take only certain weight and when it exceeds they succumb to gravity automatically and in this case a surgeon is the right person who will be able to help. Every person is not symmetrical and, for example, one eye is smaller than the other one, but sometimes the difference is evident and sometimes it is not obvious. The same thing happens with the breast. There are many women who complain that they their one breast is smaller than the other one. Anyway there are situations when it is a matter of a surgical intervention so that to correct the difference. There are no problems with that. When you decided to change the breast the first step you should do is to consult the doctor about the whole procedure and ask his or her advice about what according to his or her opinion will be appropriate to do. Moreover, the doctor should inform you about all the possible risks that are involved into the consequences. Then you will have to be sure that you get the exact treatment and understand reasons and meanings of it. Basically breast augmentation surgery was invented with the aim either to put implants in the front size of the breast muscles or in the back side. Apparently the enlargement of the breasts will change the general look of the breast but it is incorrect to think that this implant changed your appearance completely and you became more beautiful. Some women feel that breast surgery will help them to have self confidence and they opt for an operation without any useful reasons. It is very important to understand all the results, side effects that a person may face after the operation. A person should follow many precautions and keep in mind every detail a doctor is going to tell. The process is serious and it doesn’t accept any mistakes neither from the side of a doctor nor from the patient. If you decided to have breast augmentation so be sure that you have the whole experience from the very beginning till the last step when the perfect state of the breast is achieved. Pain and swelling are a common discomfort that all patients come across when undergoing surgery. A woman may feel that hardening of the implant can cause discomfort and pain, therefore, the only way to solve this problem is to remove it all together. Most problems occur with silicone implants is its leakage. You should also study other possible side effects in order to be better informed of the consequences. On the whole the first and the most crucial advice is to get a well known and professional person to do a surgery for you. With such a person you may have at least a peace of mind. What Type of Breast Implants to Choose? Several centuries ago there was no choice of implants for the breast augmentation. But time passed and new technologies appeared and today the time does what people want. These days breast implants manufacturers offer different shapes, styles and sizes and, therefore, there is a large choice. For starters doctors can suggest good old fashioned round implants that are still

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popular. The design is old but the shape didn’t change in spite of the fact that types of silicone used to make a shell for a breast implant also changed nowadays. The main advantage of round implants is their round form. There is a tendency that an implant rotates in its pocket. But it doesn’t concern round implants. You should make a choice of round implants if you do not want to deal with the event of the implant’s rotation in its pocket. Round implants are considered to be a standard type, but anatomical implants are another type of implants existing these days. Anatomical implants have a special design so that their shape is able to mimic the shape of a natural breast of a person. There is a common myth that round implants are worse than anatomical ones. It is not true. Success of the operation depends, first of all, on a surgeon who should position the round implant in a good way and it will look as natural as an anatomical implant could be. The bottom of anatomical implants is heavy and therefore it will not look pretty if to shift or rotate it in its pocket. There is nothing that could prevent an implant from rotation. Anyway anatomical implants contain textured shell that is not able to stop the process of shifting. Every implant is created with a smooth or textured surface. The main aim of it is to help the implant to be prevented from rotation or shifting in its pocket when the pocket becomes larger or was too large at the very beginning. There is no evident difference between a textured and smooth surface, but if you decided to settle on an anatomical type of implant then you will feel safer after choosing a textured shell surface for your implant. It is mistakenly to say that one type of implant is better than another one. You should remember that results of that operation depend on the skill of a surgeon who is going to perform the enlargement of the breasts. Be sure that you choose a qualified and experienced surgeon for your operation and then you will be assured that the outcome of the procedure will be as expected as it should be usually. When a woman made up her mind to go through the surgery the first decision to make is concerned with the feel and look of implants. Moreover the method of implantation also plays an important role in all the procedure. It can affect the mammograms accuracy, probability of the rupture, hardening, breakage and a possibility of breastfeed. Women who are thinking about passing the breast augmentation operation should pay special attention to the above mentioned considerations. These considerations should be discussed with an experienced plastic surgeon in all the details before any decision is made. Today there is a choice of methods used for the enlargement of the breasts. Firstly, it is pertinent to think about a method of the implant entry. Many years ago when the surgery first became popular there was a method of a small incision between the rib cage and the rest of the breast tissue. This method was the most popular within patients. The incision was performed very carefully so as no seams should be seen. Everything should have been imperceptible as if no operation was made. Recently the method of belly button or navel incisions and the method of the entry through the areola, in other words, a dark skin that surrounds the nipple, became very widespread. These two methods are almost at the same level of popularity. Anyway trans-umbilical implants remain at the top position. The main disadvantage of the second method, the entry through the areola, has one important disadvantage. After the entry of underarm implant there is a visible scar. There is one thing that is still debatable. The entry of an implant through the navel may cause migration of the implant that can happen often. Some women who passed through the areolar implant incisions complain that they lost sensitivity in nipples and feel stupor.

