Las Vegas Breast - Ask Dr. Garcia Library - Page 1

NOTICE: Las Vegas Breast: Ask Dr. Garcia is intended for educational and discussion purposes only. It does not constitute a formal medical evaluation nor consultation. No doctor-patient relationship has been formalized by this communication. If you desire such, please feel free to call and schedule an appointment. Otherwise, please be advised that all information that has been given here should be cleared with your primary care physician before changing or instituting any therapy. Explanation of off-label use of substances may be discussed here in but does not reflect an endorsement nor promotion of such off-label use. All responses regarding Las Vegas Breast are done personally by Julio Garcia.

• Well, I seem to have inadvertently given myself a breast augmentation. I had a small amount of fat suctioned from my hips two years ago, but all the fat now has migrated to my breasts. I used to be a 32A and am now a 34C/D! Some women might welcome this but not me. I feel like I`ve suddenly got two extra limbs that need to be managed. My weight has remained stable. Have you ever seen this happen before? Can I have liposuction for my breasts and underarms? Will it cause scar tissue that will interfere with mammagrophy readings? And where would it be best to remove the fat so as not to leave me with sagging breast tissue (which I never had before)? Laterally -- under the arms and by the chest wall? I can`t wear any of my old clothes and, as a runner, now have to bind my chest. Suggestions? Thanks so much for your insights.

  Answer:  liposuction can be done on both areas and any small amount of scar tissue should not interfere with a mammogram to any large extent. Depending on how firm your skin is, the fat removal might leave you small to large amount of sagging, depending on how much fat is removed. It would be best to remove it from the more superficial layers as the supporting ligaments of the breast tissue are attached to the muscle, the skin lends minimal support. Best of luck. JG 4.20.13

• Dear Dr. Garcia, I have had silicone breast implants for nearly 34 years!! I have had no problem with them they look and feel exactly the same as they did back then. I was recently told that I should have an MRI to see if I had a silent leak. If I do not have a leak do you feel they should be replaced? I have heard of people who have not had the same results as me, and could have them replaced and then have problems every few years. My feeling are if it it`s not broke why fix it? I don`t feel like going on a witch hunt! Thanks for your thoughts.

  Answer:  if there is no leak I would leave them alone. I agree with the if it isn`t broke mentality, don`t go looking for trouble where there is none. JG 4.18.13

• Hello Dr and Happy Easter to you! I have been reading about a new technique of split muscle breast augmentation which is supposed to be ideal for skinny women and to avoid the tennis ball look. Do you have any opinions on this new method? Thank you

  Answer:  It is really something that has been done for a long time and has resurfaced. The concern is that there is not complete muscle coverage of the implant. It is claimed to do so, but in reality, the muscle in certain areas, for example lower outer area, is quite thin and will usually tear and then not cover the implant. It does avoid the visibility of ripples in the upper inner part that can be seen in an evening gown, but the ripples can still be seen on the lower outer quadrant. The tennis ball look usually comes from either capsular contracture or an an inadequately dissected pocket. I hope that helps. JG 4.1.13

• I had a latismus muscle done on one breast a couple of years ago which I regret immensely. It flattened the breast and made it look much bigger than the other one. The nerve was cut over a year ago, but it reconnected..Why is that, when my surgeon said that was impossible? Can the muscle be taken out and just gotten rid of since I do not miss it from the back?

  Answer:  There can be multiple nerves in some patients or maybe the main nerve was missed and a smaller one cut. The nerve will not grow back together though. It can also be that the muscle has scarred down and has become stiff, causing the flattening of the mound. If that is the case cutting more nerves will not help and what needs to be done is some removal of scar tissue around the implant. That is much more common in breast reconstructions versus augmentations for cosmetic reasons. If the muscle were to be cut out it would leave very thin coverage over the implant and would almost certainly lead to capsular contracture of a severe nature or of the implant eroding through the skin. I wish you the best. JG 3.30.13

• Can Mentor salien breast implants last for life or do they need to get replaced? I had my implants for 20 years. They looked round or not rippled in a recent MRI of chest area.