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There is one more crucial decision a woman should make. She should decide on the placement of her implant in the breast. She can choose a placement over the muscle and behind the muscle. When we speak about muscle we mention that of the cavity of chest. The placement over the muscle costs less as it takes less time and is less invasive. But as a rule this method has not very good consequences with time as it may cause rupture of implants. The rupture happens because the implant is less protected being over the muscle and there is no protective encasement. One more disadvantage of the over muscle implants is that women can have difficulties with feeding their babies. Moreover, it is complicated to take the necessary tissue for certain analysis as the tissue is obscured by the breast implant and it is tougher to decipher mammograms. Many women choose a behind muscle implant as over the muscle implants look more artificial and this is a big reason for switching to behind muscle implants at once. There is one more thing women should think about when they turn to surgeons for the operation. They must be aware of several risks that have a tendency to be apparent over the next several years after the performed operation. Learn How to Choose Your Breast Implant Size It may appear easy to choose a breast implant size from 34A to 34D but in reality it is not so easy. Shapes, sizes and profiles of silicone and saline implants are so different these days. This situation may be compared to that of each human body. It is true, the variety is impressive. As a result it is pertinent to say that there are no sizes as 34A to 34D for implants. In fact, sizes of breast implants are estimated in cubic centimeters, for example, such as 300cc, 400cc and so far. The result of the impact of a chosen size of a breast implant on your body can be forecasted only with the help of a special breast implant sizer. There are known 34A to 34D sizers of implants. The concept of such sizers was worked out a decade ago. At the beginning of the existence of implant sizers their quantity was strictly limited and they could be used only in consultation rooms with a surgeon. You can find few special systems on sale these days that will allow you to use sizers at home and find a necessary size of your breast implant. As a rule these sizers can play a crucial role in your decision making as it is considered to be the only way when you can try different 3D sizes directly on your body. This system is an advanced one as it is much more comfortable than a method when you took before and after photos of your breast. It may seem to be very compelling and interesting to look for your potential breast implants size on the internet with the help of before and after photos. In most cases in this situation the results for your implants will be shown in the same units as your real breast size, from 34A to 34D. Without making your own photos on the internet you are able to make a research and find photos of women with the same body type and of the same age as you that may help you to make your own decisions concerning the impact of a certain implant size of your body, at least it will help you to make some intermediate conclusions visually. There is a problem concerning photos, usually there are 2D photos and because of that you can observe some distortion in them. Therefore, it is better to use these photos only as a general guide and options of implant sizes you could choose for you. In most cases distortion can happen because of web browsers and screen sizes.

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If you found some time to purchase implant sizers you should look for those in the range of 300 to 400 so that to reach an augmentation of 34A to 34D. During a usage you will notice that 300, 350 and 400 correspond to a small, a medium and a full C cup. But anyway every person has a unique body and it is not enough to estimate the implant size for you on the basis of sizers. Using different sizers you can achieve completely different results. In this way the best solution is to buy several sizes at the same time and then try them and compare in a period of a few days or even a few weeks, according to your time and desire. Let’s turn to breast implant sizing systems. The first systems attempted to imitate a perfect look of the breast and it was proposed to use a plastic shell filled with water. Nowadays sizers are similar in volume and the size resembles a current breast implant. Women discovered early that these systems are very helpful and quite efficient; using them it is just necessary to stand comfortably at home in front of the mirror. It is easy to see a rippling of the plastic through the clothes. Present-day systems are aimed at a natural look and a comfortable usage. The step from the old into the new system is very important for the history and the industry itself. Let’s return to before and after photos of yourself that you could take and use for your implant size decision making. You can wear different implant sizers and then take photos and find your personal size. This exercise is funny and helpful at the same time. Afterwards, you can bring all you photos to your plastic surgeon and communicate with him in order to choose the results you expect to have. Some surgeons keep these photos in the operating room so that to be able to remember the goal size of a patient and compare with results. There is such a tendency when many women are already very happy with the fact that they passed a breast augmentation operation. In most cases dissatisfaction arises when a woman is not satisfied with the breast implant size. The first main reason for coming back for another operation is just to change the size of inserted implants. If you want 34A to 34D implants you should buy the best existing sizing system and choose a proper size. Check your satisfaction with different sizes of implants before you are going to pass your operation. It is quite difficult to make a right decision considering costs, risks of the surgery and all the possible complications. Therefore, do not hurry up with your decision and think it over many times. Any surgery of such a kind is usually very expensive, either increasing or decreasing of the implant size. Every other operation for a change of implants is not less expensive. Therefore, if a person started these operations there is no any guarantee that he or she will not come again. Every time risks are the same, it is very important to remember about that. All the preparations and the measurement of the present and required sizes should be made with all seriousness and attention. This process is not associated with primitive tests. You should choose the right variant in order to feel yourself comfortable with a new breast size as if it was usually with you. Anatomy of Breast Implants Now let’s examine the main components of breast implants. Every breast implant consists of a shell, filler and patch. The shell represents the outside layer of the implant and is sometimes called a lumen or an envelope. Speaking about the filler it is usually inserted into the shell that was explained above. The patch covers the gap through which the filler is inserted in the shell. As a rule the shell is made of a single lumen or a single layer in other words. But these days there are certain implants that contain a double layer (a double lumen, in other words) and is called a shell within a shell.

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In silicon and saline implants there is an outer layer that is made of silicone-rubber substance. It is important to make a difference that when a person speaks about a silicone breast implant he or she means the filler of it but not the shell. In the USA there are used two types of breast implants. These are: silicone implants filled with gel that has a silicone-rubber shell and implants filled with saline that have a silicone-rubber shell. As we can see silicone shell is used in both silicone and saline implants. In fact, the silicone-rubber shell is made of powered silica (20%), cured long stands of silicone and small quantities of other substances. Saline implants contain sterile salt water. A sterile saline solution is also used in general surgery and for some other internal goals. These days there is a difference between three saline-filled breast implants. The first type contains saline that is filled before a breast operation and nothing could be added during and after the surgery, the second type represents an implant with saline that is filled during a breast surgery and can be added or extracted after the operation. The last type of the implant contains a fixed volume of saline that is filled during the operation and nothing could be added after the surgery. The first appearance of silicone breast implants was observed on the market in 1962, but due to safety issues their sale was banned by the FDA in 1992. Many thorough investigations took place and some time later the FDA decided to re-approve silicone gel-filled implants. This event was held in 2006. Nowadays such implants are accepted for all ages women who are interested in breast reconstruction and for young women of 22 years old and older who need breast augmentation. You may ask why there is a restriction of age. The answer is simple. In 20s a woman’s breast is still developing and this factor should be taken into consideration. Therefore, the FDA decided that women of 22 years old and older are ready to make educated, reasonable and informed decisions. The FDA doesn’t think that their younger counterparts will be able to do the same thing. It is known that the filler of silicone gel-filled breast implants contains the silicone oil, a small amount of uncured silicones, cured silicone and some other substances. Silicone is considered to be a very safe component and was widely utilized in a great number of medical applications for many decades. There are known four types of silicone gel-filled breast implants. The first one is called single lumen. It was filled by manufacturers with a certain volume of special silicone gel. The second type is called double lumen. The inner part was filled by manufacturers and the outer part should be filled during the enlargement of the breast with the help of a valve. The third type also includes a double lumen, but in this case the outer part is filled by manufacturers and the inner one should be filled during the procedure of augmentation. Moreover, this type is good as it allows surgeons to adjust some volume to the filler after the operation. And, finally, the fourth type includes implants that may seem to be without a shell as it feels and looks like a semi-solid rubber gel. If you are looking for another implant than saline and silicone the following information is for you. In general such alternative types of implants contain a silicone rubber shell but the filler is different than silicone or saline. This substance represents another gel than a silicone gel. There are known such breast implants that have no silicone rubber as an outer shell. But the thing is that none of these alternative types is accepted in the USA. It is very important to remember that enlargement of the breast is a temporary service and implants will not be able to serve you a lifetime. Ultimately they can be easily removed and