  Answer:  I have some patients that have had saline implants for over thirty years, if they are not broken, leave them alone. JG 2.7.13

• Hi Dr, What is realistically the recovery time to return back to work after breast augmentation (under the muscle) for a flight attendant, since a lot of lifting heavy objects is required? Thank you

  Answer:  in my opinion, 4 weeks. JG 2.5.13

• Dr. Garcia, I recently noticed that meat (i.e. chicken and turkey) cause my sinuses to inflame very badly. As you know, I have had 2 surgeries. I recently went vegan and after two weeks I notice some improvement. I must admit that I do consume alot of chicken on a daily basis {5-6 chicken breast}. Have you had any clients with similiar stories.

  Answer:  I personally have not to seen of it or heard about it, sorry. JG 1.24.13

• Hello, I had a breast implant exchange with pocket revision 10 days ago, went from saline to silicone for a more natural result without ripples. Look and feel great except for outside(armpit side) where it was anchored, after releasing sternum side, I am assuming from the internal sutures on that outside? How long for it all to settle in? Thank you! JR

  Answer:  It can take anywhere from 6 weeks to a couple of months, depends on how you heal. JG 11.27.12

• For breast implants, what is the difference between a round implant and a shaped round base implant? How does a shaped one differ?

  Answer:  In the standing position, not much difference. JG 11.5.12

• Are there breast implant shapes that are more oval than round shape. I am not sure which shape it would be, but it is for a skinny person. If a skinny person is flat chested, but does not want her breast to look fake by being round is there another shape to make it look like natural shape in skinnier woman. Not all skinny woman are flat chested and they usually have more oval or pointed shape and their breasts slope down or sag instead of stick up. Do you know what I mean? If there is such an implant or this kind of look, what is called and what texture is best? Thanks.

  Answer:  there are textured implants that come in a couple of different shapes for different desires, yes. I would usea Sientra implant for that type of patient.JG 11.5.12

• Hi Dr. Garcia! Hope all is well. I was going through some old files and came across photos of my silicone breast implants, ONE YR Post OP! It has been 5 years since. I did notice how gorgeous they once looked. What I mean is they were so full and fluffy and very BIGGER looking in diameter and nautural slope. Then I looked in the mirror 5 years later and was kind of shocked to NOW see they look s different. Even tho they are soft to the touch, somewhat pliable, they seem smaller in diameter, a bit shiny is some places and well more harder looking then the wonderful full look they once were! =( What happened?

  Answer:  could be some element of capsular contracture along with stretching of the skin and loss of your own breast tissue, hard to say without examining you in person and seeing the old pictures. JG 11.4.12

• What do you think of placing breast implants so they go a little on the side of body? I read that position might be good to balance broad shoulders if your do not have as wide a chest? Also, I read women can tell the difference between saline and silicone gel implants even if placed under the muscle- like it feels more part of tissue. Is this true?

  Answer:  well, if you do that with an average size implant the nipple might not be in the center of the breast mound and will look funny. As to people feeling differences between silicone and saline, some certainly can, but not all, especially with average size implants below the muscle and if they stay under the muscle.The larger the implant is, no matter where it was placed originally, the easier it will be to tell the difference, especially in thin women with very little breast tissue. JG 10.12.12

• Dr G: What do you think of stem cell breast augmentation and hand rejuvenation? The doctor who is offering these options is high quality and I trust him. Below is a summary from his site: Stem Cell-enhanced Breast Augmentation uses your own autologous fat tissue (adipose) that is a rich source of stem and progenitor cells. Cells do not use a machine processing system, they are processed by hand using less than minimally manipulated, proven technology. We separate progenitor cells and stem cells from the fat cells and stroma. The stem cells are then washed and concentrated. The concentrated stem cell mixture is combined with the fat cells, growth factors derived from PRP, and a hyaluronic acid scaffolding matrix. The Stem Cells can help to: Grow new blood vessels to feed the fat Releasing anti-inflammatory substances to aid in healing Release growth factors to tighten the skin over the breast

  Answer:  I think it is an improper use of the term as the number of stem cells is small at best, it is an attempt to use a buzz word to get more business and our national society has warned us against using those terms for that reason. Especially in view of the technique he is claiming to use, it will have very few stem cells, and has less than in that fat that is processed to enhance the number of true stem cells. JG 10.4.12

• Hi Dr, I am considering two procedures and not sure yet if I will do them at the same time. Can you please tell me the recovery time before I go back to work after having breast implants (under the muscle) and also liposuction for excess fat on the knees. I am a flight attendant so obviously there is a lot of lifting in my job. Thank you

  Answer:  I think your recovery with both done at the same time will be the same as the breast provedure alone. All the best. JG 8.12.11

• Okay, this is kinda hard to explain, but here goes! Had my breast implants for more than 4.5 years and not untill 10 months ago have they been noticeable in feeling in day to day activities! Not like in touch but like when I work out, get cold, or run and walk. It feels like there no longer apart of my body or in sync with my Body movements. If this makes sense? Like the other day I was doing A shoulder press and it feels like my implants are aggravated like shift up then go with my Body! This was never like this before! I always felt as they were apart of my Body but now not so much! I also get Little twinges! Can this be the scar tissue? If so what`s it doing? They don`t look distorted!