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replaced with new ones. According to specialized data in 10 years after the operation more than 50% of all previous patients need to replace their old breast implants. The FDA is in charge of all the regulations concerning breast enlargement surgery and also they control durability and safety of present-day breast implants. The best solution to find all answers to your arising questions is to address to your experienced and certified plastic surgeon. Saline Breast Implants against Silicone Implants At the beginning of 1990s lawsuits organized a detailed inspection of silicone implants produced by manufacturers in order to check whether they are safe enough or not. Moreover, it is known that in 1992 the FDA removed silicone breast implants from the market. They left only saline breast implants on sale. Many clinical studies were held from 1992 till 2005. The subject of the use of silicone breast implants for revision and reconstructive surgery was under the investigation. It was evaluated that these implants could be used only for the above mentioned kinds of surgery. One American Society for Aesthetic Plastic Surgery reported that according to surveys held in 2005 83.4% of all the interrogated women used saline-filled breast implants and only 16.6% utilized a silicone implant. In 2006 the FDA lifted some restrictions from the use of silicone implants and they were approved to be used for women not younger than 22 years old. Speaking about advantages of saline implants it is pertinent to say that in case of a rupture the saline is resolved by the organism as it represents a salt substance that doesn’t do any harm to health. The main disadvantage of saline breast implants is that these implants can have ripples inside that can be noticed easily. Moreover saline implants may seem to be less natural in reconstructive or small-breasted women. This factor should be taken into consideration by very thin patients because as a rule these women have little breast tissue and it may not be enough to cover the implant. The same thing concerns women who need a reconstruction of the breast or have a breast injury. Furthermoreб small ripples that the implant may contain may be seen through the skin of this category of women. Besides saline implants, you can choose a silicone option. It represents another type of breast implants. There is no particular difference between them, only the filler is not the same. If you want to have a more natural feel and look, it is better to choose a new silicone gel-filled implant. You may also choose an implant placement position. There are three various positions: a subgrandular, a partial submuscular and a complete submuscular. Many studies were performed so that to find a connection between silicone and tissue or certain autoimmune diseases. The results were impressive as they didn’t show any connection between them. Moreover, some other studies took place in order to find out whether silicone implants are safe or not. Later after the end of the studies the FDA approved silicone implants for enlargement of the breast. “Gummy Bear” Breast Implants If you made up your mind to undergo the operation for breast enlargement the most important decision to make it so choose a proper type of your future implant. Traditionally, most women choose between saline and silicone implants, but these days you can also find the third type on the market that is gaining popularity very fast. Such a gimmick is called a cohesive gel implant and is nicknamed as a “Gummy Bear” implant.

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Let’s find out what is cohesive gel. A new type of implants got a nickname of a popular Gummy Bear because of the style, feel and form stability. Compared to other implants cohesive gel implants are able to hold their shape longer and better. Even if you decide to cut them in half, every half will keep its shape as if it is a Gummy Bear. Turning to advantages of cohesive gel it is pertinent to mention that this gel option is designed to create a less wrinkled and smoother look in the chest. As a rule cohesive gel implants do not change their shape with a body movement or the gravity pull. This is a good feature because a shell of implants will be prevented from collapses and folds. Moreover, new products are considered to be leak proof what can also be their important advantage. Even if the shell ruptures, implants will not seep as they contain a cohesive and semi-solid substance. Furthermore, there is one more advantage of cohesive gel that should be taken into consideration. The gel can reduce a risk of capsular contracture. Besides, it is necessary to remember that these days there are many foreign objects including different breast implants that are implanted in the body. Therefore, every body is able to create a protective tissue shell in order to protect the body from various perilous secretions. It is possible that over time the tissue capsule will start to contract. In the case of enlargement of the breast such a situation can cause discomfort and the shape may change a bit and have an unnatural, unusual shape. When this case happens it is essential to pass a revision surgery and withdraw the old implant or, if necessary, cut off the capsule. According to European studies, however, the capsular contracture mentioned above is less common in cases with Gummy Bear implants. This is because of a solid shape that protects the capsule from shrinking. There are some cases when cohesive gel filler can be a big disadvantage of the implant. First of all, this occurs when a women is not satisfied with the shape that she gets after the insertion since it will not move or change with gravity. In the same case many women may do not like large Gummy Bear implants as they can have a particularly unnatural look and women may find it unattractive. One more disadvantage of Gummy Bear implants is the feel of the breast. They are much more solid inside the chest than traditional saline or silicone gel implants. Some women find the feel too solid but there are also such patients for whom this fact is not a problem. One more thing that should be mentioned is that a new type of implants has a very high price per pair and is not so affordable. It is known that cohesive gel costs hundreds of dollars, what is more that the price of other fillers for other implants. Another drawback of Gummy Bear implants is an incision length that is required for the insertion of the implant. As cohesive gel is quite firm it requires a bigger incision. Anyway they can not be squeezed into a small cut what other implants are able to do. A normal length of the incision with cohesive gel implants is nearly 5.5 cm. But firmness may also be considered as an advantage, because owing to this feature, Gummy Bear implants will have a small chance to rotate in the breast pocket and create an unpleasant and uncomfortable shape and feel. Moreover, they will not create a distorted shape with a tear-drop shaped implant. To prevent this thing cohesive gel has a special textured surface for a more solid hold. On the whole Gummy Bear implants have more advantages than potential disadvantages. In any case the best choice to do is to talk to your plastic surgeon that will help you to make a right decision about the implant you need.

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Auxiliary and Alternative Techniques in Enlargement of the Breast As a rule every implant has a special bag filled with either silicone, saline or cohesive gel. The filler may be added in order to make breasts look fuller and larger. The shape of the implant will depend on the history and needs of the patient. In breast augmentation surgery there are used some tissue expanders. These expanders are created not only for breast augmentation processes but they can also be used for reconstructive surgery. It is known that congenial defects and injuries can be fixed with the help of tissue expanders for skin expansion and bone reconstruction. People who are interested in lengthening their bones for being taller, enhancing their jaw-bone construction, getting rid of alopecia and scarring defects for grafting of hair, will have to undergo a painful and difficult procedure of tissue expansion before starting a reconstructive operation. Those patients who had mastectomy may need auxiliary techniques for enlargement of the breast before the process of implantation. These people usually have less tissue that is available in the area of breast. That is why they will need tissue expanders so that to make some space for breast implants. There is a new BRAVA system that expands tissue naturally. This process happens with the help of vacuum cups that are put over the breasts to press on the breast tissue. The vacuum cups encourage the growth of natural tissue over a certain period of time. The growth is realized for 10 hours during nearly 10-16 weeks. As a whole domes are made of silicone and can cause skin reactions in women who are allergic to silicone. Silicone domes may also produce dermatitis in the case when they are not cleaned thoroughly. Anyway results are real and a woman gets natural breast enlargements. Speaking about side effects in this situation they are avoided. In many cases simple silicone or saline substances implants are not enough to create a nice shifting and jolting of breasts during movements of a woman. Many surgeons propose to make additional tissue growth if needed. You should rely on the competence of your plastic surgeon. Women who are going to undergo a breast augmentation operation and one or two of their breasts taken out through mastectomy may have a necessity in additional tissue growth and adding it to total breast mass. Usually additional breast mass simulates ferriferous animation. It is known that an alternative technique in enlargement of the breast includes two cosmetic surgery techniques in order to add some tissue to improve a woman’s body. First of all liposuction is made to get rid of body fat and then an injection of fat is performed in the area of breast to add some mass to the breast. In order to prepare the necessary area for the autologous fat injection the BRAVA system is utilized to enlarge the tissue of the skin and then hypervascularize this area. Such a method prolongs the life of the extracted fat that will be injected into the breast and will increase the graft survival rate to 90%. How the production of breast tissue is carried out? Who besides Japanese doctors could do that? It was found out that these were exactly the Japanese who had an idea to grow breast tissue with the help of stem cells that can be harvested from fat. A certain group of Japanese in charge of the

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investigations made certain trials on women and at the end of studies they produced positive results. Stem cells that were grown from fat cells were injected into the breast tissue of a woman so that to encourage some additional growth that was necessary. This wonderful new technique is a useful gimmick that is considered to be safer and more natural because fat cells come directly from the woman’s own body. Stem cells are able to lead to new fat cells formation and then induce blood vessels to grow into new tissue and foster it. Autologous fat injection in breast tissue is a new efficient technique that will solve one of the most important problems of shrinking. These days the breast tissue expansion is the only alternative breast augmentation technique that is used in interaction with the fat injection. Autologous fat injection and the BRAVA system are created for women who have excess fat to spare. Speaking about the BRAVA system individually it can be used for those with more breast tissue. As usual it doesn’t concern slender patients. Anyway nowadays both silicone and saline implants remain popular within women with small and sagging breasts. What Should a Woman Expect from Before and After the Operation of Breast Augmentation? It is common knowledge that breast augmentation is a cosmetic surgery procedure with the aim to change the shape and size of women’s breasts. It can be a reduction of the size of breasts that are too big, an increase of the existing size or a reconstruction of the breasts after the performed operation. On the whole breast augmentation surgery is very helpful for women who would like to have a body contour they are looking for. In California there is an experienced plastic surgeon Dr. Hendricks who specializes in all forms of breast augmentation. According to his words he tries to do everything possible in order to improve his patients’ appearance and usually provides thorough consultations on the topic of preoperative and postoperative education of his patients. Before the beginning of your operation you will have a first detailed consultation with your surgeon who will inform you about all the initial processes and your preparation for them. Moreover, this consultation is your first and good chance to ask all your arising questions about enlargement of the breast. And all your questions will be answered immediately. First of all, your plastic surgeon will inform you about various directions that you should follow before the operation. Smoking, drugs are the main restrictions! Besides, you should avoid certain vitamins, some drinks and food. There is one more thing that you should know. Your plastic surgeon will evaluate your general health so that to make sure that you will not have any needless complications and side effects during the breast enlargement operation and after the operation when you will have a recovery period. These days enlargement of the breast is one of the most popular forms of the US plastic surgery. As it is a surgical process, it can be committed only by experienced professionals in a medical field. On the day of the operation you should come with somebody as you may need his or her help after you breast augmentation operation. There are several options where the operation can be held. It can be performed in a hospital or somewhere in independent surgical facilities. During the operation most of the time you will be under general anesthesia, in other words, you will not feel anything as you will be unconscious during the procedure. There are some surgeons