  Answer:  it is likely very early scar tissue, enough to be tethering to the muscles but not enough to make the implants feel firm. It might stay that way for years and never get worse, but it also might slowly progress to the point that they do look and feel hard. For the time being I might suggest increasing your vitamin E intake to about 1,000iu per day and see how it responds. If it gets worse, then go back and see your surgeon. I wish you the best. JG 7.13.12

• Lol, next question Dr. Garcia. I have had TWO boob lifts/semi-reductions. I`m about a 38D/DD. My breasts are bottom heavy meaning all of that D cup is at the bottom, though my breasts do not sag. I`ve always hated the ugly scar so I really didn`t want another one. Is there any way to put BACK some volume (perhaps a small implant. Can`t believe I`m saying that after TWICE having a reduction) without any scar? Perhaps putting the implant in from the side and then filling it? I *think* I`ve seen that done? OR is there a better method of lifting and implanting without such a scar? THANK YOU SO MUCH DR. G!

  Answer:  it would be difficult to place an implant that would correct just the upper part of the breast mound without it being a very large implant, thereby making you a lot bigger. The best thing is another lift but it appears to not last long in your case as your skin is likely stretched out and cannot support the breast in a higher position. I wish you the best. JG 7.6.12

• How long do fat injections last in the face? Also, how long do fat injections last in the butt and breasts?

  Answer:  some say for ever, but in many cases it is about 1-2 years, the greater the amount grafted in one setting, the less time it survives. The length of survival in the buttocks and breast are being followed at present but in many patients it is all gone within 2 years. JG 6.28.12

• I know this a pretty genreal question however my wife really wants a breast lift from a 38DD to a 36C. We went to one consultation here in Las Vegas and the price range was $8000 which we thought was actually steep given what weve heard from friends. Not wanting be skimpy when it comes to my wifes health I dont want to compromise the best care, that being said is this an exorbrant rate for this type of procdeure? You came highly reccomended for skill and fair and balanced pricing.

  Answer:  One of the variables is time needed, so hard to say without seeing her, but a usual fee for a reduction is $8,000-$9,500 . JG 6.14.12

• Hi, doctor. I had a relatively small amount of fat liposuctioned from my abdomen, outer thighs and hips 2 years ago in a plastic surgeon`s office. (A total of 350 cc`s was removed. Is that considered small or moderate? I know it wasn`t a large volume.) I am 5`3 and 100 pounds, so even a small amount of fat spread over those areas was really noticeable. It`s been great to have it gone. Since then, my weight has continued to remain stable -- just up or down by a half pound or so from day to day -- but my breasts have almost doubled in size, particularly the upper two thirds. While many women might welcome this, I don`t. I`m a runner, so it`s uncomfortable, and many of my clothes don`t fit. I`m 30 and have never been pregnant, so it`s not hormonal. Have I essentially just caused my fat stores to move to my breasts? Is this a known or expected phenomenon following liposuction or does this seem strange? I would have my breasts liposuctioned, but I don`t want to cause scarring that would interfere with mammography readings. Thanks for enlightening me on this matter. Hey, this is a beautiful thing you do. You are wonderful to be so generous with your time!

  Answer:  That was a small amount of fat to be removed. Once that fat is removed,new fat will tend to go to new places like .it sounds has happened in your case. Liposuction might be an option for you if the amount of fat is small and it should not interfere with good breast screening, certainly no worse than regular surgery to reduce your breast size. Thank you for the kind words and I wish you the best. JG 6.2.12

• Do saline breast implants and silicone gel implants basically feel and look the same if they are both inserted under the muscle?

  Answer:  pretty much, you might see or feel ripples slightly more on the side of the chest, especially when naked and leaning over as there is little fat or breast tissue on the side of your chest. JG 5.24.12

• What are the shortcomings of both a saline breast implant and a silicone gel implant?