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who prefer to carry out the breast augmentation surgery with local anesthesia when a patient is sedative. With local anesthetic a patient would not feel any pain and discomfort during all the procedure. As a rule an incision is made either in the navel for the Trans Umbilical Breast Augmentation process or near the areola (in the transaxillary crease, the inframammary crease). Before the operation it is obligatory to discuss with you surgeon which kind of incision is considered to be the best for you. In case when the incision is made in the armpit crease of the navel, the surgeon may need to utilize the endoscope to help in the breast implant placement. An endoscope represents a small camera with special light that is mainly used to show the operation area. When the incision is made, a plastic surgeon creates a small pocket behind the breast so that to put the implant in it. The implant will be placed depending on your decision and the surgeon’s approvement either in front, partially behind or completely behind your muscle of the chest wall. When the pocket was made the plastic surgeon will put the implant in one of the breasts. During enlargement of the breast the surgeon can choose at which moment the implant will be filled, either before the operation or after the placement of the breast implant. There are no problems will filling the implant, as the surgeon is able to fill it at any moment. Then the surgeon must close the incision and put a bandage around the operated area so that to aid the process of healing. As it was mentioned above you should have come for the operation with somebody. Therefore, after the end of the surgery you should be taken home to recover. Some days later the gauze should be removed from the operated area, except a surgical bra. Sutures and stitches will be taken away in a week after the surgery and swelling or bruising will subside a few weeks later. The pain will stay for a few weeks also but you can start your work or some other light activity in a couple of days after the operation. Your plastic surgeon must inform you about the aftercare period and the time you should wait till you will be able to start again your activities. With time scarring should lessen, but, of course, a greater part of the operation success depends on the surgeon who performs it. And, moreover, every advice should be paid special attention to and nothing should be missed. Risks and Side Effects of Breast Implants Every woman who undergoes breast augmentation operation needs to be aware of breast implant side effects. If you know what may happen and what you can prevent, you will know what to do then. This article will be very useful for you as the information mentioned below will help you to understand all the possible side effects and a healthy way of coping with them in case of their appearance. In spite of the breast implants many women breast feed successfully. However, there will be some interference from breast implants. Before the operation you must inform your plastic surgeon about your breast feeding plans as your information may influence on a surgical technique a surgeon will choose. Every breast augmentation patient should remember that the implants may impede breast cancer detection. During mammography, ultrasound or X-ray, breast implants can hide shady lesions or tumors. As a rule treatment providers should take special care of patients with breast implants during various breast exams. Additional time must be taken for additional views. When you are making an appointment for mammography inform the receptionist about your breast implants so that they can schedule properly adding some extra time. Usually radiologists use special imaging

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“Eklund displacement views”. With the help of eklund views the radiologist is able to maximize what is seen in the breast tissue so that to better detect lesions or tumors. Standard views together with eklund views will give the most exact results. Moreover, before the beginning of the mammograms, tell your radiology technician about the breast implants you have. This is done in order the technician includes Eklund views in tests. During the mammography, breasts are compressed what increases your chances for a rupture. That is why it is obligatory to warn your radiology technician about the implants. One more side effect is connected with loss of sensation. After the performed operation on breast augmentation many patients experience sensation loss in the area of nipples or the breast itself. As usual this situation happens when nerve endings in the nipple or breast were damaged during the operation. In most cases there is no any problem in the sensation loss as it is often temporary, but you should talk about it to your plastic surgeon so that this loss will not become permanent. It was found out that a chosen surgical technique often plays the main role in this complication. From the very beginning your plastic surgeon is able to determine the most appropriate implant and a proper surgical technique so that to minimize the bad consequence of the operation. Besides, the third possible complication is concerned with leaching or leaking of breast implant substance. Many studies were performed with the goal to determine harmful effects of the materials used for breast implants. Their leaking or leaching can spread in the surrounding breast tissue. It was concluded that harmful effects are not evident if the material approved by the FDA is used for the implant filling. The FDA-approved materials including intraocular lenses, pacemakers and other medical devices are very widely used in many other types of medical implants and do not bring any harm to people and their health. There is another complication as a result of the breast augmentation operation. Anyway, as we know there are no implants that will last forever. Breast implants can rupture or break and cause deflation. Many implants become old and they rupture because of this factor. It can also be excessive breast compression or some trauma to the breast. The most noticeable effect can be seen when the shape and size of your breast changes. The appearance of the breast may change in a few days or in a long period of time. According to some official FDA facts from 1992 to 2002 there were 58 ruptures of breast implants. It is really true that sometimes mammography compresses breasts strong enough to cause their rupture. Radiology technicians must pay special attention to the pressure placed on the breasts so that it is not excessive. When a breast implant is deflated a surgical operation is needed. Most women decide to replace their previous implants with new ones. What are the Complications of Breast Augmentation? Breast implant placement is considered to be a complex operation and some complications can occur. Risk is usually present when the operation is more invasive. It is usually dangerous when a foreign object is implanted into the body. The risk is usually lower when the operation is performed by experienced and skilled plastic surgeons. Moreover, you should also follow all the instruction the surgeon gives you, this also influences on the success of the operation. But anyway the risk of complications is a fact. The following information will be useful for you to understand the main risks in all details.

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As a rule infection occurs in the same day or within a week after the breast augmentation surgery. There were very few cases when infection occurred long time after the surgery, at the time when incisions were completely cured. The implant should be removed until the time when infection subsides. Then the implant can be replaced again when everything will be ok. The next complication is called bottoming out. It happens when the breast implant rides very low in the tissue of the breast and can cause the nipple to point upwards. The correction of bottoming may be performed by entering the breast and making the implant pocket once again. When breasts seem to be too close to each other such a complication is called symmastia. In order to correct it, a plastic surgeon should perform the operation once again. Larger implants are replaced by smaller breast implants. After the operation of correction the surgeon will put special support bra and some other bandages so that to provide the cleavage support, while the process of healing. Have you heard about capsular contraction? When the organism notices a foreign body during the healing process it creates a special capsule around it, in our case, the foreign body is a breast implant. Formation of a capsule is a normal process, it usually occurs also with other kinds of surgery when it concerns implants such as artificial bones, joints or pacemakers placement. There are some cases when the capsule contracts around the implant or it just closes. This cloture can also be known as capsular contraction. The time when contraction can eventuate is during a few months after the operation. But you should remember that capsular contraction is not a common complication and it doesn’t happen within all patients. It is known that capsular contraction squeezes the implant and it looks distorted. In some advanced cases the breast implant can look misshapen and feel hard. In reality the implant doesn’t change in weight or become hardened, the capsule compresses the implant and causes this feel. The measurement of capsular contraction by the Baker grading system is the following:

• Grade I – The breast looks natural and is normally soft; • Grade II – The breast looks normal but feels a bit firm; • Grade III – The breast may look distorted and feel firm; • Grave IV – The breast may look distorted, be painful and hard.

The only treatment for capsular contraction is a removal or replacement of the breast implant. How Much Are You Going to Pay for Breast Augmentation?

There are so many different available options and methods of breast enlargement these days that it is really difficult to choose the right one and answer the question about the cost of this operation. On the whole the cost varies very much. The main factors for this variation are skills of the surgeon, the region where you are going to undergo the operation, the place – either it is a hospital or an office and the type of the surgery and anesthesia. A part of the surgery fee is included in the cost of implants. The average total cost for the operation is from $4 000 till $10 000. The cost of implants is from $ 1 000 till $ 1 400. The fee for anesthesia is almost everywhere from $600 till $800. The cost of facility starts from $800 and ends at $ 1 200. And the rest of the cost is a surgeon’s fee.