  Answer:  the saline has more variety in end fill, requires a smaller incision to be placed, you need no special test to monitor for leaking as a leak will allow it to go flat as there can be no partial leaks,and it has more visible or palpable ripples. Silicone comes pre-filled so there can be no modifications during surgery, requires a larger incision to place, might feel more natural to many patients when placed above the muscle but also requires an MRI to detect a leak, and it will ripple about 60% less. Capsular contracture rates and leak rates are about the same. JG 5.21.12

• What type of breast implants do you prefer to use? Do you think silicone gel looks and feels more natural than saline? Does it make a difference?

  Answer:  I think that when placed above the muscle the silicone implant might feel more natural, but when placed below the muscle the difference is much less. As to my preference, I actually have the patients decide. I help them decide on a size, I give them the benefits and short comings of each implant and they decide. I would say that the choice ends up being about 50-50. JG 5.21.12

• I had a procedure to minimize my breast implant scars above the folds of my breasts. If I get replacement breast implants, I was thinking of having them inserted through the armpit. Is one method easier or more effective than the other? Does it help that I originally had implants inserted through the breasts if I have them inserted through armpit next time ( I mean with placement of implants). Does the type of implant matter (saline or silicone gel) through the armpit?

  Answer:  using the incision underneath the breast is the easiest of the three common incisions. The placement of the implant the second time around might be easier as the pocket has been created already and just might require a small degree of enlargement. There is likely a limit to what size silicone implant can be placed through an armpit incision but not with saline as it is filled in after the implant is inside your body whereas the silicone implants come pre-filled. JG 5.18.12

• Well, here`s a new and particularly embarrassing low in the endless surprises of aging. I am a very thin and fit woman, but I now have a fat -- and not just pudgy but actually fat and jiggly -- pubis. It`s actually making my clothes not fit. What`s up with THAT? Is this common in aging women? I mean, is this a condition that plastic surgeon regularly see and treat, like saggy breasts, or am i a rare case? I`ve never heard of this lovely side effect of aging before until it has come up for me in the past year. (I`m 54.) Can I have it liposuctioned? Have you done that for any of your own patients, Dr. Garcia? i`m humiliated even to seek out a consultation for this problem because it`s pretty embarrassing and also because I have absolutely no idea if any plastic surgeon will ever have even seen such a thing before. Oh, the indignities of the body in decline! God bless all of you brave and apparently fearless women and men who hover over us in various states of decay and try to slow it all down, even just a little. Thanks for listening and for letting me know your thoughts.

  Answer:  it is not uncommon for that to develop, it is an accumulation of fat that can be removed with liposuction and a plastic surgeon would be the one to do that for you. Best of luck. JG 5.15.12

• Hi Doc. I am more confused then ever. You recommended that I get a breast lift, because I am not happy with my reduction. After reviewing the procedure I am really confused because my breasts are not really that saggy and the nipple placement is perfect. So with that said when I was younger my breasts were very round and firm. Now that I am older my complaint is that the are not as full. Do you think that I need implants as well. I would hate to go through this again and still not be satisfied. I don`t want to look like a circus show. However, I want my big,round, firm boobs back. Is this possible? And do you think that the limited lift itself will do the trick. PS I want to thank you again for my lips, they are beautiful. I just got your quote today and before I make a final decision, I would like to know your thought. Erin Fitzerald (Lind Walter`s Mom)

  Answer:  I am sorry if I did not understand your desires when we talked as we spent most of the time on the fillers and did not have a full examination of your breast. A lift will only take the tissue that has sagged and bring it higher, a lift after a breast reduction does not always move the nipple again, just the tissues. In time though, those tissues will once again fall and we find that usually a breast lift has to be at least partially redone in 5-7 years due to the continued aging and stretching of the skin and tissues. If you want to be larger, then an implant will do that, but the problem is that the weight of the implant will cause your breast skin to sag and that will fulfill your desire for a larger rounder breast, but will bring all of the issues for which you had the breast reduction done.So placing an implant will, at least to some degree, take you back to where you were before all of it started originally. If you would rather proceed with a breast enlargement, I can have the girls in the office give you a quote for that, there are price differences between saline or silicone implants, and we would need to evaluate you for the size implant you would be able to have. Also please understand that the rates of re-operation after a breast enlargement are about 24% over time, so you can plan on that percentage for future surgery Let me know, and you can always communicate with me privately at drgarcia@lvcosmeticsurgery.com