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The type of surgery also influences on a breast augmentation total cost. As we know there are many different methods for the procedure, it concerns implants placement and incision. Some breast implant techniques are less time consuming and easier to perform. Besides, the kind of anesthesia used during the operation is also taken into consideration. A local anesthesia (you remain awake but you are sedated) is less expensive than a general anesthesia. Payments with various financing options are accepted in most surgical practices. In spite of this fact you should ask a staff member or your surgeon about the payment in your case. Enlargement of the breast with breast implants is usually considered to be a cosmetic plastic surgery operation and, therefore, you are not covered by any insurance. Beware of a Cheaper Breast Enlargement Surgery! It is a well known fact for everybody that, on the whole, breast enlargement surgery is very expensive nowadays. A great amount of money is invested in this sphere every year. It is true that there are many people who consider breast enlargement procedure to be very expensive and they are looking for surgeons who are ready to perform this type of surgery at a low price. You must be very careful about such propositions concerning surgery. There is no one and nothing that will be able to prove that a lower cost operation will be safe and with good consequences. Of course the price tells us a lot about a surgeon of breast enlargement surgery. And it is your decision whether to undergo this operation or not. In different countries and places prices will be different. Before you make up your mind about a surgical procedure on breast augmentation you should make a thorough research. If you are attracted by a cheaper choice you should know that you may spend more money after the operation because your health may be damaged and nobody is going to pay damages. Your priorities should not be based on the factor of money. Your safety is the first and a principal value. As usual high price will give you more safety and you will be certain that all efforts will be put so that to avoid side effects. Moreover, you may be sure that everything will be sterile and carried out carefully and with a high quality service. These days there are many good medical services where you can get a professional consultation and a valuable advice from medical specialists. They are always ready to guide you so that you take a right decision. Which Plastic Surgeon to Choose? Training and skills of a plastic surgeon are considered to be a very important factor. A great part of experienced and qualified surgeons who led extensive surgeries usually command high fees. You should be informed of various plastic surgeons and choose a board-certified plastic surgeon who has many years of surgical practice and a good background in breast augmentation surgery. It is very important if the doctor continues to receive trainings. This is a very good characteristic. Anyway, you should not rely completely only on professionalism of a certified plastic surgeon as the best results do not depend only on him, but also on your organism and aftercare process. Anyway, board certification usually requires rigorous and specific surgical training and education that have great influence on successful results. It is known that surgeon’s fees vary more than any other fees existing in breast surgery.

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Anyway it is important to take into consideration that when you are going to undergo a breast surgery you should make a right choice of your plastic surgeon. Your preparation for the operation, a course of the procedure and its consequences are very important. If you chose an experienced breast surgeon you will receive quality care. Moreover, professionals have not only perfect knowledge, but also well-honed skills and a huge practice so that to provide you with the results you want to have. These surgeons will be well prepared for possible complications and risks and will be able to help you in case of their appearance. Additionally, there is a good thing about experienced doctors that with practice they use their great chance to improve their techniques and knowledge of solving non-typical situations and have an individual approach to every patient. It is pertinent to mention that breast augmentation surgery should be performed in the safest place. Hospitals are those that are the best for your choice. Besides this option you can be operated in a special surgical center or in practice-based surgical facilities. Speaking about the third mentioned place you should know that in many cases these facilities are not accredited for such kind of surgery. Therefore, do not puzzle over and choose a hospital. When you are choosing your breast surgeon you should verify if this doctor has operating privileges at a state-licensed, accredited or a Medicare certified hospital or good surgical facilities. As a rule, breast surgeons are reviewed by a special committee in accredited hospitals. Before getting operating privileges surgeons have to pass special education, training and overall competency. Breast augmentation surgeons have to go through an additional screening level so that to be verified if they are really approved by the accredited hospital. That is why being operated in accredited hospitals patients may be the proof of their safety. Now we are going to tell you some final recommendations and some advice that hopefully you will keep in you mind and use in case you would like to undergo the operation of breast augmentation. Patients have all rights to see the results of the surgeon who specializes in enlargement of the breast and can see the success he achieved during his practice and the level of his professionalism. Moreover, it is pertinent to mention that breast augmentation surgeons can be estimated not only by the quality of the work they provide, but also by the level of their care about patients and attention towards them. You can make photos of your breast before the operation and leave them to your doctor and compare with results if you wish. This method of control is highly recommended. You can ask the surgeon about his patients’ testimonials so that you are able to review and evaluate the care for previous patients and the level of general service. All these little but important details will help you to receive a better overview of the doctor’s possibility to take good care of you. There is one more thing that you should not miss. You should also base on you own feelings if you like the surgeon or not. You must be able to speak freely to your doctor and discuss any subject that concerns your operation and all other procedures before and after the surgery. All your goals and expectations must be communicated to your surgeon. Choose a good surgeon for you and feel comfortable!